Variabilidad interindividual en la recuperación después de un traumatismo craneoencefálico: efecto de la reserva cognitiva

Abstract

Background and objectiveThe aim of this study was to examine the effect of cognitive reserve in recovery after a moderate or severe traumatic brain injury (TBI). Different authors proposed that this construct might account for the mismatch between TBI severity, its clinical expression, and subsequent recovery. Patients and methodEighty-four patients who sustained moderate-to-severe TBI participated in the study. Participants were divided into a high cognitive reserve group (n=46) or low cognitive reserve group (n=38) based on premorbid educational and occupational attainment. Patient's functional status was examined with the Patient Competency Rating Scale (PCRS). ResultsThere were no significant differences between groups in demographic and injury variables (sex, age, severity of injury, post-traumatic amnesia duration, and time since injury). The analysis revealed statistically significant differences between the 2 groups on the PCRS: The high cognitive reserve group scored better than the low cognitive reserve group. ConclusionsThe results of this study suggest that cognitive reserve may mediate recovery after a moderate or severe TBI. Educational and occupational attainments provide a cognitive provision that would be associated with better functional status after injury.