颅脑损伤后视觉注意成分的变化：系统评价和荟萃分析。
Changes in the components of visual attention following traumatic brain injury: A systematic review and meta-analysis.
机构信息
School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.
Department of Optometry, College of Applied Medical Science, Qassim University, Buraydah, Saudi Arabia.
出版信息
PLoS One. 2022 Jun 9;17(6):e0268951. doi: 10.1371/journal.pone.0268951. eCollection 2022.
PURPOSE
We conducted a systematic review and meta-analysis to understand the impact of traumatic brain injury (TBI) on visual attention and whether different components and processes of visual attention (such as selective, sustained, divided, and covert orientation of visual attention) are affected following brain injury.
METHODS
A literature search between January 1980 to May 2021 was conducted using Medline, Scopus, PubMed, and Google Scholar databases was undertaken for studies that assessed visual attention using different tasks that target specific or multiple components of visual attention. Three hundred twenty-nine potentially relevant articles were identified, and 20 studies met our inclusion criteria.
RESULTS
A total of 123 effect sizes (ES) were estimated from 20 studies that included 519 patients with TBI and 530 normal participants. The overall combined ES was statistically significant and large (ES = 0.92), but with high heterogeneity (Q = 614.83, p < 0.0001, I2 = 80.32%). Subgroup analysis showed that the impact of TBI severity, with the ES for moderate-severe TBI significantly higher than mild TBI (t (112) = 3.11, p = 0.002). Additionally, the component of visual attention was differentially affected by TBI (F (2, 120) = 10.25, p<0.0001); the ES for selective attention (ES = 1.13) and covert orientation of visual attention (ES = 1.14) were large, whilst for sustained attention, the ES was medium at 0.43. A subgroup analysis comparing outcome measures showed that reaction time (ES = 1.12) was significantly more affected compared to performance accuracy (ES = 0.43), F (1, 96) = 25.98, p<0.0001).
CONCLUSION
Large and significant deficits in visual attention was found following TBI which can last for years after the initial injury. However, different components of visual attention were not affected to the same extent, with selective visual attention and orientation of visual attention most affected following TBI.
目的
我们进行了一项系统回顾和荟萃分析，以了解创伤性脑损伤 (TBI) 对视注意力的影响，以及脑损伤后视觉注意力的不同成分和过程（如选择性、持续性、分散性和隐蔽性视觉注意力定向）是否受到影响。
方法
使用 Medline、Scopus、PubMed 和 Google Scholar 数据库，对 1980 年 1 月至 2021 年 5 月期间的文献进行了检索，以评估使用不同任务评估视觉注意力的研究，这些任务针对特定或多个视觉注意力成分。确定了 329 篇潜在相关文章，其中 20 项研究符合纳入标准。
结果
共有 123 个效应量（ES）来自 20 项研究，这些研究包括 519 名 TBI 患者和 530 名正常参与者。总的合并 ES 具有统计学意义且较大（ES=0.92），但存在高度异质性（Q=614.83，p<0.0001，I2=80.32%）。亚组分析显示，TBI 严重程度的影响，其中中重度 TBI 的 ES 明显高于轻度 TBI（t(112)=3.11，p=0.002）。此外，视觉注意力的成分也受到 TBI 的不同影响（F(2,120)=10.25，p<0.0001）；选择性注意力（ES=1.13）和隐蔽性视觉注意力定向（ES=1.14）的 ES 较大，而持续性注意力的 ES 为 0.43，属于中等水平。一项比较结局测量的亚组分析表明，反应时间（ES=1.12）的影响明显大于表现准确性（ES=0.43），F(1,96)=25.98，p<0.0001）。
结论
TBI 后会出现明显且严重的视觉注意力缺陷，并且这种缺陷可能会在初始损伤后持续多年。然而，不同的视觉注意力成分受到的影响程度并不相同，选择性视觉注意力和隐蔽性视觉注意力定向受到的影响最大。
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