French Louis M, Lange Rael T, Brickell Tracey
Defense and Veterans Brain Injury Center, Bethesda, MD; Neurology, Walter Reed National Military Medical Center, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine, Bethesda, MD;
J Rehabil Res Dev. 2014;51(6):933-50. doi: 10.1682/JRRD.2013.10.0226.
This study examined the relation between neuropsychological test performance and self-reported cognitive complaints following traumatic brain injury (TBI). Participants were 109 servicemembers from the U.S. military who completed a neuropsychological evaluation within the first 2 yr following mild-severe TBI. Measures included the Personality Assessment Inventory (PAI), Posttraumatic Stress Disorder Checklist (PCL-C), Neurobehavioral Symptom Inventory (NSI), and 17 select measures from a larger neurocognitive test battery that corresponded to three self-reported cognitive complaints from the NSI (i.e., memory, attention/concentration, and processing speed/organization). Self-reported cognitive complaints were significantly correlated with psychological distress (PCL-C total: r = 0.50-0.58; half the PAI clinical scales: r = 0.40-0.58). In contrast, self-reported cognitive complaints were not significantly correlated with overall neurocognitive functioning (with the exception of five measures). There was a low rate of agreement between neurocognitive test scores and self-reported cognitive complaints. For the large minority of the sample (38.5%-45.9%), self-reported cognitive complaints were reported in the presence of neurocognitive test scores that fell within normal limits. In sum, self-reported cognitive complaints were not associated with neurocognitive test performance, but rather were associated with psychological distress. These results provide information to contextualize cognitive complaints following TBI.
本研究调查了创伤性脑损伤（TBI）后神经心理测试表现与自我报告的认知主诉之间的关系。参与者为109名美国军人，他们在轻度至重度TBI后的头两年内完成了神经心理评估。测量指标包括人格评估量表（PAI）、创伤后应激障碍检查表（PCL-C）、神经行为症状量表（NSI），以及从一个更大的神经认知测试组中选取的17项指标，这些指标对应于NSI中的三项自我报告的认知主诉（即记忆、注意力/专注力和处理速度/组织能力）。自我报告的认知主诉与心理困扰显著相关（PCL-C总分：r = 0.50 - 0.58；PAI临床量表的一半：r = 0.40 - 0.58）。相比之下，自我报告的认知主诉与整体神经认知功能无显著相关性（五项指标除外）。神经认知测试分数与自我报告的认知主诉之间的一致性较低。对于样本中的很大一部分人（38.5% - 45.9%），在神经认知测试分数处于正常范围内时，仍报告有自我报告的认知主诉。总之，自我报告的认知主诉与神经认知测试表现无关，而是与心理困扰有关。这些结果为TBI后的认知主诉提供了背景信息。
