Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

  title={Neuropsychology and clinical neuroscience of persistent post-concussive syndrome},
  author={Erin D. Bigler},
  journal={Journal of the International Neuropsychological Society},
  pages={1 - 22}
  • E. Bigler
  • Published 14 December 2007
  • Medicine, Psychology, Biology
  • Journal of the International Neuropsychological Society
On the mild end of the acquired brain injury spectrum, the terms concussion and mild traumatic brain injury (mTBI) have been used interchangeably, where persistent post-concussive syndrome (PPCS) has been a label given when symptoms persist for more than three months post-concussion. Whereas a brief history of concussion research is overviewed, the focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of… 
The current status of postconcussion syndrome
The study of concussion and PCS has increased significantly over the past 10 years, with recent research supporting an underlying biological cause for initial symptomatology and early and serial monitoring and treatment of symptoms appears to result in substantial improvement in the vast majority of concussed patients.
Repeated mild closed head injury impairs short-term visuospatial memory and complex learning.
Results show that repeated mCHI can reproduce some of the deficits seen after repeated concussions in humans and may be suitable for drug discovery studies and translational research.
Transcranial Direct Current Stimulation for Post-Concussion Syndrome: Study Protocol for a Randomized Crossover Trial
The primary goal is to verify the effects of transcranial direct current stimulation (tDCS) in patients with PPCS who demonstrate cognitive deficits in long-term episodic memory, working memory, and executive function following MTBI.
Disrupted White Matter Microstructure of the Cerebellar Peduncles in Scholastic Athletes After Concussion
The prevalence of white matter abnormality in cerebellar tracts lends credence to the hypothesis that post-concussive symptoms are caused by shearing of axons within an attention network mediated by the cerebellum, and warrants further study of the correlation between cerebellary DTI findings and clinical, neurocognitive, oculomotor, and vestibular outcomes in mTBI patients.
The heterogeneity of mild traumatic brain injury: Where do we stand?
The notion of heterogeneity in mTBI was not supported when severity was based on GCS scores, but there was partial support when PTA duration was used as a measure of severity.
Mild traumatic brain injury and Postconcussion Syndrome: a neuropsychological perspective
An overview of the pathogenesis, diagnosis and treatment options for Post-concussional Syndrome is presented and the evidence for factors that may predict such symptoms is reviewed.
Evaluation and Treatment of Mild Traumatic Brain Injury: The Role of Neuropsychology
A narrative review of the current literature on behavioral assessment and management of patients presenting with mTBI/PCS and the potential role of neuropsychologists and rehabilitation psychologists in interdisciplinary care for this population during the acute, subacute, and chronic phases of recovery is provided.
Neuroimaging assessment of early and late neurobiological sequelae of traumatic brain injury: implications for CTE
Potential neuroimaging modalities that may be capable of diagnosing CTE in vivo through the detection of tau and other known pathological features are discussed.
Concussion As a Multi-Scale Complex System: An Interdisciplinary Synthesis of Current Knowledge
Concepts and ways of thinking about concussion that currently impede research design and block advancements in care of TBI are examined to provide a broader, multi-scale model for understanding concussion pathophysiology, classification, and treatment.
Concussion: pathophysiology and clinical translation.


Management of concussion and post-concussion syndrome
A clinical model is presented to suggest that concussion evolves to become mTBI after PCS has developed, representing a more severe form of brain injury.
Outcome from mild traumatic brain injury
  • G. Iverson
  • Medicine, Psychology
    Current opinion in psychiatry
  • 2005
A focus of this review is outcome from mild traumatic brain injury, which is characterized by immediate physiological changes conceptualized as a multilayered neurometabolic cascade in which affected cells typically recover, although under certain circumstances a small number might degenerate and die.
Natural history of the long-term cognitive, affective, and physical sequelae of mild traumatic brain injury.
Results suggested that aspects of cognitive functioning of the symptomatic MTBI (i.e., PCS) participants were different from matched normal control subjects, and from the 21 MTBI patients who were asymptomatic, at 4 months.
Factors moderating neuropsychological outcomes following mild traumatic brain injury: A meta-analysis
A meta-analysis of the relevant literature was conducted to determine the impact of MTBI across nine cognitive domains, finding that litigation was associated with stable or worsening of cognitive functioning over time.
Attentional deficits in patients with post-concussion symptoms: a componential perspective
  • R. Chan
  • Psychology, Medicine
    Brain injury
  • 2001
A theoretical framework is built up to guide the investigation of the varieties of attentional deficits in patients with PCS, and it is hoped that a better understanding of the underlying mechanism of such defects will foster and guide the development of intervention.
Cognitive sequelae of diffuse axonal injury.
An MRI lesion pattern compatible with isolated DAI is associated with persistent cognitive impairment, and the traumatic microbleed load is no sufficient parameter for the assessment of DAI severity or functional outcome.
Contemporary issues in mild traumatic brain injury.
  • Peter M Rees
  • Medicine, Psychology
    Archives of physical medicine and rehabilitation
  • 2003
Concussion and mild head injury
A concussion is a physical injury to the head resulting in altered mental function, with expectation of recovery within 2–3 weeks. In a significant minority of cases the symptoms persist longer,
Serum biochemical markers for post-concussion syndrome in patients with mild traumatic brain injury.
A systematic review of prospective cohort studies that assessed the ability of serum biochemical markers to predict post-concussion syndrome (PCS) concluded that no biomarker has consistently demonstrated the ability to predict PCS after MTBI.
Are mild head injuries as mild as we think? Neurobehavioral concomitants of chronic post-concussion syndrome
The results support the idea that MTBI can have sustained consequences, and that the subjectively experienced symptoms and difficulties in everyday situations are related to objectively measurable parameters in neurocognitive function.