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轻度与重度创伤性脑损伤患者主观认知主诉与神经心理学测试的比较。

Comparison of subjective cognitive complaints with neuropsychological tests in individuals with mild vs more severe traumatic brain injuries.

作者信息

Jamora Christina Weyer, Young Ashley, Ruff Ronald M

机构信息

University of California, San Francisco, CA, USA.

出版信息

Brain Inj. 2012;26(1):36-47. doi: 10.3109/02699052.2011.635352.

Abstract

PRIMARY OBJECTIVE

The aim of this study was to examine the complex inter-relationship between subjective reports of cognitive impairments and neuropsychological performances in compensation-seeking individuals with traumatic brain injury (TBI) of differing severities. Specifically, this study examined: (a) the participants' neuropsychological test scores and self-reported ratings according to TBI severity; (b) whether there was a predictive relationship between self-report and cognitive test scores; and (c) the influence of emotional functioning on self-reported cognitive functioning.

RESEARCH DESIGN

A multi-group comparative research design was employed.

METHODS AND PROCEDURE

An outpatient sample of 61 patients with TBIs using neuropsychological testing, RNBI (Ruff Neurobehavioral Inventory) and clinical interviews.

MAIN OUTCOMES AND RESULTS

The mild TBI group exhibited greater attentional impairments, while the moderate-to-severe group exhibited greater memory and learning impairments on neuropsychological tests. The mild group reported more cognitive symptoms than their more severely damaged counterparts. The mild TBI participants reported significantly more symptoms of post-traumatic stress disorder (PTSD).

CONCLUSIONS

Individuals with moderate-to-severe TBI were more accurate when reporting their memory and learning difficulties, whereas individuals with mild TBI were more accurate when reporting attentional difficulties. It is likely that the occurrence of PTSD worsens the outcome of a mild TBI. There likely is a cumulative effect between the PTSD symptoms and the emotional residuals in the mild TBI population.

摘要

主要目标

本研究旨在探讨不同严重程度的创伤性脑损伤(TBI)患者在寻求赔偿过程中认知障碍主观报告与神经心理表现之间复杂的相互关系。具体而言,本研究考察了:(a)根据TBI严重程度划分的参与者神经心理测试分数和自我报告评分;(b)自我报告与认知测试分数之间是否存在预测关系;以及(c)情绪功能对自我报告认知功能的影响。

研究设计

采用多组比较研究设计。

方法与程序

对61例TBI患者进行门诊抽样,采用神经心理测试、鲁夫神经行为量表(RNBI)和临床访谈。

主要结果

轻度TBI组在神经心理测试中表现出更严重的注意力损伤,而中度至重度组表现出更严重的记忆和学习损伤。轻度组报告的认知症状比损伤更严重的组更多。轻度TBI参与者报告的创伤后应激障碍(PTSD)症状明显更多。

结论

中度至重度TBI患者在报告记忆和学习困难时更准确,而轻度TBI患者在报告注意力困难时更准确。PTSD的发生可能会使轻度TBI的结果恶化。在轻度TBI人群中,PTSD症状和情绪残留之间可能存在累积效应。

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