认知储备调节轻度创伤性脑损伤后的认知结果

Abstract

Objective: To investigate whether cognitive reserve moderates differences in ognitive functioning between patients with mild traumatic brain injury (MTBI) and controls without MTBI and to examine whether patients with postconcussion syndrome have lower cognitive functioning than patients without postconcussion syndrome at 2 weeks and 3 months after injury.

摘要

目的: 研究认知储备是否能调节轻度创伤性脑损伤(MTBI)患者和无MTBI对照组之间的认知功能差异，并检查脑震荡后综合征患者在伤后2周和3个月的认知功能是否低于无脑震荡后综合征患者。

Design: Trondheim MTBI follow-up study is a longitudinal controlled cohort study with cognitive assessments 2 weeks and 3 months after injury.

设计: 特隆赫姆MTBI随访研究是一项纵向对照队列研究，在损伤后2周和3个月进行认知评估。

Setting: Recruitment at a level 1 trauma center and at a general practitioner-run, outpatient clinic.

背景: 向1级创伤中心和一个全科医生运行的门诊诊所招募。

Participants: Patients with MTBI (nZ160) according to the World Health Organization criteria, trauma controls (nZ71), and community controls (nZ79) (NZ310).

参与者: 根据世界卫生组织标准的创伤控制(nZ71)和社区控制(nZ79) (NZ310)的MTBI患者(nZ160)。

Main Outcome Measures: A cognitive composite score was used as outcome measure. The Vocabulary subtest was used as a proxy of cognitive reserve. Postconcussion syndrome diagnosis was assessed at 3 months with the British Columbia Postconcussion Symptom Inventory.

主要结果指标: 以认知复合得分作为结果指标。用词汇子测试评估认知储备。脑震荡后综合征3个月时，通过不列颠哥伦比亚省脑震荡后症状量表进行评估进行诊断。

Results: Linear mixed models demonstrated that the effect of vocabulary scores on the cognitive composite scores was larger in patients with MTBI than in community controls at 2 weeks and at 3 months after injury (PZ.001). Thus, group differences in the cognitive composite score varied as a function of vocabulary scores, with the biggest differences seen among participants with lower vocabulary scores. There were no signifificant differencesin the cognitive composite score between patients with (nZ29) and without (nZ131) postconcussion syndrome at 2 weeks or 3 months after injury.

结果: 线性混合模型显示，在损伤后2周和3个月的轻度创伤性脑损伤MTBI患者认知复合得分的影响大于社区对照组(PZ.001)。因此，根据词汇得分， 认知复合得分的组间差异有所改变，词汇得分较低者的组间差异最大。在受伤后2周或3个月，有(nZ29)和没有(nZ131)脑震荡后综合征的患者之间的认知复合评分没有显著差异。

Conclusion: Cognitive reserve, but not postconcussion syndrome, was associated with cognitive outcome after MTBI. This supports the cognitive reserve Hypothesis in the MTBI context and suggests that persons with low cognitive reserve are more vulnerable to reduced cognitive functioning if they sustain an MTBI.

结论: 非脑震荡后综合征认知储备与MTBI后的认知结果相关。这验证了MTBI背景下认知储备的假说，并声称认知储备低者，如果仍保持MTBI状态，更容易降低认知功能。