ABSTRACT

Objective: Characterize the working memory (WM) profile of children and youth who have experienced concussion by systematically synthesizing existing literature on the neuropsychological outcomes of these injuries.

Methods: Implemented a peer-reviewed search strategy combining key concepts of concussion/mild traumatic brain injury (mTBI), WM, and pediatrics across MedLine, Embase, PsycINFO, and CINAHL. Included studies written in English with extractable results on a WM outcome measure in individuals aged 21 and under who experienced concussion. Applied narrative synthesis to identify trends in the literature. Assessed risk of bias and quality using the NHLBI’s Quality Assessment of Observational Cohort and Cross-Sectional Studies.

Results: 40 articles met inclusion criteria. 34/40 studies compared WM performance in children or youth with concussion to healthy controls, pre-injury performance, or normative values, of which 15 reported significantly lower WM performance in the concussion sample. Visual/spatial WM was more consistently impacted than verbal WM. Cognitive demanding dual-task conditions were also reliably impacted.

Conclusion: Literature indicated that WM is vulnerable to negative outcomes following pediatric concussion, yet the nature of outcomes is variable. Clinicians and researchers should implement comprehensive and theoretically motivated WM assessments to better understand the WM components impacted by injury.

摘要

目标：通过系统地综合现有关于这些损伤的神经心理学结果的文献，表征经历过脑震荡的儿童和青少年的工作记忆 (WM) 特征。

方法：在 MedLine、Embase、PsycINFO 和 CINAHL 中实施了一项经过同行评审的搜索策略，结合了脑震荡/轻度创伤性脑损伤 (mTBI)、WM 和儿科的关键概念。包括用英语撰写的研究，其中包含对 21 岁及以下经历过脑震荡的个体的 WM 结果测量结果的可提取结果。应用叙事综合来识别文献中的趋势。使用 NHLBI 的观察性队列和横断面研究质量评估评估偏倚风险和质量。

结果： 40 篇文章符合纳入标准。34/40 的研究将脑震荡儿童或青少年的 WM 表现与健康对照、受伤前表现或规范值进行了比较，其中 15 项研究报告了脑震荡样本中 WM 表现显着降低。视觉/空间 WM 比语言 WM 更一致地受到影响。认知要求的双任务条件也受到了可靠的影响。

结论：文献表明 WM 容易受到小儿脑震荡后的负面结果的影响，但结果的性质是可变的。临床医生和研究人员应实施全面且具有理论动机的 WM 评估，以更好地了解受损伤影响的 WM 组成部分。