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Specificity of Postconcussion Symptoms at 3 Months After Mild Traumatic Brain Injury: Results From a Comparative Cohort Study

Laborey, Magali MSc; Masson, Françoise MD; Ribéreau-Gayon, Régis MD; Zongo, Drissa MD, MPH; Salmi, Louis Rachid MD, PhD; Lagarde, Emmanuel PhD

The Journal of Head Trauma Rehabilitation: January/February 2014 - Volume 29 - Issue 1 - p E28–E36
doi: 10.1097/HTR.0b013e318280f896
Original Articles

Objective: To assess the specificity of symptoms included in various symptom lists used to identify postconcussion syndrome (PCS), by using follow-up data comparing patients with mild traumatic brain injury (MTBI) and control patients during the month prior to injury and 3 months later.

Setting: The adult emergency department of a teaching hospital in Bordeaux, France.

Participants: A cohort of patients with MTBI (n = 536) and a comparison group with nonhead injuries (n = 946).

Main measures: Postconcussion symptoms listed in the Rivermead Postconcussion Symptoms Questionnaire (RPQ), the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and the 10th International Classification of Diseases (ICD-10).

Results: Analyses were performed comparing symptom occurrence in patients with MTBI and controls, before and 3 months after injury. Eight symptoms were identified as being specific to MTBI: headache, dizziness, intolerance of stress, forgetfulness, poor concentration, taking longer to think, blurred vision, and personality change.

Conclusion: The relevance of symptoms proposed to constitute PCS should be reviewed. A more specific definition of PCS would make diagnosis easier and facilitate prevention as well as treatment of patients with MTBI.

Univ. Bordeaux, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, F-33000 Bordeaux, France (Ms Laborey and Drs Salmi and Lagarde); INSERM, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique (Ms Laborey and Drs Masson, Ribéreau-Gayon, Zongo, Salmi, and Lagarde); CHU de Bordeaux, Pole de santé publique, Service d'information médicale, (Dr Salmi); Service d'Anesthésie-Réanimation, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux (Dr Masson); and Service de médicine générale et post-urgences, Hôpital Pellegrin, Centre hospitalier Universitaire de Bordeaux, F-33000, Bordeaux, France (Dr Ribéreau-Gayon)

Corresponding Author: Emmanuel Lagarde, PhD, 146 rue Léo Saignat, 33076 Bordeaux (

INSERM, the Réunica Group, the teaching hospital of Bordeaux (PHRC 2007).

M.L. is the recipient of a doctoral grant from the French National Institute for Medical Research (INSERM) and the EHESP School of Public Health.

The authors thank Catherine Meridda, Mélanie Maugeais, and Karine Senamaud, who assisted them in data collection from the emergency department.

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins