背景:简单反应时间(SRT),以毫秒(msec)为单位,等于在认知处理期间发生的受试者依赖性潜伏期和对呈现给受试者的预编程刺激的神经肌肉反应的总和。SRT的优点是相对纯净,神经驱动的运动/感觉任务,为临床医生提供功能缺陷的广义评估。SRT很容易获得,研究报告说,在10s间隔内手指敲击的平均次数可以用来区分轻度创伤性脑损伤(TBI)患者和健康对照。
目的:刺激/反应SRT方案,利用基于iPad的工具,用于观察是否可以从受试者的总SRT中区分和量化认知潜伏期(CL)和神经肌肉潜伏期(NL)的各个组成部分。研究假设是认知延迟,与特定的认知挑战有关,即使神经肌肉挑战引起的潜伏期发生变化,也会保持不变。
方法:使用两类SRT测试。第一个是简单的手指敲击测试(FTT),没有任何认知参与,旨在量化纯NL。第二项测试是选择测试(CT),其特征在于将认知任务添加到FTT。FTT的目的是让受试者在10秒的间隔内尽可能快地简单地轻敲定位在iPad屏幕上的单个目标。SRT的测量在显示目标时开始,在轻敲目标时结束。对受试者进行了FTT和CT测试的两个挑战水平:目标的小随机位移(SD)高达6mm,和一个大的随机位移(LD)的目标高达24毫米。由于手和手臂的运动学响应特性,预计SRT(FTT)的大小将与目标位移的大小直接相关。
结果:为了验证研究假设,通过从总SRT中减去相应的NL来计算小位移和大位移的CL。利用SPSS进行重复测量t检验分析,在p=0.696时,未观察到CL(SD)和CL(LD)之间的显著差异.
结论:完成了从受试者的总SRT中区分和定量CL和NL的单个组分。苹果iPadPro被选为我们研究的平台,因为:(1)它是现成的,负担得起的,和可编程;(2)它满足可移植性的要求;以及(3)它允许修改/添加测试参数以满足未来的需求。量化TBI患者认知和神经肌肉功能障碍程度的能力是制定有效治疗计划的重要组成部分。
Simple reaction times (SRTs), measured in milliseconds (msec), are equal to the sum of subject-dependent latencies that occur during cognitive processing and neuromuscular responses to a preprogrammed stimulus presented to a subject. SRTs have the advantage of being a relatively pure, neurologically driven motor/sensory task that provides a clinician with a generalized assessment of functional deficits. SRTs are easily obtained, and studies have reported that the average number of finger-taps during a 10-s interval can be utilized to distinguish between patients with mild traumatic brain injury (TBI) and healthy controls.
A stimulus/response SRT protocol, utilizing an iPad-based tool, was utilized to see if differentiation and quantification of individual components of cognitive latency (CL) and neuromuscular latency (NL) from a subject\'s total SRT could be accomplished. The study hypothesis was that cognitive latencies, related to a specific cognitive challenge, would remain constant even as latencies due to neuromuscular challenges changed.
Two categories of SRT tests were utilized. The first was a simple finger tapping test (FTT), without any cognitive involvement, that was designed to quantify pure NL. The second test was a choice test (CT) that was characterized by the addition of a cognitive task to the FTT. The objective of the FTT was for the subject to simply tap a single target positioned on the iPad screen as fast as possible over an interval of 10 s. Measurement of the SRT began when a target was displayed and ended when the target was tapped. Two levels of challenge for the FTT and CT tests were presented to the subjects: a small random displacement (SD) of the target of up to 6 mm, and a large random displacement (LD) of the target of up to 24 mm. It was expected that the magnitude of the SRT (FTT) would be directly related to the magnitude of the displacement of the target due to kinematic response characteristics of the hand and arm.
To validate the study hypothesis, CL for both small and large displacements was calculated by subtracting the respective NL from the total SRT. Utilizing a repeated measures t-test analysis utilizing SPSS, a significant difference between CL (SD) and CL (LD) at p=0.696 was not observed.
Differentiation and quantification of individual components of CL and NL from a subject\'s total SRT was accomplished. An Apple iPad Pro was selected as a platform for our study because: (1) it is readily available, affordable, and programmable; (2) it meets a requirement for portability; and (3) it allows the modification/addition of test parameters to meet future needs. The ability to quantify the extent of cognitive and neuromuscular dysfunction in the TBI patient is an essential component of developing an effective treatment plan.