Moving towards individualised and interdisciplinary approaches to treat persistent post-concussion symptoms

Jaganathan, Kannan Singaravelu; Sullivan, Karen A.

doi:10.1016/j.eclinm.2019.11.023

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…There has long been debate regarding the aetiology of the diverse range of concussion symptoms, however, more recently there is acknowledgement that complex interactions between both neurogenic and psychogenic factors contribute (Jaganathan & Sullivan, 2019; Prince & Bruhns, 2017). A biopsychosocial perspective and more patient-centred approach is useful when evaluating and treating the patient’s individual needs, irrespective of aetiology, with focus on functional and meaningful goals (Jaganathan & Sullivan, 2019; Mashima et al, 2021). Interdisciplinary intervention accommodates this comprehensive approach and yet also allows for individual needs.…”

Section: Discussionmentioning

confidence: 99%

“…This systematic review provides an evidence base for health services and clinicians to reconsider traditional rehabilitation service design and action the establishment of interdisciplinary teams for treatment of PPCS. Interdisciplinary practice accommodates the need for a comprehensive approach, encompassing the need for a biopsychosocial perspective and complex interactions present with PPCS (Jaganathan & Sullivan, 2019; Mashima et al, 2021). This review also highlights for clinicians and researchers the importance of consistent definitions and language to facilitate high-quality research.…”

Section: Discussionmentioning

confidence: 99%

“…Current research, such as the Silverberg and Iverson led expert panel working to update the definition of mTBI, will likely provide useful progress regarding clarifying necessary definitions (Silverberg et al, 2021). With evidence suggesting the way forward is multimodal intervention with capacity and flexibility for individualisation, new perspectives on determining evidence and the ability to replicate quality studies provides hope that some of the challenges inherent in TBI research can begin to be addressed (Horn et al, 2015; Jaganathan & Sullivan, 2019). This review provides a foundation for further research into persistent symptoms following concussion for adults.…”

Section: Discussionmentioning

confidence: 99%

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Examining the interdisciplinary approach for treatment of persistent post-concussion symptoms in adults: a systematic review

Jennings

Islam²

2022

Brain Impairment

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Background: The objective of this review is to examine the evidence for the interdisciplinary approach in treatment of persistent post-concussion symptoms in adults. Methods: This systematic literature search was undertaken according to the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) guidelines. Five electronic databases were searched: CINAHL, Informit, ProQuest, PubMed and Scopus. After screening and quality assessment, the review included six studies published in English and peer-reviewed journals, between 2011 and 2021 to return contemporary evidence. Results: The results revealed that there was significant variation between measures used and the timing of the pre- and post-treatment assessment. The studies found an interdisciplinary approach to be beneficial, however, the challenges of inherent heterogeneity, lack of clarity for definitions and diagnosis, and mixed results were apparent. The interdisciplinary interventions applied in all identified studies were found to reduce post-concussion symptoms across the symptom subtypes: headache/migraine, vestibular, cognitive, ocular motor and anxiety/mood. Conclusions: The results demonstrated evidence for a reduction in persistent post-concussion symptoms following interdisciplinary intervention. This evidence will inform health services, clinicians, sports administrators and researchers with regard to concussion clinic and rehabilitation team design and service delivery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Examining the interdisciplinary approach for treatment of persistent post-concussion symptoms in adults: a systematic review

Jennings

Islam²

2022

Brain Impairment

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“…Recent evidence indicates that those with mTBI may also experience subtle chronic symptoms, including impaired executive functioning, somatic dysfunction, and personality changes [64,66]. Such changes following mTBI are referred to as persistent post-concussion symptoms (PPCS) and are likely under-reported [66,67]. Furthermore, certain TBI etiologies may impart a greater risk of prolonged symptoms.…”

Section: Chronic Impairments In Tbi Populationsmentioning

confidence: 99%

Identifying the Target Traumatic Brain Injury Population for Hyperbaric Oxygen Therapy

Schimmel,

El Sayed,

Lockard

et al. 2023

IJMS

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Traumatic brain injury (TBI) results from direct penetrating and indirect non-penetrating forces that alters brain functions, affecting millions of individuals annually. Primary injury following TBI is exacerbated by secondary brain injury; foremost is the deleterious inflammatory response. One therapeutic intervention being increasingly explored for TBI is hyperbaric oxygen therapy (HBOT), which is already approved clinically for treating open wounds. HBOT consists of 100% oxygen administration, usually between 1.5 and 3 atm and has been found to increase brain oxygenation levels after hypoxia in addition to decreasing levels of inflammation, apoptosis, intracranial pressure, and edema, reducing subsequent secondary injury. The following review examines recent preclinical and clinical studies on HBOT in the context of TBI with a focus on contributing mechanisms and clinical potential. Several preclinical studies have identified pathways, such as TLR4/NF-kB, that are affected by HBOT and contribute to its therapeutic effect. Thus far, the mechanisms mediating HBOT treatment have yet to be fully elucidated and are of interest to researchers. Nonetheless, multiple clinical studies presented in this review have examined the safety of HBOT and demonstrated the improved neurological function of TBI patients after HBOT, deeming it a promising avenue for treatment.

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“…Many of the non-drug interventions described above have been combined into multi-disciplinary programs [29][30][31][32][33][34][35][36]. A 2-year randomized controlled trial with a multidomain lifestyle intervention showed a reduction in cognitive decline based on results of comprehensive neurological testing [37,38].…”

Section: The Importance Of Multimodal Interventionsmentioning

confidence: 99%

Benefits of a 12-Week Non-Drug “Brain Fitness Program” for Patients with Attention-Deficit/Hyperactive Disorder, Post-Concussion Syndrome, or Memory Loss

Fotuhi,

Khorrami,

Raji

2023

ADR

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Background: Non-pharmacologic interventions can potentially improve cognitive function, sleep, and/or mood in patients with attention-deficit/hyperactive disorder (ADHD), post-concussion syndrome (PCS), or memory loss. Objective: We evaluated the benefits of a brain rehabilitation program in an outpatient neurology practice that consists of targeted cognitive training, lifestyle coaching, and electroencephalography (EEG)-based neurofeedback, twice weekly (90 minutes each), for 12 weeks. Methods: 223 child and adult patients were included: 71 patients with ADHD, 88 with PCS, and 64 with memory loss (mild cognitive impairment or subjective cognitive decline). Patients underwent a complete neurocognitive evaluation, including tests for Verbal Memory, Complex Attention, Processing Speed, Executive Functioning, and Neurocognition Index. They completed questionnaires about sleep, mood, diet, exercise, anxiety levels, and depression—as well as underwent quantitative EEG—at the beginning and the end of the program. Results: Pre-post test score comparison demonstrated that all patient subgroups experienced statistically significant improvements on most measures, especially the PCS subgroup, which experienced significant score improvement on all measures tested (p≤0.0011; d z ≥0.36). After completing the program, 60% to 90% of patients scored higher on cognitive tests and reported having fewer cognitive and emotional symptoms. The largest effect size for pre-post score change was improved executive functioning in all subgroups (ADHD d z = 0.86; PCS d z = 0.83; memory d z = 1.09). Conclusion: This study demonstrates that a multimodal brain rehabilitation program can have benefits for patients with ADHD, PCS, or memory loss and supports further clinical trials in this field.

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Moving towards individualised and interdisciplinary approaches to treat persistent post-concussion symptoms

Cited by 6 publications

References 11 publications

Examining the interdisciplinary approach for treatment of persistent post-concussion symptoms in adults: a systematic review

Examining the interdisciplinary approach for treatment of persistent post-concussion symptoms in adults: a systematic review

Identifying the Target Traumatic Brain Injury Population for Hyperbaric Oxygen Therapy

Benefits of a 12-Week Non-Drug “Brain Fitness Program” for Patients with Attention-Deficit/Hyperactive Disorder, Post-Concussion Syndrome, or Memory Loss

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