Abstract
Purpose/Objective: To compare the cognitive profiles of a well-characterized sample of adults with and without spinal cord injury (SCI) using the NIH Toolbox Cognition Battery NIHTB-CB. Research Method/Design: Participants were 156 community-dwelling individuals with SCI recruited from 3 academic medical centers, and 156 individuals without SCI selected from the NIHTB-CB normative database (N = 312). The main outcome measures were the demographically adjusted NIHTB-CB subtest and composite scores. Results: Individuals with and without SCI performed equivalently on the NIHTB-CB crystallized composite score, suggesting comparable premorbid functioning. Individuals with SCI produced lower scores on the NIHTB-CB fluid composite score by an average of 4.5 T-score points (Cohen's d = 0.50; a medium effect size). As a group, individuals with SCI had the most difficulty on tests of processing speed and executive functions, and some difficulty on a test of episodic memory, although effect sizes were small. These differences remained even after accounting for fine motor speed and dexterity. Individuals with tetraplegia produced lower scores than individuals with paraplegia on tests of processing speed and executive functioning. Conclusion/ Implications: Community-dwelling individuals with SCI are at elevated risk of mild cognitive difficulties, particularly on tasks that rely on processing speed and executive functions. The NIHTB-CB is relatively brief, samples important cognitive domains, has good normative data, and is appropriate for some individuals with SCI (those who have functional use of one hand). The battery has standardized accommodations for individuals with minor motor limitations, but timed tests are inaccessible for individuals who are unable to perform rapid button presses.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 425-434 |
| Number of pages | 10 |
| Journal | Rehabilitation Psychology |
| Volume | 62 |
| Issue number | 4 |
| DOIs | |
| State | Published - Nov 2017 |
Funding
An abstract based on earlier data was accepted for presentation as a poster at the 2016 Annual Conference of the International Spinal Cord Society. These data were also presented at the 2017 Annual Conference of the American Psychological Association’s Division 22 (Rehabilitation Psychology). This research was supported by Grant H133B090024, Principal Investigator (PI): Allen W. Heinemann, from the United States Department of Health and Human Services, National Institutes of Health (NIH), National Institute on Disability, Independent Living, and Research Rehabilitation (NIDILRR), as well as Psychosocial Research Postdoctoral Fellowships from the Craig H. Neilsen Foundation (Grant 290474, PI: Alex Wong and Grant 364962, PI: Matthew L. Cohen). Salary support for Matthew L. Cohen was also provided by an Institutional Development Award (IDeA) from the NIH, National Institute of General Medical Sciences, Grant U54-GM104941 (PI: Binder-Macleod). We thank their talented and dedicated research staff: Ana Miskovic, Arielle Goldsmith, Sara Jerousek, Sue Tucker, Jessica Dashner, Cathy Crawley, Ben Aziz, Julie Grech, Livia Vanden Belt, and Angela Miciura.
Keywords
- Cognition
- Neuropsychological tests
- Spinal cord injuries
ASJC Scopus subject areas
- Psychiatry and Mental health
- Clinical Psychology
- Rehabilitation
- Physical Therapy, Sports Therapy and Rehabilitation
