■计算机神经认知测试是脑震荡多领域评估的一个组成部分。然而,计算机化神经认知测试的使用仅限于11岁及以上的患者,使临床医生几乎没有选择来评估年幼儿童。
■为了检查儿童脑震荡后即刻评估和认知测试的变化(Impact儿科)(Impact应用,2021)脑震荡后5-9岁儿童的得分和与表现相关的因素。
■参与者包括脑震荡30(M=8.5±5.9)天内63名5-9(M=7.5±1.0)岁的儿童(42%[n=27]名女性)。所有参与者在初次就诊时完成了ImPACT儿科检查,并在医疗许可后返回活动(RTA)就诊。IMPACT儿科测试是一种计算机化的神经认知电池,其中包括5项评估记忆和视觉处理速度的测试。使用多变量和单变量方差分析和配对t检验来比较从初次就诊到就诊的ImPACT儿科评分。协方差和多元线性回归的多变量和单变量分析检查了与ImPACT儿科表现相关的因素。
■参与者表现出从初次就诊到医疗许可就诊的总体表现(F(4,59)=3.08,p=0.02,Wilks\'Λ=0.83,ηp2=0.17),快速处理速度显著提高(F(1,62)=7.48,p<0.01,ηp2=0.11)。当控制年龄时,性别,多动症的历史,几天到诊所,整体性能的改善仍然显着(F(4,51)=2.99,p=0.03,Wilks\'Λ=0.81,ηp2=0.19)。年龄与初次就诊时的快速处理综合评分显着相关(F(4,59)=5.9,p<0.001,Adj。R2=0.25)和医疗许可访问(F(4,59)=3.8,p=0.008,Adj。R2=0.16),年龄较大的儿童在两个时间点都表现更好(初次就诊:B=8.17,p<0.001;医疗许可:B=3.62,p=0.03)。
■我们的主要发现表明,5-9岁儿童在从初次就诊到医疗许可的ImPACT儿科快速处理方面显着改善。然而,ImPACT儿科的记忆成分没有发现差异.年龄较大的孩子在处理速度上也比年龄较小的孩子表现更好。研究结果表明,ImPACT儿科的处理速度组件可用于监测5-9岁儿童脑震荡后神经认知功能的改善,但是在解释表现时需要考虑年龄差异。
UNASSIGNED: Computerized neurocognitive
testing is one component of a multidomain assessment of concussion. However, the use of computerized neurocognitive
testing has been limited to patients aged 11 years and up, leaving clinicians with few options to evaluate younger children.
UNASSIGNED: To examine the change in Immediate Post-concussion Assessment and Cognitive
Testing Pediatric (ImPACT Pediatric) (ImPACT Applications, 2021) scores and factors associated with performance in children aged 5-9 years following a concussion.
UNASSIGNED: Participants included 63 children (42% [n = 27] female) aged 5-9 (M = 7.5 ± 1.0) years within 30 (M = 8.5 ± 5.9) days of a concussion. All participants completed the ImPACT Pediatric at their initial visit and at medical clearance for their return to activity (RTA) visit. The ImPACT Pediatric test is a computerized neurocognitive battery that includes 5 tests that assess memory and visual processing speed. Multivariate and univariate analyses of variance and paired t-tests were used to compare ImPACT Pediatric scores from the initial visit to medical clearance. Multivariate and univariate analyses of covariance and multiple linear regression examined factors associated with ImPACT Pediatric performance.
UNASSIGNED: Participants demonstrated improved overall performance from the initial visit to the medical clearance visit (F(4, 59)=3.08, p = 0.02, Wilks\' Λ = 0.83, ηp2=0.17), with significant improvement in Rapid Processing Speed (F(1, 62)=7.48, p < 0.01, ηp2=0.11). When controlling for age, sex, history of ADHD, and days to clinic, the improvement in overall performance remained significant (F(4, 51)=2.99, p = 0.03, Wilks\' Λ = 0.81, ηp2=0.19). Older age was significantly associated with the Rapid Processing composite score at the initial visit (F(4, 59)=5.9, p < 0.001, Adj. R2=0.25) and medical clearance visit (F(4, 59)=3.8, p = 0.008, Adj. R2=0.16), with older children associated with better performance at both time points (Initial visit: B = 8.17, p < 0.001; Medical Clearance: B = 3.62, p = 0.03).
UNASSIGNED: Our main findings suggest that children aged 5-9 years improved significantly in Rapid Processing on the ImPACT Pediatric from the initial visit to medical clearance. However, no differences were found for the memory components of the ImPACT Pediatric. Older children also performed better on processing speed than younger children. The findings suggest that the processing speed components of ImPACT Pediatric are useful for monitoring improvements in neurocognitive functioning following concussion in children aged 5-9 years, but that age differences need to be considered when interpreting performance.