Researchers Identify Questions that Improve Concussion Diagnosis

A team of Miller School of Medicine researchers, working with collaborators at other institutions, has published a study regarding symptom identification for mild traumatic brain injury (mTBI), also known as concussion. The research indicates that five symptom clusters — post-traumatic headache/migraine, nausea, emotion/affective, fatigue/malaise and dizziness/mild cognitive impairment — were more prevalent in those who sustained mTBI. In addition, sleep disorders and emotional issues were more common in mTBI patients than in healthy control subjects.

“These findings should allow a simple set of questions about dizziness, headache and cognitive issues to be developed to provide improved diagnostic accuracy,” said Michael Hoffer, M.D., professor and Director of the Vestibular and Balance Program in the Department of Otolaryngology, and co-principal author of the study with Carey Balaban, Ph.D., of the University of Pittsburgh. The study, “Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury,” was published this month in PLOS One.

The research featured a mix of men and women, 18 to 45 years old. The individuals with mTBI were recruited from civilian and military hospitals. The study included 150 subjects, 50 of whom suffered from mTBI.

The tests completed on the mTBI patients and control subjects determined differences in symptoms levels between the two groups. In addition to the symptom clusters, patterns of sleep disorders and emotions were also monitored.

The study found that variations in symptom recognition existed between patients with mTBI and control subjects. In functional and FGA type tests, mTBI patients scored noticeably lower. Additionally, post-traumatic headache/migraine was more prevalent in female mTBI patients, while dizziness/mild cognitive impairment was more prevalent in male mTBI patients.

Because mTBI patients experienced symptoms with far greater severity and frequency than the control group, the Miller School researchers concluded that the five symptom clusters remain an important part of mTBI diagnosis.

While questions about dizziness, headache and cognitive issues should help physicians diagnose mTBI with greater accuracy, Hoffer cautioned that it remains unclear if other symptoms are more important for prognostic information or treatment planning.

The research was conducted as part of the Head Health Challenge grant, which is funded by the National Football League, UnderArmour, Neuro-Kinetics Inc., General Electric and the United States Department of Defense. The Head Health Challenge team consists of Hoffer and the Miller School’s Mikhaylo Szczupak, M.D., postdoctoral research fellow, Constanza Pelusso, M.D., clinical research coordinator, and Sara Murphy, M.P.H., clinical research coordinator. Additional researchers were from Neuro-Kinetics Inc., Madigan Army Medical Center and the University of Pittsburgh.

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