A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury

Mild traumatic brain injury (mTBI) presents a substantial burden to patients, families, and health care systems. Whereas, recovery can be expected in the majority of patients, a subset continues to report persisting somatic, cognitive, emotional, and/or behavioral problems, generally referred to as...

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Published in:Frontiers in neurology Vol. 9; p. 1113
Main Authors: Polinder, Suzanne, Cnossen, Maryse C., Real, Ruben G. L., Covic, Amra, Gorbunova, Anastasia, Voormolen, Daphne C., Master, Christina L., Haagsma, Juanita A., Diaz-Arrastia, Ramon, von Steinbuechel, Nicole
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media S.A 19.12.2018
Subjects:
diagnosis
etiology
mild traumatic brain injury
Neurology
outcome
post-concussion symptoms
prevalence
prevalence
treatment
post-concussion symptoms
diagnosis
mild traumatic brain injury
outcome
etiology
ISSN:1664-2295, 1664-2295
Online Access:Get full text
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Summary:Mild traumatic brain injury (mTBI) presents a substantial burden to patients, families, and health care systems. Whereas, recovery can be expected in the majority of patients, a subset continues to report persisting somatic, cognitive, emotional, and/or behavioral problems, generally referred to as post-concussion syndrome (PCS). However, this term has been the subject of debate since the mechanisms underlying post-concussion symptoms and the role of pre- and post-injury-related factors are still poorly understood. We review current evidence and controversies concerning the use of the terms post-concussion symptoms vs. syndrome, its diagnosis, etiology, prevalence, assessment, and treatment in both adults and children. Prevalence rates of post-concussion symptoms vary between 11 and 82%, depending on diagnostic criteria, population and timing of assessment. Post-concussion symptoms are dependent on complex interactions between somatic, psychological, and social factors. Progress in understanding has been hampered by inconsistent classification and variable assessment procedures. There are substantial limitations in research to date, resulting in gaps in our understanding, leading to uncertainty regarding epidemiology, etiology, prognosis, and treatment. Future directions including the identification of potential mechanisms, new imaging techniques, comprehensive, multidisciplinary assessment and treatment options are discussed. Treatment of post-concussion symptoms is highly variable, and primarily directed at symptom relief, rather than at modifying the underlying pathology. Longitudinal studies applying standardized assessment strategies, diagnoses, and evidence-based interventions are required in adult and pediatric mTBI populations to optimize recovery and reduce the substantial socio-economic burden of post-concussion symptoms.
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Reviewed by: Solrun Sigurdardottir, Sunnaas Sykehus, Norway; Torgeir Hellstrøm, Oslo University Hospital, Norway
This article was submitted to Neurotrauma, a section of the journal Frontiers in Neurology
Edited by: Nada Andelic, University of Oslo, Norway
ISSN:1664-2295
1664-2295
DOI:10.3389/fneur.2018.01113