McGeown Joshua P, Hume Patria A, Kara Stephen, King Doug, Theadom Alice
Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand.
Traumatic Brain Injury Network, Auckland University of Technology, Auckland, New Zealand.
Sports Med Open. 2021 Aug 9;7(1):56. doi: 10.1186/s40798-021-00340-8.
To evaluate the clinical utility of tactile somatosensory assessments to assist clinicians in diagnosing sport-related mild traumatic brain injury (SR-mTBI), classifying recovery trajectory based on performance at initial clinical assessment, and determining if neurophysiological recovery coincided with clinical recovery.
Prospective cohort study with normative controls.
At admission (n = 79) and discharge (n = 45/79), SR-mTBI patients completed the SCAT-5 symptom scale, along with the following three components from the Cortical Metrics Brain Gauge somatosensory assessment (BG-SA): temporal order judgement (TOJ), TOJ with confounding condition (TOJc), and duration discrimination (DUR). To assist SR-mTBI diagnosis on admission, BG-SA performance was used in logistic regression to discriminate cases belonging to the SR-mTBI sample or a healthy reference sample (pooled BG-SA data for healthy participants in previous studies). Decision trees evaluated how accurately BG-SA performance classified SR-mTBI recovery trajectories.
BG-SA TOJ, TOJc, and DUR poorly discriminated between cases belonging to the SR-mTBI sample or a healthy reference sample (0.54-0.70 AUC, 47.46-64.71 PPV, 48.48-61.11 NPV). The BG-SA evaluated did not accurately classify SR-mTBI recovery trajectories (> 14-day resolution 48%, ≤14-day resolution 54%, lost to referral/follow-up 45%). Mann-Whitney U tests revealed differences in BG-SA TOJc performance between SR-mTBI participants and the healthy reference sample at initial clinical assessment and at clinical recovery (p < 0.05).
BG-SA TOJ, TOJc, and DUR appear to have limited clinical utility to assist clinicians with diagnosing SR-mTBI or predicting recovery trajectories under ecologically valid conditions. Neurophysiological abnormalities persisted beyond clinical recovery given abnormal BG-SA TOJc performance observed when SR-mTBI patients achieved clinical recovery.
评估触觉体感评估在协助临床医生诊断运动相关轻度创伤性脑损伤（SR-mTBI）、根据初始临床评估表现对恢复轨迹进行分类以及确定神经生理恢复是否与临床恢复一致方面的临床效用。
有正常对照的前瞻性队列研究。
在入院时（n = 79）和出院时（n = 45/79），SR-mTBI患者完成了SCAT-5症状量表，以及皮质测量脑量表体感评估（BG-SA）的以下三个部分：时间顺序判断（TOJ）、有混淆条件的时间顺序判断（TOJc）和时长辨别（DUR）。为协助入院时的SR-mTBI诊断，BG-SA表现被用于逻辑回归，以区分属于SR-mTBI样本或健康对照样本的病例（汇总先前研究中健康参与者的BG-SA数据）。决策树评估了BG-SA表现对SR-mTBI恢复轨迹分类的准确程度。
BG-SA的TOJ、TOJc和DUR在区分属于SR-mTBI样本或健康对照样本的病例方面表现不佳（曲线下面积0.54 - 0.70，阳性预测值47.46 - 64.71，阴性预测值48.48 - 61.11）。所评估的BG-SA未能准确分类SR-mTBI恢复轨迹（> 14天恢复48%，≤ 14天恢复54%，失访/随访失败45%）。曼-惠特尼U检验显示，在初始临床评估和临床恢复时，SR-mTBI参与者与健康对照样本之间在BG-SA的TOJc表现上存在差异（p < 0.05）。
BG-SA的TOJ、TOJc和DUR在生态有效条件下协助临床医生诊断SR-mTBI或预测恢复轨迹方面的临床效用似乎有限。鉴于SR-mTBI患者临床恢复时观察到BG-SA的TOJc表现异常，神经生理异常在临床恢复后仍持续存在。
