Department of Psychology, Walter Reed Army Medical Center, Washington, DC, USA.
Arch Clin Neuropsychol. 2012 Jun;27(4):375-88. doi: 10.1093/arclin/acs036. Epub 2012 Apr 3.
Despite the prevalence of concussion in soldiers deployed to Iraq and Afghanistan, neuropsychological tests used to assist in concussion management have not been validated on the battlefield. This study evaluated the validity of the Automated Neuropsychological Assessment Metrics (ANAM) in the combat environment. Cases meeting criteria for concussion, healthy controls, and injured controls were assessed. Soldiers were administered the ANAM, traditional neuropsychological tests, and a background questionnaire. Cases were enrolled within 72 h of concussion. Cases exhibited poorer performance than controls on all ANAM subtests, with significant differences on simple reaction time (SRT), procedural reaction time (PRT), code substitution, and matching to sample (p<.001). Discriminant ability of scores on SRT and PRT subtests was 71%, which improved to 76% when pre-deployment baseline scores were available. An exploratory clinical decision tool incorporating ANAM scores and symptoms improved discriminant ability to 81%. Results provide initial validation of the ANAM for detecting acute effects of battlefield concussion.
尽管在部署到伊拉克和阿富汗的士兵中脑震荡很常见，但用于协助脑震荡管理的神经心理学测试在战场上尚未得到验证。本研究评估了自动神经心理评估指标（ANAM）在战斗环境中的有效性。符合脑震荡标准的病例、健康对照组和受伤对照组均接受了评估。士兵接受了 ANAM、传统神经心理学测试和背景问卷。病例在脑震荡后 72 小时内入组。病例在所有 ANAM 子测试中的表现均差于对照组，在简单反应时间（SRT）、程序反应时间（PRT）、代码替代和样本匹配方面存在显著差异（p<.001）。SRT 和 PRT 子测试得分的判别能力为 71%，当可获得部署前基线得分时，判别能力提高到 76%。包含 ANAM 分数和症状的探索性临床决策工具可将判别能力提高到 81%。结果为战场脑震荡急性影响的 ANAM 检测提供了初步验证。
