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RESEARCH ARTICLE
Contents Vol 24(1)

Atypical symptom reporting after mild traumatic brain injury

Karen Sullivan A , Anna Keyter B , Kelly Jones https://orcid.org/0000-0001-5692-653X C , Shanthi Ameratunga D , Nicola Starkey E , Suzanne Barker-Collo F , James Webb G and Alice Theadom C *
+ Author Affiliations
- Author Affiliations

A School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia

B Auckland University of Technology, Auckland, New Zealand

C National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand

D School of Population Health, University of Auckland, Auckland, New Zealand

E Faculty of Arts and Social Sciences, University of Waikato, Hamilton, New Zealand

F School of Psychology, University of Auckland, Auckland, New Zealand

G Webb Psychology, Auckland, New Zealand

* Correspondence to: Alice.Theadom@aut.ac.nz

Brain Impairment 24(1) 114-123 https://doi.org/10.1017/BrImp.2021.30
Submitted: 19 May 2021  Accepted: 7 November 2021  Published: 13 December 2021

© The Author(s), 2021. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

Abstract

Objective:

Early reporting of atypical symptoms following a mild traumatic brain injury (mTBI) may be an early indicator of poor prognosis. This study aimed to determine the percentage of people reporting atypical symptoms 1-month post-mTBI and explore links to recovery 12 months later in a community-dwelling mTBI sample.

Methods:

Adult participants (>16 years) who had experienced a mTBI were identified from a longitudinal incidence study (BIONIC). At 1-month post-injury, 260 participants completed the Rivermead Post-Concussion Symptoms Questionnaire (typical symptoms) plus four atypical symptom items (hemiplegia, difficulty swallowing, digestion problems and difficulties with fine motor tasks). At 12 months post-injury, 73.9% (n = 193) rated their overall recovery on a 100-point scale. An ordinal regression explored the association between atypical symptoms at 1 month and recovery at 12 months post-injury (low = 0–80, moderate = 81–99 and complete recovery = 100), whilst controlling for age, sex, rehabilitation received, ethnicity, mental and physical comorbidities and additional injuries sustained at the time of injury.

Results:

At 1-month post-injury <1% of participants reported hemiplegia, 5.4% difficulty swallowing, 10% digestion problems and 15.4% difficulties with fine motor tasks. The ordinal regression model revealed atypical symptoms were not significant predictors of self-rated recovery at 12 months. Older age at injury and higher typical symptoms at 1 month were independently associated with poorer recovery at 12 months, p < 0.01.

Conclusion:

Atypical symptoms on initial presentation were not linked to global self-reported recovery at 12 months. Age at injury and typical symptoms are stronger early indicators of longer-term prognosis. Further research is needed to determine if atypical symptoms predict other outcomes following mTBI.

Keywords: Symptoms, predictors, mild traumatic brain injury, concussion, outcome.

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