Long-term effects of mild brain injury determined by personal factors and severity of accident

Not only the severity of an accident determines the effects of mild traumatic brain injury, but personal factors too. These factors can be identified soon after the accident, which means that patients can be offered early therapy and support and are thus more likely to make a full recovery. These are the findings of a study led by neurologist Joukje van der Naalt and neuropsychologist Joke Spikman from the University Medical Center Groningen (UMCG). They have published an article about this in Lancet Neurology.

People often sustain a brain injury in accidents, and in most cases this is a mild brain injury. Many patients with a mild brain injury fail to make a full recovery and suffer from long-term impairments that affect their everyday life. In the UPFRONT study, the researchers determined whether they could identify which patients were most at risk of achieving incomplete recovery. The researchers studied a group of patients with mild brain injury, and investigated how they were coping with post injury complaints two weeks after the accident and whether they were suffering from mood disorders. They combined these data with demographic information and data about the severity of the injury and determined which patients had failed to make a full recovery six months after the accident. Over 1000 patients took part in the study, which was carried out at the ETZ Elizabeth hospital in Tilburg, Medisch Spectrum Twente and the UMCG between January 2013 and January 2015.

The study showed that not only the severity of the accident, but that – alongside age, education and psychological problems before the accident – personal factors such as coping with the effects of brain injury were important factors in determining the extent of recovery six months after the accident. The researchers believe that there are two important points in time at which it is possible to identify which patients are at risk of incomplete recovery: in the emergency room of the hospital and in the first weeks after the accident. They believe that the latter, which involves assessing the various risk factors in an interview or questionnaire, is more accurate. By determining these factors early after the accident, doctors can offer patients timely therapy and support that they need.

The Nederlandse Hersenstichting (Dutch Brain Foundation) helped fund this research.

• The publication in Lancet Neurology
• Joukje van der Naalt
• Joke Spikman
• Marieke Timmerman