Van Praag Dominique L G, Van Den Eede Filip, Wouters Kristien, Wilson Lindsay, Maas Andrew I R
Department of Psychology, Antwerp University Hospital, 2650 Edegem, Belgium.
Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, 2610 Wilrijk, Belgium.
J Clin Med. 2021 Oct 30;10(21):5109. doi: 10.3390/jcm10215109.
One out of seven individuals who have suffered a traumatic brain injury (TBI) develops a posttraumatic stress disorder (PTSD), which is often associated with neurocognitive impairment. The present study explores the impact of neurocognitive functioning after mild, moderate, and severe TBI on the course of PTSD symptoms.
The data of 671 adults admitted to hospital for a TBI was drawn from the Collaborative European Neurotrauma Effectiveness Research (CENTER-TBI) study. After six- and 12-months post-injury, participants completed the PTSD Checklist-5 (PCL-5), from which change scores were calculated. At six months, participants also completed a neurocognitive assessment including the Rey Auditory Verbal Learning Test, the Trail Making Test, and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Linear regressions were performed to identify associations between cognitive functioning and PCL-5 change scores.
Overall, mean PCL-5 change scores showed no clear change (-0.20 ± 9.88), but 87 improved and 80 deteriorated by a change score of 10 or more. CANTAB Rapid Visual Information Processing scores were significantly associated with PCL-5 change scores.
Strong sustained attention was associated with improvement in PTSD symptoms. Assessing cognitive performance may help identify individuals at risk of developing (persisting) PTSD post-TBI and offer opportunities for informing treatment strategies.
每七名遭受创伤性脑损伤（TBI）的个体中就有一人会患上创伤后应激障碍（PTSD），而这通常与神经认知障碍有关。本研究探讨了轻度、中度和重度TBI后神经认知功能对PTSD症状病程的影响。
671名因TBI入院的成年人的数据取自欧洲神经创伤协作有效性研究（CENTER-TBI）。在受伤后6个月和12个月，参与者完成了创伤后应激障碍检查表-5（PCL-5），并据此计算变化分数。在6个月时，参与者还完成了一项神经认知评估，包括雷伊听觉词语学习测试、连线测验和剑桥神经心理测试自动成套系统（CANTAB）。进行线性回归以确定认知功能与PCL-5变化分数之间的关联。
总体而言，PCL-5平均变化分数没有明显变化（-0.20±9.88），但有87人改善，80人恶化，变化分数为10或更高。CANTAB快速视觉信息处理分数与PCL-5变化分数显著相关。
持续高度的注意力与PTSD症状的改善有关。评估认知表现可能有助于识别TBI后有发展（持续）PTSD风险的个体，并为制定治疗策略提供依据。
