May 26 2016
Study on Mild Traumatic Brain Injury
In a study in the Journal of Neurotrauma, Paul McMahon at the University of Pittsburgh Medical Center and colleagues researched post-concussion syndrome (PCS) in patients with mild traumatic brain injury. They tracked the occurrence and development of PCS in a large group of survivors with mild traumatic brain injury. The three time frames that they used in the study were three, six, and twelve months.
The group studied were mTBI patients who showed up in the emergency room including those sent home and not admitted to the hospital, amounting to 375 mTBI subjects. The results of the study, entitled “Symptomatology and Functional Outcome in Mild Traumatic Brain Injury:Results from the Prospective TRACK-TBI Study,” showed that symptoms can still persist many months after the date of the injury.
This study is quite significant because much of the research published on mild traumatic brain injury has limited those with ongoing complaints to numbers in the 15 percent range. In fact, 15 percent has been the accepted norm for Persistent Post Concussion Syndrome since Alexander’s article on it published in Neurology in 1995. The article was titled “Mild traumatic brain injury: pathophysiology, natural history, and clinical management.”
Recently, flawed research published by Michael McCrea has argued that the number of those with persisting problems after mTBI has argued the number could be as low as one percent. See Mild Traumatic Brain Injury and Postconcussion Syndrome: The New Evidence Base for Diagnosis and Treatment.
In contrast to these much lower findings of the past, the current study at both the six and twelve-month checkpoints found that 82 percent of mild traumatic brain injury patients showed at least one symptom of PCS. The symptoms could include headaches and dizziness that can last months after the injury was sustained. Concussion is considered a mild traumatic brain injury.
In addition, 44.5 percent of people in the study had significantly reduced satisfaction with life scores at six months. Furthermore, 40.3 percent had significantly reduced satisfaction with life scores at twelve months. These results show further that mild traumatic brain injury can be anything but mild.
At the three-month checkpoint, one-third of the mild traumatic brain injury patients were functionally impaired. This was measured using the Glasgow Outcome Scale-Extended score. If the patient scored less than six, they were considered “functionally impaired.” A score of seven or higher indicates recovery. An example of a question on the scale is whether or not they were able to return to work at their previous capacity.
Furthermore, 22.4 percent of the Mild Traumatic Brain Injury subjects were still below functional status after one year. This statistic further shows that “mild traumatic brain injury” is a “misnomer.” The research highlights the need for development of classification strategies of clinical traumatic brain injury and targeted treatment. A disease process that impacts more than half of its survivors for almost a year and leaves 22 percent with long term problems is not mild. See our essay on this subject written more than a decade ago: Mind Damage, not Mild Brain Injury.