Cited by 393Traumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular DisturbancesLong-Term Effects of COVID-19

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Systematic Review of Multivariable Prognostic Models for Mild Traumatic Brain Injury

Silverberg, Noah D., Gardner, Andrew J., Brubacher, Jeffrey R., Panenka, William J., Li, Jun Jian, Iverson, Grant L.·2015·Journal of Neurotrauma

DOI 10.1089/neu.2014.3600

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Abstract

Prognostic models can guide clinical management and increase statistical power in clinical trials. The availability and adequacy of prognostic models for mild traumatic brain injury (MTBI) is uncertain. The present study aimed to (1) identify and evaluate multivariable prognostic models for MTBI, and (2) determine which pre-, peri-, and early post-injury variables have independent prognostic value in the context of multivariable models. An electronic search of MEDLINE, PsycINFO, PubMed, EMBASE, and CINAHL databases for English-language MTBI cohort studies from 1970–2013 was supplemented by Web of Science citation and hand searching. This search strategy identified 7789 articles after removing duplicates. Of 182 full-text articles reviewed, 26 met eligibility criteria including (1) prospective inception cohort design, (2) prognostic information collected within 1 month post-injury, and (3) 2+variables combined to predict clinical outcome (e.g., post-concussion syndrome) at least 1 month later. Independent reviewers extracted sample characteristics, study design features, clinical outcome variables, predictor selection methods, and prognostic model discrimination, calibration, and cross-validation. These data elements were synthesized qualitatively. The present review found no multivariable prognostic model that adequately predicts individual patient outcomes from MTBI. Suboptimal methodology limits their reproducibility and clinical usefulness. The most robust prognostic factors in the context of multivariable models were pre-injury mental health and early post-injury neuropsychological functioning. Women and adults with early post-injury anxiety also have worse prognoses. Relative to these factors, the severity of MTBI had little long-term prognostic value. Future prognostic studies should consider a broad range of biopsychosocial predictors in large inception cohorts.

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Lingsma H., , Yue J.K., , Mass A., , Steyerberg E.W., , Manley G.T., , Cooper S.R., , Dams-O'Connor K., , Gordon W.A., , Menon D.K., , Mukherjee P., , Okonkwo D.O., , Puccio A.M., , Schnyer D.M., , Valadka A.B., , Vassar M.J., , and Yuh E.L. (2014). Outcome prediction after mild and complicated mild traumatic brain injury: external validation of existing models and identification of new predictors using the TRACK-TBI pilot study. J. Neurotrauma Epub ahead of print.

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Items 201–300 of 391

Action Collaborative on Traumatic Brain Injury Care: Adapted Clinical Practice Guideline
Silverberg, N. D., Lee, K., Mikolić, A., Bayley, M. T., Brody, D. L., Ely, E. W., Giacino, J. T., Halabi, C., Hammond, F. M., Ignacio, D. A., et al. (2025) · Journal of Neurotrauma · doi:10.1177/08977151251378894 · Cited by 7
Self-citation
Traumatic Brain Injury-Related Symptoms Reported by Parents: Clinical, Imaging, and Host Predictors in Children with Impairments in Consciousness Less than 24 Hours
Evans, E. A., Asuzu, D., Cook, N. E., Caruso, P. A., Townsend, E. L., Costine, B. A., Fortes, C., Hotz, G., Duhaime, A., Ramon, D., et al. (2018) · Journal of Neurotrauma · doi:10.1089/neu.2017.5408 · Cited by 6
“Concussion history was not included as a predictor or collapsed into neurobehavioral history because of limited representation of previous head injury in our small sample, and some conflicting evidence regarding the effect of concussion on outcomes after mild TBI.(42,43)”
Influential
The use of rigorous methods was strongly warranted among prognostic prediction models for obstetric care
Tan, J., Qi, Y., Liu, C., Xiong, Y., He, Q., Zhang, G., Chen, M., He, G., Wang, W., Liu, X., et al. (2019) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2019.07.009 · Cited by 7
Medical Care Among Individuals with a Concussion in Ontario: A Population-based Study
Langer, L. K., Bayley, M. T., Levy, C., Munce, S., Lawrence, D. W., Tam, A. K. H., & de Oliveira, C. (2022) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2022.346 · Cited by 7
Early Measures of TBI Severity Poorly Predict Later Individual Impairment in a Rat Fluid Percussion Model
Hetzer, S. M., Casagrande, A., Qu’d, D., Dobrozsi, N., Bohnert, J., Biguma, V., Evanson, N. K., & McGuire, J. L. (2023) · Brain Sciences · doi:10.3390/brainsci13091230 · Cited by 7
“In the case of more mild injuries, such as concussion, attempts to predict chronic outcomes have been largely unsatisfactory [53].”
Background
Moving forward on the road to recovery after concussion: participant experiences of interdisciplinary intervention for persisting post-concussion symptoms
Nguyen, J. V. K., Willmott, C., Ponsford, J., Davies, K., Makdissi, M., Drummond, S. P. A., Reyes, J., Knight, J. M., Peverill, T., Brennan, J. H., et al. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2261374 · Cited by 7
Proteomic discovery of prognostic protein biomarkers for persisting problems after mild traumatic brain injury
Lee, M.-Y., Son, M., Lee, H. H., Kang, M., Yun, S. J., Seo, H. G., Kim, Y., & Oh, B. (2023) · Scientific Reports · doi:10.1038/s41598-023-45965-9 · Cited by 7
Acceptability, usability, and credibility of a mindfulness-based digital therapeutic for pediatric concussion: A mixed-method study
Sicard, V., O'Kane, K. M. K., Brown, O., Butterfield, L., Kardish, R., Choi, E., Healey, K., Silverberg, N. D., Smith, A., Goldfield, G. S., et al. (2024) · Digital Health · doi:10.1177/20552076241248296 · Cited by 8
Self-citation
Chapter 36. Mild Traumatic Brain Injury in Children and Adolescents
Kirkwood, M. W. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js36 · Cited by 7
Predictors of Social Participation Outcome after Traumatic Brain Injury Differ According to Rehabilitation Pathways
Guerrette, M.-C., & McKerral, M. (2022) · Journal of Neurotrauma · doi:10.1089/neu.2022.0232 · Cited by 7
Unraveling the Biopsychosocial Factors of Fatigue and Sleep Problems After Traumatic Brain Injury: Protocol for a Multicenter Longitudinal Cohort Study
Bruijel, J., Stapert, S. Z., Vermeeren, A., Ponsford, J. L., & Heugten, C. M. V. (2018) · JMIR Research Protocols · doi:10.2196/11295 · Cited by 8
“Multiple researchers suggested integrated biopsychosocial approaches for future studies to best explain the outcome of TBI [80-83].”
Identification of patients at risk for poor outcome after mTBI
Lingsma, H. F., & Cnossen, M. C. (2017) · The Lancet Neurology · doi:10.1016/s1474-4422(17)30171-0 · Cited by 7
Four-Year Trajectories of Symptoms and Quality of Life in Individuals Hospitalized After Mild Traumatic Brain Injury
Cairns, K., Beaulieu‐Bonneau, S., Jomphe, V., Lamontagne, M., de Guise, É., Moore, L., Savard, J., Sirois, M., SWAINE, B. R., & Ouellet, M. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.09.005 · Cited by 6
Return to work in persons with persistent postconcussion symptoms: a survey study examining the perspectives of employees and managers
Conradsen, I., Bang-Hansen, V. E., Sørensen, A. N., & Rytter, H. M. (2024) · Brain Injury · doi:10.1080/02699052.2024.2361620 · Cited by 6
Exploratory Analysis of Concussion Recovery Trajectories using Multi-modal Assessments and Serum Biomarkers
Roy, Z., Subhash, S., Bui, L. A., Hadi, B., Hier, D. B., Wunsch, D. C., Olbricht, G. R., & Obafemi-Ajayi, T. (2020) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc44109.2020.9176527 · Cited by 6
“However, despite abundant data, clinicians need better tools to assess severity and make decisions about RTP or RTD from mTBI [8].”
Background
Post-concussion symptoms 1-year after traumatic brain injury: using the Rivermead Post-concussion Questionnaire to identify predictors of severity
Obiano, K. S., Singh, R. K., & Dawson, J. (2022) · Brain Injury · doi:10.1080/02699052.2022.2140195 · Cited by 7
“This is a similar finding to previous studies (41,42).”
Result
The Secondary Impact of Mild Traumatic Brain Injury: An Interpretative Phenomenological Analysis of the Experiences of Family Members
Gamgee, J., Runacres, J., Norman, A., & Pradhan, P. (2023) · The Family Journal · doi:10.1177/10664807231164421 · Cited by 6
“However, imaging evidence (Asken et al., 2018; Khong et al., 2016; Wallace et al., 2018; Yin et al., 2019) suggests a bio-psycho-social approach to mTBI etiology is more appropriate (Aliyah et al., 2018; Cole & Bailie, 2016; Snell et al., 2016; Silverberg et al., 2015).”
Background
Usability evaluation of a self-management mobile application for individuals with a mild traumatic brain injury
Bonn, M. M., Graham, L. J., Marrocco, S. L., Jeske, S., Moran, B., & Wolfe, D. L. (2023) · Digital Health · doi:10.1177/20552076231183555 · Cited by 7
“Additionally, the Third Edition of the Guideline for Concussion/Mild Traumatic Brain Injury & Prolonged Symptoms recommends individualized treatment based on symptoms and physical examination findings.(11,12) Following an acute rest phase (24–48 hours post-injury), ‘activity as tolerated’ (physical and cognitive activ…”
Background
Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
Karvandi, E., Helmy, A. E., Kolias, A. G., Belli, A., Ganau, M., Gomes, C., Grey, M. J., Griffiths, M. J., Griffiths, T. D., Griffiths, P., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-077022 · Cited by 6
Symptom Persistence Relates to Volume and Asymmetry of the Limbic System after Mild Traumatic Brain Injury
Vanier, C. H., Santhanam, P., Rochester, N., Carter, L. B., Lim, M., Kilani, A., Venkatesh, S., Azad, S., Knoblauch, T., Surti, T., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13175154 · Cited by 6
“There are several past and ongoing efforts to understand why symptoms persist after TBI [48–50].”
Background
Attachment and symptom reporting in adolescents and young adults after a concussion
Tuborgh, A. H., Svendsen, S. W., Elklit, A., Hunter, J., Jensen, J. S., Schröder, A., Nielsen, J. F., Thastum, M. M., Næss‐Schmidt, E. T., & Rask, C. U. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2021.110603 · Cited by 6
“Current knowledge does not support a simple relationship between mechanism of injury, degree of concussion-related neuropathology and PCS [12-14].”
Background
Does the cause of the mild traumatic brain injury affect the expectation of persistent postconcussion symptoms and psychological trauma?
Sullivan, K. A., & Wade, C. (2016) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2016.1230597 · Cited by 6
“However, a recent systematic review of these empirical models concluded that none of them was adequate as a multivariable prognostic model of individual mild TBI outcome (Silverberg et al., 2015).”
Background
Common Data Elements for Concussion in Tertiary Care: Phase One in Ontario
Hunt, C., Michalak, A., Ouchterlony, D., Marshall, S., Masanic, C. A., Vaidyanath, C., Bhalerao, S., Cusimano, M. D., Quon, D., Fischer, L. K., et al. (2017) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2017.222 · Cited by 6
Chapter 17. Mood and Anxiety Disorders
Hart, T., Rabinowitz, A. R., & Fann, J. R. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js17 · Cited by 6
Chapter 39. Neuropsychiatric Sequelae of Traumatic Brain Injury in Children and Adolescents
Max, J. E. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js39 · Cited by 6
Factors Associated with Persisting Post-Concussion Symptoms Among Collegiate Athletes and Military Cadets: Findings from the NCAA-DoD CARE Consortium
Rooks, L. T., Bertò, G., Pasquina, P. F., Broglio, S. P., McAllister, T. W., McCrea, M., Pestilli, F., & Port, N. (2025) · Sports Medicine · doi:10.1007/s40279-024-02168-0 · Cited by 5
“As pointed out by Silverberg and colleagues [47], a good SRC model will need to be confirmed in a separate multicenter study.”
Influential
Prediction of Mental Health Complications Following Mild Traumatic Brain Injury
Shi, S., Mikolić, A., LeMoult, J., Rights, J. D., Panenka, W. J., & Silverberg, N. D. (2025) · Journal of Neurotrauma · doi:10.1089/neu.2024.0505 · Cited by 6
“We considered candidate predictors associated with persistent PCS and/or global disability after mTBI 13 – 15 and predictors of mental health disorders after mild TBI 1,4,10 – 12 and in all-severity TBI.”
Self-citation
Factors related to adverse long-term outcomes after mild traumatic brain injury in children: a scoping review
Ijaz, S., Scott, L. J., Dawson, S., Wilson, R. J., Jackson, J., Birnie, K., Redaniel, M. T., Savović, J., Wright, I., Lyttle, M. D., et al. (2023) · Archives of Disease in Childhood · doi:10.1136/archdischild-2022-325202 · Cited by 6
Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario
Scott, O. F. T., Bubna, M., Boyko, E., Hunt, C., Kristman, V. L., Gargaro, J., Khodadadi, M., Chandra, T., Kabir, U. S., Kenrick-Rochon, S., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-44095-6 · Cited by 5
Athlete Fear Avoidance, Depression, and Anxiety Are Associated with Acute Concussion Symptoms in Athletes
Patlan, I., Gamelin, G., Khalaj, K., Castonguay, T., & Dover, G. C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13082401 · Cited by 5
Diffusion tensor analysis of white matter tracts is prognostic of persisting post-concussion symptoms in collegiate athletes
Bertò, G., Rooks, L. T., Broglio, S. P., McAllister, T. W., McCrea, M., Pasquina, P. F., Giza, C. C., Brooks, A. S., Mihalik, J. P., Guskiewicz, K. M., et al. (2024) · NeuroImage Clinical · doi:10.1016/j.nicl.2024.103646 · Cited by 5
“In 2015, Silverberg and colleagues (Silverberg et al., 2015) published a systematic review outlining the lack of multiple clinical variable prognostic models for predicting PPCS.”
Background
Chapter 37. Multidisciplinary Assessment and Treatment
Haider, M. Z., Willer, B. S., Leddy, J. J., & Ellis, M. J. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js37 · Cited by 5
Severity of Ongoing Post-Concussive Symptoms as a Predictor of Cognitive Performance Following a Pediatric Mild Traumatic Brain Injury
Sicard, V., Hergert, D. C., Reddy, S. P., Robertson‐Benta, C. R., Dodd, A. B., Shaff, N. A., Stephenson, D. D., Yeates, K. O., Cromer, J. A., Campbell, R. A., et al. (2020) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617720001228 · Cited by 5
“Third, the current sample excluded children with premorbid psychological conditions, such as depression and anxiety, which have been consistently shown as a predictor of worse outcomes in adults (Silverberg et al., 2015; Waljas et al., 2015).”
Background
Predictors of disability in adolescents and young adults with acquired brain injury after the acute phase
Worm, M. S., Valentin, J. B., Johnsen, S. P., Nielsen, J. F., Forchhammer, B. H., & Svendsen, S. W. (2021) · Brain Injury · doi:10.1080/02699052.2021.1927183 · Cited by 5
“In patients with mild TBI, pre-injury poor mental health and early postinjury cognitive impairment have been identified as strong predictors of disability (9,10).”
BackgroundInfluential
Linking Rivermead Post Concussion Symptoms Questionnaire (RPQ) and Sport Concussion Assessment Tool (SCAT) scores with item response theory
Simons, M. U., Nelson, L. D., McCrea, M., Balsis, S. M., Hoelzle, J. B., & Magnus, B. E. (2022) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617722000807 · Cited by 5
“TBI symptoms measured soon after injury are robust predictors of later clinical outcomes (Mikolić et al., 2021; Silverberg et al., 2015) and, in the large mTBI population, are more prevalent and persisting than other TBI sequelae (e.”
Background
Mild Traumatic Brain Injury
Iverson, G. L., SILVERBERG, N. D., & Zasler, N. D. (2021) · Springer eBooks · doi:10.1007/978-3-032-07777-6_24 · Cited by 6
Self-citation
Psychological flexibility in mild traumatic brain injury: an evaluation of measures
Faulkner, J. W., Snell, D. L., Theadom, A., Mahon, S., Barker-Collo, S., & Skirrow, P. (2021) · Brain Injury · doi:10.1080/02699052.2021.1959062 · Cited by 4
Acceptability, Usability, and Credibility of a Mindfulness-Based Digital Therapeutic for Pediatric Concussion: A Mixed-Method Study (Preprint)
Sicard, V., O'Kane, K., Brown, O., Butterfield, L., Kardish, R., Choi, E., Healey, K., Silverberg, N. D., Smith, A., Goldfield, G., et al. (2022) · doi:10.2196/preprints.44757 · Cited by 4
Self-citation
Barriers to Care After Intimate Partner Violence Acquired Brain Injury: Current Systems Silence Survivors and Providers
Tsu, L., Varty, M., Reinken, D. N., & Coats, H. (2024) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0000000000001003 · Cited by 4
“45 48 It is possible that BI magnifies these issues for survivors, but more research is needed to explore this further.”
Experience of Acceptance and Commitment Therapy for those with mild traumatic brain injury (ACTion mTBI): A qualitative descriptive study
Faulkner, J. W., Chua, J., Voice-Powell, A., Snell, D., Roche, M., Moffat, J., Barker-Collo, S., & Theadom, A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0312940 · Cited by 6
The relationship between personality traits and health-related quality of life after mild-to-moderate traumatic brain injury
Madsen, B. Å., Fure, S. C. R., Røe, C., Løke, D., Løvstad, M., Anđelić, N., & Howe, E. I. (2025) · BMC Neurology · doi:10.1186/s12883-025-04153-0 · Cited by 5
“Hence, it is important to gain further insight into non-injury factors predicting mTBI recovery, such as psychological characteristics [10].”
Contribution of Peripheral Injuries to the Symptom Experience of Patients with Mild Traumatic Brain Injury
Bryant, A. M., McCrea, M., & Nelson, L. D. (2021) · Neurotrauma Reports · doi:10.1089/neur.2021.0012 · Cited by 4
“cal signs and symptoms of mTBI, and demographic and medical history variables predominating such investigations.(11,12) A number of factors contribute to poor understanding of the potential additive or interactive”
Background
Graded Exposure Therapy for Fear Avoidance Behaviour After Concussion (GET FAB): protocol for a multisite Canadian randomised controlled trial
Mikolić, A., Klotz, T., Brasher, P. M. A., Yeates, K. O., Vranceanu, A., Kendall, K. D., Snell, D. L., Debert, C. T., Bayley, M. T., Panenka, W. J., et al. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-086602 · Cited by 6
Self-citation
Predicting Recovery After Concussion in Pediatric Patients: A Meta-Analysis
Wyrwa, J. M., Hoffberg, A. S., Stearns‐Yoder, K. A., Lantagne, A., Kinney, A. R., Reis, D. J., & Brenner, L. A. (2024) · PEDIATRICS · doi:10.1542/peds.2023-065431 · Cited by 4
Preliminary Feasibility of a Novel Mind-Body Program to Prevent Persistent Concussion Symptoms Among Young Adults With Anxiety: Nonrandomized Open Pilot Study
Becker, M. E., Levey, N., Yeh, G. Y., Giacino, J. T., Iverson, G. L., Silverberg, N. D., Parker, R. A., McKinnon, E., Siravo, C., Shah, P., et al. (2024) · JMIR Formative Research · doi:10.2196/64540 · Cited by 4
“Psychological factors play a key role in recovery from concussion [3-8].”
Self-citation
Outcomes after Traumatic Brain Injury with and Without Computed Tomography
Mikolić, A., Shi, S., Panenka, W. J., Brubacher, J. R., Scheuermeyer, F. X., Nelson, L. D., & Silverberg, N. D. (2024) · Journal of Neurotrauma · doi:10.1089/neu.2024.0332 · Cited by 5
“5,7,23,40,41 Moreover, higher levels of functioning (higher GOSE) seem to be strongly determined by mental health.”
Self-citation
Postconcussive Syndrome (PCS)
Walker, W. C., & Lacey, R. W. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-65384-8.00004-3 · Cited by 4
Supportive Elements and Challenges to Return to Work Following a Concussion: A Scoping Review
Shahzad, M., Lo, J., Yuen, B., Duncan, A., Reed, N. P., & Nowrouzi‐Kia, B. (2025) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0000000000001064 · Cited by 4
Progress in Concussion/Traumatic Brain Injury Science and Clinical Care Over the Last 40 Years.
Silverberg, N., & Leddy, J. J. (2025) · The journal of head trauma rehabilitation · doi:10.1097/htr.0000000000001102 · Cited by 3
Self-citation
Valued living after mild traumatic brain injury: Characteristics and relationship with outcomes
Faulkner, J. W., Whiting, D. L., Theadom, A., Snell, D. L., Roche, M., & Barker-Collo, S. L. (2024) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2024.2328876 · Cited by 3
“A pre-injury mental health history is a robust predictor of mTBI outcomes (Silverberg et al., 2015).”
Concussion in Women's Flat-Track Roller Derby
Stockbridge, M. D., Keser, Z., & Newman, R. S. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.809939 · Cited by 3
Chapter 22. Psychotic Disorders
Gurin, L. J., & Arciniegas, D. B. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js22 · Cited by 3
Why psychological factors are still being sidelined in sport-related concussion treatment and what we can do about it
Jochimsen, K. N., Caron, J. G., Vranceanu, A., & Greenberg, J. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108090 · Cited by 6
Psychological Transdiagnostic Processes in Mild Traumatic Brain Injury Recovery: A Scoping Review
Courchesne, C., Nair, M. A., Gelineau, M., McCloskey, L., Faulkner, J. W., & Cairncross, M. (2025) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2025.07.014 · Cited by 3
The prognostic value of a screening tool for psychological risk factors after mild traumatic brain injury: prospective studies in Canada and New Zealand
Mikolić, A., Snell, D. L., Theadom, A., Faulkner, J. W., Zemek, R. L., & Silverberg, N. D. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-089471 · Cited by 3
Self-citation
“Tertiary Precision Prevention” for Concussion: Customizing Care by Predicting Outcomes
Zonfrillo, M. R. (2016) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.04.079 · Cited by 3
Chapter 48. Principles of Pharmacotherapy
Silver, J. M. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js48 · Cited by 3
Chapter 32. Overview of Mild Brain Injury
McAllister, T. W. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js32 · Cited by 3
The Toronto Concussion Study: Sense of smell is not associated with concussion severity or recovery
Foster, E., Bayley, M. T., Langer, L. K., Saverino, C., Chandra, T., Barnard, C., & Comper, P. (2022) · Brain Injury · doi:10.1080/02699052.2022.2037713 · Cited by 3
Management of Concussion and Persistent Post-concussion Symptoms
Marshall, S., & van Ierssel, J. J. (2022) · Springer eBooks · doi:10.1007/978-3-030-93813-0_8 · Cited by 3
Chapter 18. Emotional Dyscontrol
Arciniegas, D. B., & Wortzel, H. S. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js18 · Cited by 3
Chapter 14. Social Cognition
Neumann, D. M., Zupan, B., & Eberle, R. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js14 · Cited by 3
A-23 Mental Health Outcomes of Elite Athletes Following Sport Related Concussion
Hoyle, C., Mrázik, M., & Naidu, D. J. (2020) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acaa036.23 · Cited by 3
Outcomes of a brief coping skills group intervention for adults with severe postconcussion symptoms
Ali, J. I., Mahoney, P., Dance, D. L., & Silverberg, N. D. (2019) · Concussion · doi:10.2217/cnc-2019-0011 · Cited by 2
Self-citation
Assessment and Management of Persistent Post-Concussion Symptoms
Pieroth, E. M. (2022) · Operative Techniques in Sports Medicine · doi:10.1016/j.otsm.2022.150894 · Cited by 2
Identifying prioritization criteria for patients with mtbi waiting for multidisciplinary rehabilitation services: A Delphi study
Déry, J., de Guise, É., & Lamontagne, M. (2023) · Brain Injury · doi:10.1080/02699052.2023.2205662 · Cited by 2
“A similar discrepancy can be observed regarding multiple concussions as a prognostic factor in relation to post-concussion outcomes: some systematic reviews stated a positive association (61,62), while others presented mixed findings regarding this association (21,24,25,28).”
BackgroundResultInfluential
External Validation of the Post-Concussion Symptoms Rule for Predicting Mild Traumatic Brain Injury Outcome
Mikolić, A., Brasher, P. M. A., Brubacher, J. R., Panenka, W. J., Scheuermeyer, F. X., Archambault, P. M., Khazei, A., & Silverberg, N. D. (2024) · Journal of Neurotrauma · doi:10.1089/neu.2023.0484 · Cited by 2
Self-citation
Rehabilitation of Persistent Symptoms After Concussion
Lujan, A., & Lin, K. (2024) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2024.02.006 · Cited by 2
The relationship between prognostic factors and patient satisfaction with performance of self-identified goals following interdisciplinary mild traumatic brain injury rehabilitation
Bonn, M. M., Dickey, J. P., Moran, B., McGuire, S., & Graham, L. J. (2024) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2024.2397089 · Cited by 2
“Female sex (Silverberg et al, 2015; Theadom et al, 2016), older age (Lingsma et al, 2015; Theadom et al, 2016), less education (Lingsma et al, 2015), increased number/severity of symptoms, increased days since injury (Hiploylee et al, 2017), and the presence of base-line or post-injury…”
Influential
Feasibility Randomized Controlled Trial of the Toolkit for Optimal Recovery After Concussion: A Live Video Program to Prevent Persistent Concussion Symptoms in Young Adults With Anxiety
Greenberg, J., Levey, N., Becker, M. E., Yeh, G. Y., Giacino, J. T., Iverson, G. L., Silverberg, N. D., Parker, R. A., & Vranceanu, A. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.10.011 · Cited by 2
Self-citation
Exploring Person-Centered Goals in Speech-Language Pathology Services for Mild Traumatic Brain Injury
Wallace, T. D., Pei, Y., Kemp, A. M., Gartell, R., Appleberry, C., Gore, R. K., & O’Brien, K. H. (2025) · American Journal of Speech-Language Pathology · doi:10.1044/2025_ajslp-24-00117 · Cited by 2
Chapter 13. Awareness of Deficits
Sherer, M., & Fleming, J. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js13 · Cited by 2
Chapter 2. Biomechanical Forces Involved in Brain Injury
Rowson, B., Rowson, S., & Duma, S. M. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js02 · Cited by 2
Atypical symptom reporting after mild traumatic brain injury
Sullivan, K. A., Keyter, A., Jones, K., Ameratunga, S. N., Starkey, N. J., Barker-Collo, S. L., Webb, J. W., & Theadom, A. (2021) · Brain Impairment · doi:10.1017/brimp.2021.30 · Cited by 2
Cognitive-Emotional-Vestibular Triad in Mild Traumatic Brain Injury
Banerjee, N., Getz, S. J., & Levin, B. E. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-812344-7.00013-3 · Cited by 3
Chapter 16. Epidemiology and Natural History of Psychiatric Disorders
Ponsford, J. L., Alway, Y., & Gould, K. R. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js16 · Cited by 2
Chapter 47. Environmental and Behavioral Management
Alderman, N., Wood, R. L., & Worthington, A. D. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js47 · Cited by 2
Psychological Assessment and Intervention in Rehabilitation
Soble, J. R., Schulze, E. T., Resch, Z. J., Critchfield, E. A., & O’Rourke, J. J. F. (2020) · Elsevier eBooks · doi:10.1016/b978-0-323-62539-5.00004-7 · Cited by 2
Chapter 21. Behavioral Dyscontrol
Wortzel, H. S., & Silver, J. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js21 · Cited by 2
Chapter 19. Posttraumatic Stress Disorder
Vasterling, J. J., Jacob, S. N., & Rasmusson, A. M. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js19 · Cited by 2
Mixture Model Framework for Traumatic Brain Injury Prognosis Using Heterogeneous Clinical and Outcome Data
Kaplan, A. D., Cheng, Q., Mohan, K. A., Nelson, L. D., Jain, S., Levin, H. S., Espin, A. T., Chou, A., Huie, J. R., Ferguson, A. R., et al. (2021) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2021.3099745 · Cited by 7
“There is evidence to suggest that such regression modeling approaches for outcome prognosis which utilize a curated set of predictor variables are limited in their clinical utility [11].”
Background
Pre-injury psychiatric history, subacute symptoms and personality traits predict social reintegration at 3-month post-mild traumatic brain injury
Gagnon, C., Trépanier, L., Denault, S., Laguë-Beauvais, M., Saluja, R. S., Massad, J., Abouassaly, M., & de Guise, É. (2024) · Brain Injury · doi:10.1080/02699052.2024.2373919 · Cited by 1
“More specifically, in the study by Silverberg et al. (56), the best prognostic factors of outcome in the context of multivariate models were pre-injury mental health and early post-injury neuropsychological functioning, which is fully supported by the results of the present study.”
Metacognitive Therapy for People Experiencing Persistent Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Preliminary Multiple Case-Series Study
Rauwenhoff, J. C. C., Hagen, R., Karaliute, M., Hjemdal, O., Kennair, L. E. O., Solem, S., Asarnow, R. F., Einarsen, C. E., Halvorsen, J. Ø., Paoli, S., et al. (2024) · Neurotrauma Reports · doi:10.1089/neur.2024.0076 · Cited by 3
“5 11 There is a growing interest in researching psychological interventions for PPCS with cognitive training, psycho-education, cognitive behavioral therapy, third-wave therapies, and graded return to activity showing possible positive effectiveness.”
Relationship between language comprehension and chronic neurobehavioral symptoms in adults with mild traumatic brain injury
Flaugher, T., Chang, S., Reistetter, T., & Norman, R. S. (2024) · Brain Injury · doi:10.1080/02699052.2024.2445700 · Cited by 3
“These results suggest that those with fewer years of education perceive more symptoms, which is consistent with studies showing lower education is associated with more symptoms (56).”
Acute diffuse axonal injury following repeated mild traumatic brain injury in juvenile rats
McDonagh, E., Eyolfson, E., Brand, J., Shultz, S. R., & Christie, B. R. (2025) · Journal of Neurophysiology · doi:10.1152/jn.00482.2024 · Cited by 2
Longitudinal Multimodal Neuroimaging After Traumatic Brain Injury
Radanovic, A., Jamison, K. W., Kang, Y., Tozlu, C., Shah, S. A., & Kuceyeski, A. F. (2026) · Human Brain Mapping · doi:10.1002/hbm.70534 · Cited by 1
“Prognostic models are generally lacking in sensitivity (Silverberg et al. 2015; Rausa et al. 2020) or specificity (Le Sage et al. 2022) and there are currently few effective therapeutic interventions (Warden et al. 2006; Pink et al. 2021; Stein 2015).”
The relationship between cognitive reserve, cognitive performance, and outcomes of return to work and life satisfaction after brain injury: a retrospective cohort study
Ekdahl, N., Lannsjö, M., Stålnacke, B., & Möller, M. C. (2025) · Disability and Rehabilitation · doi:10.1080/09638288.2025.2517240 · Cited by 1
“…been found to be significantly lower after an acquired brain injury compared to the general population [6]. earlier studies have found that the long-term outcomes following both tBi and stroke are influenced by a complex combination of pre-injury, injury-related, and post-injury factors [7,8].”
Influential
Post-Concussion Symptoms in Older Adults Following a Mild Traumatic Brain Injury
Massé-Pelletier, M., Boucher, V., Sage, N. L., Neveu, X., Moore, L., Émond, M., & Mercier, É. (2025) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0000000000001077 · Cited by 1
Waiting time for specialized interdisciplinary rehabilitation associated with persistent symptoms of mild traumatic brain injury: an observational cohort study
Déry, J., Potvin, I., de Guise, É., & Lamontagne, M. (2025) · Brain Injury · doi:10.1080/02699052.2025.2530083 · Cited by 1
“Persistent symptoms can also be exacerbated when specific symptoms are present, such as somatic complaints (21,26), anxiety, depression (21,27) and post-traumatic stress disorder (19,28).”
Responsivity of Concussion Symptom Domains to a Mind-Body Intervention for Young Adults With a Recent Concussion and Anxiety: A Pilot RCT
Lovette, B. C., Bakhshaie, J., Vranceanu, A., & Greenberg, J. (2025) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0000000000001101 · Cited by 1
Preliminary validation of a 10-item version of the Depression, Anxiety and Stress Scale in a mild traumatic brain injury sample
Snell, D. L., Faulkner, J. W., & Siegert, R. J. (2025) · Brain Impairment · doi:10.1071/ib25025 · Cited by 1
Behavioral Deficits and Cortical Network Dysfunction Following Repeated Mild Traumatic Brain Injuries
Pinkowski, N. J., Hess, B. R., Pacheco, J. M., Hatcher, D. S., McDonald, M. K., Swindle, A., Laboy-Ramirez, R., Situ, M., Abdeljawad, T. F., Mehos, C. J., et al. (2026) · Journal of Neurotrauma · doi:10.1177/08977151261425217 · Cited by 1
Prognosis, Outcome Measures, and Prevention
Gardner, A. J., Adamova, E. V., & ZAFONTE, R. D. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-54456-6.00016-5 · Cited by 1
Self-citation
Chapter 45. Psychological Adjustment to the Effects of Moderate to Severe Traumatic Brain Injury
Prigatano, G. P. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js45 · Cited by 1
Predicting outcomes 3 months after traumatic brain injury in patients admitted to emergency department
Bolvardi, E., Ahmadzadeh, M., Disfani, H. F., Rezaeitalab, F., Ravanshad, Y., & Foroughian, M. (2019) · Universa Medicina · doi:10.18051/univmed.2019.v38.147-155 · Cited by 1
“associated with 5% higher chance of postconcussion syndrome and 2% higher chance of a GCS of less than 7.((10,18,19)) Both quantitative and qualitative analyses”
BackgroundResult
MENINJAU KEMBALI GLASGOW COMA SCALE: MASIHKAH RELEVAN?
Mawuntu, A. H. P. (2019) · Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia · doi:10.52386/neurona.v36i3.80 · Cited by 1
Involvement in litigation in children with PTSD following motor vehicle accident: Associations with emotional distress and treatment outcomes
Shorer, M., Fennig, S., Apter, A. S., & Peleg, T. P. (2021) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2021.101711 · Cited by 1
An Experimental Study of the Effects of Biased Responding on the Modified Rivermead Post-concussion Symptoms Questionnaire and Validity Indicators
Sullivan, K. A., & Bennett, D. (2021) · Psychological Injury and Law · doi:10.1007/s12207-021-09419-9 · Cited by 1
Chapter 41. Substance Use Disorders
Lemsky, C. M., & Bogner, J. A. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js41 · Cited by 1
Chapter 4. Neuropsychiatric Assessment
Arciniegas, D. B., McAllister, T. W., & Silver, J. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372645.js04 · Cited by 1

Authors: Silverberg, N. D., Gardner, A. J., Brubacher, J. R., Panenka, W. J., Li, J. J., & Iverson, G. L.
Affiliations: University of British Columbia (CA)
University of Newcastle Australia (AU)
Simon Fraser University (CA)
Harvard University (US)
Corresponding author: Silverberg, Noah D.
ORCID: Silverberg, Noah D.
Gardner, Andrew J.
Brubacher, Jeffrey R.
Panenka, William J.
Iverson, Grant L.
Venue: Journal of Neurotrauma
Publisher: SAGE Publications
Published: 2015-04
Volume: 32
Issue: 8
Pages: 517-526
ISSN: 0897-7151 (ISSN-L)
1557-9042
DOI: 10.1089/neu.2014.3600
OpenAlex: W1974797523
Cited by: 393
References: 70
Citations by year: 2026: 11 · 2025: 32 · 2024: 38 · 2023: 33 · 2022: 41 · 2021: 44 · 2020: 33 · 2019: 37 · 2018: 73 · 2017: 29 · 2016: 12 · 2015: 10
FWCI: 2.27
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of Neurotrauma (publishedVersion)
PubMed (publishedVersion)
NOVA (University of Newcastle Australia) (submittedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Keywords: mild traumatic brain injury, concussion, prognostic model, post-concussion syndrome, prognostic factors, neuropsychological performance, injury severity, discrimination and calibration
MeSH terms: Brain Injuries, Humans, Models, Neurological, Prognosis

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Systematic Review of Multivariable Prognostic Models for Mild Traumatic Brain Injury

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