Premorbid Intellectual Functioning, Education, and Brain Size in Traumatic Brain Injury: An Investigation of the Cognitive Reserve Hypothesis

  title={Premorbid Intellectual Functioning, Education, and Brain Size in Traumatic Brain Injury: An Investigation of the Cognitive Reserve Hypothesis},
  author={Shelli R. Kesler and Heather Adams and Christine M. Blasey and Erin D. Bigler},
  journal={Applied Neuropsychology},
  pages={153 - 162}
Cognitive reserve theories have been postulated in an attempt to explain individual differences in functional outcome following cerebral insult or disease. These theories suggest that higher education and psychometric intelligence may preserve functional capacity regardless of injury or disease severity. This study investigated cognitive reserve in 25 participants with traumatic brain injury (TBI) using high-resolution magnetic resonance imaging (MRI) analyses. We examined the relationships… 
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It is concluded that access to pre-morbid neuropsychological data may have facilitated the discovery of the effects of mild TBI on abstract reasoning, as well as a significant correlation between TBI-related decline in this cognitive domain and the volume of the bilateral insula, both of which had not been appreciated in the past.
The Influence of Cognitive Reserve on Recovery from Traumatic Brain Injury
  • J. Donders, J. Stout
  • Psychology
    Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists
  • 2019
Cognitive reserve has a protective effect with regard to the impact of TBI on cognitive test performance but this effect is imperfect and does not completely negate the effect of injury severity.
The Role of Cognitive Reserve in Recovery From Traumatic Brain Injury
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.
The Association Between Brain Reserve, Cognitive Reserve, and Neuropsychological and Functional Outcomes in Males With Chronic Moderate-to-Severe Traumatic Brain Injury.
Lingering neuropsychological deficits in chronic TBI support the role of BR and CR in functional outcome, and TSI interferes with CR supporting the notion that TBI sets off a chronic neurodegenerative and progressive course that interfezes with semantic knowledge.
Effect of Cognitive Reserve on Children With Traumatic Brain Injury
Cognitive reserve as reflected in parental education has a moderating effect with regard to children’s performance on the WISC–V after TBI, such that higher cognitive reserve is associated with greater preservation of acquired word knowledge and understanding of visual relationships.
Cognitive reserve index and functional and cognitive outcomes in severe acquired brain injury: A pilot study
Improvements in overall and cognitive disability emerged, but CR did not seem to substantially influence outcome in this sample of patients, although quantitatively representative of the population.
Cognitive reserve in paediatric traumatic brain injury: Relationship with neuropsychological outcome
Evidence is found against the validity of this traditional reserve proxy when applied to the paediatric population of children with TBI, and measures used to indicate CR in adult populations are not valid indicators of cognitive reserve in paediatric populations.
Cognitive Reserve Protects Against Memory Decrements Associated With Neuropathology in Traumatic Brain Injury
A clinical cutoff below which CR is no longer protective, together with a possible neuropathology ceiling effect, may be instructive for prognostication and clinical decision-making in cognitive rehabilitation.
Cognitive Reserve in Individuals Aging With Traumatic Brain Injury: Independent and Interactive Effects on Cognitive Functioning
Findings suggest that the protective effects of CR are temporally delimited, potentially contending with declines in brain reserve, and traditional outcome determinants should be considered in the context of injury chronicity.
Neuropsychological Functioning in a National Cohort of Severe Traumatic Brain Injury: Demographic and Acute Injury–Related Predictors
Findings highlight cognitive consequences of severe TBI, with nearly two-thirds of patients showing cognitive impairments in at least 1 of 3 cognitive domains and only PTA duration was related to cognitive functioning.


Prediction of neuropsychiatric outcome following mild trauma brain injury: an examination of the Glasgow Coma Scale.
The results suggest that initial GCS scores do not clearly translate into neuropsychiatric sequelae at follow-up within the rubric of GCS 13-15, and a trend associating longer PTA with lower functional outcome was observed.
Brain morphology and intelligence
It is indicated that trauma‐induced atrophic brain changes are related neither to postinjury IQ nor focal lesion volume, however, patients with TBI with smaller brain size at the time of injury did have significantly lower postin injury IQ scores when compared to a matched group that had larger premorb...
The role of pre-injury IQ in the determination of intellectual impairment from traumatic head injury.
Consideration of pre-injury IQ can improve the determination of intellectual impairment from head injury and reduce the likelihood of false positives in clinical determinations.
Head trauma and intellectual status: relation to quantitative magnetic resonance imaging findings.
2 groups that sustained somewhat similar moderate to severe closed-head traumatic brain injury (TBI), but were deliberately selected to be different with regard to postinjury intellectual status--one group average or above, the other below.
Predicting premorbid neuropsychological functioning following pediatric traumatic brain injury.
  • K. Yeates, H. Taylor
  • Psychology, Medicine
    Journal of clinical and experimental neuropsychology
  • 1997
Premorbid neuropsychological functioning can be predicted in children with TBI, but with less precision than would be desirable for clinical purposes.
Long‐Term Neuropsychological Outcome After Traumatic Brain Injury
Neuropsychological recovery after TBI is not uniform across individuals and neuropsychological domains, and for a subset of persons with moderate to severe TBI, neuroPsychological recovery may continue several years after injury with substantial recovery.
Posttraumatic amnesia: its relation to functional outcome.
Nonspecific white matter degeneration following traumatic brain injury
Results demonstrate the diffuse nature of degeneration in TBI with more severe injury, and that quantified MR identified morphologic changes relate to neuropsychological outcome, and anatomic measures correlated with severity of injury and tests of memory and motor function.
Evaluating methods for estimating premorbid intellectual ability in closed head injury
Supportive evidence is provided for the use of the CCRT and NART in estimating premorbid intellectual functioning in patients who have sustained closed head injuries, but caution is suggested when employing the spot the word test (STW).
Relation of education to brain size in normal aging
The authors’ findings demonstrate a relation between education and age-related cortical atrophy in a nonclinical sample of elderly persons, and are consistent with the reserve hypothesis as well as with a small number of brain imaging studies in patients with dementia.