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A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
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Subjective Cognitive Complaints in Concussion.

Alexandra M Stillman1, Nancy Madigan1, Karen Torres2

  • 1Beth Israel Deaconess Medical Center, Harvard School of Medicine, Boston, Massachusetts.

Journal of Neurotrauma
|August 14, 2019
PubMed
Summary
This summary is machine-generated.

Cognitive symptoms after concussion in civilians are often linked to psychological distress, particularly depression and past psychiatric history, rather than actual cognitive impairment. Early diagnosis and treatment of mood symptoms are crucial for recovery.

Keywords:
cognitionconcussiondepressionmild traumatic brain injury

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Area of Science:

  • Neuroscience
  • Psychology
  • Rehabilitation Medicine

Background:

  • Concussion symptom research has primarily focused on athletic and military populations, with limited generalizability to civilian populations.
  • Cognitive symptoms significantly impact daily functioning, affecting school and employment.
  • Assessing cognitive complaints in civilians is crucial for understanding post-concussion syndrome in the general population.

Purpose of the Study:

  • To evaluate subjective cognitive complaints in a civilian sample referred to a concussion specialty clinic.
  • To determine the factors associated with cognitive symptoms, including demographic characteristics, injury history, neurological status, and psychological factors.
  • To investigate the relationship between objective neuropsychological tests and subjective cognitive complaints.

Main Methods:

  • A cohort of 100 highly symptomatic civilians (mean PCSQ score 29.5) was assessed.
  • Subjective cognitive symptoms were measured using the Behavior Rating of Executive Functions-Adult version (BRIEF-A).
  • Independent variables included prior psychiatric history, current neurological symptoms, objective neuropsychological tests, and measures of depression, anxiety, and stress.

Main Results:

  • No demographic, injury, or neurological factors were associated with cognitive symptoms.
  • Prior psychiatric history was associated with abnormal BRIEF-A scores.
  • Objective cognitive tests were largely in the average range, with weak associations to BRIEF-A.
  • Depression, prior psychiatric history, and age were significant predictors of cognitive complaints on regression analysis.

Conclusions:

  • Subjective cognitive symptoms in this civilian cohort are primarily linked to psychological distress, especially depression and prior psychiatric history.
  • These findings highlight that psychological factors, not just cognitive impairment, contribute to post-concussion symptoms in civilians.
  • Emphasizes the importance of early screening and management of mood and emotional symptoms following concussion in the general population.