The Association of Cognitive Reserve in Chronic-Phase Functional and Neuropsychological Outcomes Following Traumatic Brain Injury.

The findings come from people who had persistent post-TBI symptoms and sought out the study, and most were from the greater Washington, D.C. area with above-average education, so they may not apply to all people with TBI. The sample included relatively few people with severe TBI, so severity findings are less certain. Participants had a higher average premorbid IQ than the general population, which may limit how well the results apply to people with lower estimated IQ. The occupational classification did not differentiate skill level within job fields, which may explain why occupational attainment was not related to outcomes. Post-injury cognitive rehabilitation was not recorded, so it could have influenced outcomes. The study did not measure participation in cognitively stimulating activities or emotional reserve, both described as parts of cognitive reserve. The study looked at associations after injury, not an intervention, so it cannot show that cognitive reserve factors caused better outcomes. Only 97 participants had usable MRI scans, and imaging was assessed anatomically rather than through network connectivity.

The authors declared no competing financial interests. The article metadata lists NIH intramural and U.S. government non-PHS research support.

Do not conclude that higher education or estimated premorbid IQ will improve functional recovery after TBI. These factors were related to neuropsychological test scores, not to daily function, physical health, or mental health, and the study did not test any treatment.