Lambregts S A M, Smetsers J E M, Verhoeven I M A J, de Kloet A J, van de Port I G L, Ribbers G M, Catsman-Berrevoets C E
a Department of Rehabilitation Medicine Erasmus MC University Medical Centre , Rotterdam , The Netherlands.
b Department of Rehabilitation Medicine, Revant Rehabilitation Centres, Breda , The Netherlands.
Brain Inj. 2018;32(2):230-241. doi: 10.1080/02699052.2017.1406990. Epub 2017 Nov 30.
10-20% of children and youth with mild traumatic brain injury (mTBI) suffer from long-term cognitive impairments with, supposedly, a negative impact on most domains of functioning.
To describe cognitive functioning and participation in children and youth two-years post-mTBI and to determine associated risk factors.
Cross-sectional study among 73 patients (aged 6-22 years), hospital diagnosed with mTBI. Linear regression modelling was used to investigate the effect of potential predictors on cognitive functioning as measured with a neuropsychological assessment (NPA), two-years post-injury. Extent of participation was assessed using the Child and Adolescent Scale of Participation and correlation analysis was conducted to examine its association with level of cognitive functioning.
7-15% of all participants had impaired cognitive functions, especially in the domains of processing speed, inhibitory control, cognitive flexibility, visuospatial constructional ability and visuospatial memory. Lower level of education and pre-injury cognitive problems were predictive for a lower level of long-term cognitive functioning. Slower inhibition speed, impaired visuospatial and verbal working memory were associated with reduced participation.
Persisting cognitive problems two years after mTBI were mostly related to the lower level of education and to pre-injury cognitive problems. Although participation of the patients was reported by parents to be relatively high, slower inhibition speed, impaired visuospatial and verbal working memory were associated with reduced participation.
10%-20%的轻度创伤性脑损伤（mTBI）儿童和青少年患有长期认知障碍，据推测，这对大多数功能领域都有负面影响。
描述mTBI后两年儿童和青少年的认知功能及参与情况，并确定相关风险因素。
对73例医院诊断为mTBI的患者（年龄6-22岁）进行横断面研究。采用线性回归模型研究潜在预测因素对损伤后两年通过神经心理学评估（NPA）测量的认知功能的影响。使用儿童和青少年参与量表评估参与程度，并进行相关分析以检验其与认知功能水平的关联。
所有参与者中有7%-15%存在认知功能受损，尤其是在处理速度、抑制控制、认知灵活性、视觉空间构建能力和视觉空间记忆等领域。较低的教育水平和伤前认知问题可预测长期认知功能较低。抑制速度较慢、视觉空间和言语工作记忆受损与参与度降低有关。
mTBI后两年持续存在的认知问题主要与较低的教育水平和伤前认知问题有关。尽管家长报告患者的参与度相对较高，但抑制速度较慢、视觉空间和言语工作记忆受损与参与度降低有关。
