A review of post-concussion syndrome and psychological factors associated with concussion

Broshek, Donna K.; Marco, Anthony P. De; Freeman, Jason

doi:10.3109/02699052.2014.974674

Cited by 312 publications

(219 citation statements)

References 77 publications

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“…Psychiatric conditions are significantly more frequent in TBI survivors compared to healthy controls [42,43], probably arising from neurobiological and pathophysiological changes initiated by TBI [44,45,46]. Anxiety disorders following TBI can be caused by disruption of neurotransmitters, disruption of the neuroendocrine system, structural responses to physical injury, and the incomplete management of postconcussive symptoms [47].…”

Section: Discussionmentioning

confidence: 99%

Aging with Traumatic Brain Injury: Effects of Age at Injury on Behavioral Outcome following Diffuse Brain Injury in Rats

Rowe¹,

Ziebell

Harrison

et al. 2016

Dev Neurosci

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Development and aging are influenced by external factors with the potential to impact health throughout the life span. Traumatic brain injury (TBI) can initiate and sustain a lifetime of physical and mental health symptoms. Over 1.7 million TBIs occur annually in the USA alone, with epidemiology suggesting a higher incidence for young age groups. Additionally, increasing life spans mean more years to age with TBI. While there is ongoing research of experimental pediatric and adult TBI, few studies to date have incorporated animal models of pediatric, adolescent, and adult TBI to understand the role of age at injury across the life span. Here, we explore repeated behavioral performance between rats exposed to diffuse TBI at five different ages. Our aim was to follow neurological morbidities across the rodent life span with respect to age at injury. A single cohort of male Sprague-Dawley rats (n = 69) was received at postnatal day (PND) 10. Subgroups of this cohort (n = 11-12/group) were subjected to a single moderate midline fluid percussion injury at age PND 17, PND 35, 2 months, 4 months, or 6 months. A control group of naïve rats (n = 12) was assembled from this cohort. The entire cohort was assessed for motor function by beam walk at 1.5, 3, 5, and 7 months of age. Anxiety-like behavior was assessed with the open field test at 8 months of age. Cognitive performance was assessed using the novel object location task at 8, 9, and 10 months of age. Depression-like behavior was assessed using the forced swim test at 10 months of age. Age at injury and time since injury differentially influenced motor, cognitive, and affective behavioral outcomes. Motor and cognitive deficits occurred in rats injured at earlier developmental time points, but not in rats injured in adulthood. In contrast, rats injured during adulthood showed increased anxiety-like behavior compared to uninjured control rats. A single diffuse TBI did not result in chronic depression-like behaviors or changes in body weight among any groups. The interplay of age at injury and aging with an injury are translationally important factors that influence behavioral performance as a quality of life metric. More complete understanding of these factors can direct rehabilitative efforts and personalized medicine for TBI survivors.

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Section: Discussionmentioning

confidence: 99%

Aging with Traumatic Brain Injury: Effects of Age at Injury on Behavioral Outcome following Diffuse Brain Injury in Rats

Rowe¹,

Ziebell

Harrison

et al. 2016

Dev Neurosci

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“…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.…”

mentioning

confidence: 97%

“…In order to investigate whether the fear avoidance model provides a possible explanation for postconcussion syndrome, the relationships between post-concussion symptoms, catastrophizing thoughts and fear avoidance beliefs after TBI were examined. Separate analyses were performed on a subgroup of patients with mTBI because a biopsychosocial approach is proposed to be of special importance in explaining persistent symptoms after mTBI (9,12).…”

mentioning

confidence: 99%

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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“…It is estimated that 10-15 % of individuals are reported to remain symptomatic one year after concussion (5). These symptoms are not specifi c for PCS and are associated with other clinical and non-clinical groups including healthy adults (in our study, 57.1 % of controls reported symptoms consistent with PCS), and patients suffering from chronic pain, spinal injury, non-brain trauma, or psychological distress (6).…”

Section: Postconcussion Syndromementioning

confidence: 55%

“…Whether PCS is experienced after MTBI appears to depend on different neurobiological and psychological factors, including pre-injury depression and anxiety, somatoform disorder, lifestressors, pain, female gender, older age, coping style, cognitive biases such as expectation of symptoms, premature return to full training regime in sport, litigation stress, exaggeration, and malingering (6,7).…”

Section: Postconcussion Syndromementioning

confidence: 99%

Type and occurrence of serious complications in patients after mild traumatic brain injury

Sivak¹,

Nosáľ²,

Bittšanský³

et al. 2016

BLL

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Traumatic brain injury (TBI) remains a major public health and socio-economic problem, and 70 -90 % of all TBIs are classifi ed as mild. Mild TBIs and concussions are mostly considered to be non-serious conditions with symptoms subsiding within a few days or weeks. However in 10 -15 % of patients, the symptoms persist one year after concussion and mostly include headache, fatigue, irritability, and cognitive problems (e.g. memory, concentration). These persisting symptoms negatively infl uence patient daily activities as postconcussion syndrome (PCS). Second-impact syndrome (SIS) is a very rare but usually fatal condition and occurs when repeated brain injuries lead to a catastrophic diffuse brain swelling. There is no scientifi c evidence on the incidence and risk of SIS. Chronic traumatic encephalopathy (CTE) is a progressive degenerative disease of the brain found in patients with a history of repetitive brain trauma. CTE presents with behavioural, cognitive, and motor symptoms. The literature to date lacks prospective epidemiological studies of the incidence of CTE. In recent medical literature, there is a description of 110 athletes with postmortem diagnosis of CTE (Tab. 1, Ref. 37

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A review of post-concussion syndrome and psychological factors associated with concussion

Abstract: Understanding, assessing and treating the psychological factors associated with concussion are effective means of preventing or shortening the length of post-concussion syndrome.

Cited by 312 publications

References 77 publications

Aging with Traumatic Brain Injury: Effects of Age at Injury on Behavioral Outcome following Diffuse Brain Injury in Rats

Aging with Traumatic Brain Injury: Effects of Age at Injury on Behavioral Outcome following Diffuse Brain Injury in Rats

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

Type and occurrence of serious complications in patients after mild traumatic brain injury

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