Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Background: Persisting post-concussion symptoms (PPCS) is a complex, multifaceted condition in which individuals continue to experience the symptoms of mild traumatic brain injury (mTBI; concussion) beyond the timeframe that it typically...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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MDPI
2020
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1087114 http://hdl.handle.net/20.500.11937/81494 |
| _version_ | 1848764377655672832 |
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| author | Gozt, Aleksandra Licari, M. Halstrom, A. Milbourn, H. Lydiard, S. Black, A. Arendts, G. Macdonald, S. Song, S. Macdonald, E. Vlaskovsky, P. Burrows, S. Bynevelt, M. Pestell, Carmela Fatovich, D. Fitzgerald, Melinda |
| author_facet | Gozt, Aleksandra Licari, M. Halstrom, A. Milbourn, H. Lydiard, S. Black, A. Arendts, G. Macdonald, S. Song, S. Macdonald, E. Vlaskovsky, P. Burrows, S. Bynevelt, M. Pestell, Carmela Fatovich, D. Fitzgerald, Melinda |
| author_sort | Gozt, Aleksandra |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Background: Persisting post-concussion symptoms (PPCS) is a complex, multifaceted condition in which individuals continue to experience the symptoms of mild traumatic brain injury (mTBI; concussion) beyond the timeframe that it typically takes to recover. Currently, there is no way of knowing which individuals may develop this condition.
Method: Patients presenting to a hospital emergency department (ED) within 48 h of sustaining a mTBI underwent neuropsychological assessment and demographic, injury-related information and blood samples were collected. Concentrations of blood-based biomarkers neuron specific enolase, neurofilament protein-light, and glial fibrillary acidic protein were assessed, and a subset of patients also underwent diffusion tensor–magnetic resonance imaging; both relative to healthy controls. Individuals were classified as having PPCS if they reported a score of 25 or higher on the Rivermead Postconcussion Symptoms Questionnaire at ~28 days post-injury. Univariate exact logistic regression was performed to identify measures that may be predictive of PPCS. Neuroimaging data were examined for differences in fractional anisotropy (FA) and mean diffusivity in regions of interest.
Results: Of n = 36 individuals, three (8.33%) were classified as having PPCS. Increased performance on the Repeatable Battery for the Assessment of Neuropsychological Status Update Total Score (OR = 0.81, 95% CI: 0.61–0.95, p = 0.004), Immediate Memory (OR = 0.79, 95% CI: 0.56–0.94, p = 0.001), and Attention (OR = 0.86, 95% CI: 0.71–0.97, p = 0.007) indices, as well as faster completion of the Trails Making Test B (OR = 1.06, 95% CI: 1.00–1.12, p = 0.032) at ED presentation were associated with a statistically significant decreased odds of an individual being classified as having PPCS. There was no significant association between blood-based biomarkers and PPCS in this small sample, although glial fibrillary acidic protein (GFAP) was significantly increased in individuals with mTBI relative to healthy controls. Furthermore, relative to healthy age and sex-matched controls (n = 8), individuals with mTBI (n = 14) had higher levels of FA within the left inferior frontal occipital fasciculus (t (18.06) = −3.01, p = 0.008).
Conclusion: Performance on neuropsychological measures may be useful for predicting PPCS, but further investigation is required to elucidate the utility of this and other potential predictors. |
| first_indexed | 2025-11-14T11:18:23Z |
| format | Journal Article |
| id | curtin-20.500.11937-81494 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:18:23Z |
| publishDate | 2020 |
| publisher | MDPI |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-814942020-11-04T01:15:27Z Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study Gozt, Aleksandra Licari, M. Halstrom, A. Milbourn, H. Lydiard, S. Black, A. Arendts, G. Macdonald, S. Song, S. Macdonald, E. Vlaskovsky, P. Burrows, S. Bynevelt, M. Pestell, Carmela Fatovich, D. Fitzgerald, Melinda Science & Technology Life Sciences & Biomedicine Neurosciences Neurosciences & Neurology persistent post-concussion symptoms blood-based biomarkers neuropsychological assessment MRI prediction POST-CONCUSSION SYMPTOMS FIBRILLARY ACIDIC PROTEIN EMERGENCY-DEPARTMENT ASSESSMENT SERUM NEUROFILAMENT LIGHT SPORT-RELATED CONCUSSION NEURON-SPECIFIC ENOLASE HEAD-INJURY POSTCONCUSSION SYNDROME HIGH-SCHOOL COGNITIVE IMPAIRMENT © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Background: Persisting post-concussion symptoms (PPCS) is a complex, multifaceted condition in which individuals continue to experience the symptoms of mild traumatic brain injury (mTBI; concussion) beyond the timeframe that it typically takes to recover. Currently, there is no way of knowing which individuals may develop this condition. Method: Patients presenting to a hospital emergency department (ED) within 48 h of sustaining a mTBI underwent neuropsychological assessment and demographic, injury-related information and blood samples were collected. Concentrations of blood-based biomarkers neuron specific enolase, neurofilament protein-light, and glial fibrillary acidic protein were assessed, and a subset of patients also underwent diffusion tensor–magnetic resonance imaging; both relative to healthy controls. Individuals were classified as having PPCS if they reported a score of 25 or higher on the Rivermead Postconcussion Symptoms Questionnaire at ~28 days post-injury. Univariate exact logistic regression was performed to identify measures that may be predictive of PPCS. Neuroimaging data were examined for differences in fractional anisotropy (FA) and mean diffusivity in regions of interest. Results: Of n = 36 individuals, three (8.33%) were classified as having PPCS. Increased performance on the Repeatable Battery for the Assessment of Neuropsychological Status Update Total Score (OR = 0.81, 95% CI: 0.61–0.95, p = 0.004), Immediate Memory (OR = 0.79, 95% CI: 0.56–0.94, p = 0.001), and Attention (OR = 0.86, 95% CI: 0.71–0.97, p = 0.007) indices, as well as faster completion of the Trails Making Test B (OR = 1.06, 95% CI: 1.00–1.12, p = 0.032) at ED presentation were associated with a statistically significant decreased odds of an individual being classified as having PPCS. There was no significant association between blood-based biomarkers and PPCS in this small sample, although glial fibrillary acidic protein (GFAP) was significantly increased in individuals with mTBI relative to healthy controls. Furthermore, relative to healthy age and sex-matched controls (n = 8), individuals with mTBI (n = 14) had higher levels of FA within the left inferior frontal occipital fasciculus (t (18.06) = −3.01, p = 0.008). Conclusion: Performance on neuropsychological measures may be useful for predicting PPCS, but further investigation is required to elucidate the utility of this and other potential predictors. 2020 Journal Article http://hdl.handle.net/20.500.11937/81494 10.3390/brainsci10010023 English http://purl.org/au-research/grants/nhmrc/1087114 http://creativecommons.org/licenses/by/4.0/ MDPI fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Neurosciences Neurosciences & Neurology persistent post-concussion symptoms blood-based biomarkers neuropsychological assessment MRI prediction POST-CONCUSSION SYMPTOMS FIBRILLARY ACIDIC PROTEIN EMERGENCY-DEPARTMENT ASSESSMENT SERUM NEUROFILAMENT LIGHT SPORT-RELATED CONCUSSION NEURON-SPECIFIC ENOLASE HEAD-INJURY POSTCONCUSSION SYNDROME HIGH-SCHOOL COGNITIVE IMPAIRMENT Gozt, Aleksandra Licari, M. Halstrom, A. Milbourn, H. Lydiard, S. Black, A. Arendts, G. Macdonald, S. Song, S. Macdonald, E. Vlaskovsky, P. Burrows, S. Bynevelt, M. Pestell, Carmela Fatovich, D. Fitzgerald, Melinda Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study |
| title | Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study |
| title_full | Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study |
| title_fullStr | Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study |
| title_full_unstemmed | Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study |
| title_short | Towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: Results from a pilot study |
| title_sort | towards the development of an integrative, evidence-based suite of indicators for the prediction of outcome following mild traumatic brain injury: results from a pilot study |
| topic | Science & Technology Life Sciences & Biomedicine Neurosciences Neurosciences & Neurology persistent post-concussion symptoms blood-based biomarkers neuropsychological assessment MRI prediction POST-CONCUSSION SYMPTOMS FIBRILLARY ACIDIC PROTEIN EMERGENCY-DEPARTMENT ASSESSMENT SERUM NEUROFILAMENT LIGHT SPORT-RELATED CONCUSSION NEURON-SPECIFIC ENOLASE HEAD-INJURY POSTCONCUSSION SYNDROME HIGH-SCHOOL COGNITIVE IMPAIRMENT |
| url | http://purl.org/au-research/grants/nhmrc/1087114 http://hdl.handle.net/20.500.11937/81494 |