Preliminary Evidence for the Clinical Utility of Tactile Somatosensory Assessments of Sport-Related mTBI

Sports Medicine - Open

Stephen Kara¹  Joshua P. McGeown²  Patria A. Hume²  Doug King³  Alice Theadom⁴ 

[1] Axis Sports Medicine Clinic, Auckland, New Zealand;Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Private Bag 92006, 1142, Auckland, New Zealand;Traumatic Brain Injury Network, Auckland University of Technology, Auckland, New Zealand;Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Private Bag 92006, 1142, Auckland, New Zealand;Traumatic Brain Injury Network, Auckland University of Technology, Auckland, New Zealand;School of Science and Technology, University of New England, Armidale, NSW, Australia;Traumatic Brain Injury Network, Auckland University of Technology, Auckland, New Zealand;

关键词: Somatosensory;    mTBI;    Modelling;    Prediction;    Diagnosis;    Recovery;    Brain Gauge;   

DOI  :  10.1186/s40798-021-00340-8

来源: Springer

【 摘 要 】

ObjectivesTo evaluate the clinical utility of tactile somatosensory assessments to assist clinicians in diagnosing sport-related mild traumatic brain injury (SR-mTBI), classifying recovery trajectory based on performance at initial clinical assessment, and determining if neurophysiological recovery coincided with clinical recovery.Research DesignProspective cohort study with normative controls.MethodsAt admission (n = 79) and discharge (n = 45/79), SR-mTBI patients completed the SCAT-5 symptom scale, along with the following three components from the Cortical Metrics Brain Gauge somatosensory assessment (BG-SA): temporal order judgement (TOJ), TOJ with confounding condition (TOJc), and duration discrimination (DUR). To assist SR-mTBI diagnosis on admission, BG-SA performance was used in logistic regression to discriminate cases belonging to the SR-mTBI sample or a healthy reference sample (pooled BG-SA data for healthy participants in previous studies). Decision trees evaluated how accurately BG-SA performance classified SR-mTBI recovery trajectories.ResultsBG-SA TOJ, TOJc, and DUR poorly discriminated between cases belonging to the SR-mTBI sample or a healthy reference sample (0.54–0.70 AUC, 47.46–64.71 PPV, 48.48–61.11 NPV). The BG-SA evaluated did not accurately classify SR-mTBI recovery trajectories (> 14-day resolution 48%, ≤14–day resolution 54%, lost to referral/follow-up 45%). Mann-Whitney U tests revealed differences in BG-SA TOJc performance between SR-mTBI participants and the healthy reference sample at initial clinical assessment and at clinical recovery (p < 0.05).ConclusionsBG-SA TOJ, TOJc, and DUR appear to have limited clinical utility to assist clinicians with diagnosing SR-mTBI or predicting recovery trajectories under ecologically valid conditions. Neurophysiological abnormalities persisted beyond clinical recovery given abnormal BG-SA TOJc performance observed when SR-mTBI patients achieved clinical recovery.

【 授权许可】

CC BY