Department of Psychology, Ohio State University, Columbus, OH 43205, USA.
J Int Neuropsychol Soc. 2010 Jan;16(1):94-105. doi: 10.1017/S1355617709991007. Epub 2009 Oct 19.
The occurrence of postconcussive symptoms (PCS) following mild traumatic brain injury (TBI) in children may depend on cognitive reserve capacity. This prospective, longitudinal study examined whether the relationship between mild TBI and PCS is moderated by cognitive ability, which served as a proxy for cognitive reserve. Participants included 182 children with mild TBI and 99 children with orthopedic injuries (OI), ranging from 8 to 15 years of age when injured. Mild TBI were classified as complicated (n = 32) or uncomplicated (n = 150) depending on whether they were associated with trauma-related intracranial abnormalities on magnetic resonance imaging. PCS were assessed initially within 3 weeks of injury, and again at 1, 3, and 12 months post injury. The initial assessment also included standardized tests of children's cognitive skills and retrospective parent ratings of pre-injury symptoms. Hierarchical linear modeling indicated that ratings of PCS were moderated jointly by cognitive ability and injury severity. Children of lower cognitive ability with a complicated mild TBI were especially prone to cognitive symptoms across time according to parents and to high acute levels of PCS according to children's self-ratings. Cognitive reserve is an important moderator of the outcomes of mild TBI in children and adolescents.
儿童轻度创伤性脑损伤 (TBI) 后出现脑震荡后症状 (PCS) 可能取决于认知储备能力。这项前瞻性纵向研究考察了轻度 TBI 和 PCS 之间的关系是否受到认知能力的调节，认知能力是认知储备的替代指标。参与者包括 182 名轻度 TBI 患儿和 99 名骨科损伤患儿（OI），受伤时年龄在 8 至 15 岁之间。根据磁共振成像上是否存在与创伤相关的颅内异常，将轻度 TBI 分为复杂型（n=32）和单纯型（n=150）。PCS 在受伤后 3 周内进行初始评估，然后在 1、3 和 12 个月时进行评估。初始评估还包括对儿童认知技能的标准化测试和受伤前症状的家长回顾性评定。分层线性模型表明，认知能力和损伤严重程度共同调节 PCS 的评分。根据父母的评定，认知能力较低且患有复杂轻度 TBI 的儿童尤其容易出现跨时间的认知症状，根据儿童的自我评定，他们也具有较高的急性 PCS 水平。认知储备是儿童和青少年轻度 TBI 结局的重要调节因素。
