@article{ref1,
title="The association between symptom burden and processing speed and executive functioning at 4 and 12 weeks following pediatric concussion",
journal="Journal of the International Neuropsychological Society",
year="2024",
author="Sicard, Veronik and Ledoux, Andrée-Anne and Tang, Ken and Yeates, Keith Owen and Brooks, Brian L. and Anderson, Peter and Keightley, Michelle and Désiré, Naddley and Beauchamp, Miriam H. and Zemek, Roger",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: Symptoms and cognition are both utilized as indicators of recovery following pediatric concussion, yet their interrelationship is not well understood. This study aimed to investigate: 1) the association of post-concussion symptom burden and cognitive outcomes (processing speed and executive functioning [EF]) at 4 and 12 weeks after pediatric concussion, and 2) the moderating effect of sex on this association. <br><br>METHODS: This prospective, multicenter cohort study included participants aged 5.00-17.99 years with acute concussion presenting to four Emergency Departments of the Pediatric Emergency Research Canada network. Five processing speed and EF tasks and the Post-Concussion Symptom Inventory (PCSI; symptom burden, defined as the difference between post-injury and retrospective [pre-injury] scores) were administered at 4 and 12 weeks post-concussion. Generalized least squares models were conducted with task performances as dependent variables and PCSI and PCSI*sex interaction as the main predictors, with important pre-injury demographic and injury characteristics as covariates. <br><br>RESULTS: 311 children (65.0% males; median age = 11.92 [IQR = 9.14-14.21 years]) were included in the analysis. After adjusting for covariates, higher symptom burden was associated with lower Backward Digit Span (χ(2) = 9.85, p =.043) and Verbal Fluency scores (χ(2) = 10.48, p =.033) across time points; these associations were not moderated by sex, ps ≥.20. Symptom burden was not associated with performance on the Coding, Continuous Performance Test, and Color-Word Interference scores, ps ≥.17. <br><br>CONCLUSIONS: Higher symptom burden is associated with lower working memory and cognitive flexibility following pediatric concussion, yet these associations were not moderated by sex. <br><br>FINDINGS may inform concussion management by emphasizing the importance of multifaceted assessments of EF.<p /> <p>Language: en</p>",
language="en",
issn="1355-6177",
doi="10.1017/S1355617724000043",
url="http://dx.doi.org/10.1017/S1355617724000043"
}