脑震荡后症状高压氧试验中的神经心理学评估。

Neuropsychological assessments in a hyperbaric trial of post-concussive symptoms.

作者信息

Wilson Steffanie H, Weaver Lindell K, Lindblad Anne S

机构信息

The Emmes Corporation, Rockville, Maryland U.S.

Division of Hyperbaric Medicine Intermountain Medical Center, Murray, Utah, and Intermountain LDS Hospital, Salt Lake City, Utah U.S.

出版信息

Undersea Hyperb Med. 2016 Aug-Sept;43(5):585-599.

PMID:28768075

Abstract

UNLABELLED

Results of studies addressing the effect of mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) on symptoms and neuropsychological assessments are mixed regarding cognitive deficits in these populations. Neuropsychological assessments were compared between U.S. military service members with mTBI only (n=36) vs. those with mTBI÷ PTSD (n=35) from a randomized interventional study of mTBI participants with persistent post-concussive symptoms (PCS). The mTBI group endorsed worse symptoms than published norms on PCS, PTSD and pain scales (⟩50% abnormal on Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Civilian, McGill Pain Questionnaire-Short Form) and some quality of life domains. Worse symptom reporting was found in the mTBI÷ PTSD group compared to mTBI (e.g., mean NSI total score in mTBI 27.5 (SD=12.7), mTBI÷ PTSD 39.9 (SD=13.6), p⟨0.001). The mTBI÷PTSD group performed worse than mTBI on the Weschler Adult Intelligence Scale digit span (mean difference -1.5, 95% CI[-2.9,-0.1], p=0.04) and symbol search (mean difference -1.5, 95% CI[-2.7,-0.2], p=0.03) and Grooved Pegboard (dominant hand mean difference -7.0, 95% CI[-11.5,-2.4], p=0.003; non-dominant mean difference -9.8, 95% CI[-14.9,-4.7], p⟨0.001). Differences were detected in ANAM simple reaction time (p=0.04) and mathematical processing (p=0.03) but not verbal fluency or visuospatial memory assessments. Results indicate increased symptom severity and some cognitive deficits in mTBI÷ PTSD compared to mTBI alone.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01611194; https://clinicaltrials.gov/show/NCT01611194.

摘要

未标注

关于轻度创伤性脑损伤（mTBI）和创伤后应激障碍（PTSD）对这些人群症状及神经心理学评估影响的研究结果，在认知缺陷方面存在分歧。在一项针对有持续性脑震荡后症状（PCS）的mTBI参与者的随机干预研究中，对仅患有mTBI的美国军人（n = 36）与患有mTBI且并发PTSD的军人（n = 35）进行了神经心理学评估比较。mTBI组在PCS、PTSD和疼痛量表（在神经行为症状量表（NSI）、平民版PTSD检查表、麦吉尔疼痛问卷简表上超过50%异常）以及一些生活质量领域的症状比已发表的常模更严重。与mTBI组相比，mTBI并发PTSD组症状报告更严重（例如，mTBI组NSI总分均值为27.5（标准差 = 12.7），mTBI并发PTSD组为39.9（标准差 = 13.6），p < 0.001）。在韦氏成人智力量表数字广度（均值差异 -1.5，95%置信区间[-2.9, -0.1]，p = 0.04）、符号搜索（均值差异 -1.5，95%置信区间[-2.7, -0.2]，p = 0.03）和沟槽钉板测试（优势手均值差异 -7.0，95%置信区间[-11.5, -2.4]，p = 0.003；非优势手均值差异 -9.8，95%置信区间[-14.9, -4.7]，p < 0.001）方面，mTBI并发PTSD组表现比mTBI组差。在自动神经心理成套测试（ANAM）简单反应时间（p = 0.04）和数学处理（p = 0.03）方面检测到差异，但在语言流畅性或视觉空间记忆评估方面未检测到差异。结果表明，与单纯mTBI相比，mTBI并发PTSD症状严重程度增加且存在一些认知缺陷。