University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Appl Neuropsychol Child. 2022 Jul-Sep;11(3):253-259. doi: 10.1080/21622965.2020.1799790. Epub 2020 Jul 29.
The purpose of the current study was to examine predictors (e.g., pre-injury anxiety and sub-types, concussion symptom severity, neurocognitive performance, and vestibular/ocular-motor impairment) of post-injury anxiety scores following concussion among youth aged 10-18 years. This observational cohort study enrolled patients ( = 129) within 30 days of a diagnosed concussion. Patients completed Screening for Child Anxiety Related Disorders-Child Reports (SCARED-C), Generalized Anxiety Disorder-7 (GAD-7), Post-concussion Symptom Scale, neurocognitive testing, and Vestibular-Ocular Motor Screening. Logistic regression analyses were conducted to evaluate the role of risk factors and clinical outcomes as predictors of mild (GAD-7 > 5) and moderate levels (GAD-7 > 10) of post-injury anxiety. Twenty-two percent ( = 28) of patients reported clinical levels of pre-injury anxiety, and 13% ( = 17) reported clinical levels of post-injury anxiety. The logistic regression model predicting mild or greater anxiety was significant ( = 31.7%; < 0.001) and supported pre-injury panic symptoms (OR = 1.38) and total symptom severity (OR = 1.04) as the most robust predictors. The logistic regression model predicting clinical anxiety was significant ( = 47.2%; < 0.001) and supported non-SRC injury type (OR = 9.48), vestibular dysfunction (OR = 1.74) and pre-injury panic symptoms (OR = 1.57) as the most robust predictors. Results suggest that clinicians should employ measures of pre-injury and post-injury emotional functioning when evaluating and treating concussion among adolescents. Moreover, these results highlight the importance of assessing different types of pre-injury and post-injury anxiety in the context of concussion management.
本研究的目的是探讨青少年（10-18 岁）脑震荡后损伤后焦虑评分的预测因素（例如，损伤前焦虑和亚型、脑震荡症状严重程度、神经认知表现以及前庭/眼动障碍）。这项观察性队列研究在确诊脑震荡后 30 天内招募了患者（n=129）。患者完成了儿童焦虑相关障碍儿童报告筛查（SCARED-C）、广泛性焦虑障碍-7（GAD-7）、脑震荡后症状量表、神经认知测试和前庭-眼动筛查。采用逻辑回归分析评估危险因素和临床结局作为轻度（GAD-7>5）和中度（GAD-7>10）损伤后焦虑的预测因素的作用。22%（n=28）的患者报告了损伤前的临床焦虑水平，13%（n=17）报告了损伤后的临床焦虑水平。预测轻度或更严重焦虑的逻辑回归模型具有统计学意义（=31.7%；<0.001），支持损伤前惊恐症状（OR=1.38）和总症状严重程度（OR=1.04）是最有力的预测因素。预测临床焦虑的逻辑回归模型具有统计学意义（=47.2%；<0.001），支持非 SRC 损伤类型（OR=9.48）、前庭功能障碍（OR=1.74）和损伤前惊恐症状（OR=1.57）是最有力的预测因素。结果表明，临床医生在评估和治疗青少年脑震荡时，应采用损伤前和损伤后情绪功能的测量方法。此外，这些结果强调了在脑震荡管理背景下评估不同类型的损伤前和损伤后焦虑的重要性。
