@article{ref1,
title="Latent profile analysis of neuropsychiatric symptoms and cognitive function of adults 2 weeks after traumatic brain injury: findings from the TRACK-TBI Study",
journal="JAMA network open",
year="2021",
author="Brett, Benjamin L. and Kramer, Mark D. and Whyte, John and McCrea, Michael A. and Stein, Murray B. and Giacino, Joseph T. and Sherer, Mark and Markowitz, Amy J. and Manley, Geoffrey T. and Nelson, Lindsay D. and Adeoye, Opeolu and Badjatia, Neeraj and Boase, Kim and Barber, Jason and Bodien, Yelena and Bullock, M. Ross and Chesnut, Randall and Corrigan, John D. and Crawford, Karen and Diaz-Arrastia, Ramon and Dikmen, Sureyya and Duhaime, Ann-Christine and Ellenbogen, Richard and Feeser, V. Ramana and Ferguson, Adam R. and Foreman, Brandon and Gardner, Raquel and Gaudette, Étienne and González, Luis and Gopinath, Shankar and Gullapalli, Rao and Hemphill, J. Claude and Hotz, Gillian and Jain, Sonia and Keene, C. Dirk and Korley, Frederick K. and Kramer, Joel and Kreitzer, Natalie and Levin, Harvey and Lindsell, Chris and Machamer, Joan and Madden, Christopher and Martin, Alastair and McAllister, Thomas and Merchant, Randall and Mukherjee, Pratik and Ngwenya, Laura B. and Noel, Florence and Okonkwo, David and Palacios, Eva and Puccio, Ava and Rabinowitz, Miri and Robertson, Claudia and Rosand, Jonathan and Sander, Angelle and Satris, Gabriella and Schnyer, David and Seabury, Seth and Taylor, Sabrina and Temkin, Nancy and Toga, Arthur and Valadka, Alex and Vassar, Mary and Wang, Kevin and Yue, John K. and Yuh, Esther and Zafonte, Ross",
volume="4",
number="3",
pages="e213467-e213467",
abstract="IMPORTANCE: Heterogeneity across patients with traumatic brain injury (TBI) presents challenges for clinical care and intervention design. Identifying distinct clinical phenotypes of TBI soon after injury may inform patient selection for precision medicine clinical trials. <br><br>OBJECTIVE: To investigate whether distinct neurobehavioral phenotypes can be identified 2 weeks after TBI and to characterize the degree to which early neurobehavioral phenotypes are associated with 6-month outcomes. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included patients presenting to 18 US level 1 trauma centers within 24 hours of TBI from 2014 to 2019 as part of the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Data were analyzed from January 28, 2020, to January 11, 2021. EXPOSURES: TBI. MAIN OUTCOMES AND MEASURES: Latent profiles (LPs) were derived from common dimensions of neurobehavioral functioning at 2 weeks after injury, assessed through National Institutes of Health TBI Common Data Elements (ie, Brief Symptom Inventory-18, Patient Health Questionnaire-9 Depression checklist, Posttraumatic Stress Disorder Checklist for DSM-5, PROMIS Pain Intensity scale, Insomnia Severity Index, Rey Auditory Verbal Learning Test, Wechsler Adult Intelligence Scale-Fourth Edition Coding and Symbol Search subtests, Trail Making Test, and NIH Toolbox Cognitive Battery Pattern Comparison Processing Speed, Dimensional Change Card Sort, Flanker Inhibitory Control and Attention, and Picture Sequence Memory subtests). Six-month outcomes were the Satisfaction With Life Scale (SWLS), Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS), Glasgow Outcome Scale-Extended (GOSE), and Rivermead Post-Concussion Symptoms Questionnaire (RPQ). <br><br>RESULTS: Among 1757 patients with TBI included, 1184 (67.4%) were men, and the mean (SD) age was 39.9 (17.0) years. LP analysis revealed 4 distinct neurobehavioral phenotypes at 2 weeks after injury: emotionally resilient (419 individuals [23.8%]), cognitively impaired (368 individuals [20.9%]), cognitively resilient (620 individuals [35.3%]), and neuropsychiatrically distressed (with cognitive weaknesses; 350 individuals [19.9%]). Adding LP group to models including demographic characteristics, medical history, Glasgow Coma Scale score, and other injury characteristics was associated with significantly improved estimation of association with 6-month outcome (GOSE R2 increase = 0.09-0.19; SWLS R2 increase = 0.12-0.22; QOLIBRI-OS R2 increase = 0.14-0.32; RPQ R2 = 0.13-0.34). <br><br>CONCLUSIONS AND RELEVANCE: In this cohort study of patients with TBI presenting to US level-1 trauma centers, qualitatively distinct profiles of symptoms and cognitive functioning were identified at 2 weeks after TBI. These distinct phenotypes may help optimize clinical decision-making regarding prognosis, as well as selection and stratification for randomized clinical trials.<p /> <p>Language: en</p>",
language="en",
issn="2574-3805",
doi="10.1001/jamanetworkopen.2021.3467",
url="http://dx.doi.org/10.1001/jamanetworkopen.2021.3467"
}