Losoi Heidi, Silverberg Noah D, Wäljas Minna, Turunen Senni, Rosti-Otajärvi Eija, Helminen Mika, Luoto Teemu M, Julkunen Juhani, Öhman Juha, Iverson Grant L
1 Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland .
2 Institute of Behavioural Sciences, University of Helsinki , Helsinki, Finland .
J Neurotrauma. 2016 Apr 15;33(8):766-76. doi: 10.1089/neu.2015.4070. Epub 2015 Dec 17.
This prospective longitudinal study reports recovery from mild traumatic brain injury (MTBI) across multiple domains in a carefully selected consecutive sample of 74 previously healthy adults. The patients with MTBI and 40 orthopedic controls (i.e., ankle injuries) completed assessments at 1, 6, and 12 months after injury. Outcome measures included cognition, post-concussion symptoms, depression, traumatic stress, quality of life, satisfaction with life, resilience, and return to work. Patients with MTBI reported more post-concussion symptoms and fatigue than the controls at the beginning of recovery, but by 6 months after injury, did not differ as a group from nonhead injury trauma controls on cognition, fatigue, or mental health, and by 12 months, their level of post-concussion symptoms and quality of life was similar to that of controls. Almost all (96%) patients with MTBI returned to work/normal activities (RTW) within the follow-up of 1 year. A subgroup of those with MTBIs and controls reported mild post-concussion-like symptoms at 1 year. A large percentage of the subgroup who had persistent symptoms had a modifiable psychological risk factor at 1 month (i.e., depression, traumatic stress, and/or low resilience), and at 6 months, they had greater post-concussion symptoms, fatigue, insomnia, traumatic stress, and depression, and worse quality of life. All of the control subjects who had mild post-concussion-like symptoms at 12 months also had a mental health problem (i.e., depression, traumatic stress, or both). This illustrates the importance of providing evidence-supported treatment and rehabilitation services early in the recovery period.
这项前瞻性纵向研究报告了在精心挑选的74名此前健康的成年人连续样本中，轻度创伤性脑损伤（MTBI）在多个领域的恢复情况。MTBI患者和40名骨科对照者（即脚踝损伤患者）在受伤后1个月、6个月和12个月完成了评估。结果指标包括认知、脑震荡后症状、抑郁、创伤应激、生活质量、生活满意度、恢复力和重返工作岗位情况。MTBI患者在恢复初期报告的脑震荡后症状和疲劳比对照组更多，但在受伤6个月后，在认知、疲劳或心理健康方面与非头部损伤创伤对照组相比没有差异，到12个月时，他们的脑震荡后症状水平和生活质量与对照组相似。几乎所有（96%）MTBI患者在1年的随访期内恢复工作/正常活动（RTW）。MTBI患者和对照组中的一个亚组在1年时报告有轻度脑震荡样症状。有持续症状的亚组中很大一部分在1个月时有可改变的心理风险因素（即抑郁、创伤应激和/或恢复力低），在6个月时，他们有更严重的脑震荡后症状、疲劳、失眠、创伤应激和抑郁，以及更差的生活质量。所有在12个月时有轻度脑震荡样症状的对照受试者也都有心理健康问题（即抑郁、创伤应激或两者皆有）。这说明了在恢复期早期提供有证据支持的治疗和康复服务的重要性。
