Objective:Victims of electrical injury (EI) often experience injuries to the peripheral nervous system and neuromuscular damage that may diminish motor function, such as flexibility/dexterity. These difficulties may continue after rehabilitation due to the reorganization of muscle afferent projections during peripheral nerve regeneration. Therefore, understanding how patients with a history of thermal burn injuries perform on motoric measures is necessary to explain the impact neuromuscular damage has on both motor and non-motor tests of cognition. However, no studies have examined the impact of motor functioning on cognition in patients who experienced thermal and electrical injuries compared to an electrical shock injury. This study explored the impact of motor dysfunction and psychiatric distress measured by depression severity on psychomotor speed and executive test performances among EI patients with and without thermal burn injuries.Participants and Methods:This cross-sectional study consisted of EI patients undergoing an outpatient neuropsychological evaluation, including tests of motor dexterity (Grooved Pegboard [GP]), psychomotor speed (Wechsler Adult Intelligence Scale-IV Coding, Trail Making Test [TMT] Part A), and executive functioning (Stroop Color and Word Test [SCWT] Color-Word trial, TMT Part B). The sample was 83% male and 17% female, 88% White, 3% Black, 5% Hispanic, and 2% other race/ethnicity, with a mean age of 43.9 years (SD=11.36), mean education of 12.9 years (SD=2.05), and mean depression severity of 20.05 (SD=12.59) on the Beck Depression Inventory-II (BDI-II). Exclusion criteria were: 1) injury history of moderate-to-severe head trauma, 2) >2 performance validity test failures, and 3) any amputation of the upper extremity. Regression analyses included GP T-Scores for dominant hand and BDI-II total score as independent variables and neuropsychological normative test data as dependent variables.Results:Among validly performing patients with EI (n=86), regression analyses revealed GP performance accounted for significant variance (R2 =.153-.169) on all neuropsychological measures. Among EI patients with burn injuries (n=50), regression analyses revealed GP performance accounted for significant variance (R2 =.197-.266) on all neuropsychological measures. Among EI patients without burn injuries (n=36), analyses revealed that neither GP performance nor BDI-II severity accounted for significant variance across the neurocognitive tests (R2=.056-.142). Furthermore, among EI patients with burn injuries and the total sample, regression analyses revealed depression severity negatively predicted GP performance (R2 =.099-.13), however, in patients without burn injuries, depression did not predict GP performance (R2 =.052).Conclusions:Overall, results showed that GP performance is a significant predictor of neurocognitive performance on both motor and non-motor measures in EI patients with burn injuries. Therefore, among EI patients with burn injuries, GP performance may have potential utility as an early indicator of injury severity, considering that it predicts neuropsychological test performance on measures of psychomotor speed and executive functioning. Lastly, depression predicted GP performance within the burn injury sample illustrating that psychological distress may negatively impact motor functionality.

中文翻译：

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74 电损伤样本中运动功能障碍对神经心理学测试表现的影响

目的：电击伤 (EI) 的受害者经常会遭受周围神经系统损伤和神经肌肉损伤，这可能会削弱运动功能，例如灵活性/敏捷性。由于周围神经再生过程中肌肉传入投射的重组，这些困难可能在康复后继续存在。因此，了解有热烧伤史的患者在运动测量方面的表现对于解释神经肌肉损伤对运动和非运动认知测试的影响是必要的。然而，还没有研究比较经历过热损伤和电损伤的患者与电击损伤相比，运动功能对认知的影响。本研究探讨了有或没有热烧伤的 EI 患者的运动功能障碍和精神困扰（通过抑郁严重程度衡量）对精神运动速度和执行测试表现的影响。 参与者和方法：这项横断面研究由接受门诊神经心理学评估的 EI 患者组成，包括运动灵活性测试（Grooved Pegboard [GP]）、精神运动速度测试（韦克斯勒成人智力量表-IV 编码、轨迹制作测试 [TMT] A 部分）和执行功能测试（斯特鲁普颜色和单词测试 [SCWT] 颜色单词）试验，TMT B 部分）。样本中 83% 为男性，17% 为女性，88% 为白人，3% 为黑人，5% 为西班牙裔，2% 为其他种族/族裔，平均年龄为 43.9 岁 (SD=11.36)，平均受教育程度为 12.9 年 ( SD=2.05)，贝克抑郁量表 II (BDI-II) 的平均抑郁严重程度为 20.05 (SD=12.59)。排除标准是：1）中度至重度头部外伤的损伤史，2）> 2次性能有效性测试失败，以及3）任何上肢截肢。回归分析包括优势手的 GP T 分数和 BDI-II 总分作为自变量，神经心理学规范测试数据作为因变量。 结果：在有效表现的 EI 患者中（n=86)，回归分析显示 GP 绩效造成显着差异（R2=.153-.169）所有神经心理学测量。烧伤 EI 患者中（n=50)，回归分析显示 GP 绩效造成显着方差 (R2=.197-.266）所有神经心理学测量。无烧伤的 EI 患者（n=36），分析显示，GP 表现和 BDI-II 严重程度均无法解释神经认知测试中的显着差异（R2=.056-.142)。此外，在烧伤的 EI 患者和总样本中，回归分析显示抑郁严重程度对 GP 表现负向预测（R2=.099-.13)，然而，在没有烧伤的患者中，抑郁症并不能预测全科医生的表现（R2=.052）。结论：总体而言，结果表明 GP 表现是烧伤 EI 患者运动和非运动测量中神经认知表现的重要预测因子。因此，在烧伤的 EI 患者中，考虑到 GP 表现可以预测精神运动速度和执行功能测量的神经心理学测试表现，因此 GP 表现可能具有作为损伤严重程度的早期指标的潜在实用性。最后，在烧伤样本中，抑郁症预测了全科医生的表现，这表明心理困扰可能会对运动功能产生负面影响。