• Christian Oldenburg, Anders Lundin, Gunnar Edman, Catharina Nygren-de Boussard, and Aniko Bartfai.
• a Department of Clinical Sciences , Karolinska Institute and Department of Rehabilitation Medicine Stockholm , Danderyd University Hospital , Stockholm , Sweden.
• Brain Inj. 2016 Jan 1; 30 (2): 146-55.

Primary ObjectiveHaving three or more persisting (i.e. > 3 months) post-concussion symptoms (PCS) affects a significant number of patients after a mild traumatic brain injury (mTBI). A common complaint is cognitive deficits. However, several meta-analyses have found no evidence of long-term cognitive impairment in mTBI patients. The study sought to answer two questions: first, is there a difference in cognitive performance between PCS and recovered mTBI patients? Second, is lower cognitive reserve a risk factor for developing PCS?Research DesignProspective inception cohort study.Methods And ProcedureOne hundred and twenty-two adult patients were recruited from emergency departments within 24 hours of an mTBI. Three months post-injury, participants completed the Rivermead Post Concussion Symptoms Questionnaire and a neuropsychological assessment. A healthy control group (n = 35) were recruited. The estimate of cognitive reserve was based upon sub-test Information from Wechsler Adult Intelligence Scale and international classifications of educational level and occupational skill level.Main Outcome And ResultsmTBI patients showed reduced memory performance. Patients with lower cognitive reserve were 4.14-times more likely to suffer from PCS.ConclusionsmTBI may be linked to subtle executive memory deficits. Lower cognitive reserve appears to be a risk factor for PCS and indicates individual vulnerabilities.

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