Deborah L Snell1,2, Rachelle Martin3, A D Macleod1, Lois J Surgenor4, Richard J Siegert5, E Jean C Hay-Smith3, Tracy Melzer6,7,8, Gary J Hooper2, Tim Anderson6,7,8. 1. a Concussion Clinic , Burwood Hospital , Christchurch , New Zealand. 2. b Department of Orthopaedic Surgery and Musculoskeletal Medicine , University of Otago Christchurch , Christchurch , New Zealand. 3. e Rehabilitation Teaching and Research Unit , University of Otago Wellington , Wellington , New Zealand. 4. c Department of Psychological Medicine , University of Otago Christchurch , Christchurch , New Zealand. 5. f Faculty of Health and Environmental Studies , AUT University , Auckland , New Zealand. 6. d Department of Medicine , University of Otago Christchurch , Christchurch , New Zealand. 7. g New Zealand Brain Research Institute , Christchurch , New Zealand. 8. h Brain Research New Zealand , Centre of Research Excellence , New Zealand.
Abstract
OBJECTIVES: Post-concussion-like symptoms (PCS) are common in patients without a history of brain injury, such as those with chronic pain (CP). This exploratory study examined neuro-cognitive and psychological functioning in patients with PCS following mild traumatic brain injury (mTBI) or CP, to assess unique and overlapping phenomenology. METHODS: In this case-control study, participants (n = 102) with chronic symptoms after mTBI (n = 45) were matched with mTBI recovered (n = 31) and CP groups (n = 26), on age, gender, ethnicity and education. Psychological status, cognitive functioning, health symptoms, beliefs and behaviours were examined. RESULTS: Participants who had not recovered from an mTBI and participants with CP did not differ in terms of PCS symptoms, quality of life, distress or illness behaviours, however, the CP group endorsed fewer subjective cognitive problems, more negative expectations about recovery and more distress (p < 0.05). On cognitive testing participants who had not recovered from an mTBI demonstrated greater difficulties with attention (p < 0.01) although differences disappeared when depression was controlled in the analyses. CONCLUSIONS: Unique patterns associated with each condition were evident though caution is required in attributing PCS and cognitive symptoms to a brain injury in people with mTBI presenting with chronic pain and/or depression. Psychological constructs such as illness and recovery beliefs appear to be important to consider in the development of treatment interventions.
OBJECTIVES: Post-concussion-like symptoms (PCS) are common in patients without a history of brain injury, such as those with chronic pain (CP). This exploratory study examined neuro-cognitive and psychological functioning in patients with PCS following mild traumatic brain injury (mTBI) or CP, to assess unique and overlapping phenomenology. METHODS: In this case-control study, participants (n = 102) with chronic symptoms after mTBI (n = 45) were matched with mTBI recovered (n = 31) and CP groups (n = 26), on age, gender, ethnicity and education. Psychological status, cognitive functioning, health symptoms, beliefs and behaviours were examined. RESULTS:Participants who had not recovered from an mTBI and participants with CP did not differ in terms of PCS symptoms, quality of life, distress or illness behaviours, however, the CP group endorsed fewer subjective cognitive problems, more negative expectations about recovery and more distress (p < 0.05). On cognitive testing participants who had not recovered from an mTBI demonstrated greater difficulties with attention (p < 0.01) although differences disappeared when depression was controlled in the analyses. CONCLUSIONS: Unique patterns associated with each condition were evident though caution is required in attributing PCS and cognitive symptoms to a brain injury in people with mTBI presenting with chronic pain and/or depression. Psychological constructs such as illness and recovery beliefs appear to be important to consider in the development of treatment interventions.
Authors: Alex R Terpstra; Molly Cairncross; Keith O Yeates; Ana-Maria Vranceanu; Jonathan Greenberg; Cindy Hunt; Noah D Silverberg Journal: Rehabil Psychol Date: 2021-08-19
Authors: Elena Sheldrake; Hiba Al-Hakeem; Brendan Lam; Benjamin I Goldstein; Anne L Wheeler; Matthew Burke; Benjamin T Dunkley; Nick Reed; Shannon E Scratch Journal: Front Neurol Date: 2022-04-11 Impact factor: 4.086