Higher education associated with better recovery from traumatic brain injury

PUBLIC RELEASE DATE:

23-Apr-2014

Contact: Stephanie Desmon sdesmon1@jhmi.edu 410-955-8665 Johns Hopkins Medicine

Better-educated people appear to be significantly more likely to recover from a moderate to severe traumatic brain injury (TBI), suggesting that a brain's "cognitive reserve" may play a role in helping people get back to their previous lives, new Johns Hopkins research shows.

The researchers, reporting in the journal Neurology, found that those with the equivalent of at least a college education are seven times more likely than those who didn't finish high school to be disability-free one year after a TBI serious enough to warrant inpatient time in a hospital and rehabilitation facility.

The findings, while new among TBI investigators, mirror those in Alzheimer's disease research, in which higher educational attainment believed to be an indicator of a more active, or more effective, use of the brain's "muscles" and therefore its cognitive reserve has been linked to slower progression of dementia.

"After this type of brain injury, some patients experience lifelong disability, while others with very similar damage achieve a full recovery," says study leader Eric B. Schneider, Ph.D., an epidemiologist at the Johns Hopkins University School of Medicine's Center for Surgical Trials and Outcomes Research. "Our work suggests that cognitive reserve the brain's ability to be resilient in the face of insult or injury could account for the difference."

Schneider conducted the research in conjunction with Robert D. Stevens. M.D., a neuro-intensive care physician with Johns Hopkins' Department of Anesthesiology and Critical Care Medicine.

For the study, the researchers studied 769 patients enrolled in the TBI Model Systems database, an ongoing multi-center cohort of patients funded by the National Institute on Disability and Rehabilitation Research. The patients had been hospitalized with a moderate to severe TBI and subsequently admitted to a rehabilitation facility.

Of the 769 patients, 219 or 27.8 percent were free of any detectable disability one year after their injury. Twenty-three patients who didn't complete high school 9.7 percent of those at that education level recovered, while 136 patients with between 12 and 15 years of schooling 30.8 percent of those at that educational level did. Nearly 40 percent of patients 76 of the 194 who had 16 or more years of education fully recovered.

Read more:
Higher education associated with better recovery from traumatic brain injury