Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment: A scoping review

Kerry McInnes, Christopher L Friesen, Diane E MacKenzie, David A Westwood, Shaun G Boe, Kerry McInnes, Christopher L Friesen, Diane E MacKenzie, David A Westwood, Shaun G Boe

Abstract

Mild traumatic brain injury (mTBI), or concussion, is the most common type of traumatic brain injury. With mTBI comes symptoms that include headaches, fatigue, depression, anxiety and irritability, as well as impaired cognitive function. Symptom resolution is thought to occur within 3 months post-injury, with the exception of a small percentage of individuals who are said to experience persistent post-concussion syndrome. The number of individuals who experience persistent symptoms appears to be low despite clear evidence of longer-term pathophysiological changes resulting from mTBI. In light of the incongruency between these longer-term changes in brain pathology and the number of individuals with longer-term mTBI-related symptoms, particularly impaired cognitive function, we performed a scoping review of the literature that behaviourally assessed short- and long-term cognitive function in individuals with a single mTBI, with the goal of identifying the impact of a single concussion on cognitive function in the chronic stage post-injury. CINAHL, Embase, and Medline/Ovid were searched July 2015 for studies related to concussion and cognitive impairment. Data relating to the presence/absence of cognitive impairment were extracted from 45 studies meeting our inclusion criteria. Results indicate that, in contrast to the prevailing view that most symptoms of concussion are resolved within 3 months post-injury, approximately half of individuals with a single mTBI demonstrate long-term cognitive impairment. Study limitations notwithstanding, these findings highlight the need to carefully examine the long-term implications of a single mTBI.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. F low diagram representing each…
Fig 1. Flow diagram representing each stage of the article selection process of the scoping search and citation review.
Fig 2. Incidence of cognitively impaired (black…
Fig 2. Incidence of cognitively impaired (black bars) and unimpaired (white bars) individuals at various time points post-injury from studies reporting cognitive outcomes using either author-supplied normative data or comparison groups (i.e., healthy or trauma controls) for the entire sample (A) and in individuals with a confirmed history of a single concussion only (B).
Fig 3. Incidence of cognitively impaired (black…
Fig 3. Incidence of cognitively impaired (black bars) and unimpaired (white bars) individuals separated into children (no pattern) and adults (pattern).

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