Determinants of recovery after traumatic brain injury:a neuropsychological perspective on symptoms across the severity spectrum

Annually, approximately 85.000 people in the Netherlands sustain a traumatic brain injury, also known as a concussion (mild traumatic brain injury) or a contusion (moderate to severe traumatic brain injury). There is great variation in the way people recover after a traumatic brain injury.Sandra Rakers' PhD research focused on further elucidating important factors that can influence recovery. Cognitive functions, fatigue, coping, anxiety, depression and neuroimaging measures were examined. It turned out that a slower mental pace after a more severe traumatic brain injury was associated with more cognitive effort and therefore higher mental fatigue. In contrast, in patients with a mild traumatic brain injury, fatigue symptoms were found to be strongly associated with psychological distress and reverting to passive coping strategies. Within the group of patients with a mild traumatic brain injury, different subgroups were present that differed with regard to the factors that influence recovery. The effect of executive disorders on the use of active coping strategies appeared to be limited. Furthermore, neuroimaging measures did not provide a clear explanation for clinical recovery after mild traumatic brain injury. Taken together, patients with mild traumatic brain injury and patients with moderate to severe traumatic brain injury should be approached as separate patient groups and each deserves tailored care