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Type: Journal article
Title: Contribution of brain or biological reserve and cognitive or neural reserve to outcome after TBI: a meta-analysis (prior to 2015)
Author: Mathias, J.
Wheaton, P.
Citation: Neuroscience and Biobehavioral Reviews, 2015; 55:573-593
Publisher: Elsevier
Issue Date: 2015
ISSN: 0149-7634
Statement of
Jane L. Mathias, Patricia Wheaton
Abstract: Brain/biological (BR) and cognitive/neural reserve (CR) have increasingly been used to explain some of the variability that occurs as a consequence of normal ageing and neurological injuries or disease. However, research evaluating the impact of reserve on outcomes after adult traumatic brain injury (TBI) has yet to be quantitatively reviewed. This meta-analysis consolidated data from 90 studies (published prior to 2015) that either examined the relationship between measures of BR (genetics, age, sex) or CR (education, premorbid IQ) and outcomes after TBI or compared the outcomes of groups with high and low reserve. The evidence for genetic sources of reserve was limited and often contrary to prediction. APOE ∈4 status has been studied most, but did not have a consistent or sizeable impact on outcomes. The majority of studies found that younger age was associated with better outcomes, however most failed to adjust for normal age-related changes in cognitive performance that are independent of a TBI. This finding was reversed (older adults had better outcomes) in the small number of studies that provided age-adjusted scores; although it remains unclear whether differences in the cause and severity of injuries that are sustained by younger and older adults contributed to this finding. Despite being more likely to sustain a TBI, males have comparable outcomes to females. Overall, as is the case in the general population, higher levels of education and pre-morbid IQ are both associated with better outcomes.
Keywords: Traumatic brain injury; reserve; brain reserve; biological reserve; cognitive reserve; outcome; meta-analysis
Rights: Crown Copyright © 2015 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (
RMID: 0030032222
DOI: 10.1016/j.neubiorev.2015.06.001
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Appears in Collections:Psychology publications

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