ABSTRACT Agitation is common during the post-traumatic amnesia (PTA) period after traumatic brain injury (TBI), although our knowledge of what causes or predicts agitation is limited. The current study aimed to examine the association of agitation in PTA with the concurrent impairments in orientation and memory while controlling for covariates of agitation. Participants were 125 patients in PTA following moderate to extremely severe TBI recruited from an inpatient brain injury rehabilitation service who were assessed throughout PTA on the Agitated Behavior Scale (ABS) and the Westmead PTA Scale (WPTAS). Agitation was observed in 42.4% of participants (ABS score > 21), with disinhibited behaviours (e.g., distractibility and impulsivity) most common. Multilevel modelling found daily ABS scores to be associated with daily scores on the WPTAS but in a non-linear pattern. Analysis of covariates found that shorter time post-admission, younger age, presence of infection and higher antipsychotic doses were associated with higher ABS scores. These results support a relationship between agitation and the concurrent cognitive impairment during PTA. While a causal link cannot yet be inferred, management strategies that can potentially interfere with cognition (e.g., sedating medications, environmental changes) should be used cautiously in case they exacerbate agitation.

中文翻译：

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脑外伤后PTA期躁动与定向记忆障碍的关系

摘要 在创伤性脑损伤 (TBI) 后的创伤后遗忘 (PTA) 期间，激动很常见，尽管我们对导致或预测激动的原因的了解有限。目前的研究旨在检查 PTA 中的躁动与同时发生的定向和记忆障碍的关联，同时控制躁动的协变量。参与者是从住院脑损伤康复服务机构招募的 125 名中度至极重度 TBI 后 PTA 患者，他们在整个 PTA 中接受了激动行为量表 (ABS) 和 Westmead PTA 量表 (WPTAS) 的评估。在 42.4% 的参与者中观察到激动（ABS 评分 > 21），其中最常见的是不受抑制的行为（例如，注意力分散和冲动）。多级建模发现每日 ABS 分数与 WPTAS 的每日分数相关，但呈非线性模式。协变量分析发现，入院后时间较短、年龄较小、存在感染和较高的抗精神病药剂量与较高的 ABS 评分相关。这些结果支持了 PTA 期间躁动与并发认知障碍之间的关系。虽然尚不能推断因果关系，但应谨慎使用可能干扰认知的管理策略（例如镇静药物、环境变化），以防它们加剧激越。这些结果支持了 PTA 期间躁动与并发认知障碍之间的关系。虽然尚不能推断因果关系，但应谨慎使用可能干扰认知的管理策略（例如镇静药物、环境变化），以防它们加剧激越。这些结果支持了 PTA 期间躁动与并发认知障碍之间的关系。虽然尚不能推断因果关系，但应谨慎使用可能干扰认知的管理策略（例如镇静药物、环境变化），以防它们加剧激越。