■神经行为失调(NBD),创伤性脑病综合征的核心临床特征,包括在有反复头部撞击暴露史的个体中报告的神经精神症状,包括接触体育运动员。本研究的目的是通过一系列因素和聚类分析来检验NBD的结构和亚结构。
■六位临床医生科学家通过盲法投票过程从七个可用的神经精神病学量表中选择了与NBD相关的自我报告问卷项目。对178名前大学和职业美式足球运动员和60名无症状个体进行了验证性因素分析,这些个体没有重复头部撞击暴露史。所有参与者都参加了诊断,成像,目的研究和评价慢性外伤性脑病的遗传学网络研究项目。因子得分是根据NBD的最佳专家知情模型生成的。使用不包括在因子得分生成中的神经精神量表评估结构效度。使用NBD因子评分的聚类分析来检查症状概况。
■因素分析证实NBD由四个子结构组成:爆炸性,情绪失控,冲动,和情感无能。聚类分析表明,该组前足球运动员中NBD的四个不同症状:无症状(N=80,45%),短熔丝(N=33,19%),高情感不稳定(N=34,19%),和高NBD(N=31,17%)。
■这些发现将NBD描述为具有异质性表现的多方面临床结构,为创伤性脑病综合征诊断标准的实证工作和NBD神经生物学基础的研究奠定基础。
UNASSIGNED: Neurobehavioral dysregulation (NBD), a core clinical feature of traumatic encephalopathy syndrome, encompasses neuropsychiatric symptoms reported among individuals with a history of repetitive head impact exposure, including contact sport athletes. The objective of this study was to examine the construct and subconstructs of NBD through a series of factor and cluster analyses.
UNASSIGNED: Six clinician-scientists selected self-report questionnaire items relevant to NBD from seven available neuropsychiatric scales through a blinded voting process. These items were subjected to confirmatory factor analyses in a sample of 178 former college and professional American football players and 60 asymptomatic individuals without a history of repetitive head impact exposure. All participants were enrolled in the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project. Factor scores were generated on the basis of the optimal expert-informed model for NBD. Construct validity was assessed with neuropsychiatric scales not included in generation of the factor scores. Cluster analyses with NBD factor scores were used to examine symptom profiles.
UNASSIGNED: Factor analyses confirmed that NBD was composed of four subconstructs: explosivity, emotional dyscontrol, impulsivity, and affective lability. Cluster analyses indicated four distinct symptom profiles of NBD in this group of former football players: asymptomatic (N=80, 45%), short fuse (N=33, 19%), high affective lability (N=34, 19%), and high NBD (N=31, 17%).
UNASSIGNED: These findings characterize NBD as a multifaceted clinical construct with a heterogeneous presentation, providing a foundation for empirical work on the diagnostic criteria for traumatic encephalopathy syndrome and research on the neurobiological underpinnings of NBD.