Disclosures: Kristen Milleville: Nothing to disclose

Objective: To examine post-acute serum inflammatory marker associations and cognitive performance at 6 and 12 months after moderate-to-severe TBI using a weighted inflammatory load score (wILS).

Design: Prospective Cohort Study evaluating serum inflammation levels 0-3 months post-injury.

Setting: Inpatient rehabilitation and community up to 12 months post-injury.

Participants: Adults with moderate-to-severe TBI who completed neuropsychological testing 6 months (n=118) or 12 months (n=121) post-injury.

Interventions: Not applicable

Main Outcome Measures: Nine neuropsychological tests categorized into the domains of verbal fluency, memory, attention and processing speed, and executive function. Overall cognitive composite scores were created as mean of normalized mean T-score values for each cognitive domain. Cognitive domain wILS were also generated.

Results: wILS values were generated using a 2-step process: 1) standardized serum cytokine levels associated with 6 or 12-month cognitive composite scores (P<.10) were assessed using multivariable linear regression. 2) Standardized levels of each marker were then multiplied by β-values generated from these linear regressions and summed to generate each wILS. Multivariable linear regression assessed associations between wILS and cognitive composite scores with covariates of age, education, and GCS. wILS added 8.43% and 10.36% additional variance capture for multivariable models at 6 and 12 months, respectively. For each 1-unit increase in wILS, overall cognitive composite T-scores increased by β=1.02931 (P=.0005) at 6 months and by β=0.90270 (P=<.0001) at 12 months. Domain specific wILS discriminated performance on domain-specific cognitive composite scores including memory, verbal fluency, attention and processing speed, and executive function.

Conclusions: Post-acute inflammatory profiles are associated with cognitive performance at both 6 and 12 months post-TBI. Compared to previous unweighted ILS in TBI, this wILS utilizes fewer markers to explain greater variance in cognitive composite scores, i.e. wILS more efficiently and effectively describes post-TBI effects of inflammation on cognitive recovery. Identifying inflammatory relationships to outcome post-TBI may suggest potential interventions to improve recovery post-TBI.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/post-acute-systemic-inflammation-and-cognition-after-tbi-a-follow-up-study/