A validation of the post concussion symptom scale in the assessment of complex concussion using cognitive testing and functional MRI
A validation of the post concussion symptom scale in the assessment of complex concussion using cognitive testing and functional MRI
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DOI：
10.1136/jnnp.2006.110395
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发表时间：
2007-11-01
影响因子：
11
通讯作者：
Ptito, Alain
中科院分区：
文献类型：
--
作者：
Chen, Jen-Kai;Johnston, Karen M.;Ptito, Alain
背景：脑震荡的临床评估依赖于脑震荡后症状的存在和持续时间。鉴于这些PCS是主观的报告，并不总是特定的脑震荡，其有用性仍有待validation.Objective：自我报告的PCS的有用性，通过认知测试和功能磁共振成像（fMRI）的方法进行评估：28名男性运动员与脑震荡，并没有根据他们的PCS评分分组。然后，他们被管理的计算机化的认知测试电池，并提交到功能磁共振成像会议，与语言和非语言的工作记忆tasks进行了analysed.Results：行为，响应的准确性和速度的认知测试电池的控制和低PCS组相媲美。中度PCS组在匹配（p < 0.05）和一回任务（p < 0.05）上的反应时间显著低于对照组。功能性MRI研究显示，低和中度PCS组的背外侧前额叶皮层的任务相关激活模式减少。在两个PCS组中也观察到了在对照组中未观察到的感兴趣区域外的激活峰。回归分析表明，PCS分数和性能的几个CogSport子测试之间呈反比关系。PCS的严重程度也预测fMRI血氧水平依赖的信号变化在大脑前额叶regions.Conclusion：自我报告的PCS是与持续的脑血流动力学异常，以及与轻度认知功能障碍。这些结果支持使用PCS量表评估脑震荡和监测恢复。
Background: Clinical assessment of cerebral concussion relies on the presence and duration of post concussive symptoms (PCS). Given that these PCS are subjective reports and not always specific to concussion, their usefulness remains to be validated.Objective: To evaluate the usefulness of self-reported PCS by means of cognitive tests and functional MRI (fMRI).Method: 28 male athletes with and without concussion were grouped according to their PCS score. They were then administered a computerised cognitive test battery and submitted to an fMRI session where cerebral activations associated with verbal and non-verbal working memory tasks were analysed.Results: Behaviourally, response accuracy and speed on the cognitive test battery were comparable for the control and low PCS group. The moderate PCS group showed significantly slower response times than the control group on the matching (p < 0.05) and one-back tasks (p < 0.05). The functional MRI study showed reduced task related activation patterns in the dorsolateral prefrontal cortex for both low and moderate PCS groups. Activation peaks outside the regions of interest, not seen in the control group, were also noted for both PCS groups. Regression analyses indicated an inverse relationship between PCS scores and performances on several CogSport subtests. Severity of PCS also predicted fMRI blood oxygen level dependent signal changes in cerebral prefrontal regions.Conclusion: Self-reported PCS is associated with an ongoing cerebral haemodynamic abnormality as well as with mild cognitive impairment. These results support the use of the PCS scale in the assessment of cerebral concussion and in monitoring recovery.