IQ After Pediatric Concussion

Author:

Ware Ashley L.1234,McLarnon Matthew J. W.5,Lapointe Andrew P.46,Brooks Brian L.47,Bacevice Ann8,Bangert Barbara A.8,Beauchamp Miriam H.9,Bigler Erin D.210,Bjornson Bruce1112,Cohen Daniel M.13,Craig William14,Doan Quynh12,Freedman Stephen B.15,Goodyear Bradley G.6,Gravel Jocelyn16,Mihalov H. Leslie K.13,Minich Nori Mercuri817,Taylor H. Gerry13,Zemek Roger18,Yeates Keith Owen34,

Affiliation:

1. aDepartment of Psychology, Georgia State University, Atlanta, Georgia

2. bDepartment of Neurology, University of Utah, Salt Lake City, Utah

3. cDepartment of Psychology, University of Calgary, Calgary, Alberta, Canada

4. dHotchkiss Brain Institute and Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada

5. eDepartment of General Management and Human Resources, Bissett School of Business, Mount Royal University, Calgary, Alberta, Canada

6. fDepartment of Radiology, University of Calgary, Calgary, Alberta, Canada

7. gNeurosciences Program, Alberta Children’s Hospital, Departments of Pediatrics, Clinical Neurosciences, and Psychology, University of Calgary, Calgary, Alberta, Canada

8. hDepartment of Pediatrics, Case Western Reserve University, Cleveland, Ohio

9. iDepartment of Psychology, University of Montreal and CHU Sainte-Justine Hospital Research Center, Montréal, Québec, Canada

10. jDepartment of Psychology, Brigham Young University, Provo, Utah

11. kDivision of Neurology

12. lDepartment of Pediatrics, University of British Columbia, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada

13. mAbigail Wexner Research Institute at Nationwide Children’s Hospital, and Department of Pediatrics, The Ohio State University, Columbus, Ohio

14. nUniversity of Alberta and Stollery Children’s Hospital, Edmonton, Alberta, Canada

15. oDepartments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

16. pDepartment of Pediatric Emergency Medicine; CHU Sainte-Justine, Department of Pediatrics, University of Montréal, Montréal, Québec, Canada

17. qRainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio

18. rDepartments of Pediatrics and Emergency Medicine, University of Ottawa, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada

Abstract

OBJECTIVES This study investigated IQ scores in pediatric concussion (ie, mild traumatic brain injury) versus orthopedic injury. METHODS Children (N = 866; aged 8–16.99 years) were recruited for 2 prospective cohort studies from emergency departments at children’s hospitals (2 sites in the United States and 5 in Canada) ≤48 hours after sustaining a concussion or orthopedic injury. They completed IQ and performance validity testing postacutely (3–18 days postinjury; United States) or 3 months postinjury (Canada). Group differences in IQ scores were examined using 3 complementary statistical approaches (linear modeling, Bayesian, and multigroup factor analysis) in children performing above cutoffs on validity testing. RESULTS Linear models showed small group differences in full-scale IQ (d [95% confidence interval] = 0.13 [0.00–0.26]) and matrix reasoning (0.16 [0.03–0.30]), but not in vocabulary scores. IQ scores were not related to previous concussion, acute clinical features, injury mechanism, a validated clinical risk score, pre- or postinjury symptom ratings, litigation, or symptomatic status at 1 month postinjury. Bayesian models provided moderate to very strong evidence against group differences in IQ scores (Bayes factor 0.02–0.23). Multigroup factor analysis further demonstrated strict measurement invariance, indicating group equivalence in factor structure of the IQ test and latent variable means. CONCLUSIONS Across multisite, prospective study cohorts, 3 complementary statistical models provided no evidence of clinically meaningful differences in IQ scores after pediatric concussion. Instead, overall results provided strong evidence against reduced intelligence in the first few weeks to months after pediatric concussion.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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