Mild head injury--a close relationship between motor function at 1 week post-injury and overall recovery at 3 and 6 months.
Based on previous findings of impaired eye and arm motor control after mild closed head injury (CHI), this study examined whether early eye and arm motor function, and the level of post-injury cerebral dysfunction manifested in motor control, relates systematically to recovery at 3 and 6 months after mild CHI. At 1 week post-injury, we assessed oculomotor function, upper-limb visuomotor performance, and cognitive status in 37 mild CHI patients. Re-examination at 3 and 6 months determined outcome in terms of postconcussional symptoms and performance of everyday tasks, as assessed by the Rivermead Postconcussion Symptoms Questionnaire, the Rivermead Head Injury Follow-up Questionnaire and the SF-36 Health Survey. We then examined the association of early motor function, cognitive status and self-reported health condition with outcome using linear regression. Motor-based regression models explained a high proportion of the variance in outcome (70-89%), with motor function at 1 week being more closely related to outcome at 3 and 6 months than early psychometric assessment (13-32%) or self-reported health status (54-79%). These motor-based models incorporated subcortical/subconscious motor functions alongside motor functions that are subject to volitional control and are primarily mediated by frontal, parietal and temporal cortical brain regions. Early assessment of eye and arm motor function may help in improving accuracy of outcome prediction after mild CHI. Such assessment may assist in the better targeting of early health care intervention and help decrease head-trauma-related morbidity and rehabilitation costs.
Heitger
Marcus H
MH
Van der Veer Institute for Parkinson's and Brain Research, Christchurch, New Zealand. marcus.heitger@chmeds.ac.nz
Jones
Richard D
RD
Dalrymple-Alford
John C
JC
Frampton
Chris M
CM
Ardagh
Michael W
MW
Anderson
Tim J
TJ
D000293:Adolescent; D000328:Adult; D006259:Craniocerebral Trauma / Q000503:physiopathology* / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009483:Neuropsychological Tests; D009801:Oculomotor Muscles / Q000502:physiology; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012044:Regression Analysis; D015599:Trauma Severity Indices