Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 1 , Pages 35-42 , January 2010

Characteristics of a Mild Head Injury Subgroup With Extreme, Persisting Distress on the Rivermead Postconcussion Symptoms Questionnaire

  • Ned L. Kirsch, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
    • Corresponding Author InformationCorrespondence to Ned L. Kirsch, PhD, Dept of Physical Medicine and Rehabilitation, University of Michigan Health Systems, 355 Briarwood Circle, Ann Arbor, MI 48109-5742
    • ,
  • Marita B. de Leon, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
    • ,
  • Ronald F. Maio, DO

      Affiliations

    • Department of Emergency Medicine and the Injury Research Center, University of Michigan, Ann Arbor, MI
    • ,
  • Scott R. Millis, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
    • ,
  • Cheribeth U. Tan-Schriner, PhD

      Affiliations

    • Michigan Public Health Institute, Okemos, MI
    • ,
  • Shirley Frederiksen, RN, MS

      Affiliations

    • Department of Emergency Medicine, University of Michigan, Ann Arbor, MI

References 

  1. Yang CC, Tu YK, Hua MS, Huang SJ. The association between the postconcussion symptoms and clinical outcomes for patients with mild traumatic brain injury. J Trauma. 2007;62:657–663
  2. Heitger MH, Jones RD, Frampton CM, Ardagh MW, Anderson TJ. Recovery in the first year after mild head injury: divergence of symptom status and self-perceived quality of life. J Rehabil Med. 2007;39:612–621
  3. Ingebrigtsen T, Waterloo K, Marup-Jensen S, Attner E, Romner B. Quantification of post-concussion symptoms 3 months after minor head injury in 100 consecutive patients. J Neurol. 1998;245:609–612
  4. Whittaker R, Kemp S, House A. Illness perceptions and outcome in mild head injury: a longitudinal study. J Neurol Neurosurg Psychiatry. 2007;78:644–646
  5. Sterr A, Herron KA, Hayward C, Montaldi D. Are mild head injuries as mild as we think? (Neurobehavioral concomitants of chronic post-concussion syndrome). BMC Neurol. 2006;6:7
  6. Vanderploeg RD, Curtiss G, Luis CA, Salazar AM. Long-term morbidities following self-reported mild traumatic brain injury. J Clin Exp Neuropsychol. 2007;29:585–598
  7. Cicerone KD, Azulay J. Diagnostic utility of attention measures in postconcussion syndrome. Clin Neuropsychol. 2002;16:280–289
  8. Chen JK, Johnston KM, Petrides M, Ptito A. Neural substrates of symptoms of depression following concussion in male athletes with persisting postconcussion symptoms. Arch Gen Psychiatry. 2008;65:81–89
  9. McCauley SR, Boake C, Pedroza C, et al. Correlates of persistent postconcussional disorder: DSM-IV criteria versus ICD-10. J Clin Exp Neuropsychol. 2008;30:360–379
  10. Cattelani R, Gugliotta M, Maravita A, Mazzucchi A. Post-concussive syndrome: paraclinical signs, subjective symptoms, cognitive functions and MMPI profiles. Brain Inj. 1996;10:187–195
  11. van der Naalt J, van Zomeren AH, Sluiter WJ, Minderhoud JM. One year outcome in mild to moderate head injury: the predictive value of acute injury characteristics related to complaints and return to work. J Neurol Neurosurg Psychiatry. 1999;66:207–213
  12. Nolin P, Heroux L. Relations among sociodemographic, neurologic, clinical, and neuropsychologic variables, and vocational status following mild traumatic brain injury: a follow-up study. J Head Trauma Rehabil. 2006;21:514–526
  13. Haboubi NH, Long J, Koshy M, Ward AB. Short-term sequelae of minor head injury (6 years experience of minor head injury clinic). Disabil Rehabil. 2001;23:635–638
  14. Fenton G, McClelland R, Montgomery A, MacFlynn G, Rutherford W. The postconcussional syndrome: social antecedents and psychological sequelae. Br J Psychiatry. 1993;162:493–497
  15. Stålnacke BM. Community integration, social support and life satisfaction in relation to symptoms 3 years after mild traumatic brain injury. Brain Inj. 2007;21:933–942
  16. Stulemeijer M, van der Werf S, Bleijenberg G, Biert J, Brauer J, Vos PE. Recovery from mild traumatic brain injury: a focus on fatigue. J Neurol. 2006;253:1041–1047
  17. Carroll LJ, Cassidy JD, Peloso PM, et al. Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med. 2004;43(Suppl):84–105
  18. McCrea M. Mild traumatic brain injury and postconcussion syndrome: the new evidence base for diagnosis and treatment. New York: Oxford Univ Pr; 2008;
  19. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med. 2008;358:453–463
  20. Rohling ML, Meyers JE, Millis SR. Neuropsychological impairment following traumatic brain injury: a dose-response analysis. Clin Neuropsychol. 2003;17:289–302
  21. Dikmen S, Machamer J, Winn HR, Temkin NR. Neuropsychological outcome at 1-year post head injury. Neuropsychol. 1995;9:80–90
  22. Ocana M, Jardine A, Ouchterlony D, Feinstein A. How mild is mild head injury? (A neuropsychiatric study). Brain Cogn. 2000;44:83–97
  23. McCullagh S, Oucherlony D, Protzner A, Blair N, Feinstein A. Prediction of neuropsychiatric outcome following mild trauma brain injury: an examination of the Glasgow Coma Scale. Brain Inj. 2001;15:489–497
  24. Hoffman RG, Scott JG, Emick MA, Adams RL. The MMPI-2 and closed head injury: effects of litigation and head injury severity. J Forensic Neuropsychol. 1999;1:3–13
  25. Kurtz JE, Shealy SE, Putnam SH. Another look at paradoxical severity effects in head injury with the Personality Assessment Inventory. J Pers Assess. 2007;88:66–73
  26. Youngjohn JR, Davis D, Wolf I. Head injury and the MMPI-2: paradoxical severity effects and the influence of litigation. Psychol Assess. 1997;9:177–184
  27. Greiffenstein M, Baker W. Miller was (mostly) right: head injury severity inversely related to simulation. Legal Criminological Psychol. 2006;11:131–145
  28. Ma M, Lindsell CJ, Rosenberry CM, Shaw GJ, Zemlan FP. Serum cleaved tau does not predict postconcussion syndrome after mild traumatic brain injury. Am J Emerg Med. 2008;26:763–768
  29. Hofman PA, Stapert SZ, van Kroonenburgh MJ, Jolles J, de Kruijk J, Wilmink JT. MR imaging, single-photon emission CT, and neurocognitive performance after mild traumatic brain injury. Am J Neuroradiol. 2001;22:441–449
  30. de Leon MB, Kirsch NL, Maio RF, et al. Baseline predictors of fatigue 1 year after mild head injury. Arch Phys Med Rehabil. 2009;90:956–965
  31. Benson RR, Meda SA, Vasudevan S, et al. Global white matter analysis of diffusion tensor images is predictive of injury severity in traumatic brain injury. J Neurotrauma. 2007;24:446–459
  32. Huisman TA, Schwamm LH, Schaefer PW, et al. Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury. Am J Neuroradiol. 2004;25:370–376
  33. Kraus MF, Susmaras T, Caughlin BP, Walker CJ, Sweeney JA, Little DM. White matter integrity and cognition in chronic traumatic brain injury: a diffusion tensor imaging study. Brain. 2007;130:2508–2519
  34. Rutgers DR, Fillard P, Paradot G, Tadie M, Lasjaunias P, Ducreux D. Diffusion tensor imaging characteristics of the corpus callosum in mild, moderate, and severe traumatic brain injury. Am J Neuroradiol. 2008;29:1730–1735
  35. Niogi SN, Mukherjee P, Ghajar J, et al. Extent of microstructural white matter injury in postconcussive syndrome correlates with impaired cognitive reaction time: a 3T diffusion tensor imaging study of mild traumatic brain injury. Am J Neuroradiol. 2008;29:967–973
  36. Miles L, Grossman RI, Johnson G, Babb JS, Diller L, Inglese M. Short-term DTI predictors of cognitive dysfunction in mild traumatic brain injury. Brain Inj. 2008;22:115–122
  37. Mooney G, Speed J, Sheppard S. Factors related to recovery after mild traumatic brain injury. Brain Inj. 2005;19:975–987
  38. Suhr JA, Gunstad J. Postconcussive symptom report: the relative influence of head injury and depression. J Clin Exp Neuropsychol. 2002;24:981–993
  39. McCauley SR, Boake C, Levin HS, Contant CF, Song JX. Postconcussional disorder following mild to moderate traumatic brain injury: anxiety, depression, and social support as risk factors and comorbidities. J Clin Exp Neuropsychol. 2001;23:792–808
  40. Spinos PC, Sakellaropoulos GC, Deli AG, Maraziotis TG, Constantoyannis CD. The low rate of chronic postconcussion symptoms following mild head injuries in Greeks: a prospective study. Eur J Neurol. 2007;14(Suppl 1):165–301
  41. Uomoto JM, Fann JR. Explanatory style and perception of recovery in symptomatic mild traumatic brain injury. Rehabil Psychol. 2004;49:334–337
  42. Ferrari R, Obelieniene D, Russell A, Darlington P, Gervais R, Green P. Symptom expectation after minor head injury: a comparative study between Canada and Lithuania. Clin Neurol Neurosurgery. 2001;103:184–190
  43. Davis CH. Self-perception in mild traumatic brain injury. Am J Phys Med Rehabil. 2002;81:609–621
  44. Mittenberg W, DiGiulio DV, Perrin S, Bass AE. Symptoms following mild head injury: expectation as aetiology. J Neurol Neurosurg Psychiatry. 1992;55:200–204
  45. Gunstad J, Suhr JA. Cognitive factors in postconcussion syndrome symptom report. Arch Clin Neuropsychol. 2004;19:391–405
  46. Binder LM, Rohling ML. Money matters: a meta-analytic review of the effects of financial incentives on recovery after closed-head injury. Am J Psychiatry. 1996;153:7–10
  47. Miller LJ, Donders J. Subjective symptomatology after traumatic head injury. Brain Inj. 2001;15:297–304
  48. Pagulayan KF, Temkin NR, Machamer J, Dikmen SS. A longitudinal study of health-related quality of life after traumatic brain injury. Arch Phy Med Rehabil. 2006;87:611–618
  49. McCrea M, Guskiewicz KM, Marshall SW, et al. Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study. JAMA. 2003;290:2556–2563
  50. Belanger HG, Vanderploeg RD. The neuropsychological impact of sports-related concussion: a meta-analysis. J Int Neuropsychol Soc. 2005;11:345–357
  51. McClincy MP, Lovell MR, Pardini J, Collins MW, Spore MK. Recovery from sports concussion in high school and collegiate athletes. Brain Inj. 2006;20:33–39
  52. Mickeviciene D, Schrader H, Obelieniene D, et al. A controlled prospective inception cohort study on the post-concussion syndrome outside the medicolegal context. Eur J Neurol. 2004;11:411–419
  53. Schretlen DJ, Shapiro AM. A quantitative review of the effects of traumatic brain injury on cognitive functioning. Int Rev Psychiatry. 2003;15:341–349
  54. McLean SA, Kirsch NL, Tan-Schriner CU, et al. Health status not head injury predicts concussion symptoms after minor injury. Am J Emerg Med. 2009;27:182–190
  55. Horner MD, Selassie AW, Lineberry L, Ferguson PL, Labbate LA. Predictors of psychological symptoms 1 year after traumatic brain injury: a population-based, epidemiological study. J Head Trauma Rehabil. 2008;23:74–83
  56. Luis CA, Vanderploeg RD, Curtiss G. Predictors of postconcussion symptom complex in community dwelling male veterans. J Int Neuropsychol Soc. 2003;9:1001–1015
  57. Kashluba S, Paniak C, Casey JE. Persistent symptoms associated with factors identified by the WHO Task Force on mild traumatic brain injury. Clin Neuropsychol. 2008;22:195–208
  58. Kay T, Newman B, Cavallo M, Ezrachi O, Resnick M. Toward a neuropsychological model of functional disability after mild traumatic brain injury. Neuropsychol. 1992;6:371–384
  59. McLean SA, Clauw DJ. Predicting chronic symptoms after an acute “stressor”—lessons learned from 3 medical conditions. Med Hypotheses. 2004;63:653–658
  60. American Congress of Medical Rehabilitation. Definition of mild traumatic brain injury. J Head Trauma Rehabil. 1993;8:86–87
  61. Whiteneck G, Mellick D, Harrison-Felix C, Brooks CA, Terrill MS, Noble K. Colorado traumatic brain injury and follow up system databook. Englewood: Craig Hospital; 2001;
  62. King NS, Crawford S, Wenden FJ, Moss NE, Wade DT. The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability. J Neurol. 1995;242:587–592
  63. Smith-Seemiller L, Fow NR, Kant R, Franzen MD. Presence of post-concussion syndrome symptoms in patients with chronic pain vs mild traumatic brain injury. Brain Inj. 2003;17:199–206
  64. Ponsford J, Willmott C, Rothwell A, et al. Factors influencing outcome following mild traumatic brain injury in adults. J Int Neuropsychol Soc. 2000;6:568–579
  65. Paniak C, Toller-Lobe G, Reynolds S, Melnyk A, Nagy J. A randomized trial of two treatments for mild traumatic brain injury: 1 year follow-up. Brain Inj. 2000;14:219–226
  66. Mittenberg W, Canyock EM, Condit D, Patton C. Treatment of post-concussion syndrome following mild head injury. J Clin Exp Neuropsychol. 2001;23:829–836
  67. Murray GD, Butcher I, McHugh GS, et al. Multivariable prognostic analysis in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007;24:329–337

 Supported by the Centers for Disease Control (grant no. R49/CCR523223-01), the National Institutes of Health, the National Institute of Child Health and Human Development, and the National Center for Medical Rehabilitation Research (grant no. 5-T32-HD007422-17).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(09)00848-X

doi: 10.1016/j.apmr.2009.09.019

Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 1 , Pages 35-42 , January 2010

Article Tools

* Image Usage & Resolution