Functional Limitations Persist One Year After Mild TBI

 Many patients with mild traumatic brain injury (mTBI) report persistent functional limitations one year after injury, according to a study published online June 3 in JAMA Neurology.

Lindsay D. Nelson, Ph.D., from the Medical College of Wisconsin in Milwaukee, and colleagues characterized the natural history of recovery of daily function following mTBI (1,154 patients) versus peripheral orthopedic traumatic injury (299 patients) in the first 12 months postinjury. Using clinical computed tomographic (CT) scans, the authors examined the correlation between the presence (CT+) or absence (CT−) of acute intracranial findings and outcomes among patients with mTBI.

The researchers found that at two weeks postinjury, functional limitations were reported by most patients (87 percent of mTBI patients and 93 percent of orthopedic traumatic injury controls [OTCs]). At 12 months, the percentage reporting functional limitations was 53 and 38 percent among those with mTBIs and OTCs, respectively. Compared with the mTBI CT− group, a higher percentage of CT+ patients reported impairment (61 versus 49 percent; relative risk, 1.24); a higher percentage of the mTBI CT− group reported impairment than the OTC group (relative risk, 1.28).

"These findings contrast with the rapid recovery observed in prospective studies of sport-related concussion, and appear to demonstrate that the natural history of mTBI recovery differs across patient populations," the authors write. "The term mild TBI misrepresents the immediate and long-term burden of TBI and other co-occurring factors experienced by this patient population."

Several authors disclosed financial ties to the biopharmaceutical and medical technology industries.

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