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Neuropsychological Predictors of Outcome Following Traumatic Brain Injury in Adults: a Meta-Analysis
Neuropsychology Review ( IF 5.8 ) Pub Date : 2017-07-05 , DOI: 10.1007/s11065-017-9353-5
Fiona Allanson , Carmela Pestell , Gilles E. Gignac , Yong Xiang Yeo , Michael Weinborn

Several neuropsychological dimensions are correlated with functional outcome (e.g., ability to return to family and community roles) following traumatic brain injury (TBI). Commonly investigated neuropsychological dimensions include verbal memory, visuo-spatial construction, set-shifting, generativity, and processing speed. Unfortunately, small sample sizes across relevant studies have contributed to inconsistent results. Furthermore, no studies have concurrently measured all of the candidate neuropsychological predictors, most of which are known to be inter-correlated. Thus, the unique predictive effects associated with the candidate predictors in TBI recovery have never been investigated. Consequently, this study used both meta-analysis and multiple regression to statistically evaluate neuropsychological candidate predictors across two outcome variables (1) the Glasgow Outcome Scale-Extended (GOS-E) and (2) the Disability Rating Scale (DRS). Seven studies met inclusion criteria. Based on the meta-analyses, the following neuropsychological dimensions were found to be correlated with the GOS-E: immediate verbal memory (r = .43, 95% CI [.27, .58]), delayed verbal memory (r = .43, 95% CI [.21, .61]), visuo-spatial construction (r = .29, 95% CI [.15, .53]), set-shifting (r = −.31, 95% CI [−.45, −.15], and generativity (r = .44, 95% CI [.32, .54]). By contrast, only one neuropsychological dimension was found to be significantly related to the DRS (generativity: r = −.21, 95% CI [−.39, −.01]). Multiple regression on the GOS-E relevant meta-analytically derived correlation matrix determined that all neuropsychological dimensions were significant predictors of the GOS-E (multiple R 2 = .31) with the exception of immediate verbal memory or learning. However, due to analytic characteristics, these findings must be interpreted with caution. Results were consistent with the need to consider multiple neuropsychological abilities in recovery and rehabilitation following TBI.

中文翻译:

成人颅脑创伤后结果的神经心理学预测因素:一项荟萃分析

创伤性脑损伤(TBI)后,一些神经心理学维度与功能结局(例如,恢复家庭和社区角色的能力)相关。普遍研究的神经心理学维度包括言语记忆,视觉空间构建,移位,生殖力和处理速度。不幸的是,相关研究中的小样本量导致了不一致的结果。此外,尚无研究同时测量所有候选神经心理学预测因子,而大多数预测因子是相互关联的。因此,从未研究过与TBI恢复中的候选预测因素相关的独特预测作用。所以,这项研究同时使用荟萃分析和多元回归来统计评估两个结果变量(1)格拉斯哥扩展结果量表(GOS-E)和(2)残疾等级量表(DRS)的神经心理学候选预测因子。七项研究符合纳入标准。根据荟萃分析,发现以下神经心理学维度与GOS-E相关:即时言语记忆(r  = .43,95%CI [.27,.58]),延迟的言语记忆(r  = .43,95%CI [.21,.61]),视觉空间构造(r  = .29,95 %CI [.15,.53]),设定偏移(r  = -.31,95%CI [-.45,-.15]和生成性(r  = .44,95 %CI [.32,。 54]),相比之下,仅发现一种神经心理学维度与DRS显着相关(生成性:r  = -.21,95%CI [-.39,-。01])。相关的荟萃分析得出的相关矩阵确定所有神经心理学维度都是GOS-E的重要预测因子(多个R 2 = .31),但立即的言语记忆或学习能力除外。但是,由于分析特性,必须谨慎解释这些发现。结果与在TBI后恢复和康复中考虑多种神经心理学能力的需求是一致的。
更新日期:2017-07-05
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