Do Mild Traumatic Brain Injury Severity Sub-classification Systems Help to Identify People Who Go on to Experience Long-Term Symptoms?

Abstract

Objective: To identify the systems available to sub-classify mild traumatic brain injury (TBI) and to determine their utility in predicting 1-year outcome.Methods: A systematic review to identify mild-TBI sub-classification systems was conducted until March 2016. The identified systems were applied to a cohort of N = 290 adults who had experienced a mild-TBI, and who had been assessed for post-concussion symptoms 1-year post injury. ANOVAs and regression models were used to determine whether each sub-classification system could distinguish between outcomes and to explore their contribution to explaining variance in post-concussion symptoms 1-year post injury.Results: Nineteen sub-classification systems for mild-TBI met the inclusion criteria for this review. The Saal (1991) classification system significantly differentiated the experience of post-concussion symptoms in our cohort 1-year post injury (F = 2.39, p = 0.05). However, the findings did not remain significant following correction for multiple comparisons and inclusion of socio-demographic and contextual factors in the regression model.Conclusions: Current sub-classification systems fail to explain much of the variance in post-concussion symptoms 1 year following mild-TBI. Further research is needed to identify the factors (including socio-demographic and contextual factors) to determine, who may be at risk of developing persistent post-concussion symptoms.

Sensitivity to Noise Following a Mild Traumatic Brain Injury: A Longitudinal Study

“…The aforementioned influence of cognitive deficits on the partitioning of variance in these analyses may again be of relevance, as poor concentration was a significant predictor in 4 of the 6 models. Of note, the variable representing mTBI risk ratings was a poor predictor of enduring postconcussive symptoms, a finding reported elsewhere and one that questions the utility of such measures 45…”

“…Of note, the variable representing mTBI risk ratings was a poor predictor of enduring postconcussive symptoms, a finding reported elsewhere and one that questions the utility of such measures. 45 The support of the Dischinger et al 10 conclusion that NS may be a marker of persistent postconcussive symptoms naturally leads to inquiry as to why this may be. Appealing to peripheral auditory mechanisms, they speculated that diffuse axonal injury in the auditory pathways could be a cause of NS and that this injuryrelated axonal shearing would not likely be focal and instead would be occurring across the central nervous system.…”

Brain Connectivity and Behaviour in Post-Concussion Syndrome: A Scoping Review Protocol

“…Although it was not explicitly stated in out inclusion criteria (Table 1), the de nition of mTBI includes a score of 13-15 on GCS, less than a day long post-traumatic amnesia (PTA), less than one hour of loss of consciousness (LOC) with slight variations in such measures reported by various research groups. 31,32 Eligible studies must employ neuroimaging tools such as DTI/DWI or resting-state/task-based fMRI for measuring the change in white matter integrity and functional connectivity, respectively. Thus, DTI/DWI and fMRI parameters and brain regions or networks reported to be disrupted will be our primary outcome.…”

The Brain Injury Screening Tool (BIST): Tool development, factor structure and validity

“…Tools designed to try and subclassify mTBI's based on injury type, level of consciousness and alterations in mental state post-injury have not been found to adequately discriminate mTBI's or to predict how a person will recover [14]. Consequently, the acute assessment now focuses on a more comprehensive assessment of acute symptoms such as the severity of headaches, dizziness and disturbed vision.…”