Atypical Somatic Symptoms in Adults With Prolonged Recovery From Mild Traumatic Brain Injury
Atypical Somatic Symptoms in Adults With Prolonged Recovery From Mild Traumatic Brain Injury
复制标题
DOI：
10.3389/fneur.2020.00043
复制
发表时间：
2020-02-04
影响因子：
3.4
通讯作者：
Panenka, William J.
中科院分区：
文献类型：
--
作者：
Stubbs, Jacob L.;Green, Katherine E.;Panenka, William J.
躯体化可能导致轻度创伤性脑损伤(MTBI)后的持续症状。在两个独立招募的研究样本中，我们描述了mTBI后恢复时间较长的成年患者出现非典型mTBI症状但对躯体化患者具有典型意义(例如，胃肠道不适、肌肉骨骼和心肺疾病)的程度。第一个样本是横断面的，包括从社区招募的mTBI患者，他们报告了可归因于先前mTBI的持续症状(n=16)，以及健康对照组(n=15)。第二个样本包括预期从一级创伤中心招募的mTBI患者，他们要么恢复良好(Gose=8；n=32)，要么恢复较差(Gose<；8；n=29)。在所有参与者中，我们使用患者健康问卷-15评估非典型的躯体症状，并使用Rivermead震荡后症状问卷评估典型的脑震荡后症状。与样本1中的健康对照组(b=4.308，p<；0.001)和样本2中恢复良好的mTBI患者(b=3.169，p<；0.001)相比，mTBI恢复不良的参与者的“非典型”躯体症状显著增加。正如预期的那样，样本2中结果不佳的参与者有更高的典型症状负担，而不是非典型症状[t((28))=4.750，p<；0.001，d=0.88]。然而，恢复不良的参与者仍然报告了非典型的躯体症状，这些症状明显高于恢复良好的参与者(平均1.4标准差)。我们的结果表明，尽管mTBI后出现“典型的”脑震荡后症状为主，但广泛的躯体症状也经常伴随着mTBI，躯体化可能是mTBI恢复过程中的一个重要的、可修改的因素。
Somatization may contribute to persistent symptoms after mild traumatic brain injury (mTBI). In two independently-recruited study samples, we characterized the extent to which symptoms atypical of mTBI but typical for patients suffering from somatization (e.g., gastrointestinal upset, musculoskeletal, and cardiorespiratory complaints) were present in adult patients with prolonged recovery following mTBI. The first sample was cross-sectional and consisted of mTBI patients recruited from the community who reported ongoing symptoms attributable to a previous mTBI (n = 16) along with a healthy control group (n = 15). The second sample consisted of patients with mTBI prospectively recruited from a Level 1 trauma center who had either good recovery (GOSE = 8; n = 32) or poor recovery (GOSE < 8; n = 29). In all participants, we evaluated atypical somatic symptoms using the Patient Health Questionnaire-15 and typical post-concussion symptoms with the Rivermead Post-Concussion Symptom Questionnaire. Participants with poor recovery from mTBI had significantly higher "atypical" somatic symptoms as compared to the healthy control group in Sample 1 (b = 4.308, p < 0.001) and to mTBI patients with good recovery in Sample 2 (b = 3.169, p < 0.001). As would be expected, participants with poor outcome in Sample 2 had a higher burden of typical rather than atypical symptoms [t((28)) = 4.750, p < 0.001, d = 0.88]. However, participants with poor recovery still reported atypical somatic symptoms that were significantly higher (1.4 standard deviations, on average) than those with good recovery. Our results suggest that although "typical" post-concussion symptoms predominate after mTBI, a broad range of somatic symptoms also frequently accompanies mTBI, and that somatization may represent an important, modifiable factor in mTBI recovery.