Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Arch Phys Med Rehabil. 2020 Jan;101(1):72-80. doi: 10.1016/j.apmr.2019.08.477. Epub 2019 Sep 25.
To investigate whether cognitive reserve moderates differences in cognitive functioning between patients with mild traumatic brain injury (MTBI) and controls without MTBI and to examine whether patients with postconcussion syndrome have lower cognitive functioning than patients without postconcussion syndrome at 2 weeks and 3 months after injury.
Trondheim MTBI follow-up study is a longitudinal controlled cohort study with cognitive assessments 2 weeks and 3 months after injury.
Recruitment at a level 1 trauma center and at a general practitioner-run, outpatient clinic.
Patients with MTBI (n=160) according to the World Health Organization criteria, trauma controls (n=71), and community controls (n=79) (N=310).
A cognitive composite score was used as outcome measure. The Vocabulary subtest was used as a proxy of cognitive reserve. Postconcussion syndrome diagnosis was assessed at 3 months with the British Columbia Postconcussion Symptom Inventory.
Linear mixed models demonstrated that the effect of vocabulary scores on the cognitive composite scores was larger in patients with MTBI than in community controls at 2 weeks and at 3 months after injury (P=.001). Thus, group differences in the cognitive composite score varied as a function of vocabulary scores, with the biggest differences seen among participants with lower vocabulary scores. There were no significant differences in the cognitive composite score between patients with (n=29) and without (n=131) postconcussion syndrome at 2 weeks or 3 months after injury.
Cognitive reserve, but not postconcussion syndrome, was associated with cognitive outcome after MTBI. This supports the cognitive reserve hypothesis in the MTBI context and suggests that persons with low cognitive reserve are more vulnerable to reduced cognitive functioning if they sustain an MTBI.
研究认知储备是否能缓和轻度外伤性脑损伤（MTBI）患者与无 MTBI 的对照组之间认知功能的差异，并检验脑震荡后综合征患者在伤后 2 周和 3 个月时的认知功能是否低于无脑震荡后综合征患者。
特隆赫姆 MTBI 随访研究是一项具有 2 周和 3 个月伤后认知评估的纵向对照队列研究。
在 1 级创伤中心和由家庭医生经营的门诊诊所招募患者。
根据世界卫生组织标准，共纳入 160 例 MTBI 患者、71 例创伤对照者和 79 例社区对照者（共 310 例）。
认知综合评分作为观察指标。词汇测验被用作认知储备的替代指标。3 个月时采用不列颠哥伦比亚脑震荡后症状清单评估脑震荡后综合征诊断。
线性混合模型显示，词汇得分对认知综合评分的影响在伤后 2 周和 3 个月时，在 MTBI 患者中比在社区对照者中更大（P=.001）。因此，认知综合评分的组间差异随词汇得分的变化而变化，词汇得分较低的参与者之间差异最大。在伤后 2 周和 3 个月时，有脑震荡后综合征（n=29）和无脑震荡后综合征（n=131）的患者之间的认知综合评分均无显著差异。
认知储备，但不是脑震荡后综合征，与 MTBI 后的认知结局相关。这支持了 MTBI 背景下的认知储备假说，并表明如果个体发生 MTBI，认知储备较低的人更易出现认知功能下降。
