Hwang Kyu-Sic, Jang Seung-Ho, Soh Min-Jung, Lee Hye-Jin, Lee Sang-Yeol
Department of Psychiatry, Wonkwang University Hospital, Iksan, Republic of Korea.
Korea Brain-Behavior Mental Health Institute, Iksan, Republic of Korea.
Psychiatry Investig. 2019 Dec;16(12):889-895. doi: 10.30773/pi.2019.0129. Epub 2019 Nov 13.
Previous studies of cognitive decline in patients with neurocognitive disorder due to traumatic brain injury (NCD-TBI) have often failed to control for baseline factors such as premorbid intelligence. The purpose of the current study was to estimate and compare cognitive function among three groups (controls, complicated mild/moderate TBI, and severe TBI) after controlling for premorbid intelligence.
Severity of TBI was classified as complicated mild/moderate or severe based on duration of loss of consciousness and brain neuroimaging results. Premorbid intelligence quotients (IQs) were estimated with the Oklahoma Premorbid Intelligence Estimate. There were no differences in premorbid intelligence between the groups, which were also matched for age and education. Current cognitive function was evaluated with the Wechsler Adult Intelligence Scale-Fourth Edition.
Comparison of current cognitive function among the three groups indicated significant group differences for all indexes and subtest scores. Processing speed showed the highest effect size. However, only working memory differed significantly between the two NCD-TBI groups.
The present findings suggest that mental memory manipulation processes seem to be more sensitive to TBI severity than are perceptual-motor processes. Specifically, both auditory rehearsal/discrimination and mental alertness/manipulation will be most strongly influenced by TBI severity.
既往关于创伤性脑损伤所致神经认知障碍（NCD-TBI）患者认知衰退的研究常常未能控制诸如病前智力等基线因素。本研究的目的是在控制病前智力之后，估计并比较三组（对照组、复杂型轻度/中度创伤性脑损伤组和重度创伤性脑损伤组）的认知功能。
根据意识丧失持续时间和脑神经影像学结果，将创伤性脑损伤的严重程度分为复杂型轻度/中度或重度。采用俄克拉荷马病前智力评估法估计病前智商。各组之间病前智力无差异，且在年龄和教育程度上也相匹配。采用韦氏成人智力量表第四版评估当前认知功能。
三组之间当前认知功能的比较表明，所有指标和子测验分数在组间均存在显著差异。加工速度的效应量最高。然而，两个NCD-TBI组之间仅工作记忆存在显著差异。
本研究结果表明，与感知运动过程相比，心理记忆操作过程似乎对创伤性脑损伤的严重程度更为敏感。具体而言，听觉复述/辨别和心理警觉性/操作将受到创伤性脑损伤严重程度的最强烈影响。
