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慢性軽度外傷性脳損傷を有する軍退役軍人の眼球運動制御と認知機能

Jeffrey R Hebert1, Brandie D Wagner, Christopher M Filley

  • 1Marcus Institute for Brain Health (JRH, CMF, KLC, DR, CHJ-B, AVM, PSS), University of Colorado School of Medicine, Aurora, Colorado; Department of Physical Medicine & Rehabilitation (JRH, CHJ-B), University of Colorado School of Medicine, Aurora, Colorado; Department of Biostatistics & Informatics (BDW), University of Colorado-Colorado School of Public Health, Aurora, Colorado; Department of Neurology (CMF), Behavioral Neurology Section, University of Colorado School of Medicine, Aurora, Colorado; Department of Family Medicine (KLC), University of Colorado School of Medicine, Aurora, Colorado; Department of Neurology (DR, AVM, PSS), University of Colorado School of Medicine, Aurora, Colorado; Department of Radiology (DR, RK), University of Colorado School of Medicine, Aurora, Colorado; Department of Ophthalmology (SMM, PSS), University of Colorado School of Medicine, Aurora, Colorado; Department of Neurosurgery (PSS), University of Colorado School of Medicine, Aurora, Colorado; and Division of Ophthalmology (Department of Surgery) (PSS), Uniformed Services University of the Health Sciences, Bethesda, Maryland.

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まとめ

軽度外傷性脳損傷（mTBI）を有する軍退役軍人は、受傷後数年経っても眼球運動制御（OMC）および認知機能障害が持続することを示す。注意および眼球運動制御の障害を含むこれらの問題は、慢性mTBI患者で検出可能である。

キーワード:
軽度外傷性脳損傷眼球運動制御認知機能障害軍退役軍人心的外傷後ストレス障害

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科学分野:

  • 神経科学;外傷性脳損傷研究;眼科学

背景:

  • 軽度外傷性脳損傷（mTBI）は、軍人において持続的な眼球運動制御（OMC）および認知機能障害を頻繁に引き起こす。;これらの障害は微妙であり、初期の外傷から長い時間が経過した後の診断を複雑にするストレス下でのみ現れることがある。;慢性期mTBIにおけるOMCと認知機能の関係については、理解が限られている。

研究 の 目的:

  • 慢性軽度外傷性脳損傷（mTBI）を有する退役軍人における眼球運動制御（OMC）と認知機能障害との持続的な関係を調査すること。;慢性mTBI集団におけるこれらの併存障害を検出できる臨床ツールを特定すること。;慢性期mTBIにおけるOMC-認知軸の可能性を探求すること。

主な方法:

  • 慢性mTBIを有する軍退役軍人（n=38）と対照群（n=40）を比較する横断的観察研究。;コンピューター化されたKing-Devick（K-D）テスト、抗サッカード課題のためのアイトラッキング、Connersの連続パフォーマンステスト（CPT）、およびFAS言語流暢性テストを使用した。;DSM-5用PTSDチェックリスト（PCL-5）を用いて心的外傷後ストレス症状を評価した。

主要な成果:

  • 慢性mTBIを有する退役軍人は、対照群と比較して、K-Dテストで有意に多くのエラーを犯し、完了時間が長かった。;mTBI群では、様々なパラダイムで抗サッカード潜時およびエラー率の増加が観察された。;mTBI群はまた、PCL-5スコアが高く、FASテストの成績が悪く、CPTエラーが多かった。外傷性脳損傷からの経過時間と特定のOMCエラーとの間に関連が見られた。

結論:

  • 眼球運動制御（OMC）および認知パフォーマンスの障害は、慢性軽度外傷性脳損傷（mTBI）を有する退役軍人において持続的かつ併存する問題である。;これらの障害は、受傷から11年後でさえ検出可能であり、慢性期mTBIにおけるOMC-認知軸を示唆している。;OMC課題の認知相関が特定され、慢性期mTBI評価のための臨床解釈を助けた。