Identifying the type of neuropsychological symptoms early post TBI is necessary in order to properly guide the patient at discharge of the acute care hospital and start rehabilitation as early as possible. The RBANS (FAB) assesses verbal memory through a list learning task (10 words repeated four times) and a short story learning task (12 items put within a context repeated twice) using an immediate and delayed recall. TBI patients were assessed using the RBANS in order to compare memory deficits according to TBI severity and link deficits to lesion severity.
While admitted to a tertiary care center following a TBI, 72 TBI patients between 18 and 76 years of age (M=43.7±4.7) and of which 34.4% (n=31) were females were tested. The number of days between the accident and the evaluation varied between 1 and 55 days (M=7.4, SD=± 5.6). There was no significant relationship between the severity of the TBI and the number of days between the accident and testing (χ2=3.12, p=.21). Most of the patients had a GCS score of 14 or 15 at the time of accident (n = 68, 75.6%), indicating a mild TBI, and most had experienced loss of consciousness (n = 67, 75.3%). On the List Learning Task, patients recalled a total average of 25.4±5.7 words over fours trials and recalled 4.7±2.7 of the 10 words during the delayed recall. As for the Story Learning Task, they recalled 16.5±4.4 items over two trials during the immediate recall and recalled 8.1±2.8 out of the 12 possible items later. When controlling for age, there was no significant difference between TBI severity levels in the immediate recalls of the List Learning (F(2,67) = 1.12, p = .331) and the Story Learning (F(2,67) = .47, p = .627) tests. However, as the TBI severity increased, the average delayed recall of the List Learning task decreased marginally (F(2,64) = 3.11, p = .051). As for the Story delayed recall, no significant difference was found between TBI severity (χ22df = .930, p = .628). Moreover, there was no statistically significant difference between Marshall category groups (i.e., classification of brain lesion localization) between the combined scores of the immediate recalls of both tasks (F(4,63)=.53, p=.711), nor in their delayed recall (χ24df=3.515, p=.515).
Thus, the delayed recall of the List Learning task may be the most sensitive measure between TBI severity levels. Although these results are below the norms expected for healthy controls as provided by the original RBANS publication, they also reveal that TBI severity classification and brain lesions severity should not be based on memory testing even early on in the acute phase.

Exploring verbal memory in TBI patients in acute care using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)