Interindividual variability in recovery after traumatic brain injury: Effect of cognitive reserve

Background and objective: The aim of this study was to examine the effect of cognitive reserve in recovery after a moderate or severe traumatic brain injury (TBI). Different authors proposed that this construct might account for the mismatch between TBI severity, its clinical expression, and subsequent recovery. Patients and method: Eighty-four patients who sustained moderate-to-severe TBI participated in the study. Participants were divided into a high cognitive reserve group (n = 46) or low cognitive reserve group (n = 38) based on premorbid educational and occupational attainment. Patient's functional status was examined with the Patient Competency Rating Scale (PCRS). Results: There were no significant differences between groups in demographic and injury variables (sex, age, severity of injury, post-traumatic amnesia duration, and time since injury). The analysis revealed statistically significant differences between the 2 groups on the PCRS: The high cognitive reserve group scored better than the low cognitive reserve group. Conclusions: The results of this study suggest that cognitive reserve may mediate recovery after a moderate or severe TBI. Educational and occupational attainments provide a cognitive provision that would be associated with better functional status after injury. (c) 2012 Elsevier Espana, S.L. All rights reserved.