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Updated: Sep 30, 2025

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
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Posttraumatic Amnesia: A Systematic Review and Meta-Analysis. Proposal for a New Severity Classification.

Alexander R Vile1, Kevin Jang1, Dugald Gourlay1

  • 1School of Medicine and Dentistry, James Cook University, Douglas, Townsville, Queensland, Australia.

World Neurosurgery
|March 15, 2022
PubMed
Summary
This summary is machine-generated.

Posttraumatic amnesia (PTA) duration reliably predicts outcomes after traumatic brain injury (TBI) when less than 7 days or greater than 42 days. However, PTA duration between 7 and 42 days is often unreliable for predicting TBI outcomes.

Keywords:
OutcomePTATBI

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Area of Science:

  • Neuroscience
  • Neurology
  • Traumatic Brain Injury Research

Background:

  • Posttraumatic amnesia (PTA) duration is a key predictor of outcomes following traumatic brain injury (TBI).
  • Existing literature lacks a comprehensive meta-analysis on the predictive accuracy of PTA duration for TBI outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze the predictive value of posttraumatic amnesia (PTA) duration for various outcomes after traumatic brain injury (TBI).
  • To assess the sensitivity and specificity of different PTA duration cutoffs in predicting functional outcomes.

Main Methods:

  • A systematic review and random-effects meta-analysis were conducted following PRISMA guidelines.
  • Databases searched included Scopus, PubMed/MEDLINE, CINAHL, PsycINFO, and Embase.
  • PTA's prediction of Glasgow Outcome Scale (GOS) and Extended (GOSE) scores was quantitatively assessed using pooled odds ratios and receiver operating characteristic curve analysis.

Main Results:

  • Nine studies with 12,386 patients were included in the meta-analysis.
  • PTA <7 days (mild TBI) demonstrated high sensitivity (87-90%) in excluding moderate/severe disability.
  • PTA >42 days (severe TBI) showed high specificity (80-96%) in predicting moderate/severe disability, while PTA between 7-42 days had variable predictive accuracy.

Conclusions:

  • PTA duration is a reliable predictor of TBI outcomes when <7 days or >42 days.
  • The predictive accuracy of PTA duration is less reliable for moderate TBI (7-42 days).
  • This meta-analysis provides quantitative evidence for PTA's prognostic value in TBI.