The prospective course of postconcussion syndrome: The role of mild traumatic brain injury.

Meares, Susanne; Shores, E. Arthur; Taylor, Alan; Batchelor, Jennifer; Bryant, Richard A.; Baguley, Ian; Chapman, Jennifer; Gurka, Joseph; Marosszeky, J. E.

doi:10.1037/a0022580

Cited by 263 publications

(215 citation statements)

References 77 publications

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“…The nature and extent of this symptom complex is similar in other patient populations such as those with chronic pain syndromes (14) or following traumas not involving the brain (e.g. after orthopaedic injuries) (6,13). Moreover, healthy controls report post-concussion like symptoms such as cognitive problems, fatigue and headache.…”

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confidence: 59%

“…However, these parameters or other biological explanations do not predict the persistence of symptoms or occurrence of post-concussion syndrome (11). Although its name suggests that this symptom complex is specifically seen after concussion, post-concussion syndrome seems not specifically related to mTBI (6,12,13). The nature and extent of this symptom complex is similar in other patient populations such as those with chronic pain syndromes (14) or following traumas not involving the brain (e.g.…”

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confidence: 95%

“…A minority of the patient group reports persistent symptoms and experience long term interfering consequences of their mTBI, also known as post-concussion syndrome. The exact size of this minority remains debatable, with reported percentages ranging between 15 and 47% due to methodological variations across studies and inconsistencies regarding its definition (5)(6)(7). Finding a possible explanation for the persistence of symptoms has been of interest to many researchers in the last three decades, but no uniform explanation has been found (8,9).…”

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confidence: 99%

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Does the fear avoidance model explain persistent symptoms after traumatic brain injury?

et al. 2017

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Background: A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking. Objective: To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI. Design: Cross-sectional study. Participants: 48 patients with TBI, of which 31 patients with mTBI, had persistent symptoms (mean time since injury 48.2 months); 92% of the entire sample fulfilled the criteria for post-concussion syndrome. Outcome variables: catastrophizing, fear-avoidance, depression and post-concussion symptoms. Results: High levels of catastrophizing were found in 10% and high levels of fear avoidance behaviour were found in 35%. Catastrophizing, fear avoidance behaviour, depressive symptoms and post-concussion symptoms correlated significantly with each other (p < 0.05). Conclusion:The fear-avoidance model proposes a possible explanation for persistent symptoms. Validation and normative data are needed for suitable measures of catastrophizing and fear avoidance of post-concussion symptoms after TBI. Longitudinal prospective cohort studies are needed to establish its causal and explanatory nature.

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Does the fear avoidance model explain persistent symptoms after traumatic brain injury?

et al. 2017

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“…15 The investigators found similar rates of PCS at 3 months post-injury within both groups. Furthermore, pre-injury depression or anxiety and acute post-traumatic stress predicted PCS regardless of mTBI.…”

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confidence: 86%

“…Post-concussion symptoms are nonspecific in nature and can be found across a variety of clinical populations. They can be influenced by post-traumatic stress, 14 preinjury depression or anxiety, 15 risk factors such as premorbid cognitive problems, substance use, and psychosocial stressors, The use of trauma patients with orthopedic injuries as a comparison group allows investigators to control for confounding factors that influence the clinical presentation of patients with mTBI, such as post-trauma stress and pre-injury risk factors including behavioral factors that predispose a person to injury. A recent study examined cognitive performance in 123 patients with mTBI and 100 age and sex matched orthopedically injured controls (OC) at presentation to the ED 1 week, and 3 months post-injury.…”

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Prevalence and Predictors of Poor Recovery from Mild Traumatic Brain Injury

Rabinowitz

McCauley

et al. 2015

Journal of Neurotrauma

114

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Although most patients with mild traumatic brain injury (mTBI) recover within 3 months, a subgroup of patients experience persistent symptoms. Yet, the prevalence and predictors of persistent dysfunction in patients with mTBI remain poorly understood. In a longitudinal study, we evaluated predictors of symptomatic and cognitive dysfunction in adolescents and young adults with mTBI, compared with two control groups-patients with orthopedic injuries and healthy uninjured individuals. Outcomes were assessed at 3 months post-injury. Poor symptomatic outcome was defined as exhibiting a symptom score higher than 90% of the orthopedic control (OC) group, and poor cognitive outcome was defined as exhibiting cognitive performance poorer than 90% of the OC group. At 3 months post-injury, more than half of the patients with mTBI (52%) exhibited persistently elevated symptoms, and more than a third (36.4%) exhibited poor cognitive outcome. The rate of high symptom report in mTBI was markedly greater than that of typically developing (13%) and OC (17%) groups; the proportion of those with poor cognitive performance in the mTBI group exceeded that of typically developing controls (15.8%), but was similar to that of the OC group (34.9%). Older age at injury, female sex, and acute symptom report were predictors of poor symptomatic outcome at 3 months. Socioeconomic status was the only significant predictor of poor cognitive outcome at 3 months.

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Association of Adverse Childhood Experiences With Poor Neuropsychiatric Health and Dementia Among Former Professional US Football Players

et al. 2022

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Key Points Question Are adverse childhood experiences (ACEs) associated with dementia symptoms and poor neuropsychiatric health in former professional football players? Findings In this cross-sectional study of 1755 former professional US football players, 10 ACEs, primarily indicators of family dysfunction, were associated with a positive dementia screening result. Players with at least 4 ACEs were 48% more likely to have a positive finding on a dementia screen and were at greater risk of poor cognition-related quality of life, pain, and depression compared with players with no ACEs. Meaning These findings suggest that childhood family dysfunction may be a risk factor for dementia symptoms and poor neuropsychiatric health in adulthood in former professional football players.

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The prospective course of postconcussion syndrome: The role of mild traumatic brain injury.

Abstract: The data suggest the phenomenon of PCS in trauma patients does not show an association with mTBI.

Cited by 263 publications

References 77 publications

Does the fear avoidance model explain persistent symptoms after traumatic brain injury?

Does the fear avoidance model explain persistent symptoms after traumatic brain injury?

Prevalence and Predictors of Poor Recovery from Mild Traumatic Brain Injury

Association of Adverse Childhood Experiences With Poor Neuropsychiatric Health and Dementia Among Former Professional US Football Players

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