Christensen Bruce K, Colella Brenda, Inness Elizabeth, Hebert Deborah, Monette Georges, Bayley Mark, Green Robin E
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Arch Phys Med Rehabil. 2008 Dec;89(12 Suppl):S3-15. doi: 10.1016/j.apmr.2008.10.002.
To ascertain patterns of cognitive recovery during the first year after traumatic brain injury (TBI). Specifically, differential recovery across cognitive domains was investigated.
Prospective, longitudinal, naturalistic, 1-year follow-up study.
Large, urban inpatient neurorehabilitation program.
Patients (N=75) with moderate to severe TBI.
Not applicable.
Patients with TBI were followed over the course of 1 year, during which participants' neuropsychological status was repeatedly evaluated at 3 time points (2, 5, and 12 months postinjury).
Multilevel modeling results were consistent with previous research, demonstrating that recovery in the first year postinjury is asymptotic in nature, with more accelerated recovery occurring during the first 5 to 6 months. Importantly, results also suggest that recovery is not uniform across cognitive domains. From 2 to 5 months postinjury, steeper recovery curves were revealed for indices of memory, speeded executive function, verbal abstraction, and manual dexterity relative to untimed tests of executive function and word knowledge. Recovery trajectories did not significantly vary as a function of cognitive domain over the course of the last 5 to 12 months.
These results are the first to explore trajectories of recovery directly as a function of multiple cognitive domains. They are expected to have implications for rehabilitative efforts as well as our understanding of the architecture of natural recovery after TBI.
确定创伤性脑损伤（TBI）后第一年认知恢复的模式。具体而言，研究了各认知领域的差异恢复情况。
前瞻性、纵向、自然主义的1年随访研究。
大型城市住院神经康复项目。
75例中重度TBI患者。
不适用。
对TBI患者进行为期1年的随访，在此期间，在3个时间点（伤后2、5和12个月）对参与者的神经心理状态进行反复评估。
多层次建模结果与先前研究一致，表明伤后第一年的恢复本质上是渐近的，在前5至6个月恢复速度更快。重要的是，结果还表明各认知领域的恢复并不一致。伤后2至5个月，相对于执行功能和单词知识的非限时测试，记忆、快速执行功能、语言抽象和手部灵活性指标的恢复曲线更陡。在最后5至12个月期间，恢复轨迹并未因认知领域的不同而有显著差异。
这些结果首次直接探讨了作为多个认知领域函数的恢复轨迹。预计它们将对康复工作以及我们对TBI后自然恢复结构的理解产生影响。
