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轻度创伤性脑损伤及其后遗症:注意力分散缺陷的特征

Mild traumatic brain injury and its sequelae: characterisation of divided attention deficits.

作者信息

Paré Nadia, Rabin Laura A, Fogel Joshua, Pépin Michel

机构信息

Kaiser Foundation Rehabilitation Center, Vallejo, CA 94589, USA.

出版信息

Neuropsychol Rehabil. 2009 Jan;19(1):110-37. doi: 10.1080/09602010802106486. Epub 2008 Jun 1.

Abstract

Deficits in divided attention occur after a mild traumatic brain injury (MTBI) but many extant tasks lack sensitivity for detecting subtle cognitive difficulties. We use the Test d'Attention Partagee Informatise (TAPI), a novel dual-task paradigm, to investigate the impact of MTBI on the ability to divide attention between two stimuli sources. Individuals with MTBI (n=37) were evaluated within the first week following head trauma and at three months post-injury. A healthy control (HC) group (n=79) was also assessed. The primary outcome was reaction time and there were three different conditions that included visual target detection and auditory digit span tasks. Analyses utilised repeated measures ANOVA and ANCOVA models that adjusted for relevant variables including post-concussive and affective symptoms. Results indicated that at both baseline and follow-up, the MTBI group had significantly slower reaction time than the HC group. Also, both the MTBI and HC groups had slower reaction times as participants progressed through each of the more challenging TAPI conditions. This study supports the usefulness of this novel instrument and allows clinicians and researchers to assess for subtle divided attention deficits that may persist in those with MTBI even three months post-injury.

摘要

轻度创伤性脑损伤(MTBI)后会出现注意力分散缺陷,但许多现有任务在检测细微认知困难方面缺乏敏感性。我们使用一种新颖的双任务范式——信息化共享注意力测试(TAPI),来研究MTBI对在两个刺激源之间分配注意力能力的影响。对MTBI患者(n = 37)在头部创伤后的第一周内以及受伤后三个月进行评估。还评估了一个健康对照组(HC)(n = 79)。主要结果是反应时间,有三种不同的条件,包括视觉目标检测和听觉数字广度任务。分析采用重复测量方差分析和协方差分析模型,并对包括脑震荡后症状和情感症状在内的相关变量进行了调整。结果表明,在基线和随访时,MTBI组的反应时间均显著慢于HC组。此外,随着参与者在更具挑战性的TAPI条件中逐一进行测试,MTBI组和HC组的反应时间都变慢了。这项研究支持了这种新颖工具的实用性,并使临床医生和研究人员能够评估那些即使在受伤三个月后仍可能存在于MTBI患者中的细微注意力分散缺陷。

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