title: Variable, not always persistent, postconcussion symptoms after mild TBI in U.S. military service members: a five-year cross-sectional outcome study.
abstract: This study examined postconcussion symptom reporting within the first 5 years after mild traumatic brain injury (mTBI). Participants were 167 U.S. military service members (mean age, 27.6 years; 74.3% blast; 96.4% male) who were evaluated subsequent to injuries sustained in theater during Operations Iraqi and Enduring Freedom (92.8%) or from other combat-related operations. Participants completed the Neurobehavioral Symptom Inventory and Post-Traumatic Stress Disorder Checklist within 3 months of injury and at least one follow-up telephone interview at 6 (n = 46), 12 (n = 89), 24 (n = 54), 36 (n = 42), 48 (n = 30), and/or 60 months (n = 25) postinjury. Approximately half of the sample (49.7%) met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) symptom criteria for postconcussion disorder (PCD) at baseline. At all six follow-ups, 46.1-72.0% met DSM-IV criteria for PCD. However, only 20.4-48.0% reported persistent PCD from baseline to follow-up. A substantial minority had also improved (4.0-24.1%) or "developed" new symptoms (16.9-27.8%). Using regression analyses, baseline symptoms were somewhat predictive of PCD symptom reporting at follow-up, though this was not always reliable. Follow-up for all service members who sustain a combat-related mTBI in the context of polytrauma, regardless of the presence or absence of symptom reporting in the acute recovery stage, should be considered the rule, not the exception.
authors.affiliation: Defense and Veterans Brain Injury Center, Bethesda, Maryland 20852, USA. rlange@dvbic.org
authors.forename: Rael T
authors.initials: RT
authors.lastname: Lange
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Brickell
authors.forename: Brian
authors.initials: B
authors.lastname: Ivins
authors.forename: Rodney D
authors.initials: RD
authors.lastname: Vanderploeg
authors.forename: Louis M
authors.initials: LM
authors.lastname: French
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D038223:Post-Concussion Syndrome / Q000453:epidemiology* / Q000209:etiology*; D014481:United States