Mathematical models of cognitive recovery

Abstract

Longitudinal psychological test results are used as dependent variables to explore the complex relationship between length of coma, time of testing on the recovery curve, and corresponding cognitive status after traumatic brain injury (TBI). A database containing 319 TBI patients with a broad spectrum of coma duration was used. Statistical analysis of mixed effects modelling was applied to longitudinal WAIS-R (Wechsler Adult Intelligence Scale-Revised) scores to construct two mathematical models (verbal IQ and performance IQ). The models predict the course of recovery (initial cognitive level post-coma, eventual recovery level, and level of cognitive functioning at any point on the recovery curve) when the duration of coma is known. Performance IQ was found to recover at a rate that is almost four times slower than verbal IQ. The results have important clinical rehabilitation implications. This statistical modelling technique also enables the medical researcher to investigate disease progression or recovery using structured assessments, which would normally be part of the routine medical monitoring.