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重复性轻度创伤性脑损伤和意识丧失的长期静息脑电图相关性:α-β功率改变

Long-term resting EEG correlates of repetitive mild traumatic brain injury and loss of consciousness: alterations in alpha-beta power.

作者信息

Franke Laura M, Perera Robert A, Sponheim Scott R

机构信息

Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States.

Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States.

出版信息

Front Neurol. 2023 Aug 29;14:1241481. doi: 10.3389/fneur.2023.1241481. eCollection 2023.

Abstract

OBJECTIVE

Long-term changes to EEG spectra after mild traumatic brain injury (mTBI, i.e., concussion) have been reported; however, the role of injury characteristics in long-term EEG changes is unclear. It is also unclear how any chronic EEG changes may underlie either subjective or objective cognitive difficulties, which might help explain the variability in recovery after mTBI.

METHODS

This study included resting-state high-density electroencephalography (EEG) and mTBI injury data from 340 service members and veterans collected on average 11 years after injury as well as measures of objective and subjective cognitive functioning. The average absolute power within standard bands was computed across 11 spatial regions of the scalp. To determine how variation in brain function was accounted for by injury characteristics and aspects of cognition, we used regression analyses to investigate how EEG power was predicted by mTBI history characteristics [number, number with post-traumatic amnesia and witnessed loss of consciousness (PTA + LOC), context of injury (combat or non-combat), potentially concussive blast exposures], subjective complaints (TBIQOL General Cognitive and Executive Function Concerns), and cognitive performance (NIH Toolbox Fluid Intelligence and premorbid IQ).

RESULTS

Post-traumatic amnesia (PTA) and loss of consciousness (LOC), poorer cognitive performance, and combat experience were associated with reduced power in beta frequencies. Executive function complaints, lower premorbid IQ, poorer cognitive performance, and higher psychological distress symptoms were associated with greater power of delta frequencies. Multiple regression confirmed the relationship between PTA + LOC, poor cognitive performance, cognitive complaints, and reduced power in beta frequencies and revealed that repetitive mTBI was associated with a higher power in alpha and beta frequencies. By contrast, neither dichotomous classification of the presence and absence of mTBI history nor blast exposures showed a relationship with EEG power variables.

CONCLUSION

Long-term alterations in resting EEG spectra measures of brain function do not appear to reflect any lasting effect of a history of mTBI or blast exposures. However, power in higher frequencies reflects both injury characteristics and subjective and objective cognitive difficulties, while power in lower frequencies is related to cognitive functions and psychological distress associated with poor long-term outcomes after mTBI.

摘要

目的

已有研究报道了轻度创伤性脑损伤(mTBI,即脑震荡)后脑电图(EEG)频谱的长期变化;然而,损伤特征在EEG长期变化中的作用尚不清楚。同样不清楚的是,任何慢性EEG变化如何可能是主观或客观认知困难的基础,这可能有助于解释mTBI后恢复的变异性。

方法

本研究纳入了340名现役军人和退伍军人的静息态高密度脑电图(EEG)和mTBI损伤数据,这些数据平均在受伤后11年收集,以及客观和主观认知功能的测量指标。计算头皮11个空间区域内标准频段的平均绝对功率。为了确定损伤特征和认知方面如何解释脑功能的变化,我们使用回归分析来研究mTBI病史特征[数量、伴有创伤后遗忘和目睹意识丧失(PTA + LOC)的数量、损伤背景(战斗或非战斗)、潜在的震荡性爆炸暴露]、主观主诉(TBIQOL一般认知和执行功能问题)和认知表现(NIH工具箱流体智力和病前智商)如何预测EEG功率。

结果

创伤后遗忘(PTA)和意识丧失(LOC)、较差的认知表现以及战斗经历与β频段功率降低有关。执行功能主诉、较低的病前智商、较差的认知表现以及较高的心理困扰症状与δ频段功率增加有关。多元回归证实了PTA + LOC、较差的认知表现、认知主诉与β频段功率降低之间的关系,并表明重复性mTBI与α和β频段较高的功率有关。相比之下,mTBI病史的有无二分分类以及爆炸暴露均与EEG功率变量无关。

结论

静息EEG频谱测量的脑功能长期改变似乎并未反映mTBI病史或爆炸暴露的任何持久影响。然而,高频段功率反映了损伤特征以及主观和客观认知困难,而低频段功率与mTBI后长期不良结局相关的认知功能和心理困扰有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61ae/10495577/0b2d8c74f9f5/fneur-14-1241481-g0001.jpg

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