多种因素影响瞳孔光反射：对军人创伤性脑损伤筛查的意义

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI:10.1016/j.cnp.2025.07.002

Michael N. Dretsch , Katie M. Williams , Diana P. Evans , Katrina S. Monti , Brian J. Guise , Mark L. Ettenhofer , Jamie N. Hershaw

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引用次数: 0

摘要

目的探讨人口统计学、病史和心理健康状况对有和无轻度创伤性脑损伤（mTBI）史军人瞳孔光反射（PLR）指数的影响。方法分析来自NeurOptics NPi-300的216名参与者的splr数据，这些参与者分为非损伤对照组（NIC）、无意识丧失mTBI （mTBILOC-）和LOC mTBI （mTBILOC+）。对各PLR指数建立多个独立回归模型，按组评估各因素对PLR指数变异性的贡献。结果两组间PLR指标差异无统计学意义。年龄是各组的重要因素，但对mTBI患者更为明显。在mTBILOC+组中主要观察到睡眠时间、损伤特征和心理健康对PLR指数的影响。在所有模型中，创伤后压力和性都不是显著的预测因子。结论：当使用PLR筛查mTBI时，在解释PLR指标时应考虑个体的年龄、既往mTBI病史、意识、睡眠、焦虑和抑郁症状的终生tbi相关改变。控制这些因素对于验证PLR筛查mTBI的使用至关重要。

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Multiple factors contribute to pupillary light reflex: implications for screening of traumatic brain injury in military service members

Objectives

This study aimed to assess the contribution of demographics, medical history, and psychological health to pupillary light reflex (PLR) indices in Service members with and without a history of mild traumatic brain injury (mTBI).

Methods

PLR data from NeurOptics NPi-300 were analyzed on 216 participants who were categorized as non-injured controls (NIC), mTBI with no loss of consciousness (mTBI^LOC-), or mTBI with LOC (mTBI^LOC+). Multiple independent regression models were conducted for each PLR index to assess the contribution of these factors to the variability of PLR indices by group.

Results

There were no significant group differences on the PLR indices. Age was a significant factor across groups, but more robust for those with mTBI. Sleep duration, injury characteristics, and psychological health effects on PLR indices were primarily observed in the mTBI^LOC+ group. Posttraumatic stress and sex were not significant predictors in any of the models.

Conclusions

When using PLR for screening of mTBI, an individual’s age, history of prior mTBI, total lifetime TBI-related alterations in consciousness, sleep, and anxiety and depression symptoms should be considered when interpreting PLR metrics.

Significance

Controlling for these factors is essential for validating the use of PLR for screening of mTBI.

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来源期刊

Clinical Neurophysiology Practice NEUROSCIENCES-

CiteScore

3.90

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.