Neurocognition after motor vehicle collision and adverse post-traumatic neuropsychiatric sequelae within 8 weeks: Initial findings from the AURORA study
Background: Previous work has indicated that differences in neurocognitive functioning may predict the development of adverse post-traumatic neuropsychiatric sequelae (APNS). Such differences may be vulnerability factors or simply correlates of APNS-related symptoms. Longitudinal studies that measure neurocognitive functioning at the time of trauma are needed to determine whether such differences precede the development of APNS.
Methods: Here, we present findings from a subsample of 666 ambulatory patients from the AURORA (Advancing Understanding of RecOvery afteR traumA) study. All patients presented to EDs after a motor vehicle collision (MVC). We examined associations of neurocognitive test performance shortly after MVC with peritraumatic symptoms in the ED and APNS (depression, post-traumatic stress, post-concussive symptoms, and pain) 2 weeks and 8 weeks later. Neurocognitive tests assessed processing speed, attention, verbal reasoning, memory, and social perception.
Results: Distress in the ED was associated with poorer processing speed and short-term memory. Poorer short-term memory was also associated with depression at 2 weeks post-MVC, even after controlling for peritraumatic distress. Finally, higher vocabulary scores were associated with pain 2 weeks post-MVC.
Limitations: Self-selection biases among those who present to the ED and enroll in the study limit generalizability. Also, it is not clear whether observed neurocognitive differences predate MVC exposure or arise in the immediate aftermath of MVC exposure.
Conclusions: Our results suggest that processing speed and short-term memory may be useful predictors of trauma-related characteristics and the development of some APNS, making such measures clinically-relevant for identifying at-risk individuals.
Keywords: cognition; digital cognitive assessment; digital neuropsychology; longitudinal; neuropsychology; trauma.
Germine LT, Joormann J, Passell E, Rutter LA, Scheuer L, Martini P, Hwang I, Lee S, Sampson N, Barch DM, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Linnstaedt SD, Jovanovic T, Clifford GD, Neylan TC, Rauch SL, Lewandowski C, Hendry PL, Sheikh S, Storrow AB, Musey PI Jr, Jones CW, Punches BE, McGrath ME, Pascual JL, Mohiuddin K, Pearson C, Peak DA, Domeier RM, Bruce SE, Rathlev NK, Sanchez LD, Pietrzak RH, Pizzagalli DA, Harte SE, Elliott JM, Koenen KC, Ressler KJ, McLean SA, Kessler RC. Neurocognition after motor vehicle collision and adverse post-traumatic neuropsychiatric sequelae within 8 weeks: Initial findings from the AURORA study. J Affect Disord. 2021 Nov 17:S0165-0327(21)01171-X. doi: 10.1016/j.jad.2021.10.104. Epub ahead of print.