Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents
Researchers operationalize persistent post-concussion symptoms in children and adolescents using varied definitions. Many pre-existing conditions, personal characteristics, and current health issues can affect symptom endorsement rates in the absence of, or in combination with, a recent concussion,...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.614648/full |
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| author | Grant L. Iverson Grant L. Iverson Grant L. Iverson Grant L. Iverson Justin E. Karr Bruce Maxwell Ross Zafonte Ross Zafonte Ross Zafonte Paul D. Berkner Nathan E. Cook Nathan E. Cook Nathan E. Cook |
| author_facet | Grant L. Iverson Grant L. Iverson Grant L. Iverson Grant L. Iverson Justin E. Karr Bruce Maxwell Ross Zafonte Ross Zafonte Ross Zafonte Paul D. Berkner Nathan E. Cook Nathan E. Cook Nathan E. Cook |
| author_sort | Grant L. Iverson |
| collection | DOAJ |
| description | Researchers operationalize persistent post-concussion symptoms in children and adolescents using varied definitions. Many pre-existing conditions, personal characteristics, and current health issues can affect symptom endorsement rates in the absence of, or in combination with, a recent concussion, and the use of varied definitions can lead to differences in conclusions about persistent symptoms and recovery across studies. This study examined how endorsement rates varied by 14 different operational definitions of persistent post-concussion symptoms for uninjured boys and girls with and without pre-existing or current health problems. This cross-sectional study included a large sample (age range: 11–18) of girls (n = 21,923) and boys (n = 26,556) without a recent concussion who completed the Post-Concussion Symptom Scale at preseason baseline. Endorsements rates varied substantially by definition, health history, and current health issues. The most lenient definition (i.e., a single mild symptom) was endorsed by most participants (54.5% of boys/65.3% of girls). A large portion of participants with pre-existing mental health problems (42.7% of boys/51.5% of girls), current moderate psychological distress (70.9% of boys/72.4% of girls), and insufficient sleep prior to testing (33.4% of boys/47.6% of girls) endorsed symptoms consistent with mild ICD-10 postconcussional syndrome; whereas participants with no current or prior health problems rarely met this definition (1.6% of boys/1.6% of girls). The results illustrate the tremendous variability in the case definitions of persistent symptoms and the importance of harmonizing definitions across future studies. |
| first_indexed | 2024-12-14T23:06:05Z |
| format | Article |
| id | doaj.art-4c2c8b8ae48249d3848cd4a845c5ee3b |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-14T23:06:05Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-4c2c8b8ae48249d3848cd4a845c5ee3b2022-12-21T22:44:19ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-02-011210.3389/fneur.2021.614648614648Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and AdolescentsGrant L. Iverson0Grant L. Iverson1Grant L. Iverson2Grant L. Iverson3Justin E. Karr4Bruce Maxwell5Ross Zafonte6Ross Zafonte7Ross Zafonte8Paul D. Berkner9Nathan E. Cook10Nathan E. Cook11Nathan E. Cook12Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United StatesMassGeneral Hospital for Children Sports Concussion Program, Boston, MA, United StatesSpaulding Rehabilitation Hospital, Charlestown, MA, United StatesSpaulding Research Institute, Charlestown, MA, United StatesDepartment of Psychology, University of Kentucky, Lexington, KY, United StatesDepartment of Computer Science, Colby College, Waterville, ME, United StatesDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United StatesSpaulding Rehabilitation Hospital, Charlestown, MA, United StatesHome Base, A Red Sox Foundation and Massachusetts General Hospital Program, Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Boston, MA, United StatesCollege of Osteopathic Medicine, University of New England, Biddeford, ME, United StatesDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United StatesMassGeneral Hospital for Children Sports Concussion Program, Boston, MA, United StatesSpaulding Rehabilitation Hospital, Charlestown, MA, United StatesResearchers operationalize persistent post-concussion symptoms in children and adolescents using varied definitions. Many pre-existing conditions, personal characteristics, and current health issues can affect symptom endorsement rates in the absence of, or in combination with, a recent concussion, and the use of varied definitions can lead to differences in conclusions about persistent symptoms and recovery across studies. This study examined how endorsement rates varied by 14 different operational definitions of persistent post-concussion symptoms for uninjured boys and girls with and without pre-existing or current health problems. This cross-sectional study included a large sample (age range: 11–18) of girls (n = 21,923) and boys (n = 26,556) without a recent concussion who completed the Post-Concussion Symptom Scale at preseason baseline. Endorsements rates varied substantially by definition, health history, and current health issues. The most lenient definition (i.e., a single mild symptom) was endorsed by most participants (54.5% of boys/65.3% of girls). A large portion of participants with pre-existing mental health problems (42.7% of boys/51.5% of girls), current moderate psychological distress (70.9% of boys/72.4% of girls), and insufficient sleep prior to testing (33.4% of boys/47.6% of girls) endorsed symptoms consistent with mild ICD-10 postconcussional syndrome; whereas participants with no current or prior health problems rarely met this definition (1.6% of boys/1.6% of girls). The results illustrate the tremendous variability in the case definitions of persistent symptoms and the importance of harmonizing definitions across future studies.https://www.frontiersin.org/articles/10.3389/fneur.2021.614648/fullmild traumatic brain injurybrain traumaoutcome researchpostconcussional syndromepediatricsassessment |
| spellingShingle | Grant L. Iverson Grant L. Iverson Grant L. Iverson Grant L. Iverson Justin E. Karr Bruce Maxwell Ross Zafonte Ross Zafonte Ross Zafonte Paul D. Berkner Nathan E. Cook Nathan E. Cook Nathan E. Cook Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents Frontiers in Neurology mild traumatic brain injury brain trauma outcome research postconcussional syndrome pediatrics assessment |
| title | Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents |
| title_full | Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents |
| title_fullStr | Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents |
| title_full_unstemmed | Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents |
| title_short | Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents |
| title_sort | examining criteria for defining persistent post concussion symptoms in children and adolescents |
| topic | mild traumatic brain injury brain trauma outcome research postconcussional syndrome pediatrics assessment |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.614648/full |
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