Mild traumatic brain injury and neural recovery: rethinking the debate

NeuroRehabilitation. 2011;28(3):167-80. doi: 10.3233/NRE-2011-0646.

Abstract

A debate exists concerning whether a mild traumatic brain injury (MTBI) can cause permanent brain-based residuals. This debate is examined by reviewing meta-analytic studies that found no significant effect sizes between large samples of patients with and without MTBI at three months post-accident. In contrast, research studies with MTBI patients have captured cognitive deficits corroborated by positive neuroimaging, which supports the viewpoint that brain-based postconcussive disorders likely exist in a small minority of individuals. Ongoing hurdles that likely contribute to this debate are identified. This includes the lack of agreed upon definitions; substantial differences exist between the ICD-10 definition for Postconcussion Syndrome and the DSM-IV-TR definition for Postconcussional Disorder. Confining the debate to brain-based versus psychologically-based viewpoints results in a false dichotomy. Instead, a more refined sub-classification of the postconcussive complex is proposed that captures different constellations across the physical, emotional, and cognitive symptoms complex. Moreover, this diagnostic framework attempts to expand discipline-based approaches with a patient-based understanding.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Brain Injuries / diagnosis
  • Brain Injuries / physiopathology*
  • Brain Injuries / psychology
  • Chronic Disease
  • Cognition Disorders / etiology
  • Diagnosis, Differential
  • Emotions
  • Humans
  • Nervous System / physiopathology*
  • Post-Concussion Syndrome / classification
  • Post-Concussion Syndrome / diagnosis
  • Recovery of Function*
  • Reproducibility of Results
  • Severity of Illness Index
  • Time Factors