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Objective: To examine whether cognitive reserve (CR) attenuates the initial impact of traumatic brain injury (TBI) on cognitive performance (neural reserve theory) and results in faster cognitive recovery rates in the first year post-injury (neural compensation theory), and whether the advantage of CR differs based on the severity of TBI. Method: Adults with mild TBI (mTBI; n = 28), complicated mild TBI (cmTBI; n = 24), and moderate-to-severe TBI (msevTBI; n = 57), and demographically-matched controls (n = 66) were recruited from inpatient/outpatient clinics at an academic medical center and assessed at 1-, 6-, and 12-months post-injury. Outcomes were 3 cognitive domains: processing speed/executive function, verbal fluency, and memory. Premorbid IQ, estimated with the Wechsler Test of Adult Reading, served as the CR proxy. Results: Longitudinal mixed effects models were used to examine the main effects and interaction between injury severity and CR on the initial status and rate of change over time for each of the 3 cognitive domains. Higher premorbid IQ was associated with better performance on all domains at one-month post-injury (p < .05), and the effect did not differ by injury severity. Cognitive recovery rate was moderated only by TBI severity (p < .05); those with more severe TBI had faster recovery in the first year. Conclusion: Results support only the neural reserve theory of CR within a TBI population and indicate that CR is neuroprotective regardless of the degree of TBI. However, higher premorbid CR does not allow for more rapid adaptation and recovery from injury. Thus, early intervention and cognitive rehabilitation efforts should be equally targeted regardless of estimated IQ.

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POSTER SESSIONS SCHEDULE > Poster Session B: Thursday, October 26, 2017 6:30 pm - 8:00 pm
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