Di Stefano G, Radanov B P
Klinik Bethesda, Clinic for Epilepsy and Neurorehabilitation, Tschugg, Switzerland.
Acta Neurol Scand. 1995 May;91(5):346-52. doi: 10.1111/j.1600-0404.1995.tb07019.x.
Attentional functioning and memory of common whiplash patients were evaluated during the first two years after experiencing injury. The study was based on a non-selected sample of 117 whiplash patients referred from primary care and recruited according to a strict injury definition. All patients had a similar socioeconomic background, all being injured in automobile accidents and fully covered by insurance plans. Two years following initial trauma, 21 patients remained symptomatic. For each of these 21 patients, a counterpart matched by age, educational attainment and gender was selected from the group of patients who had fully recovered during the follow-up period. Symptomatic patients and matched controls were compared with regard to baseline, six-months and two-years findings. Examinations included testing of different aspects of attention (i.e. Digit Span, Corsi Block-Tapping Test, Trail Making Test, Number Connection Test, Paced Auditory Serial Addition Task) and memory functioning (California Verbal Learning Test). Cognitive functioning was assessed in conjunction with self-ratings of cognitive abilities (Cognitive Failures Questionnaire), well-being (Well-being Scale), headache and neckpain intensity, utilized medication and subjective complaints. Results show no impairment of memory in symptomatic patients. In attentional functioning, different levels of improvement were found for symptomatic patients and matched counterparts, with the former showing difficulty at follow-up with tasks of divided attention. Utilized medication and pain intensity could not explain this difference in recovery of attentional functioning between the groups. These findings suggest problems in selective aspects of attentional functioning after common whiplash, which under real life circumstances may explain these patients' cognitive complaints and cause adaptational problems in daily life.
在普通挥鞭样损伤患者受伤后的头两年内，对其注意力功能和记忆力进行了评估。该研究基于从初级保健机构转诊的117名挥鞭样损伤患者的非选择性样本，并根据严格的损伤定义进行招募。所有患者具有相似的社会经济背景，均在汽车事故中受伤且全部由保险计划承保。初始创伤两年后，21名患者仍有症状。对于这21名患者中的每一位，从随访期间已完全康复的患者组中挑选出年龄、教育程度和性别相匹配的对照者。对有症状患者和匹配的对照者在基线、六个月和两年时的检查结果进行了比较。检查包括对注意力不同方面（即数字广度、科西方块敲击测试、连线测验、数字连接测试、听觉连续加法任务）和记忆功能（加利福尼亚言语学习测试）的测试。结合认知能力自评（认知失误问卷）、幸福感（幸福感量表）、头痛和颈部疼痛强度、所用药物及主观症状对认知功能进行评估。结果显示，有症状患者的记忆力未受损。在注意力功能方面，有症状患者和匹配的对照者有不同程度的改善，前者在随访时进行分散注意力任务有困难。所用药物和疼痛强度无法解释两组在注意力功能恢复方面的这种差异。这些发现表明普通挥鞭样损伤后注意力功能的某些特定方面存在问题，在现实生活中这可能解释了这些患者的认知症状，并导致其在日常生活中出现适应问题。
