The prospective course of postconcussion syndrome: the role of mild traumatic brain injury

Neuropsychology. 2011 Jul;25(4):454-65. doi: 10.1037/a0022580.


Objective: To investigate whether postconcussion syndrome (PCS) represents long-term sequelae associated with mild traumatic brain injury (mTBI).

Methods: Prospective consecutive admissions to a Level 1 trauma hospital were assessed a mean 4.9 days and again 106.2 days post-injury. The final sample comprised 62 mTBI and 58 nonbrain injured trauma controls (TC). Change or lack of change in individual PCS-like symptoms and PCS was examined. Multilevel logistic regression was used to analyze whether mTBI predicts 3-month PCS (Time 2; T2); whether predictors of PCS (within 14 days of injury, Time 1; T1) predict 3-month PCS, and how change in these predictors from T1 to T2 were associated with change in PCS status. Variables included demographic, injury-related, financial incentives, neuropsychological, and psychiatric disorder.

Results: MTBI did not predict PCS. PCS was comparable (T1: mTBI: 40.3%, TC: 50.0%; T2: mTBI: 46.8%, TC: 48.3%). At T2, 38.6% were new cases of PCS; between 30.8% and 86.2% reported either a new or more frequent symptom. A pre-injury depressive or anxiety disorder (OR = 2.99, 95% CI [1.38, 6.45]), and acute posttraumatic stress (OR = 1.05, 95% CI [1.00, 1.00]) were early markers of PCS, regardless of mTBI. An interaction between time and posttraumatic stress disorder (PTSD) suggested the relationship between the severity of PTSD symptoms and PCS strengthened over time (OR = 2.66, 95% CI [1.08, 6.55]). Pain was related to PCS. Females were more likely than males to have PCS.

Conclusion: The data suggest the phenomenon of PCS in trauma patients does not show an association with mTBI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Brain Injuries / complications*
  • Brain Injuries / drug therapy
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / etiology
  • Middle Aged
  • Neuropsychological Tests
  • Post-Concussion Syndrome / classification
  • Post-Concussion Syndrome / complications*
  • Post-Concussion Syndrome / drug therapy
  • Predictive Value of Tests
  • Prospective Studies
  • Psychological Tests
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Young Adult


  • Analgesics, Opioid