Summary of the findings of the International Collaboration on Mild Traumatic Brain Injury Prognosis

Abstract

In 2004, the WHO Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation Task Force published the first large systematic review and best evidence synthesis on the clinical course and prognosis for recovery after MTBI. Ten years later, the International Collaboration on Mild Traumatic Brain Injury Prognosis (ICoMP) formed to update the original WHO Task Force results. This summary review highlights important clinical findings from the full ICoMP results including the current evidence on the course and prognosis of recovery after MTBI in diverse patient populations (e.g., adults, athletes and children) and injury environments (e.g., motor vehicle collisions) as well as on the risk of long-term outcomes after MTBI, such as Parkinson’s disease and dementia. Additional clinical areas of interest in MTBI are also discussed including the similarities between MTBI and other traumatic injuries and the risk of Second Impact Syndrome after sport concussion. Clinicians can use this information to help inform patients on the likely course of recovery after MTBI/concussion and guide better decision-making in the care of these patients.

Approaches to Monitor Circuit Disruption after Traumatic Brain Injury: Frontiers in Preclinical Research

“…Mild TBI cases (20-50%) develop persistent morbidities within one-month post-injury [16]. Patients often suffer transient symptoms that can persist months after initial injury with impaired brain function in cognitive, affective, somatic, and motor domains [17,18]. Neuropsychological tests in patients and neuropathological assessments in experimental TBI indicate continued posttraumatic symptoms that can persist for months to years after TBI [19][20][21][22] or late-onset symptoms of variable in duration with subjective symptomologies [23].…”

Summary of the findings of the International Collaboration on Mild Traumatic Brain Injury Prognosis

“…This is virtually the same low acceptance rate reported by the WHO Task Force (i.e., 28%). Despite being a decade on from the original review, significant methodological issues persist in the MTBI literature [35]. For example, of those accepted studies, only 10% were Phase III confirmatory studies.…”

“…For example, of those accepted studies, only 10% were Phase III confirmatory studies. In turn, MTBI prognosis research remains highly heterogeneous and primarily exploratory in nature (i.e., consists of mainly Phase I and II studies) [35]. Also, there is no universally accepted definition of MTBI and ICoMP tallied over 50 unique case definitions [35].…”

Vestibular system dysfunction in patients after mild traumatic brain injury

“…The continuous development of civilization and an associated rapid growth in the incidence of motor crashes and ensuing injuries are the reason why general practitioners, laryngologists or neurologists more often consult the victims of those accidents who are suffering from posttraumatic vertigo or disequilibrium. The number of traumatic injuries is increasing immensely in industrialized countries and mild traumatic brain injury (MTBI) is one of the most common types [1][2][3][4][5]. Patients after severe head injuries are often referred to the ambulatory emergency care units and those with mild traumas seek medical care from family physicians or general practitioners at outpatient departments or speciality healthcare centres at various times after injury.…”

“…In the United States, it is estimated that 1.5-2 million people sustain head trauma annually, of which 400,000 require hospitalization. However, many injuries are not included in the statistics because patients do not always seek help [1,2,[4][5][6][7][8].…”