Which of the following is NOT a typical long-term cognitive sequela after moderate-severe TBI?

• A. Auditory discrimination
• B. Attention impairment
• C. Memory impairment
• D. Processing speed impairment

Answer: (A)

After a moderate to severe TBI, lingering cognitive problems usually involve higher-order thinking processes that rely on widespread brain networks, especially attention, memory, and how quickly information is processed. Attention deficits reflect difficulties sustaining, shifting, or filtering attention, often tied to frontal-subcortical circuits. Memory issues commonly arise from disruptions in memory encoding and retrieval, involving the temporal lobes and hippocampus. Processing speed impairment stems from diffuse white matter disruption and slower neural transmission, which slows overall cognitive functioning.

Auditory discrimination—the ability to distinguish different sounds or phonemes—is primarily a sensory-perceptual function. In most cases, this basic perceptual skill remains intact in the long term, unless there is specific injury to the auditory pathways or a central auditory processing disorder. So, while attention, memory, and processing speed tend to be persistent cognitive sequelae after moderate-severe TBI, auditory discrimination is not typically a long-term cognitive deficit.