Memory functioning following severe traumatic brain injury in children: Results of the TGE (Traumatisme crânien grave de l’enfant) Cohort

Abstract

Severe Traumatic Brain Injury (TBI) is the main cause of children mortality and disability in developed countries. Among cognitive sequelae, memory impairment is frequent and impacts everyday functioning and academic achievement. The aims of this study were: (1) to measure memory functioning in children who sustained a severe TBI, and performance's evolution over time; (2) to assess factors associated to memory function and recovery. In the TGE (Traumatisme crânien grave de l’enfant) cohort, a prospective longitudinal study, 65 children aged 0 to 15 years old who sustained a severe TBI were included. Memory function was assessed using the Children's Memory Scale (CMS) at 3, 12 and 24 months post-injury. Memory was assessed in 46 children aged 5–15 years. Significant memory impairment was found at 3months post-injury (mean general memory (GENM) score = 89.1, SD = 20.5). Significant improvement was found at 24 months, but less so for verbal, learning and attention/concentration abilities. At 3 and 24 months post-injury, GENM score was significantly correlated to TBI severity indices (length of coma, Pediatric Traumatic Scale and Injury Severity Score). It was strongly correlated to full-scale intellectual quotient at each time point. Female gender was associated with worse memory impairment, whereas age at injury and socio-economic status were not. Furthermore, presence of motor impairment (MI) was correlated with worse memory recovery, probably as a marker of injury severity. Finally, the GENM score was significantly correlated with less favorable educational outcome. Memory functioning is significantly impaired following severe TBI; it is mostly influenced by initial TBI severity and strongly impacts educational outcome. Those patients should benefit from long-term follow-up post injury.