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轻度创伤性脑损伤伴意识丧失后长期前瞻性记忆障碍:来自加拿大老龄化纵向研究的结果。

Long-term prospective memory impairment following mild traumatic brain injury with loss of consciousness: findings from the Canadian Longitudinal Study on Aging.

机构信息

a Bruyère Research Institute , Ottawa , Canada.

b School of Psychology , University of Ottawa , Ottawa , Canada.

出版信息

Clin Neuropsychol. 2018 Jul;32(5):1002-1018. doi: 10.1080/13854046.2017.1404644. Epub 2017 Dec 18.

Abstract

OBJECTIVE

We aimed to examine the extent to which loss of consciousness (LOC) following mild traumatic brain injury (mTBI) may be associated with impairments in time- and event-based prospective memory (PM). PM is thought to involve executive processes and be subserved by prefrontal regions. Neuroimaging research suggests alterations to these areas of the brain several years after mTBI, particularly if LOC was experienced. However, it remains unclear whether impairments in time- or event-based functioning may persist more than a year after mTBI, and what the link with duration of LOC may be.

METHOD

Analyses were run on data from the Canadian Longitudinal Study on Aging, a nationwide study on health and aging involving individuals between the ages of 45-85. The present study consisted of 1937 participants who experienced mTBI more than 12 months prior, of whom 1146 reported spending less than 1 min unconscious, and 791 had LOC between 1 and 20 min, and 13,525 cognitively healthy adults. Participants were administered the Miami Prospective Memory Test, and tests of retrospective memory and executive functioning.

RESULTS

Both mTBI groups were impaired in time-based PM relative to people with no history of TBI. Time- and event-based impairments were predicted by older age, and executive dysfunction among those who spent more time unconscious.

CONCLUSIONS

Those with mTBI with LOC may experience impairments in PM, particularly in conditions of high demand on executive processes (time-based PM). Implications for interventions aimed at ameliorating PM among those who have experienced mTBI are discussed.

摘要

目的

我们旨在研究轻度创伤性脑损伤(mTBI)后意识丧失(LOC)与时间和事件为基础的前瞻性记忆(PM)损伤的程度。PM 被认为涉及执行过程,由前额叶区域提供。神经影像学研究表明,在 mTBI 后几年,这些大脑区域会发生变化,尤其是在经历 LOC 的情况下。然而,尚不清楚时间或事件为基础的功能障碍是否会在 mTBI 后持续一年以上,以及与 LOC 持续时间的关系是什么。

方法

分析了加拿大老龄化纵向研究的数据,这是一项涉及 45-85 岁人群的全国性健康与老龄化研究。本研究包括 1937 名在 12 个月以上前经历过 mTBI 的参与者,其中 1146 名报告无意识时间少于 1 分钟,791 名 LOC 时间在 1 至 20 分钟之间,13525 名认知健康的成年人。参与者接受了迈阿密前瞻性记忆测试以及回溯记忆和执行功能测试。

结果

与没有 TBI 史的人相比,两个 mTBI 组在时间为基础的 PM 上都有损伤。时间和事件为基础的损伤是由年龄较大和那些无意识时间较长的人执行功能障碍预测的。

结论

那些有 LOC 的 mTBI 患者可能会出现 PM 损伤,特别是在执行过程(时间为基础的 PM)要求较高的情况下。讨论了针对经历过 mTBI 的人改善 PM 的干预措施的意义。

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