Skip to main content
    • Aa
    • Aa

Cognitive reserve as a moderator of postconcussive symptoms in children with complicated and uncomplicated mild traumatic brain injury

  • TARYN B. FAY (a1) (a2), KEITH OWEN YEATES (a2) (a3), H. GERRY TAYLOR (a4) (a5), BARBARA BANGERT (a6), ANN DIETRICH (a2) (a7), KATHRYN E. NUSS (a2) (a7), JEROME RUSIN (a8) and MARTHA WRIGHT (a4) (a5)...

The occurrence of postconcussive symptoms (PCS) following mild traumatic brain injury (TBI) in children may depend on cognitive reserve capacity. This prospective, longitudinal study examined whether the relationship between mild TBI and PCS is moderated by cognitive ability, which served as a proxy for cognitive reserve. Participants included 182 children with mild TBI and 99 children with orthopedic injuries (OI), ranging from 8 to 15 years of age when injured. Mild TBI were classified as complicated (n = 32) or uncomplicated (n = 150) depending on whether they were associated with trauma-related intracranial abnormalities on magnetic resonance imaging. PCS were assessed initially within 3 weeks of injury, and again at 1, 3, and 12 months post injury. The initial assessment also included standardized tests of children’s cognitive skills and retrospective parent ratings of pre-injury symptoms. Hierarchical linear modeling indicated that ratings of PCS were moderated jointly by cognitive ability and injury severity. Children of lower cognitive ability with a complicated mild TBI were especially prone to cognitive symptoms across time according to parents and to high acute levels of PCS according to children’s self-ratings. Cognitive reserve is an important moderator of the outcomes of mild TBI in children and adolescents. (JINS, 2010, 16, 94–105.)

Corresponding author
*Correspondence and reprint requests to: Keith Owen Yeates, Ph.D., Department of Psychology, Nationwide Children’s Hospital, 700 Children’s Dr., Columbus, OH 43205. E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

American Academy of Pediatrics. (1999). The management of minor closed head injury in children. Pediatrics, 104, 14071415.

J.J. Bazarian , J. McClung , M.N. Shah , Y.T. Cheng , W. Flesher , & J. Kraus (2005). Mild traumatic brain injury in the United States, 1998–2000. Brain Injury, 19, 8591.

Y.Y. Choi , N.A. Shamosh , S.H. Cho , C.G. DeYoung , M.J. Lee , J.-M. Lee , (2008). Multiple bases of human intelligence revealed by cortical thickness and neural activation. Journal of Neuroscience, 28, 1032310329.

R.I. Jennrich , & M.D. Schluchter (1986). Unbalanced repeated measures models with structured covariance matrices. Biometrics, 42, 805820.

K.C. Koenen , T.E. Moffitt , A.L. Roberts , L.T. Martin , L. Kubzansky , H. Harrington , (2009). Childhood IQ and adult mental disorders: A test of the cognitive reserve hypothesis. American Journal of Psychiatry, 166, 5057.

H.S. Levin , G. Hanten , G. Roberson , L. Xiaoqi , L. Ewing-Cobbs , M. Dennis , (2008). Prediction of cognitive sequelae based on abnormal computed tomography findings in children following mild traumatic brain injury. Journal of Neurosurgery in Pediatrics, 1, 461470.

T. Mayer , M. Matlak , D. Johnson , & M. Walker (1980). The Modified Injury Severity Scale in pediatric multiple trauma patients. Journal of Pediatric Surgery, 15, 719726.

A.S. Masten (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227238.

G.H. McClelland , & C.M. Judd (1993). Statistical difficulties of detecting interactions and moderator effects. Psychological Bulletin, 114, 376390.

M.A. McDaniel (2005). Big-brained people are smarter: A meta-analysis of the relationship between in vivo brain volume and intelligence. Intelligence, 33, 337346.

W. Mittenberg , M.S. Wittner , & L.J. Miller (1997). Postconcussion syndrome occurs in children. Neuropsychology, 11(3), 447452.

J. Ponsford , C. Wilmott , A. Rothwell , P. Cameron , G. Ayton , R. Nelms , (1999). Cognitive and behavioral outcome following mild traumatic head injury in children. Journal of Head Trauma Rehabilitation, 14(4), 360372.

J.B. Rivara , J.M. Jaffe , N.L. Polissar , G.C. Fay , K.M. Martin , H.A. Shurtleff , & S. Liao (1994). Family functioning and children’s academic performance and behavior problems in the year following traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 75, 369379.

P. Satz (1993). Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. Neuropsychology, 7, 273295.

P. Satz (2001). Mild head injury in children and adolescents. Current Directions in Psychological Science, 10(3), 106109.

P. Satz , K. Zaucha , C. McCleary , R. Light , & R.F. Asarnow (1997). Mild head injury in children and adolescents: A review of studies (1970–1995). Psychological Bulletin, 122(2), 107131.

D. Thurman , & J. Guerrero (1999). Trends in hospitalization associated with traumatic brain injury. Journal of the American Medical Association, 282(10), 954957.

D.H. Williams , H.S. Levin , & H.M. Eisenberg (1990). Mild head injury classification. Neurosurgery, 27, 422428.

K.O. Yeates , K. Armstrong , J. Janusz , H.G. Taylor , S. Wade , T. Stancin , & D. Drotar (2005). Long-term attention problems in children with traumatic brain injury. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 574584.

K.O. Yeates , J. Luria , H. Bartkowski , J. Rusin , L. Martin , & E.D. Bigler (1999). Postconcussive symptoms in children with mild closed head injuries. Journal of Head Trauma Rehabilitation, 14(4), 337350.

K.O. Yeates , H.G. Taylor , J. Rusin , B. Bangert , A. Dietrich , K. Nuss , (2009). Longitudinal trajectories of post-concussive symptoms in children with mild traumatic brain injuries and their relationship to acute medical status. Pediatrics, 123, 735743.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 9
Total number of PDF views: 73 *
Loading metrics...

Abstract views

Total abstract views: 338 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd September 2017. This data will be updated every 24 hours.