Brain injury : [BI]
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Brain injury : [BI] · Jan 2019
Multicenter Study Comparative Study Observational StudyComparison of the Neurobehavioral Symptom Inventory and the Rivermead Postconcussion Symptoms Questionnaire.
Objective: This study sought to determine the similarity of constructs measured by the Neurobehavioral Symptom Inventory (NSI) and Rivermead Postconcussive Symptoms Questionnaire (RPQ) and the potential for interchangeability of scores from the two scales. Setting: Three acute inpatient rehabilitation hospitals in the USA. Participants: 497 community dwelling persons with traumatic brain injury (TBI) who completed the NSI and the RPQ during the same assessment. ⋯ A crosswalk between the two measures was created by equating scores from the scales based on percentile ranks. Conclusion: Results indicate substantial conceptual and empirical overlap between the NSI and RPQ. The percentile crosswalk developed from this dataset may allow combined analysis of post-concussive symptoms from datasets that include either the NSI or the RPQ.
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Brain injury : [BI] · Jan 2019
Observational StudyOptical pupillometry in traumatic brain injury: neurological pupil index and its relationship with intracranial pressure through significant event analysis.
Primary Objective: Treatment paradigms for traumatic brain injury (TBI) rely on invasive monitoring of intracranial pressure (ICP) for planning intervention. Optical pupillometry is a non-invasive, objective monitoring method, measuring parameters of pupillary response and displaying a scalar value - a neurological pupil index (NPi). An impaired response on NPi has been tentatively correlated with ICP, through analysis of mean/peak NPi and ICP readings. ⋯ The results show that there is a weak but statistically insignificant relationship between NPi and ICP, where reduced pupil reactivity may indicate a raised ICP. The strength of this trend appears to diminish post-decompressive surgery. Conclusions: Whilst pupillometry may not be a reliable surrogate marker for ICP, NPi may still prove to be a useful tool in a multimodal prognostic assessment of the patient with acute brain injury.
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Brain injury : [BI] · Jan 2019
The role of sleep deficiency in the trajectory of postconcussive symptoms in adolescents.
Objective: To investigate the trajectory of sleep deficiency after concussion and examine its role as a predictor of postconcussive symptoms (PCS) over 3 weeks and at 3 months post-concussion. Design: This was a prospective pilot study of 29 adolescents recruited from a pediatric Emergency Department (69% female, mean age = 14.0 years, SD = 1.8) following a concussion. Methods: Adolescents completed questionnaire assessments at baseline, Weeks 1, 2, and 3 on PCS and sleep patterns. ⋯ After accounting for age, sex and time since concussion, greater insomnia symptoms at enrollment were associated with more severe PCS at 3 weeks and 3 months (β = 1.17, p < .001). In contrast, sleep duration, efficiency, and waketime after sleep onset were not predictors. Conclusions: Study findings suggest that insomnia symptoms after concussion may provide a target for early intervention to reduce prolonged severity and duration of PCS.
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Brain injury : [BI] · Jan 2019
Prevalence of post-concussion-like symptoms in the general population in Italy, The Netherlands and the United Kingdom.
Objectives: To evaluate the frequency of post-concussion symptoms and prevalence and risk factors of post-concussion syndrome (PCS) in the general population, investigate the association between the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and self-perceived health, and evaluate differences between three European countries. Methods: A web-based survey including the RPQ and EQ-5D was conducted among representative samples in three European countries. Results: A total of 11,759 respondents completed the questionnaire. ⋯ All items of the RPQ were positively correlated with the EQ-5D and the strongest positive correlation (0.633, p<0.001) was between RPQ item 'feeling depressed or tearful' and EQ-5D domain 'anxiety/depression'. Conclusions: We found a high frequency of post-concussion-like symptoms and PCS in the general population, indicating that these symptoms are not specific for patients with traumatic brain injury (TBI), and PCS is not a unique syndrome after TBI. Therefore, the use of post-concussion symptoms and PCS as outcome following mild TBI should be interpreted with caution.
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Brain injury : [BI] · Jan 2019
Loss of consciousness and altered mental state predicting depressive and post-concussive symptoms after mild traumatic brain injury.
Objective: Limited studies exist on the association between loss of consciousness (LOC) and altered mental state (AMS) and development of depressive and post-concussive symptoms within six months after mild traumatic brain injury (mTBI). We tested the hypothesis that presence of both LOC and AMS predict the highest risk of symptoms within the first six months post-mTBI compared to either variable alone, and that LOC alone is more strongly associated with these symptoms. Research design: We analyzed data from 407 subjects with mTBI from the Head injury S erum M arkers for A ssessing R esponse to T rauma (HeadSMART) cohort, a prospective cohort of patients post-TBI presenting to two urban emergency departments. ⋯ LOC was associated only with post-concussive symptoms at one month (OR = 1.55;p = .048). Among those without LOC, AMS was associated with depressive symptoms at one month (OR = 2.24; p = .028). Conclusions: AMS predicts post-mTBI depressive symptoms both in the acute and chronic mTBI phases whereas LOC is a more sensitive predictor of post-concussive symptoms in the acute mTBI period.