New Gist-Reasoning Tool Provides Insight on Traumatic Brain Injury

A new study from researchers at UT Dallas’ Center for BrainHealth shows that individuals with traumatic brain injury (TBI) have significantly more difficulty with gist reasoning than traditional cognitive tests.

Using a new cognitive assessment they developed, the researchers also found that post-TBI gist-reasoning ability helps predict the performance of daily life skills better than traditional cognitive tests alone. The findings were published recently in the Journal of Clinical and Experimental Neuropsychology.

“Assessing how well one understands and expresses big ideas from information they are exposed to, commonly known as an ability to ‘get the gist’, is a window into real-life functionality. I do not know of any other paper-and-pencil test that can tell us both,” said Dr. Asha Vas, research scientist at the Center for BrainHealth and lead author of the study.

The study featured 70 participants ages 25-55, including 30 who had a TBI one year or longer before the study. All the participants had similar socioeconomic status, educational backgrounds and IQ.

The participants were given a series of standard cognitive assessments, including working memory, inhibition and switching. They also received the researchers’ gist-reasoning assessment, which examines the number of gist-based ideas — not explicitly stated facts — they are able to abstract from multiple complex texts.

“Although performance on traditional cognitive tests is informative, widely used measures do not paint the full picture. Adults with TBI often fare average or above on these structured measures. All too often, adults with brain injury have been told that they ought to be fine. In reality, they are not doing and thinking like they used to prior to the injury and struggle managing everyday life responsibilities years after the injury,” Vas said.

“Gist reasoning could be a sensitive tool to connect some of those dots as to why they are having trouble with real-life functionality despite falling into the range of ‘normal’ on other cognitive tests.”

For the TBI group, daily life functions were evaluated with a self-rated questionnaire that included topics such as problem solving at work, managing finances, organizing grocery lists at home and social interactions.

Nearly 70 percent of the TBI group scored lower on gist reasoning compared to the other participants. The TBI participants’ decreased gist-reasoning performance showed a direct correlation with difficulties at work and at home. The results of all standard cognitive tests predicted daily function with 45 percent accuracy in individuals with TBI. Adding the gist-reasoning measure boosted the accuracy to 58 percent.

“TBI needs to be treated as a chronic condition. While acute recovery care is essential, long-term monitoring and effective interventions are necessary to mitigate persistent or later emerging deficits and ensure maximum brain regeneration and cognitive performance,” said Dr. Sandra Chapman, founder and chief director at the Center for BrainHealth and Dee Wyly Distinguished University Professor in the School of Behavioral and Brain Sciences.

“We don’t want anyone who has survived a TBI to think that if gist reasoning and day-to-day life is challenging today that it will always be that way, because gist reasoning can be improved.”

This research was made possible by a Friends of BrainHealth Distinguished New Scientist Award.

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