Relationship among apathy, cognition, and real-world disability after mild traumatic brain injury

It is well established that most people recover soon after a mild traumatic brain injury (mTBI), yet protracted neuropsychological impairment is evident in many individuals. We sought to elucidate the relationship between apathy and neuropsychological impairment and disability as it pertains to real-world function in patients who sustained a mTBI reporting and demonstrating protracted neuropsychological impaired (i.e., more than three months post-injury). We employed a battery of neuropsychological and psychological measures, along with a measure of apathy in 104 patients who sustained a mTBI reporting neuropsychological complaints (38 in the not disabled group and 66 in the disabled group). Their ability to return to work was used as proxy for real-world disability. Specific deficits in verbal fluency, memory, and information processing predicted real-world disability but apathy did not, suggesting that psychological factors may play less of a mediating role than specific neuropsychological factors in the relationship between impairment and real world disability. Our research furthers our understanding of the cognitive and psychological differences that exist in patients with mTBI who have real-world disability compared to those who do not.