Jones Kelly M, Prah Philip, Starkey Nicola, Theadom Alice, Barker-Collo Suzanne, Ameratunga Shanthi, Feigin Valery L
a National Institute for Stroke and Applied Neurosciences, School of Public Health & Psychosocial Studies, Faculty of Health and Environmental Studies , Auckland University of Technology , Auckland , New Zealand.
b School of Psychology, Faculty of Arts & Social Sciences , The University of Waikato , Hamilton , New Zealand.
Brain Inj. 2019;33(7):884-893. doi: 10.1080/02699052.2019.1606445. Epub 2019 Apr 23.
: Research following mild traumatic brain injury (mTBI) during childhood predominantly examines recovery up to 12 months post-injury. : To determine children's longer-term (4 years) patterns and predictors of recovery. : Parents of 196 children (aged 1-15 years) completed the Behaviour Assessment System for Children and Pediatric Quality of Life Inventory at baseline, 1, 6, 12, and 48 months post-injury. Children aged ≥8 years at each assessment completed a computerized neurocognitive testing battery. At 1 month, parents completed the Hospital Anxiety and Depression Scale. Multilevel modeling accounted for repeated measures. : Children had significantly fewer child behavior problems, better adaptability, and improved quality of life after 12 months. Concurrent improvements in overall neurocognitive function were no longer significant once adjusted for age, gender, and socio-economic status. From 12 to 48 months, quality of life reduced significantly while child behavior and neurocognition plateaued. Child behavior problems and worse quality of life were associated with parental anxiety and lower socio-economic satus. : Children's recovery in the year following mTBI appears to plateau from 12 to 48 months, with a concomitant reduction in quality of life. Identification and treatment of parent mental health issues may reduce the exacerbation of negative child outcomes following mTBI.
儿童期轻度创伤性脑损伤（mTBI）后的研究主要考察损伤后12个月内的恢复情况。为了确定儿童的长期（4年）恢复模式和预测因素。196名儿童（年龄在1至15岁之间）的父母在损伤后基线、1个月、6个月、12个月和48个月时完成了儿童行为评估系统和儿童生活质量量表。每次评估时年龄≥8岁的儿童完成了一套计算机化神经认知测试。在1个月时，父母完成了医院焦虑抑郁量表。多水平模型考虑了重复测量。12个月后，儿童的行为问题显著减少，适应性更好，生活质量得到改善。一旦对年龄、性别和社会经济地位进行调整，总体神经认知功能的同时改善就不再显著。从12个月到48个月，生活质量显著下降，而儿童行为和神经认知趋于平稳。儿童行为问题和较差的生活质量与父母焦虑和较低的社会经济地位有关。儿童mTBI后12至48个月的恢复似乎趋于平稳，同时生活质量下降。识别和治疗父母的心理健康问题可能会减少mTBI后儿童负面结果的恶化。
