Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, GF Strong Rehab Centre, Vancouver, British Columbia, Canada.
J Neurotrauma. 2013 Aug 15;30(16):1398-404. doi: 10.1089/neu.2012.2827. Epub 2013 Jul 20.
The relationship between previous mild traumatic brain injury/injuries (MTBI) and recovery from a subsequent MTBI may be complex. The present study investigated three factors hypothesized to influence this relation: (1) the number of prior MTBIs, (2) the interval between MTBIs, and (3) the certainty level of previous MTBIs. The study design was retrospective cross-sectional. Participants (N=105) were evaluated at a concussion clinic on average 1 month after sustaining an MTBI, defined by World Health Organization diagnostic criteria. Approximately half the sample had at least one previous MTBI. Subgroups with 0, 1, or 2+ previous MTBIs did not differ in levels of current post-concussion symptom reporting on the British Columbia Post-Concussion Symptom Inventory. Time since the most recent previous MTBI was significantly associated with current post-concussion symptom reporting. This relation was best characterized as logarithmic; i.e., the impact of previous MTBI(s) lessens exponentially as time elapses to a subsequent MTBI. Defining previous MTBIs with a higher certainty level (i.e., probable versus possible) was not consistently associated with greater post-concussion symptom reporting. In conclusion, participants with multiple MTBIs did not report more post-concussion symptoms than those with no history of MTBI. Previous MTBI(s), however, were associated with increased symptom reporting from a subsequent MTBI to the extent they occurred closer in time. Having one or two previous remote MTBIs was not associated with worse outcome from subsequent MTBI in this sample.
先前轻度创伤性脑损伤/损伤（MTBI）与随后 MTBI 的恢复之间的关系可能很复杂。本研究调查了三个被假设影响这种关系的因素：（1）先前 MTBI 的数量，（2）MTBI 之间的间隔，以及（3）先前 MTBI 的确定性水平。研究设计为回顾性横断面研究。参与者（N=105）在遭受 MTBI 后平均 1 个月在脑震荡诊所接受评估，MTBI 的定义符合世界卫生组织的诊断标准。大约一半的样本有至少一次先前的 MTBI。先前 MTBI 为 0、1 或 2+的亚组在不列颠哥伦比亚省脑震荡后症状清单上当前脑震荡后症状报告水平上没有差异。距最近一次先前 MTBI 的时间与当前脑震荡后症状报告显著相关。这种关系最好用对数来描述；即，先前 MTBI 的影响随着时间的推移呈指数级减弱，直到发生随后的 MTBI。使用更高确定性水平（即可能而非可能）来定义先前的 MTBI 并不总是与更大的脑震荡后症状报告相关。总之，有多次 MTBI 的参与者并没有比没有 MTBI 史的参与者报告更多的脑震荡后症状。然而，先前的 MTBI 与随后 MTBI 的症状报告增加有关，程度取决于它们发生的时间间隔。在这个样本中，有一两个先前的遥远 MTBI 与随后的 MTBI 没有更差的结果相关。
