Dretsch Michael N, Kelly Mark P, Coldren Rodney L, Parish Robert V, Russell Michael L
1 Warfighter Health Division, U.S. Army Aeromedical Research Laboratory , Fort Rucker, Alabama.
2 National Intrepid Center of Excellence, Walter Reed National Military Medical Center , Bethesda, Maryland.
J Neurotrauma. 2015 Aug 15;32(16):1217-22. doi: 10.1089/neu.2014.3637. Epub 2015 Mar 31.
Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes.
71名受伤后72小时内因爆炸或钝性机制而接受脑震荡治疗的美国现役陆军士兵,接受了军事急性脑震荡评估、自动神经心理评估指标(ANAM)、传统神经心理测试和健康状况问卷调查。在初次测试后10天(±5天)进行了随访ANAM测试。21名士兵被排除:2名因测试不认真,19名有爆炸伤和钝性伤合并情况。在其余50名男性参与者中,34名有爆炸伤,16名有钝性伤。在受伤后72小时内,爆炸伤和钝性伤参与者在人口统计学、身体或心理健康因素、脑震荡症状或自动和传统神经认知测试分数方面没有统计学上的显著差异。此外,受伤后15天内的随访ANAM分数也没有显著差异(21名爆炸伤受试者和13名钝性伤受试者的数据可用)。在有可用数据的情况下,对受伤前的基线ANAM分数进行了比较,结果显示22名爆炸伤参与者和8名钝性伤参与者之间没有统计学上的显著差异。这些发现表明,在战斗环境中部署期间,急性和亚急性期的神经行为性脑震荡后遗症的损伤机制之间没有显著差异。本研究支持在部署环境中使用运动/机械性脑震荡模型进行早期脑震荡管理,并探索潜在长期结果的变异性。