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The Role of Preinjury Cognitive Function in Future Traumatic Brain Injury and Functional Recovery
Wivi Taalas1, Rahul Raj1, Jari Siironen1
1Neurosurgery, Helsinki University Hospital, Finland.
Neurology
|October 16, 2025
Summary
Lower cognitive function (CF) is linked to incomplete recovery after traumatic brain injury (TBI). Individuals with TBI also showed lower pre-injury CF compared to controls, suggesting CF may impact TBI susceptibility.
Area of Science:
- Neuroscience
- Traumatic Brain Injury Research
- Cognitive Psychology
Background:
- Cognitive function (CF) is a critical factor influencing outcomes after traumatic brain injury (TBI).
- Previous studies often rely on estimated pre-TBI CF, necessitating research using measured preinjury cognitive abilities.
- Understanding the relationship between preinjury CF and TBI susceptibility is crucial for prevention and rehabilitation strategies.
Purpose of the Study:
- To investigate the association between measured preinjury cognitive function (CF) and functional outcomes following traumatic brain injury (TBI).
- To determine if cognitive function differs between individuals who sustain a TBI and those who do not.
- To explore the role of preinjury CF as a potential predisposing factor for TBI.
Main Methods:
- Retrospective observational study of Finnish male conscripts treated for TBI at Helsinki University Hospital (1997-2020).
- Cognitive function assessed using the Finnish Defense Forces P1 test (visuospatial, verbal, arithmetic abilities).
- Functional outcome measured by the 6-month Glasgow Outcome Scale (GOS); logistic regression used to analyze associations, adjusting for age and TBI severity. Mann-Whitney U tests compared CF between TBI patients and non-TBI controls.
Main Results:
- A significant association was found between lower preinjury cognitive function (CF) and incomplete recovery (GOS 1-4) after TBI (OR, 0.86; 95% CI, 0.76-0.96).
- Patients with TBI exhibited significantly lower preinjury CF compared to non-TBI controls (p < 0.001).
- Among TBI patients with available data (n=377), 18% experienced unfavorable outcomes (GOS 1-3) and 55% had incomplete recovery.
Conclusions:
- Preinjury cognitive function is associated with recovery outcomes after traumatic brain injury.
- Lower cognitive function in individuals with TBI suggests a potential role in TBI susceptibility.
- Findings highlight the importance of preinjury cognitive status in TBI research, though generalizability is limited by single-center, male-only cohort.
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