title: Systematic review of prognosis after mild traumatic brain injury in the military: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.
abstract: OBJECTIVE
  The World Health Organization Collaborating Centre Task Force on Mild Traumatic Brain Injury (MTBI) published its findings on the prognosis of MTBI in 2004. This is an update of that review with a focus on deployed military personnel.
  
  
  METHODS
  Relevant literature published between January 2001 and February 2012 listed in MEDLINE and 4 other databases.
  
  
  METHODS
  Controlled trials and cohort and case-control studies were selected according to predefined criteria. After 77,914 titles and abstracts were screened, 13 articles were rated eligible for this review and 3 (23%) with a low risk of bias were accepted. Two independent reviewers critically appraised eligible studies using a modification of the Scottish Intercollegiate Guidelines Network criteria.
  
  
  METHODS
  The reviewers independently extracted data from eligible studies and produced evidence tables.
  
  
  RESULTS
  The evidence was synthesized qualitatively and presented in evidence tables. Our findings are based on 3 studies of U.S. military personnel who were deployed in Iraq or Afghanistan. We found that military personnel with MTBI report posttraumatic stress disorder and postconcussive symptoms. In addition, reporting of postconcussive symptoms differed on the basis of levels of combat stress the individuals experienced. The evidence suggests a slight decline in neurocognitive function after MTBI, but this decline was in the normal range of brain functioning.
  
  
  CONCLUSIONS
  We found limited evidence that combat stress, posttraumatic stress disorder, and postconcussive symptoms affect recovery and prognosis of MTBI in military personnel. Additional high-quality research is needed to fully assess the prognosis of MTBI in military personnel.
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: eboyle@health.sdu.dk.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Boyle
authors.affiliation: Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Cancelliere
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Hartvigsen
authors.affiliation: School of Public Health and Alberta Centre for Injury Control and Research, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Carroll
authors.affiliation: Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lena W
authors.initials: LW
authors.lastname: Holm
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: J David
authors.initials: JD
authors.lastname: Cassidy
mesh_terms: D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D003130:Combat Disorders / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D054542:Iraq War, 2003-2011; D008889:Military Personnel / Q000523:psychology*; D038223:Post-Concussion Syndrome / Q000209:etiology; D011379:Prognosis; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology; D015599:Trauma Severity Indices
keywords: Blast injuries; Brain concussion; Military personnel; Prognosis; Rehabilitation