Prognostic Factors for Persistent Symptoms in Adults with Mild Traumatic Brain Injury: an Overview of Systematic Reviews

Overview

Journal Syst Rev

Publisher Biomed Central

Date 2023 Jul 19

PMID 37468999

Authors

Julien Dery

Beatrice Ouellet

Elaine de Guise

Eve-Line Bussieres

Marie-Eve Lamontagne

Affiliations

Soon will be listed here.

Abstract

Background: Mild traumatic brain injury (mTBI) is an increasing public health problem, because of its persistent symptoms and several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help to guide the prevention of persistent symptoms following mTBI. The prognosis of mTBI has stimulated several empirical primary research papers and many systematic reviews leading to the identification of a wide range of factors. We aim to synthesize these factors to get a better understanding of their breadth and scope.

Methods: We conducted an overview of systematic reviews. We searched in databases systematic reviews synthesizing evidence about the prognosis of persistent symptoms after mTBI in the adult population. Two reviewers independently screened all references and selected eligible reviews based on eligibility criteria. They extracted relevant information using an extraction grid. They also rated independently the risk of bias using the ROBIS tool. We synthesized evidence into a comprehensive conceptual map to facilitate the understanding of prognostic factors that have an impact on persistent post-concussion symptoms.

Results: From the 3857 references retrieved in a database search, we included 25 systematic reviews integrating the results of 312 primary articles published between 1957 and 2019. We examined 35 prognostic factors from the systematics reviews. No single prognostic factor demonstrated convincing and conclusive results. However, age, sex, and multiple concussions showed an affirmatory association with persistent post-concussion outcomes in systematic reviews.

Conclusion: We highlighted the need for a comprehensive picture of prognostic factors related to persistent post-concussion symptoms. We believe that these prognostic factors would guide clinical decisions and research related to prevention and intervention regarding persistent post-concussion symptoms.

Systematic Review Registration: PROSPERO CRD42020176676.

Citing Articles

Longitudinal assessment of glymphatic changes following mild traumatic brain injury: Insights from perivascular space burden and DTI-ALPS imaging.

Zhuo J, Raghavan P, Li J, Roys S, Tchoquessi R, Chen H Front Neurol. 2024; 15:1443496.

PMID: 39170078 PMC: 11335690. DOI: 10.3389/fneur.2024.1443496.

Longitudinal Assessment of Glymphatic Changes Following Mild Traumatic Brain Injury: Insights from PVS burden and DTI-ALPS Imaging.

Zhuo J, Raghavan P, Jiang L, Roys S, Tchoquessi R, Chen H medRxiv. 2024; .

PMID: 38854000 PMC: 11160843. DOI: 10.1101/2024.06.01.24307927.

References

Mercier E, Tardif P, Cameron P, Emond M, Moore L, Mitra B . Prognostic value of neuron-specific enolase (NSE) for prediction of post-concussion symptoms following a mild traumatic brain injury: a systematic review. Brain Inj. 2017; 32(1):29-40. DOI: 10.1080/02699052.2017.1385097. View

Hung R, Carroll L, Cancelliere C, Cote P, Rumney P, Keightley M . Systematic review of the clinical course, natural history, and prognosis for pediatric mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014; 95(3 Suppl):S174-91. DOI: 10.1016/j.apmr.2013.08.301. View

Kristman V, Borg J, Godbolt A, Salmi L, Cancelliere C, Carroll L . Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014; 95(3 Suppl):S265-77. DOI: 10.1016/j.apmr.2013.04.026. View

Silverberg N, Iaccarino M, Panenka W, Iverson G, McCulloch K, Dams-OConnor K . Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines. Arch Phys Med Rehabil. 2019; 101(2):382-393. DOI: 10.1016/j.apmr.2019.10.179. View

Voss J, Connolly J, Schwab K, Scher A . Update on the Epidemiology of Concussion/Mild Traumatic Brain Injury. Curr Pain Headache Rep. 2015; 19(7):32. DOI: 10.1007/s11916-015-0506-z. View

Cancelliere C, Hincapie C, Keightley M, Godbolt A, Cote P, Kristman V . Systematic review of prognosis and return to play after sport concussion: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014; 95(3 Suppl):S210-29. DOI: 10.1016/j.apmr.2013.06.035. View

Mercier E, Tardif P, Cameron P, Batomen Kuimi B, Emond M, Moore L . Prognostic Value of S-100β Protein for Prediction of Post-Concussion Symptoms after a Mild Traumatic Brain Injury: Systematic Review and Meta-Analysis. J Neurotrauma. 2017; 35(4):609-622. DOI: 10.1089/neu.2017.5013. View

Lunny C, Brennan S, McDonald S, McKenzie J . Toward a comprehensive evidence map of overview of systematic review methods: paper 1-purpose, eligibility, search and data extraction. Syst Rev. 2017; 6(1):231. PMC: 5698938. DOI: 10.1186/s13643-017-0617-1. View

Sullivan K, Kempe C, Edmed S, Bonanno G . Resilience and Other Possible Outcomes After Mild Traumatic Brain Injury: a Systematic Review. Neuropsychol Rev. 2016; 26(2):173-85. DOI: 10.1007/s11065-016-9317-1. View

10.

Levin H, Diaz-Arrastia R . Diagnosis, prognosis, and clinical management of mild traumatic brain injury. Lancet Neurol. 2015; 14(5):506-17. DOI: 10.1016/S1474-4422(15)00002-2. View

11.

Rytter H, Westenbaek K, Henriksen H, Christiansen P, Humle F . Specialized interdisciplinary rehabilitation reduces persistent post-concussive symptoms: a randomized clinical trial. Brain Inj. 2018; 33(3):266-281. DOI: 10.1080/02699052.2018.1552022. View

12.

Pieper D, Buechter R, Jerinic P, Eikermann M . Overviews of reviews often have limited rigor: a systematic review. J Clin Epidemiol. 2012; 65(12):1267-73. DOI: 10.1016/j.jclinepi.2012.06.015. View

13.

Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L, Ouchterlony D . Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms. Brain Inj. 2015; 29(6):688-700. DOI: 10.3109/02699052.2015.1004755. View

14.

Riley R, Hayden J, Steyerberg E, Moons K, Abrams K, Kyzas P . Prognosis Research Strategy (PROGRESS) 2: prognostic factor research. PLoS Med. 2013; 10(2):e1001380. PMC: 3564757. DOI: 10.1371/journal.pmed.1001380. View

15.

Puig J, Ellis M, Kornelsen J, Figley T, Figley C, Daunis-I-Estadella P . Magnetic Resonance Imaging Biomarkers of Brain Connectivity in Predicting Outcome after Mild Traumatic Brain Injury: A Systematic Review. J Neurotrauma. 2020; 37(16):1761-1776. DOI: 10.1089/neu.2019.6623. View

16.

Mott T, McConnon M, Rieger B . Subacute to chronic mild traumatic brain injury. Am Fam Physician. 2012; 86(11):1045-51. View

17.

Hiploylee C, Dufort P, Davis H, Wennberg R, Tartaglia M, Mikulis D . Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers. J Neurotrauma. 2016; 34(8):1511-1523. PMC: 5397249. DOI: 10.1089/neu.2016.4677. View

18.

Jaber A, Hartwell J, Radel J . Interventions to Address the Needs of Adults With Postconcussion Syndrome: A Systematic Review. Am J Occup Ther. 2019; 73(1):7301205020p1-7301205020p12. DOI: 10.5014/ajot.2019.028993. View

19.

Silverberg N, Gardner A, Brubacher J, Panenka W, Li J, Iverson G . Systematic review of multivariable prognostic models for mild traumatic brain injury. J Neurotrauma. 2014; 32(8):517-26. DOI: 10.1089/neu.2014.3600. View

20.

Lefevre-Dognin C, Cogne M, Perdrieau V, Granger A, Heslot C, Azouvi P . Definition and epidemiology of mild traumatic brain injury. Neurochirurgie. 2020; 67(3):218-221. DOI: 10.1016/j.neuchi.2020.02.002. View