Mild traumatic brain injury and neural recovery: Rethinking the debate

Issue title: Assistive Technology for People with Neurological Disability

Guest editors: Tony Gentry

Article type: Research Article

Authors: Ruff, Ronald M.

Affiliations: San Francisco Clinical Neurosciences, 909 Hyde Street, Suite 620, San Francisco, CA 94109, USA. E-mail: ronruff@mindspring.com | Department of Occupational Therapy, Virginia Commonwealth University, P.O. Box 980008, Richmond, VA 23298-0008, USA

Abstract: A debate exists concerning whether a mild traumatic brain injury (MTBI) can cause permanent brain-based residuals. This debate is examined by reviewing meta-analytic studies that found no significant effect sizes between large samples of patients with and without MTBI at three months post-accident. In contrast, research studies with MTBI patients have captured cognitive deficits corroborated by positive neuroimaging, which supports the viewpoint that brain-based postconcussive disorders likely exist in a small minority of individuals. Ongoing hurdles that likely contribute to this debate are identified. This includes the lack of agreed upon definitions; substantial differences exist between the ICD-10 definition for Postconcussion Syndrome and the DSM-IV-TR definition for Postconcussional Disorder. Confining the debate to brain-based versus psychologically-based viewpoints results in a false dichotomy. Instead, a more refined sub-classification of the postconcussive complex is proposed that captures different constellations across the physical, emotional, and cognitive symptoms complex. Moreover, this diagnostic framework attempts to expand discipline-based approaches with a patient-based understanding.

DOI: 10.3233/NRE-2011-0646

Journal: NeuroRehabilitation, vol. 28, no. 3, pp. 167-180, 2011