Persistent impairment based symptoms post mild traumatic brain injury: Does a standard symptom scale detect them?

Abstract

Persistent impairment based symptoms post Mild Traumatic Brain Injury: does a standard symptom scale detect them? ABSTRACT Aim To further explore symptoms in patients beyond the expected recovery period post mild Traumatic Brain Injury (mTBI) that are potentially indicative of impairment. Methods Ninety-four individuals (62 diagnosed with mTBI within the previous 4-24 weeks and 32 healthy controls) participated in the study. Participants in the mTBI group were further grouped as symptomatic (n=33) or asymptomatic (n=29) based on their spontaneous report of symptoms at the time of screening. Measures included a demographic questionnaire, 8 impairment specific self-report clinical tools, and a standard post-mTBI selfreport symptom scale (Head Injury Scale (HIS)). Results Compared to the control group, scores for all instruments (including the HIS) were higher in the symptomatic mTBI group (P< .05), and higher for the neck disability and hyperarousal measures in the asymptomatic mTBI group (p<0.035), but not the HIS (p>0.093). Overall 94% of the symptomatic and 62% of the asymptomatic participants post-mTBI, recorded scores considered to be clinically relevant on at least one impairment screening tool. In contrast, only 28% of the asymptomatic mTBI group recorded a clinically relevant score for the HIS. Conclusion Symptoms indicative of persisting impairments beyond the expected recovery period were apparent in a substantial proportion of individuals post mTBI. Furthermore, a high percentage of individuals initially reporting as symptom free demonstrated clinically relevant scores on at least one impairment screening tool. Findings also suggest that a standard post-mTBI self-report symptom scale may often not detect the presence of persisting symptoms.

An Investigation of Physiological System Impairments in Individuals 4 Weeks to 6 Months Following Mild Traumatic Brain Injury

“…Our previous study showed elevated levels of selfreported hyperarousal (a potential indicator of ANS function) in mTBI participants, 4 weeks to 6 months post-injury, even in those who considered themselves symptom-free. 13 The aim of the current study was to explore PSI in mTBI participants, 4 weeks to 6 months post-injury, using the standard BCTT "failure" criteria, as well as exploratory measures of test duration and HR responses. It was hypothesized that a proportion of the mTBI group would "fail" the BCTT and would be higher in those reporting persisting symptoms during screening.…”