Pediatric concussion working memory outcomes: a scoping review
Keelia Quinn de Launay1, Amanda Martino1, Lily Riggs1
1Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Insights
Pediatric concussion can negatively impact working memory (WM) in children and youth. Visual/spatial WM and dual-task performance appear more vulnerable than verbal WM following mild traumatic brain injury.
Area of Science:
- Neuroscience
- Pediatric neurology
- Cognitive psychology
Background:
- Concussion, or mild traumatic brain injury (mTBI), is common in children and youth.
- Working memory (WM) is crucial for cognitive function and development.
- Understanding the WM profile after pediatric concussion is essential for effective management.
Purpose of the Study:
- To systematically synthesize literature on the working memory (WM) profile in pediatric concussion.
- To characterize the neuropsychological outcomes related to WM following concussion in individuals under 21.
- To identify trends and specific WM deficits in youth after concussion.
Main Methods:
- Conducted a systematic literature search across major databases (MedLine, Embase, PsycINFO, CINAHL).
- Included English-language studies with extractable WM outcome data in individuals aged 21 and under post-concussion.
- Applied narrative synthesis and assessed study quality using NHLBI criteria.
Main Results:
- 40 articles met inclusion criteria; 34 compared concussion samples to controls or norms.
- 15 studies reported significantly lower WM performance in children and youth with concussion.
- Visual/spatial WM and performance under dual-task conditions were more consistently impaired than verbal WM.
Conclusions:
- Working memory (WM) is demonstrably vulnerable to negative outcomes after pediatric concussion.
- The specific nature and extent of WM deficits following concussion can be variable.
- Comprehensive, theoretically-driven WM assessments are recommended for clinicians and researchers.
Abstract:
Objective: Characterize the working memory (WM) profile of children and youth who have experienced concussion by systematically synthesizing existing literature on the neuropsychological outcomes of these injuries.Methods: Implemented a peer-reviewed search strategy combining key concepts of concussion/mild traumatic brain injury (mTBI), WM, and pediatrics across MedLine, Embase, PsycINFO, and CINAHL. Included studies written in English with extractable results on a WM outcome measure in individuals aged 21 and under who experienced concussion. Applied narrative synthesis to identify trends in the literature. Assessed risk of bias and quality using the NHLBI's Quality Assessment of Observational Cohort and Cross-Sectional Studies.Results: 40 articles met inclusion criteria. 34/40 studies compared WM performance in children or youth with concussion to healthy controls, pre-injury performance, or normative values, of which 15 reported significantly lower WM performance in the concussion sample. Visual/spatial WM was more consistently impacted than verbal WM. Cognitive demanding dual-task conditions were also reliably impacted.Conclusion: Literature indicated that WM is vulnerable to negative outcomes following pediatric concussion, yet the nature of outcomes is variable. Clinicians and researchers should implement comprehensive and theoretically motivated WM assessments to better understand the WM components impacted by injury.
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