Mapping the Interplay Between Postconcussion Symptoms and Functional Disability After Mild Traumatic Brain Injury: A
Josh W Faulkner1, Deborah Snell, Alice Theadom
1Author Affiliations: Te Herenga Waka-Victoria University of Wellington (Faulkner), Wellington, New Zealand; University of Otago (Snell), Christchurch, New Zealand; Brain Health Research Institute (Theadom and Siegert), Auckland University of Technology, Northcote, Auckland, New Zealand; Department of Psychology (Cairncross), Simon Fraser University, Burnaby, British Columbia, Canada; BC Children's Hospital Research Institute (Cairncross), Vancouver, British Columbia, Canada; Centre for Aging SMART (Cairncross), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Massey University (Williams), Massey University, Albany, Auckland, New Zealand; Department of Psychology (Silverberg), University of British Columbia, Vancouver, British Columbia, Canada; Centre for Aging SMART (Silverberg), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; and Djavad Mowafaghian Centre for Brain Health (Silverberg), Vancouver, British Columbia, Canada.
Cognitive and emotional symptoms like slowed thinking and mood disturbance are key links between postconcussion symptoms (PCS) and functional disability after mild traumatic brain injury (mTBI). Identifying these bridging symptoms can improve targeted interventions for mTBI patients.
Area of Science:
- Neuroscience and Neurology
- Public Health and Epidemiology
- Psychiatry and Psychology
Background:
- Mild traumatic brain injury (mTBI) is a common neurological condition with diverse outcomes.
- Understanding the interplay between postconcussion symptoms (PCS) and functional disability is crucial for effective management.
- Current research often examines PCS and functional disability in isolation or across different care settings.
Purpose of the Study:
- To examine the network structure of PCS and functional disability in individuals with mTBI.
- To compare network structures between primary care and specialized outpatient mTBI clinics.
- To identify cross-domain bridging symptoms linking PCS and functional disability across care settings.
Main Methods:
- Secondary data analysis of 1058 adult participants with mTBI from primary care (Canada) and specialized mTBI clinics (New Zealand).
- Cross-sectional network analyses using EBICglasso to estimate symptom interconnectedness and bridging.
- Measurement of PCS using the Rivermead PostConcussion Symptoms Questionnaire and functional disability with the 12-item WHODAS 2.0.
Main Results:
- Frustration, thinking speed, and concentration were central PCS nodes; household responsibilities were central in functional disability.
- Key bridging nodes included mood disturbance, slowed thinking speed, emotional impact, and concentration difficulties.
- Bridge connectivity was higher in primary care, with emotional impact and concentration difficulties showing stronger bridging.
Conclusions:
- Specific cognitive and emotional symptoms significantly connect PCS and functional disability following mTBI.
- Slowed thinking, mood disturbance, emotional impact, and concentration difficulties represent potential intervention targets.
- Findings support the development of targeted treatment strategies for mTBI patients across diverse care pathways.
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