Bene Edina Reka, Sepulveda Amanda M
School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee.
Department of Rehabilitation Sciences, Speech-Language Pathology Program, College of Health Sciences, University of Texas at El Paso, El Paso, Texas.
Semin Speech Lang. 2014 Aug;35(3):173-85. doi: 10.1055/s-0034-1384679. Epub 2014 Aug 12.
Over the past 25 years, neuropsychological assessment has been the prominent clinical method for evaluating neurocognitive functioning and monitoring recovery following mild traumatic brain injury (mTBI), or concussion. During this time, neuropsychological assessment of concussion has developed extensively starting from traditional paper-and-pencil tests to the more current computerized assessment batteries that are specifically designed for evaluating mTBI. Concussion assessment is complex and challenging due to the highly variable neurocognitive behavior and the wide range of diverse symptoms that follow an injury. Therefore, neuropsychological testing is only one component of a multifaceted, comprehensive assessment approach that also includes balance testing and symptom assessment. Because concussions may go undetected, more emphasis has been placed on objective and sensitive neuropsychological measures. Factors that could affect the validity of test performance include athletes not recognizing or intentionally hiding their symptoms or sandbagging their baseline performance. Due to the complex nature of identifying and evaluating mild head injuries, the purpose of this review is to discuss (1) the clinical use of neuropsychological testing in concussion management, (2) the methods used for evaluating and monitoring recovery following concussion, (3) the characteristics of current assessment instruments, and (4) additional clinical factors and approaches for concussion assessment and management.
在过去25年里,神经心理学评估一直是评估轻度创伤性脑损伤(mTBI)即脑震荡后神经认知功能和监测恢复情况的主要临床方法。在此期间,脑震荡的神经心理学评估从传统的纸笔测试发展到专门为评估mTBI设计的更新的计算机化评估组合。由于受伤后神经认知行为高度可变且症状多样,脑震荡评估复杂且具有挑战性。因此,神经心理学测试只是多方面综合评估方法的一个组成部分,该方法还包括平衡测试和症状评估。由于脑震荡可能未被发现,人们更加重视客观和敏感的神经心理学测量方法。可能影响测试表现有效性的因素包括运动员未认识到或故意隐瞒其症状,或故意压低其基线表现。鉴于识别和评估轻度头部损伤的复杂性,本综述的目的是讨论:(1)神经心理学测试在脑震荡管理中的临床应用;(2)用于评估和监测脑震荡后恢复情况的方法;(3)当前评估工具的特点;(4)脑震荡评估和管理的其他临床因素及方法。