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Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment: A scoping review
Kerry McInnes1,2, Christopher L Friesen1,3, Diane E MacKenzie2,4
1Laboratory for Brain Recovery and Function, Dalhousie University, Halifax, Nova Scotia, Canada.
Abstract:
Mild traumatic brain injury (mTBI), or concussion, is the most common type of traumatic brain injury. With mTBI comes symptoms that include headaches, fatigue, depression, anxiety and irritability, as well as impaired cognitive function. Symptom resolution is thought to occur within 3 months post-injury, with the exception of a small percentage of individuals who are said to experience persistent post-concussion syndrome. The number of individuals who experience persistent symptoms appears to be low despite clear evidence of longer-term pathophysiological changes resulting from mTBI. In light of the incongruency between these longer-term changes in brain pathology and the number of individuals with longer-term mTBI-related symptoms, particularly impaired cognitive function, we performed a scoping review of the literature that behaviourally assessed short- and long-term cognitive function in individuals with a single mTBI, with the goal of identifying the impact of a single concussion on cognitive function in the chronic stage post-injury. CINAHL, Embase, and Medline/Ovid were searched July 2015 for studies related to concussion and cognitive impairment. Data relating to the presence/absence of cognitive impairment were extracted from 45 studies meeting our inclusion criteria. Results indicate that, in contrast to the prevailing view that most symptoms of concussion are resolved within 3 months post-injury, approximately half of individuals with a single mTBI demonstrate long-term cognitive impairment. Study limitations notwithstanding, these findings highlight the need to carefully examine the long-term implications of a single mTBI.
Insights
Mild traumatic brain injury (mTBI) can cause long-term cognitive impairment in about half of individuals, challenging the belief that concussion symptoms resolve quickly. Further research is needed on the chronic effects of single concussions.
Area of Science:
- Neuroscience
- Neurology
- Public Health
Background:
- Mild traumatic brain injury (mTBI), or concussion, is a common brain injury.
- mTBI symptoms include headaches, fatigue, depression, anxiety, irritability, and cognitive impairment.
- While symptom resolution is typically expected within 3 months, persistent post-concussion syndrome occurs in a small percentage.
Purpose of the Study:
- To conduct a scoping review of literature assessing cognitive function in individuals with a single mTBI.
- To identify the impact of a single concussion on cognitive function in the chronic stage post-injury.
- To address the incongruency between longer-term brain pathology changes and reported symptom duration after mTBI.
Main Methods:
- Searched CINAHL, Embase, and Medline/Ovid databases in July 2015.
- Included studies that behaviorally assessed short- and long-term cognitive function in individuals with a single mTBI.
- Extracted data on the presence or absence of cognitive impairment from 45 eligible studies.
Main Results:
- Approximately half of individuals with a single mTBI demonstrate long-term cognitive impairment.
- This finding contrasts with the prevailing view of rapid symptom resolution post-concussion.
- Evidence suggests significant long-term cognitive deficits following even a single concussion.
Conclusions:
- Contrary to common belief, a single mild traumatic brain injury can lead to persistent cognitive impairment in a substantial portion of individuals.
- The findings underscore the need for thorough evaluation of the chronic implications of concussion.
- Long-term cognitive function deficits warrant greater attention in the management and understanding of mTBI.