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Published in: Journal of Neurology 11/2020

Open Access 01-11-2020 | Central Nervous System Trauma | Original Communication

Mild traumatic brain injury recovery: a growth curve modelling analysis over 2 years

Authors: Ellen L. Carroll, Joanne G. Outtrim, Faye Forsyth, Anne E. Manktelow, Peter J. A. Hutchinson, Olli Tenovuo, Jussi P. Posti, Lindsay Wilson, Barbara J. Sahakian, David K. Menon, Virginia F. J. Newcombe

Published in: Journal of Neurology | Issue 11/2020

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Abstract

Background

An improved understanding of the trajectory of recovery after mild traumatic brain injury is important to be able to understand individual patient outcomes, for longitudinal patient care and to aid the design of clinical trials.

Objective

To explore changes in health, well-being and cognition over the 2 years following mTBI using latent growth curve (LGC) modelling.

Methods

Sixty-one adults with mTBI presenting to a UK Major Trauma Centre completed comprehensive longitudinal assessment at up to five time points after injury: 2 weeks, 3 months, 6 months, 1 year and 2 years.

Results

Persisting problems were seen with neurological symptoms, cognitive issues and poor quality of life measures including 28% reporting incomplete recovery on the Glasgow Outcome Score Extended at 2 years. Harmful drinking, depression, psychological distress, disability, episodic memory and working memory did not improve significantly over the 2 years following injury. For other measures, including the Rivermead Post-Concussion Symptoms and Quality of Life after Brain Injury (QOLIBRI), LGC analysis revealed significant improvement over time with recovery tending to plateau at 3–6 months.

Interpretation

Significant impairment may persist as late as 2 years after mTBI despite some recovery over time. Longitudinal analyses which make use of all available data indicate that recovery from mTBI occurs over a longer timescale than is commonly believed. These findings point to the need for long-term management of mTBI targeting individuals with persisting impairment.
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Metadata
Title
Mild traumatic brain injury recovery: a growth curve modelling analysis over 2 years
Authors
Ellen L. Carroll
Joanne G. Outtrim
Faye Forsyth
Anne E. Manktelow
Peter J. A. Hutchinson
Olli Tenovuo
Jussi P. Posti
Lindsay Wilson
Barbara J. Sahakian
David K. Menon
Virginia F. J. Newcombe
Publication date
01-11-2020
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 11/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-09979-x

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