Executive functions and attention 7 years after severe childhood traumatic brain injury : Results of the Traumatisme Grave de l’Enfant (TGE) cohort / Clément Le Fur in Annals of physical and rehabilitation medicine, Vol. 63, n°4 (Juillet 2020)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 63, n°4 (Juillet 2020) . - p. 270-279 Titre : Executive functions and attention 7 years after severe childhood traumatic brain injury : Results of the Traumatisme Grave de l’Enfant (TGE) cohort Type de document : texte imprimé Auteurs : Clément Le Fur ; Hugo Câmara-Costa ; Leila Francillette ; Marion Opatowski ; Anna Toure ; Dominique Brugel ; Anne Laurent-Vannier ; Philippe Meyer ; Laurence Watier ; Georges Dellatolas ; Mathilde Chevignard Année de publication : 2020 Article en page(s) : p. 270-279 Note générale : doi.org/10.1016/j.rehab.2019.09.003 Langues : Anglais (eng) Mots-clés : Severe traumatic brain injury  Child  Adolescent  Long-term outcome  Executive functions Résumé : Objectives Severe childhood traumatic brain injury (TBI) leads to long-standing executive function and attention deficits, with negative consequences for participation, academic outcome and independence. This study aimed to assess executive function and attention 7 years after severe childhood TBI in comparison with a matched control group and to investigate associated factors. Methods Children (< 15 years) with severe accidental TBI consecutively admitted in a single trauma center over 3 years were included in the Traumatisme Grave de l’Enfant (TGE) prospective longitudinal study. Of the 81 children initially included, 65 survived. At 7 years post-TBI, executive functions and attention were assessed in 27 participants (42 % of the 65 survivors) by using a combination of computerized tasks from the Test of Attentional Performance (TAP) and the Behavioral Rating of Executive Functions (BRIEF) questionnaire. Patients were compared to a group of 27 typically developing controls who were matched for sex, age and parental education level. Results Among the 27 participants, mean (SD) age at injury was 7.7 (4.6) years, and mean length of coma 5.6 (4.6) days. Regarding the TAP, the number of errors was significantly higher (P = 0.003) and reaction time marginally slower (P = 0.08) in the TBI than control group. The BRIEF questionnaire completed by parents indicated significantly more executive difficulties in the TBI than control group (Behavior Regulation Index, P = 0.005; Metacognitive index, P = 0.02; Global Executive Composite, P = 0.012). Correlations between BRIEF and TAP scores did not reach statistical significance. BRIEF total score was correlated moderately with length of coma (r = 0.40, P = 0.037), and TAP scores were correlated with the Full-Scale Intellectual Quotient (total number of errors: r = -0.48; P = 0.01; mean reaction time: r = −0.51; P = 0.009). Conclusions Executive and attention deficits were evident 7 years after severe childhood TBI. Computerized tasks and questionnaires provide complementary and non-redundant information. Systematic long-term follow-up should be provided until the transition to adulthood, to assess ongoing development and to implement timely tailored interventions. Permalink : ./index.php?lvl=notice_display&id=90823 [article] Executive functions and attention 7 years after severe childhood traumatic brain injury : Results of the Traumatisme Grave de l’Enfant (TGE) cohort [texte imprimé] / Clément Le Fur ; Hugo Câmara-Costa ; Leila Francillette ; Marion Opatowski ; Anna Toure ; Dominique Brugel ; Anne Laurent-Vannier ; Philippe Meyer ; Laurence Watier ; Georges Dellatolas ; Mathilde Chevignard . - 2020 . - p. 270-279. doi.org/10.1016/j.rehab.2019.09.003 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 63, n°4 (Juillet 2020) . - p. 270-279 Mots-clés : Severe traumatic brain injury  Child  Adolescent  Long-term outcome  Executive functions Résumé : Objectives Severe childhood traumatic brain injury (TBI) leads to long-standing executive function and attention deficits, with negative consequences for participation, academic outcome and independence. This study aimed to assess executive function and attention 7 years after severe childhood TBI in comparison with a matched control group and to investigate associated factors. Methods Children (< 15 years) with severe accidental TBI consecutively admitted in a single trauma center over 3 years were included in the Traumatisme Grave de l’Enfant (TGE) prospective longitudinal study. Of the 81 children initially included, 65 survived. At 7 years post-TBI, executive functions and attention were assessed in 27 participants (42 % of the 65 survivors) by using a combination of computerized tasks from the Test of Attentional Performance (TAP) and the Behavioral Rating of Executive Functions (BRIEF) questionnaire. Patients were compared to a group of 27 typically developing controls who were matched for sex, age and parental education level. Results Among the 27 participants, mean (SD) age at injury was 7.7 (4.6) years, and mean length of coma 5.6 (4.6) days. Regarding the TAP, the number of errors was significantly higher (P = 0.003) and reaction time marginally slower (P = 0.08) in the TBI than control group. The BRIEF questionnaire completed by parents indicated significantly more executive difficulties in the TBI than control group (Behavior Regulation Index, P = 0.005; Metacognitive index, P = 0.02; Global Executive Composite, P = 0.012). Correlations between BRIEF and TAP scores did not reach statistical significance. BRIEF total score was correlated moderately with length of coma (r = 0.40, P = 0.037), and TAP scores were correlated with the Full-Scale Intellectual Quotient (total number of errors: r = -0.48; P = 0.01; mean reaction time: r = −0.51; P = 0.009). Conclusions Executive and attention deficits were evident 7 years after severe childhood TBI. Computerized tasks and questionnaires provide complementary and non-redundant information. Systematic long-term follow-up should be provided until the transition to adulthood, to assess ongoing development and to implement timely tailored interventions. Permalink : ./index.php?lvl=notice_display&id=90823

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