ABSTRACT

This prospective controlled study examined long-term trajectories of neuropsychological performance in individuals with traumatic brain injury (TBI) compared to healthy controls, and the impact of IQ, age at injury, time since injury, and injury severity on change over time. Fifty-three individuals with moderate to severe TBI (60.37% male; M = 59.77 yrs, SD = 14.03), and 26 controls (46.15% male; M = 63.96 yrs, SD = 14.42) were studied prospectively (M = 12.72 yrs between assessments). Participants completed measures of premorbid IQ (Weschler Test of Adult Reading), processing speed (Digit Symbol Coding Test), working memory (Digit Span Backwards), memory (Rey Auditory Verbal Learning Test) and executive function (Trail Making Test Part B; Hayling Errors), at a mean of 10.62 yrs (Initial) and 23.91 yrs (Follow-Up) post injury. Individuals with TBI did not show a significantly greater decline in neuropsychological performance over time compared with demographically similar controls. There was no association between change over time with IQ, time since injury or injury severity. Being older at injury had a greater adverse impact on executive function at follow-up. In this small sample, a single moderate to severe TBI was not associated with ongoing cognitive decline up to three decades post injury. Changes in cognitive function were similar between the groups and likely reflect healthy aging.

摘要

这项前瞻性对照研究检查了与健康对照组相比，创伤性脑损伤 (TBI) 患者的神经心理表现的长期轨迹，以及智商、受伤年龄、受伤后的时间和受伤严重程度对随时间变化的影响。前瞻性研究了 53 名中度至重度 TBI 患者（60.37% 男性；M  = 59.77 岁，SD  = 14.03）和 26 名对照（46.15% 男性；M  = 63.96 岁，SD  = 14.42）（M= 评估之间的 12.72 年）。参与者完成了病前智商（成人阅读韦施勒测试）、处理速度（数字符号编码测试）、工作记忆（向后数字跨度）、记忆（Rey 听觉语言学习测试）和执行功能（Trail Making Test Part B; Hayling）的测量错误），受伤后平均 10.62 年（初始）和 23.91 年（后续）。与人口统计学相似的对照组相比，TBI 患者的神经心理表现并没有随着时间的推移而显着下降。随时间的变化与智商、受伤后的时间或受伤严重程度之间没有关联。受伤时年龄较大对随访时的执行功能产生更大的不利影响。在这个小样本中，一次中度至重度 TBI 与受伤后 30 年的持续认知能力下降无关。各组之间认知功能的变化相似，可能反映了健康老龄化。