Abstract
Traumatic brain injury of any severity can result in post-concussion syndrome (PCS). Although the post-concussive symptoms are complex, there is an emerging scientific consensus regarding the initiation of the treatment for these symptoms to improve quality of life and prevent long-term effects. The objective of this systematic review is to assess the comprehensive interventions used for the PCS and it aims to appraise if these interventions could prevent the development of depression as a complication. This research has used randomized controlled trials (RCTs) that evaluate the treatment of PCS and its effect on long-term complications like depression. We searched PubMed/MEDLINE, PubMed Central, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE from January 1, 2016 to May 31, 2021 for our literature search. A quality check was conducted on the identified studies using the Cochrane risk of bias quality assessment tool (modified Cochrane RoB 2). In total, we included 11 RCTs and used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines for the reporting of this systematic review. Most of the studies reinforced early initiation of the treatment by providing education to the patients and conducting their risk assessment. Strong evidence for the multidisciplinary treatment consisting of cognitive-behavioral therapy, psychoeducation, and physiotherapy is emphasized by some studies. More studies with a longer follow-up period are required to assess the effectiveness of intervention more accurately on depression. Regardless, this study will discuss guidelines and provide direction to physicians. It will help in developing future guidelines by addressing the clinical gaps in the implementation of these guidelines.
Highlights
BackgroundMild traumatic brain injury is increasingly becoming a common health problem, affecting 600-1,200 per 100,000 people each year [1]
Three clinical practice recommendations deemed important by Neurotrauma Evidence Translation (NET) guidelines are (a) assessing post-traumatic amnesia (PTA) in emergency department (ED) using a validated tool; (b) ascertaining the proper use and timing of computed tomography (CT) imaging; and (c) providing verbal patient information as well as patient education handouts consisting of advice and reassurance during discharge from ED [3]
There is an increase in the incidence of post-concussion syndrome (PCS) following traumatic brain injury (TBI), and various causes that inflict the injury in combination with the rising awareness of PCS among the patients could play a role
Summary
Mild traumatic brain injury (mTBI) is increasingly becoming a common health problem, affecting 600-1,200 per 100,000 people each year [1]. It may be caused by a motor vehicle collision, falls, assaults, strikes by/against an object, and sports and recreational injuries [2]. Prolonged post-concussion syndrome (PPCS) is associated with poor outcomes resulting in lower community reintegration, higher healthcare utilization, higher economic cost, greater cognitive burden, and elevated reporting of psychiatric symptoms [6]. Healthcare professionals acknowledge the significance of timely assessment, diagnosis, and treatment [12] Considering this fact, various guidelines for the treatment of PCS are being evolved.
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