Neurology:轻度颅脑损伤后平衡障碍的感觉表型

2022-06-28 Naomi MedSci原创

最新的基于团队的护理模式使用症状亚型来指导轻度创伤性脑损伤(MTBI)患者的治疗。患MTBI的个体表现出各种慢性平衡缺陷,涉及不同的感觉整合问题。未来的研究应该考虑平衡缺陷的具体分类,包括平衡控制。

最新的基于团队的护理模式使用症状亚型来指导轻度创伤性脑损伤(MTBI)患者的治疗。然而,这些亚型或表型可能过于宽泛,特别是不利于平衡障碍(例如,前庭亚型)。近日,一项发表在Neurology 上的研究为了深入了解MTBI相关的失衡,以1)探索了占主导地位的2)确定与感觉表型相关的临床特征、症状群、功能测量和损伤机制,以便在该人群中进行平衡控制;3)比较既往有和没有MTBI的个体之间感觉表型的表现。

对军事脑损伤联合体的长期影响--神经创伤联合体的慢性效应进行二次分析。感觉比率是从感觉组织测试中计算出来的,个体被归类为八种可能的感觉表型之一。比较了不同表型的人口学、临床和损伤特征。症状、认知和身体功能在不同的表型、组和它们之间的相互作用中进行了比较。

  • 纳入了758名患有创伤性脑损伤的现役军人和退伍军人以及172名无创伤性脑损伤终生病史的军人的数据。
  • 视觉、前庭和本体感觉比率的异常分别在29%、36%和38%的MTBI患者中观察到,其中32%的人表现出不止一个感觉比率的异常。
  • 在mTBI组中,总体结果(p<0.001)、自我报告的症状严重程度(p<0.027)以及几乎所有的身体和认知功能测试(p<0.027)在感觉表型上有所不同。
  • 在相同的表型中,MTBI患者的症状通常比非MTBI患者更严重(p=0.026),但具有前庭缺陷表现型的MTBI患者的症状负担比他们的非MTBI患者低[例如,mTBI患者的平均(SD)头晕残疾指数=4.9vs.12.8(12.4),表型交互作用p<0.001]。
  • 在考虑了表型后,不同组之间的身体和认知功能没有差异。

患MTBI的个体表现出各种慢性平衡缺陷,涉及不同的感觉整合问题。虽然依赖前庭信息时失衡是常见的,但将所有与MTBI相关的平衡功能障碍都归于前庭是不准确的。未来的研究应该考虑平衡缺陷的具体分类,包括平衡控制的特定感觉表型。

文献来源:Fino PC, Dibble LE, Wilde EA, et al. Sensory Phenotypes for Balance Dysfunction After Mild Traumatic Brain Injury [published online ahead of print, 2022 May 16]. Neurology. 2022;10.1212/WNL.0000000000200602. doi:10.1212/WNL.0000000000200602 

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    2023-05-24 yinhl1978
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    2022-06-28 tastas

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