Citation

Tsao JW. Neurology 2022; 99(17): e773.

Copyright

(Copyright © 2022, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0000000000201415

PMID

36280282

Abstract

Schneider et al.1 are to be commended for developing a set of measures that can define poor cognitive outcomes 1 year after mild traumatic brain injury (mTBI). The authors discovered that 13.5% of individuals who had sustained a mTBI had poor cognitive outcomes at 1 year, a metric that is far lower than previous estimates, compared with 4.5% of controls. These findings raise several questions. The mTBI definition was a Glasgow Coma Scale (GCS) score of 13-15--some would contend that any GCS score <15 could be considered a more serious injury, even on the mild spectrum. Would different outcomes have been seen with only individuals with a GCS score of 15? The population consisted of individuals seeking care in an emergency department who received head CTs; would findings be similar in a concussed population not seeking immediate treatment? It is also surprising that nearly 5% of normal control individuals had a measurable cognitive decline given their average age of 37, an age where cognitive decline is not typically expected. Finally, the data appear to show multiple individuals with a decline less than the cutoff threshold. Are these individuals at highest risk for future mild cognitive impairment or dementia diagnoses?

Language: en