Randomized treatment trial in mild traumatic brain injury
Randomized treatment trial in mild traumatic brain injury
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DOI：
10.1016/j.jpsychores.2005.07.018
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发表时间：
2006-08-01
影响因子：
4.7
通讯作者：
Feinstein, Anthony
中科院分区：
文献类型：
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作者：
Ghaffar, Omar;McCullagh, Scott;Feinstein, Anthony
目的：确定轻度创伤性脑损伤 (MTBI) 的多学科治疗是否可以改善损伤后 6 个月的神经行为结果。方法：患有 MTBI 的受试者被随机分配到治疗组（n=97）或非治疗组（对照组，n=94）。接受治疗的患者在受伤后 1 周内接受评估，然后由多学科团队根据临床需要进行为期 6 个月的管理。对照受试者不接受治疗。六个月的结果测量包括：脑震荡后症状的严重程度（Rivermead 脑震荡后障碍问卷）、心理社会功能（Rivermead 随访问卷）、心理困扰（一般健康问卷）和认知（神经认知电池）。结果：治疗对象和对照对象的人口统计学和 MTBI 严重程度数据非常匹配。此外，两组在任何结果指标上都没有差异。然而，在受伤前有精神困难的个体中（占整个样本的 22.9%），与未经治疗的对照组相比，治疗组受试者在受伤后 6 个月的抑郁症状明显减少（P=0.01）。结论：这些研究结果表明，对所有 MTBI 患者进行常规治疗收效甚微；相反，针对受伤前有精神问题的个体可能会被证明是一种更合理且更具成本效益的方法。 (c) 2006 Elsevier Inc. 保留所有权利。
Objective: To determine whether multidisciplinary treatment of mild traumatic brain injury (MTBI) improves neurobehavioral outcome at 6 months postinjury. Methods: Subjects with MTBI were randomly assigned to treatment (n=97) or non-treatment (control, n=94) groups. Treated patients were assessed within 1 week of injury and thereafter managed by a multidisciplinary team according to clinical need for a further 6 months. Control subjects were not offered treatment. Six-month outcome measures included: severity of postconcussive symptoms (Rivermead Post-Concussion Disorder Questionnaire), psychosocial functioning (Rivermead Follow-up Questionnaire), psychological distress (General Health Questionnaire), and cognition (neurocognitive battery). Results: Treatment and control subjects were well-matched for demographic and MTBI severity data. In addition, the two groups did not differ on any outcome measure. However, in individuals with preinjury psychiatric difficulties (22.9% of the entire sample), subjects in the treatment group had significantly fewer depressive symptoms 6 months postinjury compared with untreated controls (P=.01). Conclusions: These findings suggest that routine treatment of all MTBI patients offers little benefit; rather, targeting individuals with preinjury psychiatric problems may prove a more rational and cost-effective approach. (c) 2006 Elsevier Inc. All rights reserved.