Roth E, Davidoff G, Thomas P, Doljanac R, Dijkers M, Berent S, Morris J, Yarkony G
Department of Rehabilitation Medicine, Northwestern University Medical School, Chicago, IL.
Paraplegia. 1989 Dec;27(6):480-9. doi: 10.1038/sc.1989.75.
According to a number of studies, between 40% and 60% of acute traumatic spinal cord injury (SCI) patients demonstrate cognitive dysfunction resulting from various forms of cerebral damage, including concurrent or premorbid closed head injury, chronic alcohol or substance abuse, and other causes. However, applicability of findings from these reports has been limited due to the use of inadequate neuropsychological testing techniques and the lack of control data. In a collaborative investigation, 81 acute SCI patients and 61 non-injured control subjects between 18 and 55 years of age completed a comprehensive motor-free neuropsychological test battery, including: Halstead Category Test (HCT), Vocabulary Subtest (VOCAB) of the Wechsler Adult Intelligence Scale - Revised; Mental Control (MC) Subtest, and Initial and Recall trials of Logical Memory (LM) and Paired Associates (PA) Subtests of the Wechsler Memory Scale; and the 8 trials of the Rey Auditory Verbal Learning Test (RAVLT). Percentages of retained information on the LM and PA were also calculated. Impairment levels for each test were defined as values which exceeded two standard deviations (one-tailed) from the control mean. Based on this definition, the prevalence of neuropsychological abnormality on each test ranged between 10% and 40%. Mean performance levels of patients were significantly more impaired than those of control subjects for all tests except for the Interference trial of the RAVLT and for the percentages of retained information on the LM and PA subtests. Comparison of test results of SCI patients with those of control subjects demonstrates that poor attention span and limited initial learning ability are frequent problems among SCI patients. Other common neuropsychological deficits among these patients include poor concentration ability, impaired memory function, and altered problem solving ability. These deficits may interfere with rehabilitation following SCI.
多项研究表明，40%至60%的急性创伤性脊髓损伤（SCI）患者存在因各种形式的脑损伤导致的认知功能障碍，这些脑损伤包括并发或病前的闭合性颅脑损伤、慢性酒精或药物滥用以及其他原因。然而，由于使用的神经心理学测试技术不充分以及缺乏对照数据，这些报告结果的适用性受到了限制。在一项合作调查中，81名年龄在18至55岁之间的急性SCI患者和61名未受伤的对照受试者完成了一套全面的无运动神经心理学测试组合，包括：霍尔斯特德类别测验（HCT）；韦氏成人智力量表修订版的词汇子测验（VOCAB）；心理控制（MC）子测验；韦氏记忆量表的逻辑记忆（LM）和配对联想学习（PA）子测验中的初始和回忆试验；以及雷伊听觉词语学习测验（RAVLT）的8次试验。还计算了LM和PA上的信息保留百分比。每项测试的损伤水平定义为超过对照均值两个标准差（单尾）的值。基于此定义，每项测试中神经心理学异常的患病率在10%至40%之间。除了RAVLT的干扰试验以及LM和PA子测验上的信息保留百分比外，患者在所有测试中的平均表现水平均显著低于对照受试者。将SCI患者与对照受试者的测试结果进行比较表明，注意力持续时间短和初始学习能力有限是SCI患者中常见的问题。这些患者中其他常见的神经心理学缺陷包括注意力集中能力差、记忆功能受损和解决问题能力改变。这些缺陷可能会干扰SCI后的康复。
