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Symptom Frequency and Persistence in the First Year after Traumatic Brain Injury: A TRACK-TBI Study
Abstract
Symptom endorsement after traumatic brain injury (TBI) is common acutely post-injury and is associated with other adverse outcomes. Prevalence of persistent symptoms has been debated, especially in mild TBI (mTBI). A cohort of participants ≥17 years with TBI ( n = 2039), 257 orthopedic trauma controls (OTCs), and 300 friend controls (FCs) were enrolled in the TRACK-TBI study and evaluated at 2 weeks and 3, 6, and 12 months post-injury using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). TBI participants had significantly higher symptom burden than OTCs or FCs at all times, with average scores more than double. TBI cases showed significant decreases in RPQ score between each evaluation ( p < 0.001), decreasing ∼1.7 points per month between 2 weeks and 3 months and 0.2 points per month after that. More than 50% of the TBI sample, including >50% of each of the mild and moderate/severe TBI subsamples, continued to endorse three or more symptoms as worse than pre-injury through 12 months post-injury. A majority of TBI participants who endorsed a symptom at 3 months or later did so at the next evaluation as well. Contrary to reviews that report symptom resolution by 3 months post-injury among those with mTBI, this study of participants treated at level 1 trauma centers and having a computed tomography ordered found that persistent symptoms are common to at least a year after TBI. Additionally, although symptom endorsement was not specific to TBI given that they were also reported by OTC and FC participants, TBI participants endorsed over twice the symptom burden compared with the other groups.
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“These symptoms may persist for years and interfere with academic and social functioning (2–6).”
From Hyperbaric oxygen therapy improves post-concussion symptoms in adults with childhood traumatic brain injury: a retrospective cohort study (2025) · cites this paper as [2]
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Self-citationA Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury
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Cited by
Faulkner, J., Prouty, D., Devlin, L., Appleton, D., Roche, M., Below, K., Moffat, J., Snell, D., Williams, M. N., Barker-Collo, S., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-089727 · Cited by 7
Shabi Shlifer, A., Suzin, G., Shorer, R., Lang, E., Finci, S., Elman-Shina, K., Doenyas-Barak, K., & Efrati, S. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1641033 · Cited by 2
Metadata
- Authors
- Machamer, J., Temkin, N., Dikmen, S., Nelson, L. D., Barber, J., Hwang, P., Boase, K., Stein, M. B., Sun, X., Giacino, J., McCrea, M. A., Taylor, S. R., Jain, S., Manley, G., the TRACK-TBI Investigators, Badjatia, N., Bodien, Y., Diaz-Arrastia, R., Duhaime, A.-C., Feeser, V. R., Ferguson, A. R., Foreman, B., Gaudette, E., Gopinath, S., Korley, F. K., Madden, C., Mukherjee, P., Ngwenya, L. B., Okonkwo, D., Puccio, A., Robertson, C., Rosand, J., Schnyer, D., Vassar, M., Yue, J. K., & Zafonte, R.
- Affiliations
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
- Department of Anatomy and Neurobiology, Boston University, Boston, Massachusetts, USA.
- Department of Psychiatry and Herbert Wertheim School of Public Health, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA.
- Biostatistics Research Center, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA.
- Department of Rehabilitation Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts, USA.
- Department of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
- Brain and Spinal Injury Center, San Francisco, California, USA.
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2022-02-22
- Volume
- 39
- Issue
- 5-6
- Pages
- 358-370
- ISSN
- 0897-7151
- 1557-9042
- Cited by
- 129
- References
- 6
- Language
- en
- Licence
- journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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- Machamer, J., Temkin, N., Dikmen, S., Nelson, L. D., Barber, J., Hwang, P., Boase, K., Stein, M. B., Sun, X., Giacino, J., McCrea, M. A., Taylor, S. R., Jain, S., Manley, G., the TRACK-TBI Investigators, Badjatia, N., Bodien, Y., Diaz-Arrastia, R., Duhaime, A.-C., . . . Zafonte, R. (2022). Symptom Frequency and Persistence in the First Year after Traumatic Brain Injury: A TRACK-TBI Study. Journal of Neurotrauma. https://doi.org/10.1089/neu.2021.0348
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