在功能性和创伤性脑损伤中,通过神经行为疗法减少主观认知问题
Ryan Van Patten1, Lawrence Chan1, Krista Tocco1
1Center for Neurorestoration and Neurotechnology, Veterans Affairs (VA) Providence Health Care System, and Department of Psychiatry and Human Behavior, Brown University, Providence, R.I. (Van Patten, Chan, Tocco, LaFrance); Rhode Island Hospital, Providence (Tocco, LaFrance); VA Maryland Health Care System, Baltimore (Mordecai); VA Connecticut Health Care System and Department of Neurology, Yale University, New Haven (Altalib); Department of Psychiatry and Behavioral Sciences and Department of Neurology, Northwestern University Feinberg School of Medicine, Evanston, Ill. (Cotton); College of Public Health, University of Georgia, Athens (Correia); Department of Neurology, University of Alabama at Birmingham, Birmingham (Gaston, Grayson, Martin, Fry, Goodman, Allendorfer, Szaflarski).
功能性发作在创伤性脑损伤 (TBI) 中很常见. 神经行为疗法减少了功能性发作的TBI患者的主观认知问题,这表明它是一种可行的治疗选择.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 康复医学 康复医学 康复医学
背景情况:
- 功能性 (FS) 经常发生在创伤性脑损伤 (TBI) 患者中.
- 主观认知问题 (SCC) 是认知功能影响日常生活的自我感知缺陷.
- 了解FS患者TBI中SCC及其管理对于改善患者的治疗结果至关重要.
研究的目的:
- 调查TBI和FS的成年人中SCC的患病率和相关性.
- 评估神经行为疗法 (NBT) 在治疗该群体中SCC的有效性.
- 将接受NBT的TBI+FS患者的SCC与仅TBI的比较组进行比较.
主要方法:
- 一项观察性研究涉及47名TBI和FS的成年人 (TBI+FS组) 和50名没有FS的TBI的成年人 (比较组).
- 该TBI+FS组接受了12个会议的NBT协议,用于发作.
- 评估包括SCC,客观认知,心理健康和生活质量,进行治疗前后 (2018-2022年).
主要成果:
- 在基线观察到高SCC患病率:TBI+FS组的79%,比较组的40%.
- 在TBI+FS组中,较差的基线全球心理健康和较高的强迫症症状显著与更大的SCC相关.
- 经过NBT后,TBI+FS组的SCC显著减少,而对比组的SCC显著增加.
结论:
- SCC在TBI和FS患者中很普遍,并且与心理健康和强迫症症状有关.
- 对FS的基于证据的NBT似乎是减轻该人口中SCC的有效策略.
- 建议对FS患者进行多样化样本的进一步研究和有针对性的认知康复干预.
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