{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:26Z","timestamp":1792787726054,"version":"4.5.0"},"reference-count":77,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs Program","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Joseph & Antoinette Sorbara Foundation"},{"DOI":"10.13039\/501100000241","name":"Physicians\u2019 Services Incorporated Foundation","doi-asserted-by":"publisher","award":["12-43"],"award-info":[{"award-number":["12-43"]}],"id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Walter and Maria Schroeder Foundation"},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP 86704"],"award-info":[{"award-number":["MOP 86704"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Moderate-severe traumatic brain injury (TBI) has been associated with progressive cognitive decline in the chronic injury stages in a small number of studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to (i) replicate our previous findings of decline from 1 to 3+\u2009years post-injury in a larger, non-overlapping sample and (ii) extend these findings by examining the proportion of decliners in 2 earlier time windows, and by investigating novel predictors of decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>N\u2009=\u200948 patients with moderate-severe TBI underwent neuropsychological assessment at 2, 5, 12\u2009months, and 30+\u2009months post-injury. We employed the Reliable Change Index (RCI) to evaluate decline, stability and improvement across time and logistic regression to identify predictors of decline (demographic\/cognitive reserve; injury-related).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The proportions of patients showing decline were: 12.5% (2-5\u2009months post-injury), 17% (5-12\u2009months post-injury), and 27% (12-30+\u2009months post-injury). Measures of verbal retrieval were most sensitive to decline. Of the predictors, only left progressive hippocampal volume loss from 5 to 12\u2009months post-injury significantly predicted cognitive decline from 12 to 30+\u2009months post-injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Identical to our previous study, 27% of patients declined from 12 to 30+\u2009months post-injury. Additionally, we found that the further from injury, the greater the proportion of patients declining. Importantly, earlier progressive hippocampal volume loss predicted later cognitive decline. Taken together, the findings highlight the need for ongoing research and treatment that target these deleterious mechanisms affecting patients in the chronic stages of moderate-severe TBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683231212861","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T05:43:45Z","timestamp":1700631825000},"page":"799-809","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Moderate-Severe TBI as a Progressive Disorder: Patterns and Predictors of Cognitive Declines in the Chronic Stages of Injury"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9451-3963","authenticated-orcid":false,"given":"Robin E. 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