Examining and comparing the clinical characteristics of adults with persisting post-concussion symptoms presenting for outpatient rehabilitation following a mild traumatic brain injury or a minimal head injury.
Linda Fordal, Grant L Iverson, Julia E Maietta and 4 others
PMID 40598804WHAT IT FOUND
Patients referred to rehab with persisting symptoms after a mild head injury report similar high symptom burdens and disability whether their injury met criteria for mild TBI or was even milder.
Nearly half had no loss of consciousness or amnesia. Treat symptoms and function, not just injury severity.
Key findings
01The group with minimal head injury (no loss of consciousness or amnesia) reported similar symptom severity (RPQ scores) and functional disability (GOS-E scores) as the mild TBI group.
02Despite sustaining objectively milder injuries, the minimal head injury group had significantly worse return-to-work outcomes than the mild TBI group.
03Intracranial findings on neuroimaging were rare (1-3%) despite the high symptom burden and functional disability reported by patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Retrospective categorization of injury severity based on patient recall may introduce bias. The sample was referred to a specialized rehabilitation clinic, so results may not generalize to the broader population of people with mild head injuries. Questionnaire response rate was approximately 60%, though non-respondents did not differ significantly on key demographics or outcomes. The study did not measure specific speech-language or cognitive testing outcomes, relying on self-report scales (RPQ) and global functioning (GOS-E).
Declared interests
Funding was provided by the Central Norway Regional Health Authority and the Norwegian University of Science and Technology. One author (Grant Iverson) has financial ties to several test publishers and consulting firms, including those involved in neuropsychological assessment.
The easy way to misread this
Do not interpret the similar symptom burden between MTBI and MHI groups as evidence that the initial injury severity is irrelevant to prognosis. The MHI group's worse return-to-work outcome may reflect different psychosocial contexts or validation issues rather than a direct biological effect of the injury, and the authors note this finding requires confirmation.