Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, USA; Hunter Holmes McGuire VA Medical Center, USA.
Department of Biostatistics, Virginia Commonwealth University, USA.
Clin Neurophysiol. 2021 Dec;132(12):2979-2988. doi: 10.1016/j.clinph.2021.09.007. Epub 2021 Oct 8.
Auditory event-related potential (ERP) correlates of pre-dementia in late-life may also be sensitive to chronic effects of mild traumatic brain injury (mTBI) in mid-life. In addition to mTBI history, other clinical factors may also influence ERP measures of brain function. This study's objective was to evaluate the relationship between mTBI history, auditory ERP metrics, and common comorbidities.
ERPs elicited during an auditory target detection task, psychological symptoms, and hearing sensitivity were collected in 152 combat-exposed veterans and service members, as part of a prospective observational cohort study. Participants, with an average age of 43.6 years, were grouped according to positive (n = 110) or negative (n = 42) mTBI history. Positive histories were subcategorized into repetitive mTBI (3 + ) (n = 40) or non-repetitive (1-2) (n = 70).
Positive history of mTBI was associated with reduced N200 amplitude to targets and novel distractors. In participants with repetitive mTBI compared to non-repetitive and no mTBI, P50 was larger in response to nontargets and N100 was smaller in response to nontargets and targets. Changes in N200 were mediated by depression and anxiety symptoms and hearing loss, with no evidence of a supplementary direct mTBI pathway.
Auditory brain function differed between the positive and negative mTBI groups, especially for repetitive injury, which implicated more basic, early auditory processing than did any mTBI exposure. Symptoms of internalizing psychopathology (depression and anxiety) and hearing loss are implicated in mTBI's diminished brain responses to behaviorally relevant and novel stimuli.
A mid-life neurologic vulnerability conferred by mTBI, particularly repetitive mTBI, may be detectable using auditory brain potentials, and so auditory ERPs are a target for study of dementia risk in this population.
老年期痴呆的听觉事件相关电位（ERP）相关因素也可能对中年期轻度创伤性脑损伤（mTBI）的慢性影响敏感。除了 mTBI 病史外，其他临床因素也可能影响脑功能的 ERP 测量。本研究的目的是评估 mTBI 病史、听觉 ERP 指标和常见合并症之间的关系。
在一项听觉目标检测任务中，共收集了 152 名经历过战斗的退伍军人和现役军人的 ERP、心理症状和听力敏感度，作为前瞻性观察队列研究的一部分。参与者的平均年龄为 43.6 岁，根据 mTBI 病史分为阳性（n=110）或阴性（n=42）。阳性病史分为重复 mTBI（3+）（n=40）或非重复（1-2）（n=70）。
mTBI 阳性史与目标和新干扰物的 N200 振幅降低有关。与非重复和无 mTBI 相比，重复 mTBI 参与者的 P50 对非目标的反应更大，N100 对非目标和目标的反应更小。N200 的变化是由抑郁和焦虑症状以及听力损失介导的，没有证据表明 mTBI 有直接的通路。
阳性和阴性 mTBI 组之间的听觉脑功能不同，尤其是重复损伤，比任何 mTBI 暴露都更涉及基本的、早期的听觉处理。内化心理病理学（抑郁和焦虑）和听力损失的症状与 mTBI 对行为相关和新刺激的大脑反应减弱有关。
mTBI 赋予的中年期神经易损性，特别是重复 mTBI，可能可以通过听觉脑电位来检测，因此听觉 ERP 是该人群痴呆风险研究的目标。
