Conder Alanna, Conder Robert, Friesen Christopher
Carolina Neuropsychological Service, Raleigh, NC, USA.
Niagara Neuropsychology, Grimsby, Ontario, Canada.
NeuroRehabilitation. 2020;46(2):167-180. doi: 10.3233/NRE-192966.
Persistent Sport-Related Post-Concussion Syndrome is often diagnosed with any type of prolonged PCS symptoms. However, there are not specific diagnostic criteria for PPCS such that misdiagnosis often occurs. Further, the signs and symptoms of PCS overlap with other common illnesses such as depression, anxiety, migraines, ADHD and others. Misdiagnosis may lead to less than efficacious treatment, resulting in prolonged symptoms.
This article will review relevant evidence-based literature on PCS, pointing out the lack of a systemic diagnostic framework. It will also provide evidence that highlights the multiple conflicting findings in the literature. This article will posit the BioPsychoSocial framework as the best diagnostic framework for understanding the impact of concussions on the person and to generate individualized and personal interventions.
A narrative review of sport concussion-related articles was conducted, after extensive searches of relevant and non-relevant literature by each author, as well as articles recommended by colleagues. Articles varied from American Academy of Neurology Class I to IV for evaluation and critique. Class IV articles were reviewed, as there is much public misconception regarding sport and other concussion treatment that needed identification and discussion.
Articles reviewed varied by quality of research design and methodology. Multiple symptoms, recovery patterns and rehabilitation treatment approaches are purported in the sport-related concussion literature. Current consensus data as well as the mixed and contradictory findings were explored.
Persistent Sport-Related Post-Concussion Syndrome is a topic of great interest to both professionals and the general public. There is much misunderstanding about the etiology, causation, diagnostic formulations, symptom presentation, prolonging factors and treatment involved in this syndrome. This article posits an individualized multi-system diagnostic formulation, examining all relevant factors, as generating the best interventions for neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome.
持续性运动相关脑震荡后综合征通常依据任何类型的长期脑震荡后综合征症状来诊断。然而,对于持续性运动相关脑震荡后综合征,目前尚无特定的诊断标准,因此误诊情况经常发生。此外,脑震荡后综合征的体征和症状与其他常见疾病(如抑郁症、焦虑症、偏头痛、注意力缺陷多动障碍等)存在重叠。误诊可能导致治疗效果不佳,进而使症状持续时间延长。
本文将回顾关于脑震荡后综合征的相关循证文献,指出缺乏系统性诊断框架的问题。同时,还将提供证据,凸显文献中存在的诸多相互矛盾的研究结果。本文将提出生物心理社会框架,作为理解脑震荡对个体影响并制定个性化干预措施的最佳诊断框架。
在每位作者广泛检索相关及不相关文献以及同事推荐的文章之后,对与运动性脑震荡相关的文章进行了叙述性综述。文章的评估和批判等级从美国神经病学学会的I级到IV级不等。之所以对IV级文章进行综述,是因为公众对运动及其他脑震荡治疗存在诸多误解,需要加以识别和讨论。
所综述的文章在研究设计和方法的质量方面存在差异。运动相关脑震荡文献中提出了多种症状、恢复模式及康复治疗方法。探讨了当前的共识数据以及混杂和相互矛盾的研究结果。
持续性运动相关脑震荡后综合征是专业人士和公众都极为关注的话题。对于该综合征的病因、发病机制、诊断方式、症状表现、症状迁延因素及治疗等方面存在诸多误解。本文提出一种个性化的多系统诊断方式,对所有相关因素进行考量,以此为持续性运动相关脑震荡后综合征的神经康复制定最佳干预措施。