Author Affiliations: TIRR Memorial Hermann, Houston, Texas (Drs Juengst, Perna, and Taiwo); Departments of Physical Medicine & Rehabilitation (Dr Juengst) and Biostatistics and Data Science (Dr Novelo), The University of Texas Health Science Center at Houston; Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas (Drs Juengst and Wright); Spectrum Health Medical Group, Neurosciences, Grand Rapids, Michigan (Dr Vos); Department of Psychology, University of Houston, Houston, Texas (Dr Williams and Ms Dudek); School of Nursing, The University of Texas Medical Branch, Galveston (Dr DeMello); and Department of Neurology, Section of Neuropsychology, Baylor College of Medicine, Houston, Texas (Dr Taiwo).
J Head Trauma Rehabil. 2024;39(2):E83-E94. doi: 10.1097/HTR.0000000000000887. Epub 2024 Mar 18.
To determine the association between self-reported emotional and cognitive symptoms and participation outcomes in chronic traumatic brain injury (TBI) and to explore the relative contribution of self-reported versus performance-based cognition to participation outcomes.
Community.
Community-dwelling adults ( n = 135) with a lifetime history of mild to severe TBI.
Secondary analysis of a cross-sectional study on neurobehavioral symptoms in chronic TBI.
Behavioral Assessment Screening Tool (BAST) (Negative Affect, Fatigue, Executive Dysfunction, Impulsivity, Substance Abuse subscales) measured self-reported neurobehavioral symptoms; Participation Assessment with Recombined Tools (Productivity, Social Relations, and Out and About) measured self-reported participation outcomes; and Brief Test of Adult Cognition by Telephone (BTACT) measured performance-based cognition (Episodic Memory and Executive Function summary scores) in a subsample ( n = 40).
The BAST Executive Dysfunction was significantly associated with less frequent participation and had the strongest effect on participation in all participation domains. No other BAST subscales were associated with participation, after adjusting for all subscale scores and age, with the exception of BAST Impulsivity, which was associated with more frequent Social Relationships. Exploratory analysis in the sample including the BTACT revealed that, after accounting for subjective Executive Dysfunction using the BAST, performance-based Executive Function was associated with Productivity and Working Memory was associated with Social Relations, but neither was associated with being Out and About; the BAST Executive Dysfunction remained significant in all models even after including BTACT scores.
Self-reported Executive Dysfunction contributed to participation outcomes after mild to severe TBI in community-dwelling adults, whereas self-reported emotional and fatigue symptoms did not. Performance-based cognition measures may capture different variability in participation after injury.
确定自我报告的情绪和认知症状与慢性创伤性脑损伤（TBI）的参与结果之间的关联，并探讨自我报告与基于表现的认知对参与结果的相对贡献。
社区。
有轻度至重度 TBI 终生史的社区居住成年人（n=135）。
对慢性 TBI 神经行为症状的横断面研究进行二次分析。
行为评估筛选工具（BAST）（负性情绪、疲劳、执行功能障碍、冲动、物质滥用子量表）测量自我报告的神经行为症状；参与评估与重组工具（生产力、社会关系和外出和外出）测量自我报告的参与结果；以及在亚组（n=40）中使用电话进行成人认知简易测试（BTACT）测量基于表现的认知（情景记忆和执行功能综合得分）。
BAST 执行功能障碍与参与频率较低显著相关，并且对所有参与领域的参与都有最强的影响。在调整所有子量表评分和年龄后，除 BAST 冲动与更频繁的社会关系相关外，没有其他 BAST 子量表与参与相关。在包括 BTACT 的样本中进行的探索性分析表明，在用 BAST 评估主观执行功能后，基于表现的执行功能与生产力相关，工作记忆与社会关系相关，但两者都与外出无关；即使包括 BTACT 评分，BAST 执行功能障碍在所有模型中仍然显著。
在社区居住的成年人中，自我报告的执行功能障碍与轻度至重度 TBI 后的参与结果相关，而自我报告的情绪和疲劳症状则没有。基于表现的认知测量可能会在受伤后捕获参与的不同变化。
