Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms.

Objective: To introduce a set of revised guidelines for the management of mild traumatic brain injury (mTBI) and persistent symptoms following concussive injuries.

Quality Of Evidence: The Guidelines for Mild Traumatic Brain Injury and Persistent Symptoms were made available in March 2011 based on literature and information up to 2008. A search for new clinical practice guidelines addressing mTBI and a systematic review of the literature evaluating treatment of persistent symptoms was conducted.

Predicting Posttraumatic Stress Symptoms Following Mild, Moderate, and Severe Traumatic Brain Injury: The Role of Posttraumatic Amnesia.

Objective: To explore the relation between posttraumatic amnesia (PTA) and posttraumatic stress symptoms in traumatic brain injury.

Design: Single-site prospective cohort study.

Participants: A total of 1114 individuals between the ages of 18 and 65 years with a traumatic brain injury seen on average 3 months following injury.

Clinical practice guidelines for mild traumatic brain injury and persistent symptoms.

Objective: To outline new guidelines for the management of mild traumatic brain injury (MTBI) and persistent postconcussive symptoms (PPCS) in order to provide information and direction to physicians managing patients’ recovery from MTBI.

Quality Of Evidence: A search for existing clinical practice guidelines addressing MTBI and a systematic review of the literature evaluating treatment of PPCS were conducted. Because little guidance on the management of PPCS was found within the traumatic brain injury field, a second search was completed for clinical practice guidelines and systematic reviews that addressed management of these common symptoms in the general population.

Quality of clinical practice guidelines for persons who have sustained mild traumatic brain injury.

Background: Mild TBI is one of the most common neurological disorders occurring today. For individuals who experience persistent symptoms following mild TBI, consequences can include functional disability, stress and time away from one's occupation. The objective of the study was to evaluate the quality of clinical practice guidelines (CPGs) that include recommendations on the care of persons who have sustained mild TBI and associated persistent symptoms.

Genetic predictors of response to treatment with citalopram in depression secondary to traumatic brain injury.

Objectives: To determine which serotonergic system-related single nucleotide polymorphisms (SNPs) predicted variation in treatment response to citalopram in depression following a traumatic brain injury (TBI).

Methods: Ninety (50 M/40 F, aged 39.9, SD = 18.

A randomized controlled trial of antidepressant continuation for major depression following traumatic brain injury.

Objective: This study examines whether continuation therapy with citalopram can prevent a relapse following remission of major depression due to traumatic brain injury.

Method: After 65 subjects with DSM-IV-diagnosed major depression following traumatic brain injury were treated with open-label citalopram (20 mg to 50 mg/d), 25 subjects (38.5%) met criteria for remission.

Factor analysis of the Rivermead Post-Concussion Symptoms Questionnaire in mild-to-moderate traumatic brain injury patients.

Posttraumatic brain injury patients with depressive symptoms were compared with nondepressed mild and moderate traumatic brain injury (TBI) patients based on their scores on the Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ). A factor analysis demonstrated that the items of the RPCSQ loaded into three factors: mood and cognition, general somatic, and visual somatic symptom groups. Factor scores based on this model were calculated for each group and it was found that depressed subjects reported a greater severity of all three symptom groups compared to nondepressed patients.

The serotonin transporter polymorphisms and major depression following traumatic brain injury.

Objective: The purpose of this study was to examine the role of the serotonin transporter gene polymorphisms on the risk of major depression following traumatic brain injury (TBI).

Methods: Seventy-five patients who had sustained a TBI and who met the Diagnostic and Statistical Manual of Mental Disorders (4th ed) (DSM-IV) criteria for mood disorder due to TBI were compared to 99 controls with TBI but no mood disorder. The severity of depression was rated using the Hamilton Depression Rating Scale (HAMD) for the depressed patients.

Randomized treatment trial in mild traumatic brain injury.

Objective: To determine whether multidisciplinary treatment of mild traumatic brain injury (MTBI) improves neurobehavioral outcome at 6 months postinjury.

Methods: Subjects with MTBI were randomly assigned to treatment (n=97) or nontreatment (control, n=94) groups. Treated patients were assessed within 1 week of injury and thereafter managed by a multidisciplinary team according to clinical need for a further 6 months.

Cognitive impairment associated with major depression following mild and moderate traumatic brain injury.

Traumatic brain injury (TBI) and major depression are neuropsychiatric conditions that have been associated with cognitive dysfunction. The aim of this study was to explore the relationship between major depression and cognitive impairment following mild and moderate TBI. Seventy-four TBI patients were assessed for the presence of major depression using the Structured Clinical Interview for the DSM-IV and completed a neurocognitive assessment battery.

Age and major depression after mild traumatic brain injury.

Objective: The authors investigated the relationship between age and major depression in the acute period following mild traumatic brain injury (TBI).

Methods: Patients with mild TBI (N=210) were assessed for the presence of major depression with the Structured Clinical Interview for DSM-IV.

Results: Older patients (age 60-plus) had lower rates of major depression than younger patients.

The clinical significance of major depression following mild traumatic brain injury.

Objective: The authors assessed the association of major depression with behavioral outcome following mild traumatic brain injury.

Method: Consecutive patients with mild traumatic brain injury (N=170) were assessed for major depression. Those with major depression were compared with those without on self-report measures of psychosocial dysfunction, psychological distress, and postconcussive symptoms in addition to examiner-rated neurobehavioral disturbance.

Posttraumatic amnesia and recall of a traumatic event following traumatic brain injury.

The relationship between posttraumatic amnesia (PTA) and symptoms of posttraumatic stress disorder (PTSD) was examined in 282 outpatients at a mean of 53 days after traumatic brain injury (TBI). Patients were assessed for TBI severity, intrusive and avoidant PTSD-type symptoms, and psychological distress, and were stratified into four comparison groups by duration of PTA. Levels of PTSD-type symptoms and psychological distress did not differ significantly between groups.