The association between symptom burden and processing speed and executive functioning at 4 and 12 weeks following pediatric concussion.

IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Journal of the International Neuropsychological Society Pub Date : 2024-07-01 Epub Date: 2024-01-26 DOI:10.1017/S1355617724000043
Veronik Sicard, Andrée-Anne Ledoux, Ken Tang, Keith Owen Yeates, Brian L Brooks, Peter Anderson, Michelle Keightley, Naddley Desire, Miriam H Beauchamp, Roger Zemek
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Abstract

Objectives: Symptoms and cognition are both utilized as indicators of recovery following pediatric concussion, yet their interrelationship is not well understood. This study aimed to investigate: 1) the association of post-concussion symptom burden and cognitive outcomes (processing speed and executive functioning [EF]) at 4 and 12 weeks after pediatric concussion, and 2) the moderating effect of sex on this association.

Methods: This prospective, multicenter cohort study included participants aged 5.00-17.99 years with acute concussion presenting to four Emergency Departments of the Pediatric Emergency Research Canada network. Five processing speed and EF tasks and the Post-Concussion Symptom Inventory (PCSI; symptom burden, defined as the difference between post-injury and retrospective [pre-injury] scores) were administered at 4 and 12 weeks post-concussion. Generalized least squares models were conducted with task performances as dependent variables and PCSI and PCSI*sex interaction as the main predictors, with important pre-injury demographic and injury characteristics as covariates.

Results: 311 children (65.0% males; median age = 11.92 [IQR = 9.14-14.21 years]) were included in the analysis. After adjusting for covariates, higher symptom burden was associated with lower Backward Digit Span (χ2 = 9.85, p = .043) and Verbal Fluency scores (χ2 = 10.48, p = .033) across time points; these associations were not moderated by sex, ps ≥ .20. Symptom burden was not associated with performance on the Coding, Continuous Performance Test, and Color-Word Interference scores, ps ≥ .17.

Conclusions: Higher symptom burden is associated with lower working memory and cognitive flexibility following pediatric concussion, yet these associations were not moderated by sex. Findings may inform concussion management by emphasizing the importance of multifaceted assessments of EF.

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小儿脑震荡后4周和12周的症状负担与处理速度和执行功能之间的关系。
目的:症状和认知能力都被用作儿科脑震荡后康复的指标,但它们之间的相互关系却不甚了解。本研究旨在调查:1)小儿脑震荡后 4 周和 12 周的脑震荡后症状负担与认知结果(处理速度和执行功能 [EF])之间的关系;2)性别对这种关系的调节作用:这项前瞻性多中心队列研究纳入了在加拿大儿科急诊研究网络(Pediatric Emergency Research Canada network)的四个急诊科就诊的 5.00-17.99 岁急性脑震荡患者。研究人员在脑震荡后 4 周和 12 周分别进行了五项处理速度和 EF 任务以及脑震荡后症状量表(PCSI;症状负担,定义为受伤后与回顾性[受伤前]得分之间的差异)的测试。以任务表现为因变量,以 PCSI 和 PCSI* 性别交互作用为主要预测因素,以受伤前重要的人口统计学特征和受伤特征为协变量,建立了广义最小二乘法模型:共有 311 名儿童(65.0% 为男性;中位年龄 = 11.92 [IQR = 9.14-14.21 岁])参与分析。在对共变量进行调整后,症状负担越重,各时间点的后向数字跨度得分(χ2 = 9.85,P = .043)和言语流畅性得分(χ2 = 10.48,P = .033)越低;这些关联不受性别影响,Ps ≥ .20。症状负担与编码、连续表现测试和颜色-文字干扰得分的表现无关,ps ≥ .17:结论:小儿脑震荡后,较高的症状负担与较低的工作记忆和认知灵活性有关,但这些关联不受性别影响。研究结果强调了对EF进行多方面评估的重要性,可为脑震荡管理提供参考。
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来源期刊
CiteScore
5.40
自引率
3.80%
发文量
185
审稿时长
4-8 weeks
期刊介绍: The Journal of the International Neuropsychological Society is the official journal of the International Neuropsychological Society, an organization of over 4,500 international members from a variety of disciplines. The Journal of the International Neuropsychological Society welcomes original, creative, high quality research papers covering all areas of neuropsychology. The focus of articles may be primarily experimental, applied, or clinical. Contributions will broadly reflect the interest of all areas of neuropsychology, including but not limited to: development of cognitive processes, brain-behavior relationships, adult and pediatric neuropsychology, neurobehavioral syndromes (such as aphasia or apraxia), and the interfaces of neuropsychology with related areas such as behavioral neurology, neuropsychiatry, genetics, and cognitive neuroscience. Papers that utilize behavioral, neuroimaging, and electrophysiological measures are appropriate. To assure maximum flexibility and to promote diverse mechanisms of scholarly communication, the following formats are available in addition to a Regular Research Article: Brief Communication is a shorter research article; Rapid Communication is intended for "fast breaking" new work that does not yet justify a full length article and is placed on a fast review track; Case Report is a theoretically important and unique case study; Critical Review and Short Review are thoughtful considerations of topics of importance to neuropsychology and include meta-analyses; Dialogue provides a forum for publishing two distinct positions on controversial issues in a point-counterpoint format; Special Issue and Special Section consist of several articles linked thematically; Letter to the Editor responds to recent articles published in the Journal of the International Neuropsychological Society; and Book Review, which is considered but is no longer solicited.
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