Department of Neurology, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands.
Research School of Behavioural and Cognitive Neurosciences (BCN), University of Groningen, Groningen, The Netherlands.
Brain Inj. 2024 Jun 6;38(7):550-558. doi: 10.1080/02699052.2024.2328307. Epub 2024 Mar 13.
Older adults (OA) after mild traumatic brain injury (mTBI) have a high risk of developing persistent post-injury cognitive impairments. Lower pre-morbid cognitive reserve (CR) is increasingly investigated as a risk factor for cognitive dysfunction in OA. However, how CR protects against effects of mTBI at the brain level remains largely understudied.
We examined 22 OA who sustained mTBI (mean 67.69 years, SD 5.11) in the sub-acute phase and 15 age- and CR-matched healthy OA (mean 68 years, SD 5.55) performing a three-level visual N-back task using electroencephalography. We calculated inverse efficiency scores of performance from accuracy and reaction times. Event-related potentials served as neurocognitive correlates of attentional (P2) and working memory (P3) processing.
Overall, mTBI OA performed worse than healthy OA ( = 0.031). Lower CR generally decreased performance ( < 0.001). Furthermore, with increasing task difficulty, task performance was more affected by CR ( = 0.004). At the brain level, P2 amplitude was lower in mTBI OA than in healthy OA ( = 0.05). There was no clear effect of CR on P2 or P3 measures.
As mTBI OA with lower CR performed worse on a working-memory task, lower CR may be a risk factor for worse recovery after mTBI in this group.
轻度创伤性脑损伤（mTBI）后老年人（OA）发生持续性损伤后认知障碍的风险较高。较低的发病前认知储备（CR）越来越被认为是 OA 认知功能障碍的一个风险因素。然而，CR 如何在大脑水平上保护免受 mTBI 的影响在很大程度上仍未得到充分研究。
我们检查了 22 名处于亚急性期的 mTBI 老年患者（平均年龄 67.69 岁，标准差 5.11）和 15 名年龄和 CR 匹配的健康老年患者（平均年龄 68 岁，标准差 5.55），他们使用脑电图执行了三级视觉 N-回任务。我们从准确性和反应时间计算了表现的逆效率得分。事件相关电位作为注意力（P2）和工作记忆（P3）处理的神经认知相关性。
总的来说，mTBI OA 的表现不如健康 OA（ = 0.031）。较低的 CR 通常会降低表现（ < 0.001）。此外，随着任务难度的增加，CR 对任务表现的影响更大（ = 0.004）。在大脑水平上，mTBI OA 的 P2 振幅低于健康 OA（ = 0.05）。CR 对 P2 或 P3 测量值没有明显影响。
由于 CR 较低的 mTBI OA 在工作记忆任务上表现更差，因此较低的 CR 可能是该组 mTBI 后恢复较差的一个风险因素。
