Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers

Hiploylee, Carmen; Dufort, Paul; Davis, Hannah S.; Wennberg, Richard; Tartaglia, Maria Carmela; Mikulis, David J.; Hazrati, Lili‐Naz; Tator, Charles H.

doi:10.1089/neu.2016.4677

Cited by 230 publications

(170 citation statements)

References 38 publications

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“…While the majority of individuals experience a resolution of sleep disturbances and other post‐concussion symptoms within 2 weeks, other studies indicated that sleep disturbances have been shown to persist in some individuals for 1 to up to 6 years following concussion . Furthermore, sleep quality has been shown to worsen in some individuals following concussion .…”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbances in the Acute Stage of Concussion are Associated With Poorer Long‐Term Recovery: A Systematic Review

Ludwig

D’Silva

Vaduvathiriyan

et al. 2020

PM&R

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Objective: To examine the association between sleep during the acute stage of concussion and long-term outcomes. Literature Survey: Literature searches were performed 1 July 2018 to 1 August 2018 in Ovid MEDLINE, CINAHL, and Web of Science, along with hand searching for gray literature and cited references. Of the 610 search results, 359 unique references were reviewed after duplicates were removed. Methodology: Two reviewers independently reviewed and came to consensus on which titles/abstracts met inclusion/exclusion criteria (n = 23). The 23 full-text articles were assessed independently by the same two reviewers for eligibility. Consensus was achieved, leaving four articles for quality assessment and data extraction. One person extracted relevant data from each study using a standard data-extraction table. The data extraction table was reviewed by two reviewers and consensus was achieved for completeness and accuracy. Quality appraisal was conducted to assess the risk for potential bias and quality of included articles. Synthesis: Two of the articles included children younger than 16 years old and two included a wide age range. In general, poorer sleep was associated with poorer outcomes following concussion at reassessments across any age population. In addition, poorer sleep in the acute stage of concussion was associated with poorer long-term outcomes and recovery. Conclusions: The variability in sleep assessments used, symptoms assessed, length of time to reassessments, and comparator group included made data synthesis challenging. The use of standard valid and reliable sleep assessments is recommended. Future studies may consider if addressing sleep disturbances early following concussion will improve longer-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Sleep Disturbances in the Acute Stage of Concussion are Associated With Poorer Long‐Term Recovery: A Systematic Review

Ludwig

D’Silva

Vaduvathiriyan

et al. 2020

PM&R

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“…5 Income was grouped as follows low (UK; less than £14.000, Italy and the Netherlands; less than €20.000), middle (UK; £14.000-£27.999, Italy and the Netherlands; €20.000-€39.999) and high (UK; more than £27.999, Italy and the Netherlands; more than €39.999). 6 Chronic health complaints were defined as: asthma, chronic bronchitis, severe heart disease, consequences of a stroke, diabetes, severe back complaints, arthrosis, rheumatism, cancer, memory problems due to neurological disease/dementia, memory problems due to ageing, depression or anxiety disorder, and other chronic health complaints.…”

Section: Frequency Of Post-concussion-like Symptoms and Prevalence Ofmentioning

confidence: 99%

“…The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is a frequently applied instrument to assess the existence and severity of post-concussion symptoms (5), Over the last decennia, the concept of PCS has been debated in an abundance of studies. The prevalence rates of PCS throughout the literature vary greatly (6) and depend on the definition used (7) as well as the applied classification method (8). Researchers and clinicians who have performed extensive research concerning the etiology of PCS have still not been able to successfully identify the pre-and postinjury-related factors as well as the underlying structure of post-concussion symptoms (9).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of post-concussion-like symptoms in the general population in Italy, The Netherlands and the United Kingdom

et al. 2019

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Objectives: To evaluate the frequency of post-concussion symptoms and prevalence and risk factors of post-concussion syndrome (PCS) in the general population, investigate the association between the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and self-perceived health, and evaluate differences between three European countries. Methods: A web-based survey including the RPQ and EQ-5D was conducted among representative samples in three European countries. Results: A total of 11,759 respondents completed the questionnaire. The most frequently reported symptom was fatigue (49.9%). Almost half (45.1%) of the respondents were classified as having PCS considering rating score 2 (three RPQ items with score ≥ 2) as a cutoff. Chronic health complaints were found as a significant risk factor for PCS. All items of the RPQ were positively correlated with the EQ-5D and the strongest positive correlation (0.633, p<0.001) was between RPQ item 'feeling depressed or tearful' and EQ-5D domain 'anxiety/depression'. Conclusions: We found a high frequency of post-concussion-like symptoms and PCS in the general population, indicating that these symptoms are not specific for patients with traumatic brain injury (TBI), and PCS is not a unique syndrome after TBI. Therefore, the use of post-concussion symptoms and PCS as outcome following mild TBI should be interpreted with caution.

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“…Due to its diverse array of causes, TBI has broad social impact across many demographics and continues to pose a challenge to researchers attempting to develop treatments. Although many recover completely from mild TBI, other patients suffer longterm consequences (Masel and DeWitt, 2010;Blennow et al, 2016;Hiploylee et al, 2017;Wilson et al, 2017), which include memory deficits, sleep disturbances, or mood disorders (Masel and DeWitt, 2010;Wilson et al, 2017). Recent work shows that some of these long-term effects are associated with lasting changes in brain networks.…”

Section: Introductionmentioning

confidence: 99%

Neuronal Degeneration Impairs Rhythms Between Connected Microcircuits

Schumm

Gabrieli

Meaney

2020

Front. Comput. Neurosci.

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Synchronization of neural activity across brain regions is critical to processes that include perception, learning, and memory. After traumatic brain injury (TBI), neuronal degeneration is one possible effect and can alter communication between neural circuits. Consequently, synchronization between neurons may change and can contribute to both lasting changes in functional brain networks and cognitive impairment in patients. However, fundamental principles relating exactly how TBI at the cellular scale affects synchronization of mesoscale circuits are not well understood. In this work, we use computational networks of Izhikevich integrate-and-fire neurons to study synchronized, oscillatory activity between clusters of neurons, which also adapt according to spike-timing-dependent plasticity (STDP). We study how the connections within and between these neuronal clusters change as unidirectional connections form between the two neuronal populations. In turn, we examine how neuronal deletion, intended to mimic the temporary or permanent loss of neurons in the mesoscale circuit, affects these dynamics. We determine synchronization of two neuronal circuits requires very modest connectivity between these populations; approximately 10% of neurons projecting from one circuit to another circuit will result in high synchronization. In addition, we find that synchronization level inversely affects the strength of connection between neuronal microcircuits-moderately synchronized microcircuits develop stronger intercluster connections than do highly synchronized circuits. Finally, we find that highly synchronized circuits are largely protected against the effects of neuronal deletion but may display changes in frequency properties across circuits with targeted neuronal loss. Together, our results suggest that strongly and weakly connected regions differ in their inherent resilience to damage and may serve different roles in a larger network.

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Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers

Cited by 230 publications

References 38 publications

Sleep Disturbances in the Acute Stage of Concussion are Associated With Poorer Long‐Term Recovery: A Systematic Review

Sleep Disturbances in the Acute Stage of Concussion are Associated With Poorer Long‐Term Recovery: A Systematic Review

Prevalence of post-concussion-like symptoms in the general population in Italy, The Netherlands and the United Kingdom

Neuronal Degeneration Impairs Rhythms Between Connected Microcircuits

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