Research finds effects of concussion in children can linger up to a year

HOUSTON – (Nov. 13, 2018) – A study of children who experienced mild traumatic brain injury revealed that almost a third of them were still dealing with headaches, irritability, difficulty concentrating and other post-injury issues a year later, reported researchers with The University of Texas Health Science Center at Houston (UTHealth) in the journal Pediatrics.

“Most children with mild traumatic brain injury do not show significant post-concussion symptoms that last more than one to three months. We were surprised at the number of children whose symptoms persisted throughout the first year following their injuries,” said Linda Ewing-Cobbs, Ph.D., the study’s lead author and a professor with the Children’s Learning Institute at McGovern Medical School at UTHealth.

Post-concussion symptoms refer to new physical, emotional, cognitive and fatigue/sleep problems arising after mild traumatic brain injury or concussion. These symptoms are nonspecific and may also be experienced by youth who sustain orthopedic or bodily injuries not involving the head. Other factors such as pain and stress may contribute to what are called post-concussion symptoms.

Researchers also identified characteristics increasing a child’s likelihood of long-term symptoms or reducing them. For example, investigators found that girls were twice as likely as boys to still be experiencing symptoms a year later. Conversely, children from more stable families were less likely to have lasting symptoms.

Ewing-Cobbs’ team analyzed the medical records and completed follow-up studies on 347 children ranging in age from 4 to 15 who had been treated at one of two pediatric trauma centers with Level 1 status in the United States between 2013 and 2015.  Two hundred and twenty-nine of the children had suffered a mild traumatic brain injury. For comparison purposes, the study included 118 children with orthopedic injuries.

New post-injury symptoms persisted in 25 to 31 percent of the traumatic brain injury group at one year compared to 18 percent in the orthopedic group. 

When researchers studied the demographics of the children, the investigators found that children with pre-existing mood or anxiety disorders, or attention deficit hyperactivity disorder, had a greater likelihood of post-injury symptoms, as did children from lower-income families.

Because emotional and cognitive issues may emerge over time, children with symptoms persisting at one month following injury should be managed clinically by their primary care providers to monitor symptom course and referred to specialists for any needed physical, cognitive or psychological health interventions, the authors wrote.

Ewing-Cobbs’ coauthor from UTHealth was Charles Cox, Jr., M.D. Also contributing to the paper were Richard Holubkov, Ph.D.; Heather T. Keenan, M.D., Ph.D.; and Amy E. Clark, M.S., of The University of Utah.

Ewing-Cobbs and Cox are both professors of pediatrics at McGovern Medical School. Ewing-Cobbs holds the Harriet and Joe Foster Chair in Cognitive Neuroscience at McGovern Medical School. Cox holds the George and Cynthia Mitchell Distinguished Chair in Neurosciences.

The study, titled “Persistent postconcussion symptoms after injury,” was supported by Centers for Disease Control and Prevention (Cooperative Agreement U01/CE002188).

Research finds effects of concussion in children can linger up to a year