Mild traumatic brain injury (mTBI), or concussion, is a common condition that frequently causes impaired executive functioning (mental processing skills that allow people to plan, focus, learn, and remember), limited independence, and decreased ability to engage in social activities and work. Previous studies on executive functioning in mTBI have produced conflicting results—a discrepancy that can be attributed to the lack of well-established definitions for executive functions. Scientists have recently developed models to predict the risk of post-concussive symptoms in mTBI patients, but few studies have attempted to apply these models to executive functioning.
To address this gap in the literature, a team of researchers sought to characterize the associations between individuals’ executive functioning and the risk, causative, and perpetuating factors that may lead to post-concussive symptoms after mTBI. The researchers predicted that mTBI patients with more education, higher pre-injury IQ scores, and younger age would perform better on executive functioning tests. The study sampled 172 mTBI patients aged 16 and older. The results of the study found that:
- Patients with a higher level of education and patients with higher premorbid IQ scores performed better on tasks that measure working memory and updating memory. Patients diagnosed with anxiety or depression after mTBI performed worse on the memory updating task.
- Older patients and patients with higher levels of education took longer to perform tasks related to planning.
- Injury-related factors, including the loss of consciousness and post-traumatic amnesia, showed no association with later executive dysfunction.
These results suggest that this predictive model can be applied to executive functioning among mTBI patients and that individual characteristics among patients may be successful in predicting outcomes. For instance, it may be important for clinicians to consider their patients’ level of education, as this demographic variable was a significant factor in multiple tests of executive functioning. While mTBI severity may play a more significant role in short-term executive dysfunction, perpetuating factors (such as psychological conditions) have a greater impact on executive function in the long term. Future directions in this research may include developing clinical guidelines for executive function in specific patient demographics and better understanding the impact of other social and psychological factors.
Tabet S, Tinawi S, Frenette LC, et al. Relationships between predisposing, precipitating, and perpetuating factors and executive functioning following mild traumatic brain injury. Brain Injury. (September 2022).