Evaluating Cognitive Impact of Traumatic Brain Injury and Risk for Post-Traumatic Epilepsy
- 1Rutgers Robert Wood Johnson Medical School
Abstract
ObjectivePost-traumatic epilepsy (PTE) is a common sequela of traumatic brain injury (TBI). Research indicates that individuals with PTE tend to experience greater cognitive difficulties compared to those with TBI alone. However, it is plausible that a distinct cognitive profile exists that distinguishes between TBI cases with and without PTE. We aimed to identify longitudinal changes in cognitive measures among TBI patients to better assess the changes associated with developing PTE.
SettingOutpatient.
ParticipantsProspective subjects who had suffered TBI within 6 months post-injury (TBI-6M, n=32), retrospective subjects with pre-existing PTE diagnoses (PTE, n=20), and healthy control subjects (HC, n=41).
DesignWe examined cognitive performance for TBI patients within 6 months post-injury, then again within 12 months (TBI-12M, n=26), and within 18-months (TBI-18M, n=25), and compared this with cognitive performance among HC and PTE.
Main MeasuresCognitive tests administered yielded 15 test components for analysis. We utilized linear mixed effects modeling to examine cohort-level differences cognitive function.
Results11/15 tests showed a significant performance deficit in the PTE subjects compared to HC. TBI-6M was not significantly different from the PTE subjects; with time, 9/15 tests showed some degree of recovery in TBI subjects. Tests for information processing speed/working memory and executive function showed strong recovery (TBI-6M vs. TBI-18M, SDMT written: p<0.0001, SDMT oral and COWAT: p<0.001). Tests for visual attention/working memory also showed a smaller but significant recovery (TBI-18M vs. PTE, p<0.05). By contrast, tests for verbal memory [HVLT-R Delayed Recall] showed chronic impairment in TBI (TBI-18M vs HC, p<0.0001). TBI subjects generally trend towards recovery in cognitive performance post-TBI.
ConclusionsInformation processing speed/working memory are strong indicators for TBI recovery, while auditory learning/memory shows chronic impairment. The stagnation of recovery in cognitive domains typically characterized by robust recovery may correlate with an elevated risk of developing PTE.
Related
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- Astragaloside IV ameliorates cognitive impairment after traumatic brain injury with involvement of NMDAR-related signaling
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- Improved inhibitory control following combined transcranial direct current stimulation (tDCS) and cognitive training in individuals with traumatic brain injury and impulsivity
- Comparative study of acute-phase traumatic brain injury in rats of different weeks of age under identical impact force
BibTeX
@misc{zink2026evaluating,
title = {{Evaluating Cognitive Impact of Traumatic Brain Injury and Risk for Post-Traumatic Epilepsy}},
author = {T. Zink and H. Noren and D. Valdivia and C. Yohn and J. Hundal and S. Chen and D. Scarisbrick and H. Sun},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.30.26361760},
url = {https://www.medrxiv.org/content/10.64898/2026.08.30.26361760v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Evaluating Cognitive Impact of Traumatic Brain Injury and Risk for Post-Traumatic Epilepsy
AU - T. Zink
AU - H. Noren
AU - D. Valdivia
AU - C. Yohn
AU - J. Hundal
AU - S. Chen
AU - D. Scarisbrick
AU - H. Sun
PY - 2026
DA - 2026/08/30
PB - medRxiv
DO - 10.64898/2026.08.30.26361760
UR - https://www.medrxiv.org/content/10.64898/2026.08.30.26361760v1
AB - ObjectivePost-traumatic epilepsy (PTE) is a common sequela of traumatic brain injury (TBI). Research indicates that individuals with PTE tend to experience greater cognitive difficulties compared to those with TBI alone. However, it is plausible that a distinct cognitive profile exists that distinguishes between TBI cases with and without PTE. We aimed to identify longitudinal changes in cognitive measures among TBI patients to better assess the changes associated with developing PTE. SettingOutpatient. ParticipantsProspective subjects who had suffered TBI within 6 months post-injury (TBI-6M, n=32), retrospective subjects with pre-existing PTE diagnoses (PTE, n=20), and healthy control subjects (HC, n=41). DesignWe examined cognitive performance for TBI patients within 6 months post-injury, then again within 12 months (TBI-12M, n=26), and within 18-months (TBI-18M, n=25), and compared this with cognitive performance among HC and PTE. Main MeasuresCognitive tests administered yielded 15 test components for analysis. We utilized linear mixed effects modeling to examine cohort-level differences cognitive function. Results11/15 tests showed a significant performance deficit in the PTE subjects compared to HC. TBI-6M was not significantly different from the PTE subjects; with time, 9/15 tests showed some degree of recovery in TBI subjects. Tests for information processing speed/working memory and executive function showed strong recovery (TBI-6M vs. TBI-18M, SDMT written: p<0.0001, SDMT oral and COWAT: p<0.001). Tests for visual attention/working memory also showed a smaller but significant recovery (TBI-18M vs. PTE, p<0.05). By contrast, tests for verbal memory [HVLT-R Delayed Recall] showed chronic impairment in TBI (TBI-18M vs HC, p<0.0001). TBI subjects generally trend towards recovery in cognitive performance post-TBI. ConclusionsInformation processing speed/working memory are strong indicators for TBI recovery, while auditory learning/memory shows chronic impairment. The stagnation of recovery in cognitive domains typically characterized by robust recovery may correlate with an elevated risk of developing PTE.
ER -