title: Mild traumatic brain injury and neural recovery: rethinking the debate.
abstract: A debate exists concerning whether a mild traumatic brain injury (MTBI) can cause permanent brain-based residuals. This debate is examined by reviewing meta-analytic studies that found no significant effect sizes between large samples of patients with and without MTBI at three months post-accident. In contrast, research studies with MTBI patients have captured cognitive deficits corroborated by positive neuroimaging, which supports the viewpoint that brain-based postconcussive disorders likely exist in a small minority of individuals. Ongoing hurdles that likely contribute to this debate are identified. This includes the lack of agreed upon definitions; substantial differences exist between the ICD-10 definition for Postconcussion Syndrome and the DSM-IV-TR definition for Postconcussional Disorder. Confining the debate to brain-based versus psychologically-based viewpoints results in a false dichotomy. Instead, a more refined sub-classification of the postconcussive complex is proposed that captures different constellations across the physical, emotional, and cognitive symptoms complex. Moreover, this diagnostic framework attempts to expand discipline-based approaches with a patient-based understanding.
authors.affiliation: San Francisco Clinical Neurosciences, 909 Hyde Street, Suite 620, San Francisco, CA 94109, USA. ronruff@mindspring.com
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Ruff
mesh_terms: D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D002908:Chronic Disease; D003072:Cognition Disorders / Q000209:etiology; D003937:Diagnosis, Differential; D004644:Emotions; D006801:Humans; D009420:Nervous System / Q000503:physiopathology*; D038223:Post-Concussion Syndrome / Q000145:classification / Q000175:diagnosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013997:Time Factors