• Seb Potter, Eleanor Leigh, Derick Wade, and Simon Fleminger.
• Lishman Brain Injury Unit, The Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK. s.potter@iop.kcl.ac.uk
• J. Neurol. 2006 Dec 1; 253 (12): 1603-14.

ObjectiveTo investigate the factor structure of the Rivermead Post Concussion Symptoms Questionnaire (RPQ) among individuals seen as part of routine follow-up following traumatic brain injury.MethodsRPQ data from 168 participants was examined (mean age 35.2, SD 14.3; 89% with post traumatic amnesia duration<24 hours) six months after admission to an Accident & Emergency Department following TBI. Structural equation modelling was carried out to evaluate proposed models of the underlying structure of post-concussion symptoms (PCS).ResultsThe results support the existence of separate cognitive, emotional and somatic factors, although there was a high degree of covariation between the three factors. A two-factor model that collapsed the emotional and somatic factors together showed a similar goodness-of-fit to the data, whilst a one-factor model proved a poor fit.ConclusionThe results support the notion of post-concussion symptoms as a collection of associated but at least partially separable cognitive, emotional and somatic symptoms, although questions persist regarding symptom specificity. The use of the RPQ is discussed, and classification bands for use in clinical practice are suggested.

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