Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers
#MMPMID27784191
Hiploylee C
; Dufort PA
; Davis HS
; Wennberg RA
; Tartaglia MC
; Mikulis D
; Hazrati LN
; Tator CH
J Neurotrauma
2017[Apr]; 34
(8
): 1511-1523
PMID27784191
show ga
We examined recovery from postconcussion syndrome (PCS) in a series of 285
patients diagnosed with concussion based on international sport concussion
criteria who received a questionnaire regarding recovery. Of 141 respondents,
those with postconcussion symptoms lasting less than 3 months, a positive
computed tomography (CT) and/or magnetic resonance imaging (MRI), litigants, and
known Test of Memory Malingering (TOMM)-positive cases were excluded, leaving 110
eligible respondents. We found that only 27% of our population eventually
recovered and 67% of those who recovered did so within the first year. Notably,
no eligible respondent recovered from PCS lasting 3 years or longer. Those who
did not recover (n?=?80) were more likely to be non-compliant with a
do-not-return-to-play recommendation (p?=?0.006) but did not differ from the
recovered group (n?=?30) in other demographic variables, including age and sex
(p???0.05). Clustergram analysis revealed that symptoms tended to appear in a
predictable order, such that symptoms later in the order were more likely to be
present if those earlier in the order were already present. Cox proportional
hazards model analysis showed that the more symptoms reported, the longer the
time to recovery (p?=?7.4?×?10(-6)), with each additional symptom reducing the
recovery rate by approximately 20%. This is the first longitudinal PCS study to
focus on PCS defined specifically as a minimum of 3 months of symptoms, negative
CT and/or MRI, negative TOMM test, and no litigation. PCS may be permanent if
recovery has not occurred by 3 years. Symptoms appear in a predictable order, and
each additional PCS symptom reduces recovery rate by 20%. More long-term
follow-up studies are needed to examine recovery from PCS.
|Adolescent
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Child
[MESH]
|Cluster Analysis
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Longitudinal Studies
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Outcome Assessment, Health Care/*statistics & numerical data
[MESH]
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