Differences in narrative discourse ability in traumatic brain injury and a neurotypical comparison group: Influence of age, education, and sex.

Abstract

To examine the influence of traumatic brain injury (TBI) on narrative discourse comprehension and production of individuals with TBI compared to a non-brain-injured (NBI) group. Further, this work investigated the potential influence of socio-demographic factors (i.e., age, education, sex) on narrative discourse performance. Case-control design SETTING: General community PARTICIPANTS: A total of 44 adults were grouped into two age- and education-matched cohorts. The TBI group comprised 21 participants with mild-moderate cognitive impairment, and the NBI comprised 23 participants. Not applicable MAIN OUTCOME MEASURES: Narrative discourse outcomes were measured by two comprehension measures (Discourse Comprehension Test, picture story comprehension task) and two production measures (story grammar, story completeness). Four univariate analyses of covariance (ANCOVA) were performed with age, education, and sex as covariates. The ANCOVAs were performed using parameter estimates with robust standard errors, and boxplots were constructed to understand differences between cohorts for each discourse measure. No sociodemographic variables (i.e., the covariates) were significant for any of the four discourse measures. The NBI group outperformed the TBI group on the DCT (p = .003, 95% CI [1.46, 6.82], partial η² = .20), PSC (p = .005, 95% CI [.61, 3.26], partial η² = .18), and story completeness (p = .005, 95% CI [.43, 2.26], partial η² = .21). Effect sizes were large across these three discourse measures. No significant difference between groups was found for story grammar (p = .440, 95% CI [-.11, .25], partial η² = .02). TBI disrupts both narrative discourse comprehension and production ability. Findings underscore the need to evaluate both narrative comprehension and production performance following TBI. Age, education, and sex did not influence discourse outcomes.