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Neuropsychological Predictors of Outcome Following Traumatic Brain Injury in Adults: a Meta-Analysis

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Abstract

Several neuropsychological dimensions are correlated with functional outcome (e.g., ability to return to family and community roles) following traumatic brain injury (TBI). Commonly investigated neuropsychological dimensions include verbal memory, visuo-spatial construction, set-shifting, generativity, and processing speed. Unfortunately, small sample sizes across relevant studies have contributed to inconsistent results. Furthermore, no studies have concurrently measured all of the candidate neuropsychological predictors, most of which are known to be inter-correlated. Thus, the unique predictive effects associated with the candidate predictors in TBI recovery have never been investigated. Consequently, this study used both meta-analysis and multiple regression to statistically evaluate neuropsychological candidate predictors across two outcome variables (1) the Glasgow Outcome Scale-Extended (GOS-E) and (2) the Disability Rating Scale (DRS). Seven studies met inclusion criteria. Based on the meta-analyses, the following neuropsychological dimensions were found to be correlated with the GOS-E: immediate verbal memory (r = .43, 95% CI [.27, .58]), delayed verbal memory (r = .43, 95% CI [.21, .61]), visuo-spatial construction (r = .29, 95% CI [.15, .53]), set-shifting (r = −.31, 95% CI [−.45, −.15], and generativity (r = .44, 95% CI [.32, .54]). By contrast, only one neuropsychological dimension was found to be significantly related to the DRS (generativity: r = −.21, 95% CI [−.39, −.01]). Multiple regression on the GOS-E relevant meta-analytically derived correlation matrix determined that all neuropsychological dimensions were significant predictors of the GOS-E (multiple R 2 = .31) with the exception of immediate verbal memory or learning. However, due to analytic characteristics, these findings must be interpreted with caution. Results were consistent with the need to consider multiple neuropsychological abilities in recovery and rehabilitation following TBI.

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Notes

  1. It is noted that the Maze Task has been classified as a measure of working memory in previous versions of the Wechsler intelligence tests. However, recent conceptualizations of executive functioning (e.g., Fisk and Sharp 2004) have included both working memory and fluid reasoning as dimensions of executive functioning and have classified maze tasks as measures of fluid reasoning (e.g., Lezak et al. 2004).

  2. As reported in the Results section, only one neuropsychological dimension was found to relate to the DRS in a statistically significant manner. Thus, it was not considered necessary to conduct a meta-analytic multiple regression for the DRS relevant data.

  3. The multiple regression was conducted upon data that reflected the correlations to three decimal places. This data is available upon request.

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Acknowledgements

The authors would like to thank Brightwater Care Group who supported this study through a student scholarship.

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  1. School of Psychogical Science, University of Western Australia, M304, Perth, WA, 6009, Australia

    Fiona Allanson, Carmela Pestell, Gilles E. Gignac, Yong Xiang Yeo & Michael Weinborn

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  1. Fiona Allanson
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Allanson, F., Pestell, C., Gignac, G. et al. Neuropsychological Predictors of Outcome Following Traumatic Brain Injury in Adults: a Meta-Analysis. Neuropsychol Rev 27, 187–201 (2017). https://doi.org/10.1007/s11065-017-9353-5

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