背景：近期研究者對於腦震盪後症狀（post-concussion symptoms, PCS）的分析逐漸轉向以網絡分析之視角剖析症狀間的交互關係。然而，由於過往的網絡分析研究甚少同時納入一般輕度創傷性腦損傷（mild traumatic brain injury, MTBI）患者受傷前與受傷後之症狀資料，因此本研究分別對受試者受傷前及受傷後之主觀報告內容進行網絡分析，並進一步進行網絡比較檢定，以期能更完整瞭解MTBI患者之PCS表現。
方法：本研究對既有研究的受試者資料進行次級分析，最終樣本為296名具有MTBI診斷之患者。依據受傷後天數，受試者進一步被分為受傷後天數7日內組以及受傷後天數8至21日內組。本研究以腦震盪後症狀檢核表（Checklist of Post-Concussion Symptoms, CPCS）測量受試者之PCS，並分別針對受試者之資料進行描述性統計、網絡分析、探索式圖形分析（exploratory graph analysis, EGA）及網絡比較檢定。
結果：MTBI患者受傷後之PCS嚴重程度顯著高於其回顧之受傷前狀態。在整體受試者受傷前之PCS網絡中，線段權重（edge weight, EW）最高之線段為噁心與嘔吐，最核心之症狀則為「焦慮」、「反應遲鈍」、「憂鬱」以及「容易疲倦」；在受傷後網絡中，EW最高之線段為焦慮與憂鬱，而最核心之症狀則為「體力變差」以及「反應遲鈍」。在受傷後天數7日內組受傷後之PCS網絡中，EW最高之線段為焦慮與憂鬱，最核心之症狀則為「體力變差」以及「反應遲鈍」，而在受傷後天數8至21日內組受傷後之PCS網絡中，EW最高之線段為噁心與嘔吐，最核心之症狀則為「反應遲鈍」以及「焦慮」。除此之外，EGA結果顯示受傷前之PCS一共被分成四個群集，受傷後之PCS則被分成三個群集。最後，網絡比較檢定結果顯示MTBI患者受傷前後之PCS網絡在網絡結構、全局強度及線段強度上均未具顯著差異。
結論：本研究具體呈現MTBI患者受傷前後之PCS網絡，發現關聯性較強之線段普遍存在於相同領域（例如：生理、情緒、認知等）內之症狀間。在整體受試者受傷前PCS網絡中，最核心之症狀為「焦慮」、「反應遲鈍」、「憂鬱」以及「容易疲倦」，而在整體受試者受傷後PCS網絡中則以「體力變差」與「反應遲鈍」為主。

Background: Recent research on post-concussion symptoms (PCS) has increasingly shifted towards a network analysis perspective to examine the interrelationships between symptoms. However, as previous network analysis studies rarely included both pre- and post-injury PCS data from patients with mild traumatic brain injury (MTBI), this study applied network analysis to examine MTBI patients’ self-reported pre- and post-injury symptoms. Furthermore, the Network Comparison Test (NCT) was conducted to gain a more comprehensive understanding of PCS in MTBI patients.
Methods: This study conducted a secondary analysis of participant data from previous research. A final sample of patients (N = 296) with a diagnosis of MTBI were included in this study. Participants were further divided into two groups (within 7 days and between 8 to 21 days) based on the time since injury. PCS were assessed using the Checklist of Post-Concussion Symptoms (CPCS), and the data were analyzed using descriptive statistics, network analysis, exploratory graph analysis (EGA), and the NCT.
Results: The severity of PCS in MTBI patients was significantly greater post-injury. In the overall pre-injury network, the highest edge weight was between nausea and vomiting. Central symptoms of the network included anxiety, slowed processing, depression, and fatigue. In the overall post-injury network, the highest edge weight was between anxiety and depression, and the most central symptoms included energy loss and slowed processing. In the post-injury PCS network of the ≤7 days group, the highest edge weight was between anxiety and depression, and the most central symptoms included energy loss and slowed processing. In the post-injury PCS network of the 8-21 days group, the highest edge weight was between nausea and vomiting, and the most central symptoms included slowed processing and anxiety. The EGA results showed that the pre-injury symptoms were divided into four clusters, while the post-injury symptoms were divided into three. The NCT results revealed no significant differences in network structure, global strength, and edge strength between pre- and post-injury PCS networks.
Conclusion: This study examined the pre- and post-injury PCS networks in patients with MTBI. Edges with stronger associations were generally observed between symptoms within the same domain (e.g., physical, emotional and cognitive). In the overall pre-injury PCS network, anxiety, slowed processing, depression, and fatigue were the most central symptoms. In the overall post-injury PCS network, energy loss and slowed processing were central to the network.

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