Yeates Keith Owen, Levin Harvey S, Ponsford Jennie
1Department of Psychology,Hotchkiss Brain Institute,& Alberta Children's Hospital Research Institute,University of Calgary,Calgary,Alberta,Canada.
2Department of Physical Medicine and Rehabilitation,Baylor College of Medicine, and the Michael E. De Bakey Veterans Affairs Medical Center,Houston,Texas.
J Int Neuropsychol Soc. 2017 Oct;23(9-10):806-817. doi: 10.1017/S1355617717000686.
The past 50 years have been a period of exciting progress in neuropsychological research on traumatic brain injury (TBI). Neuropsychologists and neuropsychological testing have played a critical role in these advances. This study looks back at three major scientific advances in research on TBI that have been critical in pushing the field forward over the past several decades: The advent of modern neuroimaging; the recognition of the importance of non-injury factors in determining recovery from TBI; and the growth of cognitive rehabilitation. Thanks to these advances, we now have a better understanding of the pathophysiology of TBI and how recovery from the injury is also shaped by pre-injury, comorbid, and contextual factors, and we also have increasing evidence that active interventions, including cognitive rehabilitation, can help to promote better outcomes. The study also peers ahead to discern two important directions that seem destined to influence research on TBI over the next 50 years: the development of large, multi-site observational studies and randomized controlled trials, bolstered by international research consortia and the adoption of common data elements; and attempts to translate research into health care and health policy by the application of rigorous methods drawn from implementation science. Future research shaped by these trends should provide critical evidence regarding the outcomes of TBI and its treatment, and should help to disseminate and implement the knowledge gained from research to the betterment of the quality of life of persons with TBI. (JINS, 2017, 23, 806-817).
在过去的50年里,创伤性脑损伤(TBI)的神经心理学研究取得了令人兴奋的进展。神经心理学家和神经心理学测试在这些进展中发挥了关键作用。本研究回顾了TBI研究中的三项重大科学进展,它们在过去几十年推动该领域发展方面至关重要:现代神经影像学的出现;认识到非损伤因素在决定TBI恢复中的重要性;以及认知康复的发展。得益于这些进展,我们现在对TBI的病理生理学有了更好的理解,以及损伤恢复如何也受到损伤前、共病和背景因素的影响,并且我们也有越来越多的证据表明,包括认知康复在内的积极干预可以帮助促进更好的结果。该研究还展望未来,辨别出两个似乎注定会在未来50年影响TBI研究的重要方向:在国际研究联盟的支持下,开展大规模、多地点的观察性研究和随机对照试验,并采用通用数据元素;以及通过应用从实施科学中汲取的严格方法,尝试将研究转化为医疗保健和卫生政策。由这些趋势塑造的未来研究应提供关于TBI及其治疗结果的关键证据,并应有助于传播和实施从研究中获得的知识,以改善TBI患者的生活质量。(《神经心理学杂志》,2017年,第23卷,第806 - 817页)