Mathias Jane L, Wheaton Patricia
School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
Neurosci Biobehav Rev. 2015 Aug;55:573-93. doi: 10.1016/j.neubiorev.2015.06.001. Epub 2015 Jun 6.
Brain/biological (BR) and cognitive/neural reserve (CR) have increasingly been used to explain some of the variability that occurs as a consequence of normal ageing and neurological injuries or disease. However, research evaluating the impact of reserve on outcomes after adult traumatic brain injury (TBI) has yet to be quantitatively reviewed. This meta-analysis consolidated data from 90 studies (published prior to 2015) that either examined the relationship between measures of BR (genetics, age, sex) or CR (education, premorbid IQ) and outcomes after TBI or compared the outcomes of groups with high and low reserve. The evidence for genetic sources of reserve was limited and often contrary to prediction. APOE ∈4 status has been studied most, but did not have a consistent or sizeable impact on outcomes. The majority of studies found that younger age was associated with better outcomes, however most failed to adjust for normal age-related changes in cognitive performance that are independent of a TBI. This finding was reversed (older adults had better outcomes) in the small number of studies that provided age-adjusted scores; although it remains unclear whether differences in the cause and severity of injuries that are sustained by younger and older adults contributed to this finding. Despite being more likely to sustain a TBI, males have comparable outcomes to females. Overall, as is the case in the general population, higher levels of education and pre-morbid IQ are both associated with better outcomes.
脑/生物学储备（BR）和认知/神经储备（CR）越来越多地被用于解释因正常衰老、神经损伤或疾病而产生的一些变异性。然而，评估储备对成人创伤性脑损伤（TBI）后结局影响的研究尚未进行定量综述。这项荟萃分析整合了90项研究（2015年之前发表）的数据，这些研究要么考察了BR指标（遗传学、年龄、性别）或CR指标（教育程度、病前智商）与TBI后结局之间的关系，要么比较了高储备组和低储备组的结局。储备的遗传来源证据有限，且往往与预测相反。APOE ε4状态研究得最多，但对结局没有一致或显著的影响。大多数研究发现，年龄较小与较好的结局相关，但大多数研究未能对与TBI无关的正常年龄相关认知表现变化进行调整。在少数提供年龄调整分数的研究中，这一发现发生了逆转（老年人结局更好）；尽管尚不清楚年轻人和老年人所受损伤的原因和严重程度差异是否导致了这一发现。尽管男性更易发生TBI，但他们与女性的结局相当。总体而言，与普通人群情况一样，较高的教育水平和病前智商均与较好的结局相关。
