Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA.
Med Sci Sports Exerc. 2013 Jun;45(6):1030-7. doi: 10.1249/MSS.0b013e3182814595.
Head trauma in adolescents has been linked with deficits in attention and executive function that can compromise the performance of everyday tasks. Although previous research has examined this issue using computerized neuropsychological testing, little work has been done using laboratory-based measurements of attention and executive function in this population. A longitudinal analysis of recovery patterns of these measures among adolescents is central to understanding the effects of concussions across the age spectrum.
This study prospectively and longitudinally examined laboratory-based measures of attention and executive function in concussed adolescents sequentially during a 2-month period after injury.
Two measures of attention and executive function, the Attentional Network Test and the Task-Switching Test, were administered to 20 concussed adolescents within 72 h postinjury as well as at 1 wk, 2 wk, 1 month, and 2 months postinjury. Twenty healthy, matched control subjects were similarly assessed at the same time intervals. Data were analyzed by two-way, mixed-effects ANOVA to determine the effect of group and time on the dependent variables.
Compared with control subjects, the concussed group exhibited a significantly greater switch cost on the Task-Switching Test (P = 0.038, mean difference value = 38 ms) and a significantly greater reaction time for the Attentional Network Test conflict effect component (P = 0.015, mean difference value = 34 ms) for up to 2 months after injury.
Concussed adolescents have difficulty recovering executive function after injury and may require extended recuperation time before full recovery is achieved. Evaluations focusing on attention and executive function can be useful additions in the assessment and follow-up after head injury.
青少年头部创伤与注意力和执行功能缺陷有关,这些缺陷会影响日常任务的表现。尽管先前的研究已经使用计算机神经心理学测试来研究这个问题,但在该人群中使用基于实验室的注意力和执行功能测量来研究这个问题的工作很少。对这些措施在青少年中的恢复模式进行纵向分析对于理解脑震荡在整个年龄范围内的影响至关重要。
本研究前瞻性地、纵向地研究了 20 名脑震荡青少年在受伤后 2 个月内连续进行的基于实验室的注意力和执行功能测量。
在受伤后 72 小时内,对 20 名脑震荡青少年以及 20 名健康、匹配的对照者进行了两种注意力和执行功能的测量,即注意网络测试和任务转换测试。数据通过双因素混合效应方差分析进行分析,以确定组和时间对因变量的影响。
与对照组相比,脑震荡组在任务转换测试中的切换成本显著增加(P=0.038,平均差异值为 38 毫秒),在注意力网络测试的冲突效应成分中的反应时间显著增加(P=0.015,平均差异值为 34 毫秒),直到受伤后 2 个月。
脑震荡青少年在受伤后很难恢复执行功能,可能需要更长的恢复时间才能完全恢复。关注注意力和执行功能的评估可以在头部损伤的评估和随访中增加有用的内容。