Network Analysis and Precision Rehabilitation for the Post-concussion Syndrome
Open accessAbstract
Some people experience persistent symptoms following a mild traumatic brain injury (MTBI), and the etiology of those symptoms has been debated for generations. Post-concussion-like symptoms are caused by many factors both before and after MTBI, and this non-specificity is the bedrock of the conundrum regarding the existence of the post-concussion syndrome. A latent model or common cause theory for the syndrome is inconsistent with the prevailing biopsychosocial conceptualization. It is the thesis of this paper that adopting a network perspective for persistent symptoms following MTBI, including the post-concussion syndrome, could lead to new insights and targeted treatment and rehabilitation strategies. The network perspective posits that symptoms co-occur because they are strongly inter-related, activating, amplifying, and mutually reinforcing, not because they arise from a common latent disease entity. This approach requires a conceptual shift away from thinking that symptoms reflect an underlying disease or disorder toward viewing inter-related symptoms as constituting the syndrome or disorder. The symptoms do not arise from an underlying syndrome-the symptoms are the syndrome. A network analysis approach allows us to embrace heterogeneity and comorbidity, and it might lead to the identification of new approaches to sequenced care. The promise of precision rehabilitation requires us to better understand the interconnections among symptoms and problems so that we can produce more individualized and effective treatment and rehabilitation.
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PPCS have a biopsychosocial conceptualisation.
“it has been argued that PPCS have a biopsychosocial conceptualisation.”
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- Authors
- Iverson, G. L.
- Affiliations
- Harvard University (US)
- Corresponding author
- Iverson, Grant L.
- ORCID
- Iverson, Grant L.
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2019-05-29
- Volume
- 10
- Pages
- 489-489
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC6548833
- OpenAlex
- W2947325756
- Cited by
- 121
- References
- 165
- Citations by year
- 2026: 20 · 2025: 9 · 2024: 10 · 2023: 19 · 2022: 25 · 2021: 18 · 2020: 17 · 2019: 2 · 2018: 1
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Spaulding Research Institute
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- post-concussion syndrome, mild traumatic brain injury, symptom networks, symptom co-occurrence, precision rehabilitation, biopsychosocial model, symptom heterogeneity, comorbidities, personalized treatment
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