Coldren Rodney L, Russell Michael L, Parish Robert V, Dretsch Michael, Kelly Mark P
Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4712, USA.
Mil Med. 2012 Feb;177(2):179-83. doi: 10.7205/milmed-d-11-00278.
Congress has mandated that the Department of Defense perform screening for concussion, or mild traumatic brain injury, on all service members redeploying from Iraq and Afghanistan. However, the retrospective diagnosis of concussion is complicated by the subjective nature of the complaints, overlap of symptoms with other conditions, and the normally rapid recovery of neurocognitive function following a concussive event. One diagnostic and screening test in current use by the Department of Defense is the Automated Neuropsychological Assessment Metrics (ANAM). A team of researchers deployed to Iraq between January and April 2009 to test the validity of the ANAM for the diagnosis of concussion in the combat environment. Performance by concussed participants on all six ANAM subtests was compared with that of controls. The ANAM appears to have no utility as an individual diagnostic or population screening tool for the detection of neurocognitive dysfunction from a single, uncomplicated concussion when administered 10 or more days following injury. Further studies are required to determine the modalities providing optimal sensitivity and specificity for use as diagnostic or screening tests beyond the first 72-hour acute postinjury period.
国会已授权国防部对所有从伊拉克和阿富汗重新部署的军人进行脑震荡或轻度创伤性脑损伤筛查。然而，脑震荡的回顾性诊断因症状主诉的主观性、与其他病症症状的重叠以及脑震荡事件后神经认知功能通常快速恢复而变得复杂。国防部目前使用的一种诊断和筛查测试是自动神经心理评估指标（ANAM）。一组研究人员于2009年1月至4月被派往伊拉克，以测试ANAM在战斗环境中诊断脑震荡的有效性。将脑震荡参与者在所有六项ANAM子测试中的表现与对照组进行比较。当在受伤10天或更长时间后进行测试时，ANAM作为一种用于检测单一、无并发症脑震荡所致神经认知功能障碍的个体诊断或群体筛查工具似乎并无用处。需要进一步研究以确定在受伤后72小时急性期之后用作诊断或筛查测试时能提供最佳敏感性和特异性的方式。
