Longitudinal trajectories and risk factors for persistent postconcussion symptom reporting following uncomplicated mild traumatic brain injury in U.S. Military service members

Trajectories of Persistent Postconcussion Symptoms and Factors Associated With Symptom Reporting After Mild Traumatic Brain Injury

“…The patients with MTBI had a less stable BC-PSI total score than the control groups, where both symptom worsening (22.2%) and improvement (20.9%) were common from 3 to 12 months. This finding highlights that symptom reporting tends to fluctuate, a common observation in clinical practice and also reported in a recent study on military personnel 9 and in children. 44 To our knowledge, data on typical change on the BC-PSI in healthy controls have not been published.…”

“…The prevalence of msPPCS was similar at 3 and 12 months, which is in line with findings from some other studies reporting the prevalence of PCS in cohorts assessed at 2 or several time points postinjury. [7][8][9][10] The stable group-level prevalence of msPPCS from 3 months onward (21%) might leave the impression that the chances of a recovery after 3 months are small. However, almost half of the patients with msPPCS at 3 months improved by 12 months (44%).…”

“…The nature and prevalence of PPCS after MTBI have been reported in numerous cross-sectional studies and in some longitudinal studies. [3][4][5][6][7][8][9][10][11] However, surprisingly few have examined the individual trajectories of PPCS in adults recruited from the time of injury. 6,8 Postconcussion-like symptoms are common in other conditions, such as depression and chronic pain, and are even common in community controls.…”

American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering

“…Notably, non-brain injured individuals have been found to report the same symptoms, with comparable frequency and severity (e.g. Kashluba et al, 2004;Mickevi ciene et al, 2004;Lange et al, 2020). The sequelae of concussion on somatic, cognitive, and emotional functioning are considerably contentious in litigation contexts and tend to be primarily represented by two opposing points of view: those who view concussion as directly leading to long-term cognitive, emotional, and somatic symptoms versus those who view outcome from concussion as benign and long-term symptom report as due to other factors.…”

Is Traumatic Brain Injury Severity in Service Members and Veterans Related to Health-Related Quality of Life in Their Caregivers?

“…Comorbid conditions are common in a military population and may be associated with the TBI event itself or occur pre- or postinjury. Comorbid conditions, particularly posttraumatic stress disorder (PTSD) and depression, can have a profound influence on long-term postconcussion symptom reporting following a TBI of any severity and have been implicated in “persistent” or “newly developed” self-reported postconcussion symptoms long after a remote uncomplicated MTBI 10–13…”