Synthesis of Behavioral Health Outcomes in Mild Traumatic Brain Injury using Principal Component Analysis (PCA) (P8-1.008)

Abstract

<h3>Objective:</h3> To identify principal components of a battery of cognitive assessments that best capture the clinical state of mTBI patients across multiple time points and can be used to inform selection of outcome measures in future mTBI research studies. <h3>Background:</h3> A current difficulty in the design of mTBI clinical trials is the wide overlap in cognitive domains assessed, use of various assessments to evaluate a single domain, and the large variation in assessments. There is a need for statistically driven data reduction strategies to identify the domains that most accurately capture the clinical state of mTBI patients. <h3>Design/Methods:</h3> 325 patients and 152 controls were enrolled after mTBI. Patients were enrolled at either Encounter 1 (&lt;72 hours post-injury) or Encounter 2 (5–10 days), and returned for Encounter 3 (12–16 days) and Encounter 4 (83–97 days). At each encounter, subjects underwent a neuropsychological assessment battery (RPQ, BSI, TMT, HVLT, WAIS/WISC). A covariance matrix was calculated from clinical assessments. PCA was used as a data reduction strategy to elucidate the core dimensions of the mTBI sequelae. <h3>Results:</h3> In mTBI patients, there was a high degree of covariance among symptoms inventories. Among neurocognitive assessments, TMT correlated significantly with WAIS/WISC and to a lesser degree total recall from HVLT. In the PCA, the primary component correlated mostly with TMT-B (0.6), delayed recall and retention (0.5 each), and BSI (0.4), and explained 89.7% of the variance in the data across visits. The remaining components explained 10.3% of the variance. <h3>Conclusions:</h3> In our population of mTBI patients, 89.7% of the variance was explained by a primary component which remained consistent across all encounters. Clinical and neurocognitive metrics showed a significant degree of correlation suggesting that neurocognitive batteries could be simplified. The results of the study are useful for future clinical trial design of similarly stratified mTBI subjects. <b>Disclosure:</b> Dr. Shetty has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven Pharmaeucticals. Dr. Shetty has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for mTBI, Inc. The institution of Dr. Shetty has received research support from Marker AG. The institution of Dr. Shetty has received research support from Teva Pharmaceuticals Industry. The institution of Dr. Shetty has received research support from GE-NFL. Mr. Westafer has nothing to disclose. Joseph T Nguyen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The American Journal of Sports Medicine. Joseph T Nguyen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The Women’s Journal of Sports Medicine. Miss Coffey has nothing to disclose.