Executive functions and attention 7 years after severe childhood traumatic brain injury: results of the Traumatisme Grave de l’Enfant (TGE) cohort

Abstract Objectives: Severe childhood traumatic brain injury (TBI) leads to long-standing executive function and attention deficits, with negative consequences for participation, academic outcome and independence. This study aimed to assess executive function and attention 7 years after severe childhood TBI in comparison with a matched control group and to investigate associated factors. Methods: Children ( Results: Among the 27 participants, mean (SD) age at injury was 7.7 (4.6) years, and mean length of coma 5.6 (4.6) days. Regarding the TAP, the number of errors was significantly higher (p = 0.003) and reaction time marginally slower (p = 0.08) in the TBI than control group. The BRIEF questionnaire completed by parents indicated significantly more executive difficulties in the TBI than control group (Behavior Regulation Index, p = 0.005; Metacognitive index, p = 0.02; Global Executive Composite, p = 0.012). Correlations between BRIEF and TAP scores did not reach statistical significance. BRIEF total score was correlated moderately with length of coma (r = 0.40, p = 0.037), and TAP scores were correlated with the Full-Scale Intellectual Quotient (total number of errors: r = -0.48; p = 0.01; mean reaction time: r = -0.51; p = 0.009). Conclusions: Executive and attention deficits were evident 7 years after severe childhood TBI. Computerized tasks and questionnaires provide complementary and non-redundant information. Systematic long-term follow-up should be provided until the transition to adulthood, to assess ongoing development and to implement timely tailored interventions.