The relationship between cognition and vocational training outcome in patients with acquired brain injury: Contribution of Machine Learning

The aim of this study was to identify specific cognitive patterns related to long-term vocational training outcome. Records of twenty-eight patients who had benefited from a professional rehabilitation program were retrospectively processed. Screening through machine learning algorithms of patients’ neuropsychological scores identified cognitive patterns related to both vocational training outcomes: succeeded or failed. These patterns were based on cognitive performance intervals even if the cognitive ability was not impaired. The cognitive pattern related to a successful vocational training included performance intervals on measures underlying verbal memory consolidation, visual memory incidental recall, problem solving and planning abilities. The cognitive pattern explaining failure of vocational training included performance intervals on tasks involving planning and problem solving abilities. From a comprehensive neuropsychological battery, memory and executive measures appeared to be the best attributes related to the vocational training outcome in patients with brain injury. Even with a cognitive functioning above the pathological cutoff, patients suffering from a brain injury could fail a vocational training. The attributes related to the vocational training outcome would be more a specific level of cognitive functioning rather than an interpretation of neuropsychological scores only based on a normal versus pathological distinction.

本研究旨在明确与长期职业培训结局相关的特异性认知模式。本研究回顾性分析了28例曾受益于专业康复项目的患者的病历资料。通过机器学习算法对患者的神经心理学评分进行筛选，本研究识别出了与职业培训两种结局（成功或失败）均相关的认知模式。即使患者认知能力未受损，上述认知模式仍基于认知表现区间构建。与职业培训成功相关的认知模式，涵盖了言语记忆巩固、视觉记忆偶发回忆、问题解决与计划能力相关测评的表现区间；而解释职业培训失败的认知模式，则包含了涉及计划与问题解决能力的任务表现区间。在成套神经心理学测评中，记忆与执行功能测评指标被证实是脑损伤患者职业培训结局的最佳关联属性。即使脑损伤患者的认知功能高于病理临界值（cutoff），仍可能在职业培训中失败。与职业培训结局相关的关联属性，更应体现为认知功能的特异性水平，而非仅基于正常与病理二分法对神经心理学评分进行解读。