title: Response inhibition after traumatic brain injury (TBI) in children: impairment and recovery.
abstract: Children who experience traumatic brain injury (TBI) often show cognitive impairments postinjury, some of which recover over time. We examined the recovery of motor response inhibition immediately following TBI and over 2 years. We assessed the role of injury severity, age at injury, and lesion characteristics on initial impairment and recovery while considering the role of pre-injury psychiatric disorder. Participants were 136 children with TBI aged 5-16 years. Latency of motor response inhibition was measured with the stop-signal task within 1 month of the injury and again at 3, 6, 12, and 24 months. The performance of the TBI participants at each measurement occasion was standardized with 117 children of similar age, but without injury. Residualized latency scores were calculated. Growth curve analyses showed an initial impairment in response inhibition and improvement over the 2 years following injury. Younger TBI patients were initially more impaired although they exhibited greater recovery of response inhibition than did older TBI patients. Longer duration of coma, but not reactivity of pupils or Glasgow Coma Scale score, predicted initial deficit. Lesion characteristics or pre-injury attention deficit hyperactivity disorder did not predict initial impairment or recovery. Replication with longitudinal testing of a comparison group of children sustaining extracranial injury is necessary to confirm our findings.
authors.affiliation: Department of Psychiatry, Brain and Behaviour Programme, The Hospital for Sick Children, University of Toronto, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Leblanc
authors.forename: Shirley
authors.initials: S
authors.lastname: Chen
authors.forename: Paul R
authors.initials: PR
authors.lastname: Swank
authors.forename: Linda
authors.initials: L
authors.lastname: Ewing-Cobbs
authors.forename: Marcia
authors.initials: M
authors.lastname: Barnes
authors.forename: Maureen
authors.initials: M
authors.lastname: Dennis
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Max
authors.forename: Harvey
authors.initials: H
authors.lastname: Levin
authors.forename: Russell
authors.initials: R
authors.lastname: Schachar
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D015601:Injury Severity Score; D008297:Male; D009483:Neuropsychological Tests; D020127:Recovery of Function; D013997:Time Factors