Recovery versus retest effects in attention after closed head injury

Recovery in 60 patients with a closed-head injury (CHI) in the first year p osttrauma was assessed repeatedly with a series of attention tests. A match ed group of healthy subjects was tested at the same intervals to allow us t o control for practice effects. The results of a multilevel analysis for lo ngitudinal data show retest effects in all but one of the tests. Patients p erformed more poorly on all tests, but their results on each test appeared to show recovery over time. The indicator of recovery was an improvement in test performance that was greater than the retest effect shown by the cont rols. On most tests, the performance of the more severely injured patients was initially worse, but showed more recovery over time. Test results diffe red with respect to changes over time, sensitivity to severity of injury, a nd subject specific characteristics Like age and vocational level. Recovery rate was not related to age or vocational status. Despite their recovery, the patient group was still impaired 1 year posttrauma on all tests sensiti ve to mental slowness. Outcome after 1 year, scored on a modified Glasgow O utcome Scale, was predicted to a small extent by PTA duration and initial p erformance on the RT-Distraction task. Return to work 2 to 5 years posttrau ma was predicted by initial performance and improvement over time on the St roop Color Word Test.