Brooks Brian L, Low Trevor A, Daya Hussain, Khan Samna, Mikrogianakis Angelo, Barlow Karen M
1 Department of Neurosciences (Brain Injury and Vi Riddell Rehabilitation Programs), Alberta Children's Hospital , Calgary, Alberta, Canada .
2 Department of Pediatrics, University of Calgary , Calgary, Alberta, Canada .
J Neurotrauma. 2016 Dec 1;33(23):2091-2096. doi: 10.1089/neu.2015.4301. Epub 2016 May 9.
Rest is commonly prescribed following a mild traumatic brain injury (mTBI). There is concern that cognitive exertion by an acutely or sub-acutely injured brain may negatively alter outcome. The objective of this study was to determine if computerized cognitive testing in the emergency department alters symptom outcome from mTBI. Participants included 77 youth with mTBI who underwent computerized cognitive testing (mean age, 13.6; 95% confidence interval [CI] = 13.0-14.2) and were matched to 77 youth with mTBI who did not participate in cognitive testing (mean age, 13.5; 95% CI = 12.9-14.0). Participants who underwent cognitive testing did not differ from those who did not undergo acute cognitive testing on mean symptom ratings or the proportion who were not recovered at 7-10 days, 1 month, 2 months, or 3 months. There also was no difference in symptom outcome for those who underwent a shortened (four subtests, mean time = 16 min) or full-length (seven subtests, mean time = 28 min) version of the computerized test. Brief cognitive exertion using a computerized cognitive assessment after mTBI in youth does not result in worse symptoms at these follow-up periods, does not prolong symptom recovery, should not be considered contraindicated to recovery, and could be considered as another tool to aid in the management of these injuries. Further research with different samples is warranted.
轻度创伤性脑损伤（mTBI）后通常会建议休息。有人担心急性或亚急性损伤的大脑进行认知活动可能会对预后产生负面影响。本研究的目的是确定急诊科的计算机化认知测试是否会改变mTBI的症状预后。参与者包括77名接受计算机化认知测试的mTBI青少年（平均年龄13.6岁；95%置信区间[CI]=13.0-14.2），并与77名未参与认知测试的mTBI青少年进行匹配（平均年龄13.5岁；95%CI=12.9-14.0）。接受认知测试的参与者与未接受急性认知测试的参与者在平均症状评分或7-10天、1个月、2个月或3个月时未恢复的比例方面没有差异。对于接受缩短版（四个子测试，平均时间=16分钟）或完整版（七个子测试，平均时间=28分钟）计算机化测试的参与者，症状预后也没有差异。青少年mTBI后使用计算机化认知评估进行简短的认知活动在这些随访期内不会导致更严重的症状，不会延长症状恢复时间，不应被视为恢复的禁忌，并且可以被视为辅助管理这些损伤的另一种工具。有必要对不同样本进行进一步研究。
