Loss of consciousness and altered mental state predicting depressive and post-concussive symptoms after mild traumatic brain injury

Durga Roy, Matthew Peters, Allen D Everett, Jeannie-Marie S Leoutsakos, Haijuan Yan, Vani A Rao, Kathleen Bechtold Kortte, Haris Sair, Timothy E. Van Meter, Hayley Falk, Alexandra Vassila, Anna Hall, Uju Ofoche, Freshta Akbari, Constantine G Lyketsos, Frederick Korley

Research output: Contribution to journalArticle

Abstract

Objective: Limited studies exist on the association between loss of consciousness (LOC) and altered mental state (AMS) and development of depressive and post-concussive symptoms within six months after mild traumatic brain injury (mTBI). We tested the hypothesis that presence of both LOC and AMS predict the highest risk of symptoms within the first six months post-mTBI compared to either variable alone, and that LOC alone is more strongly associated with these symptoms. Research design: We analyzed data from 407 subjects with mTBI from the Head injury Serum Markers for Assessing Response to Trauma (HeadSMART) cohort, a prospective cohort of patients post-TBI presenting to two urban emergency departments. Results: There were higher rates of depressive (44%) and post-concussive symptoms (54%) at 1 month post-injury, among participants with both LOC and AMS compared to other groups. AMS was associated with depressive symptoms at one and six months (OR = 1.59, p =.038; OR = 1.60; p =.060) and post-concussive symptoms at one month (OR = 1.56, p =.053). LOC was associated only with post-concussive symptoms at one month (OR = 1.55;p =.048). Among those without LOC, AMS was associated with depressive symptoms at one month (OR = 2.24; p =.028). Conclusions: AMS predicts post-mTBI depressive symptoms both in the acute and chronic mTBI phases whereas LOC is a more sensitive predictor of post-concussive symptoms in the acute mTBI period.

Original languageEnglish (US)
JournalBrain Injury
DOIs
StatePublished - Jan 1 2019

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Post-Concussion Syndrome
Brain Concussion
Unconsciousness
Depression
Wounds and Injuries
Craniocerebral Trauma
Hospital Emergency Service
Research Design
Biomarkers

Keywords

  • neuropsychiatric
  • prediction
  • Traumatic brain injury

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology

Cite this

@article{f00d4c07117b42c5ab570a8b8780d7aa,
title = "Loss of consciousness and altered mental state predicting depressive and post-concussive symptoms after mild traumatic brain injury",
abstract = "Objective: Limited studies exist on the association between loss of consciousness (LOC) and altered mental state (AMS) and development of depressive and post-concussive symptoms within six months after mild traumatic brain injury (mTBI). We tested the hypothesis that presence of both LOC and AMS predict the highest risk of symptoms within the first six months post-mTBI compared to either variable alone, and that LOC alone is more strongly associated with these symptoms. Research design: We analyzed data from 407 subjects with mTBI from the Head injury Serum Markers for Assessing Response to Trauma (HeadSMART) cohort, a prospective cohort of patients post-TBI presenting to two urban emergency departments. Results: There were higher rates of depressive (44{\%}) and post-concussive symptoms (54{\%}) at 1 month post-injury, among participants with both LOC and AMS compared to other groups. AMS was associated with depressive symptoms at one and six months (OR = 1.59, p =.038; OR = 1.60; p =.060) and post-concussive symptoms at one month (OR = 1.56, p =.053). LOC was associated only with post-concussive symptoms at one month (OR = 1.55;p =.048). Among those without LOC, AMS was associated with depressive symptoms at one month (OR = 2.24; p =.028). Conclusions: AMS predicts post-mTBI depressive symptoms both in the acute and chronic mTBI phases whereas LOC is a more sensitive predictor of post-concussive symptoms in the acute mTBI period.",
keywords = "neuropsychiatric, prediction, Traumatic brain injury",
author = "Durga Roy and Matthew Peters and Everett, {Allen D} and Leoutsakos, {Jeannie-Marie S} and Haijuan Yan and Rao, {Vani A} and Kortte, {Kathleen Bechtold} and Haris Sair and {Van Meter}, {Timothy E.} and Hayley Falk and Alexandra Vassila and Anna Hall and Uju Ofoche and Freshta Akbari and Lyketsos, {Constantine G} and Frederick Korley",
year = "2019",
month = "1",
day = "1",
doi = "10.1080/02699052.2019.1606447",
language = "English (US)",
journal = "Brain Injury",
issn = "0269-9052",
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TY - JOUR

T1 - Loss of consciousness and altered mental state predicting depressive and post-concussive symptoms after mild traumatic brain injury

AU - Roy, Durga

AU - Peters, Matthew

AU - Everett, Allen D

AU - Leoutsakos, Jeannie-Marie S

AU - Yan, Haijuan

AU - Rao, Vani A

AU - Kortte, Kathleen Bechtold

AU - Sair, Haris

AU - Van Meter, Timothy E.

AU - Falk, Hayley

AU - Vassila, Alexandra

AU - Hall, Anna

AU - Ofoche, Uju

AU - Akbari, Freshta

AU - Lyketsos, Constantine G

AU - Korley, Frederick

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Limited studies exist on the association between loss of consciousness (LOC) and altered mental state (AMS) and development of depressive and post-concussive symptoms within six months after mild traumatic brain injury (mTBI). We tested the hypothesis that presence of both LOC and AMS predict the highest risk of symptoms within the first six months post-mTBI compared to either variable alone, and that LOC alone is more strongly associated with these symptoms. Research design: We analyzed data from 407 subjects with mTBI from the Head injury Serum Markers for Assessing Response to Trauma (HeadSMART) cohort, a prospective cohort of patients post-TBI presenting to two urban emergency departments. Results: There were higher rates of depressive (44%) and post-concussive symptoms (54%) at 1 month post-injury, among participants with both LOC and AMS compared to other groups. AMS was associated with depressive symptoms at one and six months (OR = 1.59, p =.038; OR = 1.60; p =.060) and post-concussive symptoms at one month (OR = 1.56, p =.053). LOC was associated only with post-concussive symptoms at one month (OR = 1.55;p =.048). Among those without LOC, AMS was associated with depressive symptoms at one month (OR = 2.24; p =.028). Conclusions: AMS predicts post-mTBI depressive symptoms both in the acute and chronic mTBI phases whereas LOC is a more sensitive predictor of post-concussive symptoms in the acute mTBI period.

AB - Objective: Limited studies exist on the association between loss of consciousness (LOC) and altered mental state (AMS) and development of depressive and post-concussive symptoms within six months after mild traumatic brain injury (mTBI). We tested the hypothesis that presence of both LOC and AMS predict the highest risk of symptoms within the first six months post-mTBI compared to either variable alone, and that LOC alone is more strongly associated with these symptoms. Research design: We analyzed data from 407 subjects with mTBI from the Head injury Serum Markers for Assessing Response to Trauma (HeadSMART) cohort, a prospective cohort of patients post-TBI presenting to two urban emergency departments. Results: There were higher rates of depressive (44%) and post-concussive symptoms (54%) at 1 month post-injury, among participants with both LOC and AMS compared to other groups. AMS was associated with depressive symptoms at one and six months (OR = 1.59, p =.038; OR = 1.60; p =.060) and post-concussive symptoms at one month (OR = 1.56, p =.053). LOC was associated only with post-concussive symptoms at one month (OR = 1.55;p =.048). Among those without LOC, AMS was associated with depressive symptoms at one month (OR = 2.24; p =.028). Conclusions: AMS predicts post-mTBI depressive symptoms both in the acute and chronic mTBI phases whereas LOC is a more sensitive predictor of post-concussive symptoms in the acute mTBI period.

KW - neuropsychiatric

KW - prediction

KW - Traumatic brain injury

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U2 - 10.1080/02699052.2019.1606447

DO - 10.1080/02699052.2019.1606447

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JF - Brain Injury

SN - 0269-9052

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