Department of Neurology, The University of Illinois College of Medicine, Chicago, Illinois, USA.
J Int Neuropsychol Soc. 2010 May;16(3):506-16. doi: 10.1017/S135561771000010X. Epub 2010 Mar 1.
Following mild traumatic brain injury (TBI), a percentage of individuals report chronic memory and attention difficulties. Traditional neuropsychological assessments often fail to find evidence for such complaints. We hypothesized that mild TBI patients may, in fact, experience subtle cognitive deficits that reflect diminished initial acquisition that can be explained by changes in cerebral white matter microstructure. In the data presented here, a sample of nonlitigating and gainfully employed mild TBI patients demonstrated statistically significant differences from age and education matched control participants in performance on the first trial of a verbal learning task. Performance on this trial was associated with reduced fractional anisotropy in the uncinate fasciculus and the superior longitudinal fasciculus providing an anatomical correlate for the cognitive findings. Mild TBI patients were not impaired relative to control participants on total learning or memory composite variables. Performance on the first learning trial was not related to any psychological variables including mood. We concluded that patients with mild TBI demonstrate diminished verbal learning that is not often interpreted in standard neuropsychological assessment.
在轻度创伤性脑损伤(TBI)后,有一定比例的人报告存在慢性记忆和注意力困难。传统的神经心理学评估往往无法发现此类主诉的证据。我们假设,轻度 TBI 患者实际上可能存在细微的认知缺陷,反映了初始获得能力的下降,这种下降可以用大脑白质微观结构的变化来解释。在本研究中,一组非诉讼和有酬工作的轻度 TBI 患者在言语学习任务的第一次尝试中表现出与年龄和教育程度匹配的对照组参与者相比有统计学显著差异。该试验的表现与钩束和上纵束的分数各向异性降低相关,为认知发现提供了解剖学相关性。与对照组相比,轻度 TBI 患者在总学习或记忆综合变量上没有受损。第一次学习试验的表现与包括情绪在内的任何心理变量均无关。我们得出结论,轻度 TBI 患者表现出言语学习能力下降,而这在标准神经心理学评估中通常未被解释。