The impact of level of injury on patterns of cognitive dysfunction in individuals with spinal cord injury

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2019.1696076 · Published: September 1, 2020

Spinal Cord Injury Mental Health Neurology

Simple Explanation

This study investigated how the level of spinal cord injury (SCI) affects cognitive functions such as memory, attention, and processing speed. Researchers compared individuals with tetraplegia (C3-T1 injury level) and paraplegia (T2-T12 injury level) to a control group without SCI. The study revealed that individuals with paraplegia showed poorer performance in new learning and memory compared to the control group. Those with tetraplegia had impaired processing speed compared to controls, and both SCI groups had difficulty with verbal fluency. These findings suggest that different levels of SCI may lead to distinct patterns of cognitive deficits. Recognizing these differences can help tailor treatments to improve the quality of life for individuals with SCI.

Study Duration

October 2013-March 2016

Participants

59 individuals with SCI (30 with tetraplegia, 29 with paraplegia) and 30 age-matched healthy controls

Evidence Level

Cross-sectional, 3-group study

Key Findings

1
Individuals with paraplegia showed significantly lower performance on new learning and memory tests compared to healthy controls.
2
The tetraplegia group showed significantly impaired performance on a processing speed task compared to healthy controls.
3
Both the tetraplegia and paraplegia groups were similarly impaired on a verbal fluency measure compared to healthy controls.

Research Summary

This study examined the impact of spinal cord injury (SCI) lesion level on cognitive performance, comparing individuals with tetraplegia and paraplegia to healthy controls. Results indicated distinct patterns of cognitive deficits based on the level of injury. The paraplegia group showed impaired new learning and memory, while the tetraplegia group exhibited reduced processing speed compared to healthy controls. Both SCI groups demonstrated impaired verbal fluency. The findings suggest that level of injury may differentially affect cognitive performance in individuals with SCI, highlighting the importance of detailed neuropsychological assessments to identify and address specific cognitive deficits.

Practical Implications

Targeted Cognitive Rehabilitation

Rehabilitation programs can be tailored to address the specific cognitive deficits associated with different levels of SCI, such as memory training for individuals with paraplegia and processing speed training for those with tetraplegia.

Comprehensive Assessment

Clinicians should conduct comprehensive neuropsychological assessments to identify subtle cognitive changes that may not be detected by general screening measures.

Improved Quality of Life

Addressing cognitive deficits through appropriate screening and treatment can improve the quality of life, functional independence, and participation in society for individuals with SCI.

Study Limitations

1
The general lack of motor-free neuropsychological assessment measures limits the measures available.
2
Excluding individuals with comorbid or prior history of TBI may reduce generalization to the broader SCI population.
3
The sample size in the current research study was smaller than ideal.

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