Early and long-term outcomes of cognitive communication disorders following traumatic brain injury at our institution

Abstract

Background: Traumatic brain injury (TBI) is a leading cause of disability worldwide and is frequently associated with cognitive impairments affecting domains relevant to communication, which may be under-recognized, particularly after mild TBI (mTBI). Understanding the evolution of these deficits from the acute to chronic phase is essential for guiding assessment and rehabilitation. Methods: This retrospective observational study included patients with closed mTBI admitted to a tertiary referral trauma center between December 2023 and October 2025. Global cognitive performance, including domains relevant to communication, was assessed using the Arabic version of the Montreal Cognitive Assessment (MoCA) on admission, at 3 months, and at 12 months post-injury. Demographic, clinical, and radiological data were collected. Changes in MoCA scores over time were analyzed. Results: A total of 364 patients were analyzed (mean age 27.45 ± 16.46 years; 79.1% males). The mean MoCA score on admission was 18.3 ± 3.2, indicating significant early cognitive impairment. Scores improved significantly at 3 months (25.1 ± 2.7) and at 12 months (29.0 ± 1.1) ( p < 0.0001). Most recovery occurred within the first 3 months, with continued improvement up to 1 year. Conclusion: mTBI is associated with significant early cognitive impairment followed by substantial recovery over time. While global cognitive scores normalize in most patients, subtle higher-level deficits may persist, underscoring the importance of structured longitudinal assessment and multidisciplinary follow-up.