Soury S, Mazaux J M, Lambert J, De Seze M, Joseph P A, Lozes-Boudillon S, McCauley S, Vanier M, Levin H S
Unité UEROS, service MP réadaptation, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France.
Ann Readapt Med Phys. 2005 Mar;48(2):61-70. doi: 10.1016/j.annrmp.2004.08.007. Epub 2005 Jan 15.
Cognitive and behavioral impairment are a major source of disability in daily living of patients with traumatic brain injury (TBI). The Neurobehavioral Rating Scale-Revised (NRS-R) is a short, easy-to administer interview tool developed to improve assessment by clinicians. Data are available on its criterion validity and reliability, but the concurrent validity of the French NRS-R was not yet documented.
To assess the concurrent validity of the NRS-R with current psychometric tests.
One hundred and four patients with TBI enrolled in a community adjustment program underwent concurrent examination with the NRS-R, cognitive tests assessing memory, attention, and executive functions, and scales of anxiety (STAI) and depressive mood (CES-D). Intercorrelations were undertaken between these variables and the five factors of the NRS-R: F1, intentional behavior; F2, lowered emotional state; F3, survival-oriented behaviour/hightened emotional state; F4, arousal state; and F5, language. Patients were 82 men and 22 women, the mean age was 28.5 years, and 70% had severe TBI (Glasgow coma score [GCS] below 8 on admission). They were assessed 52 months on average after their injury.
Factor F1 was correlated with results on the GCS (P<0.05), the Tower of London test (TL, P<0.01), the Trail Making Test (TMT, P<0.01), divided attention (DA) and inhibition (IN) subscales of the Zimmermann and Fimm's Attention battery (TEA) (P<0.01) and reverse digit span (DS, P<0.05). Factor F2 was positively related to age at injury, time since injury (TSI) (P<0.05) and CESD and STAI scores (P<0.001). Factor F3 was related to DA (P<0.01) TL scores and TSI (P<0.05). Factor F4 was related to TL, TMT, DA, flexibility, DS (P<0.05), TSI, duration of post-traumatic amnesia, CES-D score (P<0.05) and STAI scores (P<0.01). Factor F5 was related to GCS, DA (P<0.05), and reaction time on the subscales IN and Go/nogo (GO) of the TEA battery (P<0.01). The NRS-R total score was related to CESD, STAI scores, TMT score, DA (P<0.01) and TL score, IN and GO scores and TSI (P<0.05).
As McCauley et al found with the English version of the NRS-R, significant relationships were found between NRS-R factor scores, cognitive tests and emotional scales. Relationships were also found between factor scores and indicators of injury severity and time since injury. These data suggest fair concurrent validity of the NRS-R.
认知和行为障碍是创伤性脑损伤（TBI）患者日常生活中致残的主要原因。修订后的神经行为评定量表（NRS-R）是一种简短、易于实施的访谈工具，旨在改善临床医生的评估。已有关于其标准效度和信度的数据，但法国版NRS-R的同时效度尚未得到记录。
评估NRS-R与当前心理测量测试的同时效度。
104名参加社区适应项目的TBI患者同时接受了NRS-R、评估记忆、注意力和执行功能的认知测试以及焦虑量表（STAI）和抑郁情绪量表（CES-D）的检查。对这些变量与NRS-R的五个因子进行了相互关联分析：F1，故意行为；F2，情绪状态降低；F3，生存导向行为/情绪状态增强；F4，觉醒状态；F5，语言。患者中男性82名，女性22名，平均年龄28.5岁，70%有重度TBI（入院时格拉斯哥昏迷评分[GCS]低于8分）。他们在受伤后平均52个月接受评估。
因子F1与GCS结果（P<0.05）、伦敦塔测试（TL，P<0.01）、连线测验（TMT，P<0.01）、齐默尔曼和菲姆注意力测验（TEA）的分散注意力（DA）和抑制（IN）子量表（P<0.01）以及倒背数字广度（DS，P<0.05）相关。因子F2与受伤年龄、受伤后时间（TSI）（P<0.05）以及CESD和STAI评分（P<0.001）呈正相关。因子F3与DA（P<0.01）、TL评分和TSI（P<0.05）相关。因子F4与TL、TMT、DA、灵活性、DS（P<0.05）、TSI、创伤后遗忘持续时间、CES-D评分（P<0.05）和STAI评分（P<0.01）相关。因子F5与GCS、DA（P<0.05）以及TEA测验IN和Go/NoGo（GO）子量表上的反应时间（P<0.01）相关。NRS-R总分与CESD、STAI评分、TMT评分、DA（P<0.01）以及TL评分、IN和GO评分以及TSI（P<0.05）相关。
正如麦考利等人对英文版NRS-R的研究结果，NRS-R因子评分、认知测试和情绪量表之间存在显著关系。因子评分与损伤严重程度指标和受伤后时间之间也存在关系。这些数据表明NRS-R具有一定的同时效度。
