Déry Véronique, Lafond Gabrielle, Picard Rosemarie, Langevin Pierre
School of Rehabilitation Science, Faculty of Medicine, Université Laval, Quebec City, Canada.
Clinique PCN Physiothérapie, Quebec City, Canada.
Neurotrauma Rep. 2025 Apr 24;6(1):355-374. doi: 10.1089/neur.2025.0006. eCollection 2025.
The objective of this study was to document the resolution rate of mild Traumatic Brain Injury (mTBI) symptoms at various time points in a nonathletic adult population and identify prognostic factors influencing recovery. Sixteen prospective cohort studies were included, focusing on participants aged 18-65 with acute mTBI, followed for a minimum of 1 month. The recovery criterion was the resolution of symptoms not attributable to pre-existing conditions. Risk of bias was assessed using the Quality in Prognostic Studies tool, with most studies rated as moderate risk, highlighting variability in methodological rigor. Symptom resolution was reported in 49.0% to 69.5% of patients at 1 month, 40.8% to 84.4% at 3 months, 38.3% to 72.2% at 6 months, and 58.1 to 68.3% at 12 months. These findings emphasize the first 6 months as a critical period for evaluating the risk of symptom chronicity. The most commonly reported prognostic factors was baseline symptom severity, including higher intensity of symptoms such as headaches, nausea, and dizziness, as well as elevated scores on validated symptom scales. Psychiatric history, such as pre-existing anxiety or depression, was also a significant predictor of prolonged symptoms. Biomarkers, including NSE and S-100B levels, and reduced blood-derived neurotrophic factors, were associated with poorer recovery at 6 months. Demographic factors, including age, gender, and education level, showed mixed results. While some studies associated female gender, older age, and lower education with poorer recovery, others found no significant correlations. These discrepancies highlight the complexity of mTBI prognosis. Overall, more than half of patients recover within 6 months, but persistent symptoms can have a profound impact on quality of life and functional status. Identifying patients at higher risk of prolonged recovery is crucial for targeted management strategies, emphasizing the importance of individualized, evidence-based care in mTBI populations.
本研究的目的是记录非运动员成年人群中轻度创伤性脑损伤（mTBI）症状在不同时间点的缓解率，并确定影响恢复的预后因素。纳入了16项前瞻性队列研究，重点关注年龄在18 - 65岁的急性mTBI参与者，随访至少1个月。恢复标准是可归因于既往疾病之外的症状得到缓解。使用预后研究质量工具评估偏倚风险，大多数研究被评为中度风险，突出了方法学严谨性的差异。1个月时，49.0%至69.5%的患者症状得到缓解；3个月时为40.8%至84.4%；6个月时为38.3%至72.2%；12个月时为58.1%至68.3%。这些发现强调了前6个月是评估症状慢性化风险的关键时期。最常报告的预后因素是基线症状严重程度，包括头痛、恶心和头晕等症状的较高强度，以及经过验证的症状量表上的高分。精神病史，如既往存在的焦虑或抑郁，也是症状持续时间延长的重要预测因素。生物标志物，包括NSE和S - 100B水平，以及血液衍生神经营养因子的降低，与6个月时较差的恢复情况相关。人口统计学因素，包括年龄、性别和教育水平，结果不一。虽然一些研究将女性性别、老年和较低教育水平与较差的恢复情况相关联，但其他研究未发现显著相关性。这些差异突出了mTBI预后的复杂性。总体而言，超过一半的患者在6个月内康复，但持续症状可能对生活质量和功能状态产生深远影响。识别恢复时间延长风险较高的患者对于有针对性的管理策略至关重要，强调了在mTBI人群中个体化、循证护理的重要性。
