中重度頭部創傷後之神經認知功能障礙

Neurocognitive Deficits in Patients with Moderate to Severe Traumatic Brain Injury

楊啟正(Chi-Cheng Yang) ； 王瑋瀚(Wei-Han Wang) ； 黃勝堅(Sheng-Jean Huang) ； 花茂棽(Mau-Sun Hua)

《臨床心理學刊》 3卷2期 (2006/12) Pp. 68-75

https://doi.org/10.6550/ACP.200612_3(2).0002

摘要

目的：臨床上，頭部創傷後之認知功能異常甚為常見。雖然國外研究亦證實頭部創傷患者具有明顯之認知功能損傷；然而，國內卻仍缺乏頭部創傷後神經認知功能缺損之文獻資料。故本研究欲初探國內中重度頭部創傷後的認知功能異常。
方法：本研究收集36名頭部創傷患者，利用包含「智力功能」、「記憶功能」、「執行功能」與「其他認知功能」四部分的神經心理測驗組合，評估患者的神經認知功能異常。
結果：本研究結果顯示，頭部創傷患者具有明顯的認知功能異常。其中，將近半數之患者在「智力功能中之處理速度」與「執行功能」有明顯異常。此外，亦有1/3患者之「記憶功能」有明顯下降。其他認知功能部分，僅約有1/5之患者呈現缺損。
結論：本研究為首篇國內文獻初探國內中重度頭部創傷患者的神經認知功能損傷。該損傷則以「記憶功能」的「回憶」部分、「智力功能」的「訊息處理速度」部分與「執行功能」為主。有鑑於此，未來仍須進一步深入分析頭部創傷患者之神經行為功能，以建立更完整的國內相關資料。

關鍵字

頭部創傷 ； 神經認知缺損 ； 中重度

並列摘要

Objective: Neurocognitive deficits after traumatic brain injury (TBI) are not uncommon in clinical settings. Although cognitive impairments in TBI patients have been well documented in Western countries, this issue has not been systematically studied in Taiwan. Hence, the present study presents a preliminary investigation into the neurocognitive dysfunctions after TBI in Taiwanese populations.
Method: The present study recruited 36 moderate-to-severe TBI patients. With a use of a neuropsychological test battery, the patients were evaluated for their intellectual functioning, memory, executive function and other domains of cognitive functions.
Results: The results showed that almost half of the evaluated TBI patients manifested a significant impairment of psychomotor speed and executive function, while one-third of the patients had a deficit in episodic memory. Furthermore, only less than 20% of the patients presented with other domains of cognitive dysfucntions.
Conclusion: This is the first preliminary study in Taiwan to analyze and document the neurocognitive deficits after TBI. It also uncovered that memory deficits, psychomotor slowing and executive dysfunction are the three major neurocognitive impairments following head trauma. Accordingly, it is necessary to establish a more comprehensive profile of post-TBI neurobehavioral functions.

並列關鍵字

Traumatic brain injury ； Neurocognitive deficits ； Moderate-to-severe

參考文獻

花茂棽(1986)。中文字詞序列學習測驗。台北市:台灣大學心理學研究所。

花茂棽(1998)。臨床神經心理衡鑑測驗使用手冊。台北市:台灣大學心理學研究所。

關茿云(2003)。頭部創傷後病人認知功能及扣帶回切開術後病人認知功能之探討(碩士論文)。高雄醫學大學行為科學研究所。

Axelrod, B.N.,Fichtenberg, N.L.,Liethen, P.C.,Czarnota, M.A.(2001).Performance characteristics of postacute traumatic brain injury patients on the WAIS-Ⅲand WMS-Ⅲ.Clinical Neuropsychologist.15,516-520.

Benton, A.L.(1983).Benton Visual Retention Test.New York:Psychological Corporation.