Results from the TRACK-TBI study show that patients who have sustained mild traumatic brain injury (TBI) are at risk of cognitive impairment or decline. They are also likely to report low levels of life satisfaction.

This prospective study enrolled participants from the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study, which included 656 persons with mild traumatic brain injury with a Glasgow Coma Scale (GCS) score of 13-15; 156 healthy matched persons with no head injuries were selected as controls. The purpose of the study was to monitor the cognitive outcomes over the period of one year of the study. These patients had presented to the ER within 24 hours of the injury. Poor cognitive outcome was assessed as either cognitive impairment (lower-than-expected performance on at least two cognitive tests) or cognitive decline (clinically meaningful decline on ≥ 2 cognitive tests) or the presence of both.

A year later, 86 (13.5%) out of 656 patients with TBI were found to have poor cognitive outcomes versus eight (4.5%) out of 156 people with no head trauma. Out of the 14% TBI patients with poor cognitive outcomes, 10% had only cognitive impairment, 2% had only cognitive decline, while 2% had both. Among the controls, 3% had cognitive impairment, no patient had cognitive decline alone and 1% had both.

Patients with prior depression, with no medical insurance and lower educational status (high school or less), hyperglycemia and a score of >3 on the prognostic Rotterdam CT Score of TBI were twice as likely to be at risk of poor cognitive outcome vis-à-vis those with no history of depression or were highly educated or had health insurance.

The life satisfaction among the participants was also examined. One year after the injury, those with good cognitive outcomes reported higher life satisfaction with an average score of 26. Patients with poor cognitive outcomes scored low on the test with an average score of 21.

These observations from the TRACK-TBI Study, wherein nearly 14% of patients with mild TBI had adverse cognitive outcomes in contrast to just 5% of healthy controls, confirm that poor cognitive outcome after traumatic brain injury is not uncommon. While it does not establish a cause-and-effect relationship, it does show an association between the two. The authors have called for further research “to study the mechanisms underlying poor cognitive outcome, even after relatively mild brain injuries, to improve therapy for recovery”.

Reference

1. Christman Schneider AL, et al; TRACK-TBI Investigators. Cognitive outcome 1 year after mild traumatic brain injury: Results From the TRACK-TBI Study. Neurology. 2022 Feb 16:10.1212/WNL.0000000000200041. doi: 10.1212/WNL.0000000000200041.