No CrossRef data available.
Article contents
Distinct trajectories of neuropsychiatric symptoms in the 12 months following traumatic brain injury (TBI): a TRACK-TBI study
Published online by Cambridge University Press: 04 September 2024
Abstract
Background
Neuropsychiatric symptoms are common after traumatic brain injury (TBI) and often resolve within 3 months post-injury. However, the degree to which individual patients follow this course is unknown. We characterized trajectories of neuropsychiatric symptoms over 12 months post-TBI. We hypothesized that a substantial proportion of individuals would display trajectories distinct from the group-average course, with some exhibiting less favorable courses.
Methods
Participants were level 1 trauma center patients with TBI (n = 1943), orthopedic trauma controls (n = 257), and non-injured friend controls (n = 300). Trajectories of six symptom dimensions (Depression, Anxiety, Fear, Sleep, Physical, and Pain) were identified using growth mixture modeling from 2 weeks to 12 months post-injury.
Results
Depression, Anxiety, Fear, and Physical symptoms displayed three trajectories: Stable-Low (86.2–88.6%), Worsening (5.6–10.9%), and Improving (2.6–6.4%). Among symptomatic trajectories (Worsening, Improving), lower-severity TBI was associated with higher prevalence of elevated symptoms at 2 weeks that steadily resolved over 12 months compared to all other groups, whereas higher-severity TBI was associated with higher prevalence of symptoms that gradually worsened from 3–12 months. Sleep and Pain displayed more variable recovery courses, and the most common trajectory entailed an average level of problems that remained stable over time (Stable-Average; 46.7–82.6%). Symptomatic Sleep and Pain trajectories (Stable-Average, Improving) were more common in traumatically injured groups.
Conclusions
Findings illustrate the nature and rates of distinct neuropsychiatric symptom trajectories and their relationship to traumatic injuries. Providers may use these results as a referent for gauging typical v. atypical recovery in the first 12 months post-injury.
Keywords
- Type
- Original Article
- Information
- Copyright
- Copyright © The Author(s), 2024. Published by Cambridge University Press
References
Alway, Y., Gould, K. R., Johnston, L., McKenzie, D., & Ponsford, J. (2016). A prospective examination of axis I psychiatric disorders in the first 5 years following moderate to severe traumatic brain injury. Psychological Medicine, 46(6), 1331–1341. doi: 10.1017/S0033291715002986CrossRefGoogle ScholarPubMed
Asken, B. M., Snyder, A. R., Clugston, J. R., Gaynor, L. S., Sullan, M. J., & Bauer, R. M. (2017). Concussion-like symptom reporting in non-concussed collegiate athletes. Archives of Clinical Neuropsychology, 32(8), 963–971. doi: 10.1093/arclin/acx018CrossRefGoogle ScholarPubMed
Asparouhov, T., & Muthen, B. (2012). Using Mplus TECH11 and TECH14 to test the number of latent classes. https://www.statmodel.com/examples/webnotes/webnote14.pdf.Google Scholar
Bastien, C. (2001). Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297–307. doi: 10.1016/S1389-9457(00)00065-4CrossRefGoogle ScholarPubMed
Belanger, H. G., Curtiss, G., Demery, J. A., Lebowitz, B. K., & Vanderploeg, R. D. (2005). Factors moderating neuropsychological outcomes following mild traumatic brain injury: A meta-analysis. Journal of the International Neuropsychological Society, 11(3), 215–227. doi: 10.1017/S1355617705050277CrossRefGoogle ScholarPubMed
Belanger, H. G., Kretzmer, T., Vanderploeg, R. D., & French, L. M. (2010). Symptom complaints following combat-related traumatic brain injury: Relationship to traumatic brain injury severity and posttraumatic stress disorder. Journal of the International Neuropsychological Society, 16(1), 194–199. doi: 10.1017/S1355617709990841CrossRefGoogle ScholarPubMed
Bombardier, C. H., Hoekstra, T., Dikmen, S., & Fann, J. R. (2016). Depression trajectories during the first year after traumatic brain injury. Journal of Neurotrauma, 33(23), 2115–2124. doi: 10.1089/neu.2015.4349CrossRefGoogle ScholarPubMed
Bown, D., Belli, A., Qureshi, K., Davies, D., Toman, E., & Upthegrove, R. (2019). Post-traumatic stress disorder and self-reported outcomes after traumatic brain injury in victims of assault. PLOS ONE, 14(2), e0211684. doi: 10.1371/journal.pone.0211684CrossRefGoogle ScholarPubMed
Brett, B. L., Kramer, M. D., Whyte, J., McCrea, M. A., Stein, M. B., Giacino, J. T., … Zafonte, R. (2021). Latent profile analysis of neuropsychiatric symptoms and cognitive function of adults 2 weeks after traumatic brain injury: Findings from the TRACK-TBI study. JAMA Network Open, 4(3), e213467. doi: 10.1001/jamanetworkopen.2021.3467CrossRefGoogle ScholarPubMed
Carmichael, J., Hicks, A. J., Gould, K. R., Ponsford, J., & Spitz, G. (2023). Ten-year cohort study of emotional distress trajectories after moderate-severe traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 104(7), 1081–1090. doi: 10.1016/j.apmr.2023.02.008CrossRefGoogle ScholarPubMed
Carroll, L. J., Cassidy, J. D., Peloso, P. M., Borg, J., von Holst, H., Holm, L., … WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. (2004). Prognosis for mild traumatic brain injury: Results of the WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, (43 Suppl), 84–105. doi: 10.1080/16501960410023859CrossRefGoogle ScholarPubMed
Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., … Rose, M. (2007). The Patient-Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH roadmap cooperative group during its first two years. Medical Care, 45(5), S3–S11. doi: 10.1097/01.mlr.0000258615.42478.55CrossRefGoogle ScholarPubMed
Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: The seven pillars of RDoC. BMC Medicine, 11(1), 126. doi: 10.1186/1741-7015-11-126CrossRefGoogle ScholarPubMed
Derogatis, L. R. (2001). Brief symptom inventory 18. Baltimore: Johns Hopkins University.Google Scholar
Garden, N., & Sullivan, K. A. (2010). An examination of the base rates of post-concussion symptoms: The influence of demographics and depression. Applied Neuropsychology, 17(1), 1–7. doi: 10.1080/09084280903297495CrossRefGoogle ScholarPubMed
Gomez, R., Skilbeck, C., Thomas, M., & Slatyer, M. (2017). Growth mixture modeling of depression symptoms following traumatic brain injury. Frontiers in Psychology, 8, 1320. doi: 10.3389/fpsyg.2017.01320CrossRefGoogle ScholarPubMed
Guilmette, T. J., Sweet, J. J., Hebben, N., Koltai, D., Mahone, E. M., & Spiegler, B. J., … Conference Participants. (2020). American Academy of Clinical Neuropsychology Consensus Conference statement on uniform labeling of performance test scores. The Clinical Neuropsychologist, 34(3), 437–453. doi: 10.1080/13854046.2020.1722244CrossRefGoogle ScholarPubMed
Howlett, J. R., Nelson, L. D., & Stein, M. B. (2022). Mental health consequences of traumatic brain injury. Biological Psychiatry, 91(5), 413–420. doi: 10.1016/j.biopsych.2021.09.024CrossRefGoogle ScholarPubMed
Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., … Wang, P. (2010). Research Domain Criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167(7), 748–751. doi: 10.1176/appi.ajp.2010.09091379CrossRefGoogle Scholar
Iverson, G. L., & Lange, R. T. (2003). Examination of “Postconcussion-Like” symptoms in a healthy sample. Applied Neuropsychology, 10(3), 137–144. doi: 10.1207/S15324826AN1003_02CrossRefGoogle Scholar
Kay, T., Harrington, D., Adams, R., Anderson, T. P., Berrol, S., Cicerone, K., … Malec, J. (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8(3), 86–87. https://www.semanticscholar.org/paper/Definition-of-mild-traumatic-brain-injury-Kay-Harrington/5fa32914e093c8b766a10a6ade54fc92b77070f2.CrossRefGoogle Scholar
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., … Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477. doi: 10.1037/abn0000258CrossRefGoogle ScholarPubMed
Kotov, R., Krueger, R. F., Watson, D., Cicero, D. C., Conway, C. C., DeYoung, C. G., … Wright, A. G. C. (2021). The Hierarchical Taxonomy of Psychopathology (HiTOP): A quantitative nosology based on consensus of evidence. Annual Review of Clinical Psychology, 17(1), 83–108. doi: 10.1146/annurev-clinpsy-081219-093304CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. doi: 10.1046/j.1525-1497.2001.016009606.xCrossRefGoogle ScholarPubMed
Lo, Y., Mendell, N. R., & Rubin, D. (2001). Testing the number of components in a normal mixture. Biometrika, 88(3), 767–778.CrossRefGoogle Scholar
Mathias, J. L., Harman-Smith, Y., Bowden, S. C., Rosenfeld, J. V., & Bigler, E. D. (2014). Contribution of psychological trauma to outcomes after traumatic brain injury: Assaults versus sporting injuries. Journal of Neurotrauma, 31(7), 658–669. doi: 10.1089/neu.2013.3160CrossRefGoogle ScholarPubMed
McLachlan, G. J., & Peel, D. (2000). Finite mixture models. New York: Wiley. Retrieved from http://archive.org/details/finitemixturemod00geofCrossRefGoogle Scholar
Mooney, G., Speed, J., & Sheppard, S. (2005). Factors related to recovery after mild traumatic brain injury. Brain Injury, 19(12), 975–987. doi: 10.1080/02699050500110264CrossRefGoogle ScholarPubMed
National Academies of Sciences, Engineering, and Medicine. (2022). Traumatic Brain Injury: A Roadmap for Accelerating Progress. Washington, DC: The National Academies Press. doi: 10.17226/25394.Google Scholar
Nelson, L. D., Temkin, N. R., Dikmen, S., Barber, J., Giacino, J. T., Yuh, E., … Zafonte, R. (2019). Recovery after mild traumatic brain injury in patients presenting to US level I trauma centers: A transforming research and clinical knowledge in traumatic brain injury (TRACK-TBI) study. JAMA Neurology, 76(9), 1049. doi: 10.1001/jamaneurol.2019.1313CrossRefGoogle Scholar
Nelson, L. D., Kramer, M. D., Joyner, K. J., Patrick, C. J., Stein, M. B., Temkin, N., … TRACK-TBI Investigators. (2021). Relationship between transdiagnostic dimensions of psychopathology and traumatic brain injury (TBI): A TRACK-TBI study. Journal of Abnormal Psychology, 130(5), 423–434. doi: 10.1037/abn0000672CrossRefGoogle ScholarPubMed
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535–569. doi: 10.1080/10705510701575396CrossRefGoogle Scholar
Polinder, S., Cnossen, M. C., Real, R. G. L., Covic, A., Gorbunova, A., Voormolen, D. C., … von Steinbuechel, N. (2018). A multidimensional approach to post-concussion symptoms in mild traumatic brain injury. Frontiers in Neurology, 9, 1113. doi: 10.3389/fneur.2018.01113CrossRefGoogle ScholarPubMed
Ren, D., Fan, J., Puccio, A. M., Okonkwo, D. O., Beers, S. R., & Conley, Y. (2017). Group-based trajectory analysis of emotional symptoms among survivors after severe traumatic brain injury. Journal of Head Trauma Rehabilitation, 32(6), E29–E37. doi: 10.1097/HTR.0000000000000294CrossRefGoogle ScholarPubMed
Rohling, M. L., Binder, L. M., Demakis, G. J., Larrabee, G. J., Ploetz, D. M., Langhinrichsen-Rohling, J. (2011). A meta-analysis of neuropsychological outcome after mild traumatic brain injury: Re-analyses and reconsiderations of Binder et al., Frencham et al., and Pertab et al. The Clinical Neuropsychologist, 25(4), 608–623. doi: 10.1080/13854046.2011.565076CrossRefGoogle ScholarPubMed
Tham, S. W., Palermo, T. M., Vavilala, M. S., Wang, J., Jaffe, K. M., Koepsell, T. D., … Rivara, F. P. (2012). The longitudinal course, risk factors, and impact of sleep disturbances in children with traumatic brain injury. Journal of Neurotrauma, 29(1), 154–161. doi: 10.1089/neu.2011.2126CrossRefGoogle ScholarPubMed
Thurmond, V. A., Hicks, R., Gleason, T., Miller, A. C., Szuflita, N., Orman, J., & Schwab, K. (2010). Advancing integrated research in psychological health and traumatic brain injury: Common data elements. Archives of Physical Medicine and Rehabilitation, 91(11), 1633–1636. doi: 10.1016/j.apmr.2010.06.034CrossRefGoogle ScholarPubMed
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Retrieved from www.ptsd.va.govGoogle Scholar
Wickwire, E. M., Albrecht, J. S., Capaldi, V. F., Jain, S. O., Gardner, R. C., Werner, J. K., … Zafonte, R. (2022). Trajectories of insomnia in adults after traumatic brain injury. JAMA Network Open, 5(1), e2145310. doi: 10.1001/jamanetworkopen.2021.45310CrossRefGoogle ScholarPubMed
Yue, J. K., Ramesh, R., Krishnan, N., Chyall, L., Halabi, C., Huang, M. C., … DiGiorgio, A. M. (2024). Medicaid insurance is a predictor of prolonged hospital length of stay after traumatic brain injury: A stratified national trauma data bank cohort analysis of 552 949 patients. Neurosurgery, Advance online publication. doi: 10.1227/neu.0000000000002855CrossRefGoogle ScholarPubMed
Zahniser, E., Nelson, L. D., Dikmen, S. S., Machamer, J. E., Stein, M. B., Yuh, E., … Zafonte, R. (2019). The temporal relationship of mental health problems and functional limitations following mTBI: A TRACK-TBI and TED study. Journal of Neurotrauma, 36(11), 1786–1793. doi: 10.1089/neu.2018.6172CrossRefGoogle ScholarPubMed
Martinez et al. supplementary material 1
Martinez et al. supplementary material
File
633.3 KB
Martinez et al. supplementary material 2
Martinez et al. supplementary material
File
632.4 KB
Martinez et al. supplementary material 3
Martinez et al. supplementary material
File
635.1 KB
Martinez et al. supplementary material 4
Martinez et al. supplementary material
File
605.4 KB
Martinez et al. supplementary material 5
Martinez et al. supplementary material
File
619.6 KB
Martinez et al. supplementary material 6
Martinez et al. supplementary material
File
2.8 MB
Martinez et al. supplementary material 7
Martinez et al. supplementary material
File
40.7 KB