A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury
Open accessAbstract
Mild traumatic brain injury (mTBI) presents a substantial burden to patients, families, and health care systems. Whereas, recovery can be expected in the majority of patients, a subset continues to report persisting somatic, cognitive, emotional, and/or behavioral problems, generally referred to as post-concussion syndrome (PCS). However, this term has been the subject of debate since the mechanisms underlying post-concussion symptoms and the role of pre- and post-injury-related factors are still poorly understood. We review current evidence and controversies concerning the use of the terms post-concussion symptoms vs. syndrome, its diagnosis, etiology, prevalence, assessment, and treatment in both adults and children. Prevalence rates of post-concussion symptoms vary between 11 and 82%, depending on diagnostic criteria, population and timing of assessment. Post-concussion symptoms are dependent on complex interactions between somatic, psychological, and social factors. Progress in understanding has been hampered by inconsistent classification and variable assessment procedures. There are substantial limitations in research to date, resulting in gaps in our understanding, leading to uncertainty regarding epidemiology, etiology, prognosis, and treatment. Future directions including the identification of potential mechanisms, new imaging techniques, comprehensive, multidisciplinary assessment and treatment options are discussed. Treatment of post-concussion symptoms is highly variable, and primarily directed at symptom relief, rather than at modifying the underlying pathology. Longitudinal studies applying standardized assessment strategies, diagnoses, and evidence-based interventions are required in adult and pediatric mTBI populations to optimize recovery and reduce the substantial socio-economic burden of post-concussion symptoms.
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PPCS have a biopsychosocial conceptualisation.
“it has been argued that PPCS have a biopsychosocial conceptualisation.”
From Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study (2025) · cites this paper as [15]
mTBI, especially when experienced repetitively, is linked to several broad symptoms involving mood, behavior, and cognitive changes.
“mTBI, especially when experienced repetitively [52], is linked to several symptoms which are broad in nature, involving mood, behavior, and cognitive changes [126, 140].”
From DNA repair deficiency and senescence in concussed professional athletes involved in contact sports (2019) · cites this paper as [126]
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Mental Health Consequences of Traumatic Brain Injury
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- Authors
- Polinder, S., Cnossen, M. C., Real, R. G. L., Covic, A., Gorbunova, A., Voormolen, D. C., Master, C. L., Haagsma, J. A., Diaz-Arrastia, R., & von Steinbuechel, N.
- Affiliations
- Erasmus MC (NL)
- University of Göttingen (DE)
- University of Pennsylvania (US)
- Corresponding author
- Polinder, Suzanne
- ORCID
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2018-12-19
- Volume
- 9
- Pages
- 1113-1113
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC6306025
- OpenAlex
- W2905320148
- Cited by
- 376
- References
- 122
- Citations by year
- 2026: 32 · 2025: 46 · 2024: 49 · 2023: 65 · 2022: 66 · 2021: 46 · 2020: 52 · 2019: 19 · 2017: 1
- FWCI
- 4.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- Funders
- European Commission (602150, 2007–2013, FP7 2007-2013, FP7/2007)
- National Institute of Neurological Disorders and Stroke (U01NS086090)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- post-concussion syndrome, mild traumatic brain injury, post-concussion symptoms, prevalence, etiology, diagnosis, symptom assessment, treatment, pediatric concussion, somatic symptoms, prognosis, multidisciplinary assessment
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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