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Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury

Luke T A Mounce1, W Huw Williams, Janelle M Jones

  • 1Centre for Clinical Neuropsychological Research, University of Exeter (Drs Mounce, Haslam, and Williams); Emergency Department, Royal Devon and Exeter Foundation Trust (Mr Harris), Exeter, United Kingdom; and School of Psychology, University of Queensland, Brisbane, Queensland, Australia (Drs. Jones and Jetten).

The Journal of Head Trauma Rehabilitation
|June 14, 2012
PubMed
Abstract

Insights

Mild traumatic brain injury (mTBI) can cause specific neurogenic symptoms like headaches and dizziness, distinct from psychogenic symptoms. Differentiating between complicated and uncomplicated mTBI is crucial for accurate diagnosis and treatment.

Area of Science:

  • Neuroscience
  • Traumatology
  • Clinical Psychology

Background:

  • The origin of postconcussion symptoms following mild traumatic brain injury (mTBI) is debated, with similar symptom rates observed in non-injured populations.
  • Distinguishing mTBI-specific symptoms from general post-injury complaints is essential for effective clinical management.

Purpose of the Study:

  • To identify postconcussion symptoms uniquely associated with mild traumatic brain injury (mTBI) compared to orthopedic injury controls.
  • To investigate differences in symptom presentation between complicated and uncomplicated mTBI cases.

Main Methods:

  • A cohort of adult patients presenting to an emergency department following injury was recruited.
  • Participants included individuals with complicated mTBI (n=34), uncomplicated mTBI (n=76), and orthopedic controls (n=47).
  • The Rivermead Postconcussion Symptom Questionnaire was administered at two weeks post-injury, with pre-injury factors accounted for as covariates.

Main Results:

  • The complicated mTBI group reported significantly higher severity of headaches, dizziness, nausea, and concentration difficulties compared to orthopedic controls, suggesting a neurogenic origin.
  • Other symptoms assessed by the questionnaire did not differ significantly between mTBI and control groups, indicating a potential psychogenic basis.
  • Distinct differences in dizziness, nausea, fatigue, sleep disturbance, and concentration difficulties were observed between the complicated and uncomplicated mTBI groups.

Conclusions:

  • Neurogenic and psychogenic postconcussion symptoms can be identified in the acute phase after injury.
  • Treating all mild traumatic brain injury (mTBI) cases as a uniform group is not advisable due to varying symptom profiles.
  • These findings necessitate refined prognostic models and tailored follow-up support for individuals after emergency department discharge.

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