Magnitudes of Decline on Automated Neuropsychological Assessment Metrics Subtest Scores Relative to Predeployment Baseline Performance Among Service Members Evaluated for Traumatic Brain Injury in Iraq
Magnitudes of Decline on Automated Neuropsychological Assessment Metrics Subtest Scores Relative to Predeployment Baseline Performance Among Service Members Evaluated for Traumatic Brain Injury in Iraq
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DOI：
10.1097/htr.0b013e318238f146
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发表时间：
2012-01-01
影响因子：
2.4
通讯作者：
Hernandez, Marie
中科院分区：
文献类型：
--
作者：
Bryan, Craig;Hernandez, Marie
目的：确定在部署到伊拉克期间进行的创伤性脑损伤 (TBI) 评估的一部分中，自动神经心理评估指标 (ANAM) 评分下降的军人比例。背景：虽然 TBI 与普通人群和军事战斗人员认知测试表现较差有关，但人们对 TBI 后 ANAM 分数下降的服役人员比例知之甚少。方法：转介到伊拉克战斗支持医院进行 TBI 评估的军事人员 (N = 116) 接受了标准化的入院评估，包括计算机化神经认知测试、心理和身体健康问卷、临床访谈和医生体检。对有和没有 TBI 诊断的服役人员的部署前和受伤后认知表现进行了比较。结果：与没有 TBI 的患者相比，有更大比例的 TBI 患者在所有 ANAM 子测试中表现出更大的速度下降。与没有 TBI 的患者相比，TBI 患者的准确度评分差异不显着。 TBI 患者的简单反应时间、程序反应时间、代码替换学习和空间记忆评分也表现出大于最低限度的下降，而代码替换延迟或数学处理 (MATH) 方面没有显着差异。在指数损伤后 72 小时内接受检查的个体中也发现了类似的模式。结论：对战区 TBI 后的认知障碍进行评估可能有助于提供者为患有轻度 TBI 的军人提出治疗建议。
Objective: Identify the proportion of service members demonstrating declines in Automated Neuropsychological Assessment Metrics (ANAM) scores as part of a traumatic brain injury (TBI) evaluation conducted while deployed to Iraq. Background: Although TBI has been associated with poorer performance on cognitive test in the general population and military combatants, little is known about the proportion of service members demonstrating declines in ANAM scores after TBI. Methods: Military personnel (N = 116) referred to a combat support hospital for TBI evaluation in Iraq underwent a standardized intake evaluation including computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician. Predeployment and postinjury cognitive performance among service members with and without a TBI diagnosis was compared. Results: A significantly larger proportion of patients with TBI demonstrated greater declines in speed across all ANAM subtests compared with patients with no TBI. Differences in accuracy scores among patients with TBI relative to patients without TBI were nonsignificant. Patients with TBI also demonstrated greater than minimal declines on throughput Simple Reaction Time, Procedural Reaction Time, Code Substitution-Learning, and Spatial Memory scores, with no significant differences on Code Substitution-Delayed or Mathematical Processing (MATH). A similar pattern was seen among individuals examined within 72 hours of index injury. Conclusion: Assessment of cognitive impairment following TBI in a combat zone may assist providers in making treatment recommendations for service members with mild TBI.