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BMC Neurology
Published in: BMC Neurology 1/2020

01-12-2020 | Central Nervous System Trauma | Study protocol

A prospective cohort study investigating contributors to mild cognitive impairment in adults with spinal cord injury: study protocol

Authors: Danielle Sandalic, Ashley Craig, Mohit Arora, Ilaria Pozzato, Grahame Simpson, Bamini Gopinath, Jasbeer Kaur, Sachin Shetty, Gerard Weber, Ian Cameron, Yvonne Tran, James Middleton

Published in: BMC Neurology | Issue 1/2020

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Abstract

Background

Studies report rates of mild cognitive impairment (MCI) in spinal cord injury (SCI) range between 10 and 60%. This broad estimate of MCI in SCI is most likely a result of: (i) inconsistent operationalization of MCI; (ii) heterogeneity among individuals with SCI; (iii) failure to account for MCI subtypes, thereby adding to the heterogeneity of samples; and, (iv) poor control for traumatic brain injury (TBI) that obscures differentiation of MCI attributable to TBI versus other factors. There is a paucity of longitudinal studies following the course of MCI in SCI, and none that account for multiple predictors of MCI, including interactions among predictors.

Methods

An inception cohort longitudinal study will assess approximately 100 individuals aged 17–80 years with acute SCI, with measures taken at three timepoints (baseline, 3 months post-baseline, and 12 months post-injury). Data relevant to medical care received within the first 24–48 h of presentation to the emergency department will be analysed, as will measures of cognition, injury characteristics, medical history, personal factors, psychological status, psychosocial functioning, and quality of life. Latent class mixture modelling will determine trajectories for the primary outcome of interest, cognitive functioning and its subtypes, and secondary outcomes of interest such as depression. Multiple regression analyses will identify predictors of MCI and its subtypes.

Discussion

The prospective design will reveal change in cognitive functioning across time and unveil different outcome trajectories; thus addressing the lack of knowledge on trajectories of MCI and MCI subtypes in SCI. Through subtyping MCI, we hope to yield groups of cognitively impaired individuals with SCI that are potentially more homogenous and thereby stable and predictable. This is the first study to capture emergency department and acute care diagnostic evidence of mild TBI, which has been poorly controlled in previous studies. Our study will also be the first to distinguish the contribution of TBI from other factors to the development of MCI in individuals with SCI.

Trial registration

The study was prospectively registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12619001702​101) on 3rd December 2019.
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Metadata
Title
A prospective cohort study investigating contributors to mild cognitive impairment in adults with spinal cord injury: study protocol
Authors
Danielle Sandalic
Ashley Craig
Mohit Arora
Ilaria Pozzato
Grahame Simpson
Bamini Gopinath
Jasbeer Kaur
Sachin Shetty
Gerard Weber
Ian Cameron
Yvonne Tran
James Middleton
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-020-01899-7

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