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创伤性脑损伤与认知

Traumatic brain injury and cognition.

作者信息

Cristofori Irene, Levin Harvey S

机构信息

Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA.

Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.

出版信息

Handb Clin Neurol. 2015;128:579-611. doi: 10.1016/B978-0-444-63521-1.00037-6.

Abstract

Traumatic brain injury (TBI) is a major cause of death and disability, and therefore an important health and socioeconomic problem for our society. Individuals surviving from a moderate to severe TBI frequently suffer from long-lasting cognitive deficits. Such deficits include different aspects of cognition such as memory, attention, executive functions, and awareness of their deficits. This chapter presents a review of the main neuropsychological and neuroimaging studies of patients with TBI. These studies found that patients evolve differently according to the severity of the injury, the mechanism causing the injury, and the lesion location. Further research is necessary to develop rehabilitation methods that enhance brain plasticity and recovery after TBI. In this chapter, we summarize current knowledge and controversies, focusing on cognitive sequelae after TBI. Recommendations from the Common Data Elements are provided, with an emphasis on diagnosis, outcome measures, and studies organization to make data more comparable across studies. Final considerations on neuroimaging advances, rehabilitation approaches, and genetics are described in the final section of the chapter.

摘要

创伤性脑损伤(TBI)是死亡和残疾的主要原因,因此是我们社会面临的一个重要健康和社会经济问题。中度至重度TBI幸存者经常遭受长期的认知缺陷。这些缺陷包括认知的不同方面,如记忆、注意力、执行功能以及对自身缺陷的意识。本章对TBI患者的主要神经心理学和神经影像学研究进行了综述。这些研究发现,患者的病情发展因损伤的严重程度、损伤机制和病变位置而异。有必要进行进一步研究以开发增强TBI后大脑可塑性和恢复的康复方法。在本章中,我们总结了当前的知识和争议,重点关注TBI后的认知后遗症。提供了通用数据元素的建议,重点是诊断、结果测量和研究组织,以使各研究的数据更具可比性。本章最后一部分描述了关于神经影像学进展、康复方法和遗传学的最终思考。

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