Representation of concussion subtypes in common postconcussion symptom-rating scales

Author:

Lumba-Brown Angela1ORCID,Ghajar Jamshid2,Cornwell Jordan1,Bloom O Josh3,Chesnutt James4,Clugston James R5,Kolluri Raina6,Leddy John J7,Teramoto Masaru8,Gioia Gerard9

Affiliation:

1. Department of Emergency Medicine, Stanford University, Stanford, CA 94304, USA

2. Department of Neurosurgery, Brain Performance Center, Stanford University, Stanford, CA 94304 USA

3. Carolina Sports Concussion Clinic, Cary, NC 27513, USA

4. Departments of Family Medicine, Neurology, Oregon Health & Science University, Portland, OR & Rebound Orthopedics & Neurosurgery, Portland, OR 97239, USA

5. Departments of Community Health & Family Medicine & Neurology, University of Florida, Gainesville, FL 32611, USA

6. Department of Neurosurgery, Brain Performance Center, Stanford University, Stanford, CA 94304, USA

7. UBMD Department of Orthopaedics & Sports Medicine, Jacobs School of Medicine & Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA

8. Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT 84108, USA

9. Division of Pediatric Neuropsychology, Safe Concussion Outcome Recovery & Education Program, Children’s National Health System, Departments of Pediatrics & Psychiatry & Behavioral Sciences, George Washington University School of Medicine, Rockville, MD 20850, USA

Abstract

Aim: Postconcussion symptom-rating scales are frequently used concussion assessment tools that do not align directly with new expert, consensus-based concussion subtype classification systems. This may result in delays in concussion diagnosis, subspecialty referral and rehabilitative strategies. Objective: To determine the representation of subtype-directed symptomatology in common postconcussion symptom-rating scales. Methods: Literature review and expert consensus were used to compile commonly used concussion symptom-rating scales. Statistics were generated to describe the degree of representation of the consensus symptom set. Results: The percentage of symptoms representing each subtype/associated condition is low overall (15–26%). The ocular-motor (11%) and vestibular subtypes (19%) and cervical strain (5%)-associated condition were the most under-represented and also had the greatest unmet needs. Conclusion: Concussion subtypes do not have equal representation on commonly used concussion symptom-rating scales. There is a need for a subtype-directed symptom assessment to allow for increased accuracy of diagnosis and to guide management.

Publisher

Future Medicine Ltd

Subject

Neurology (clinical),Neurology

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