A SHORT-TERM LONGITUDINAL STUDY ON MULTIDIMENSIONAL OUTCOMES FOLLOWING MILD TRAUMATIC BRAIN INJURY IN MULTI-ETHNIC MALAYSIA

Abstract

This is a short-term longitudinal study of physical, cognitive, psychological and functional outcomes following mild traumatic brain injury (mTBI) in adults, caused by road traffic accident (RTA). Outcome measures were the Montreal Cognitive Assessment (MoCA), the Neuropsychological Assessment Battery Screening Module (S-NAB), the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7 (GAD-7) scale. Functional outcomes included returning to working/academia and driving, lifestyle changes, financial claims and litigation status. A total of 285 individuals were diagnosed with mTBI, involving young male motorcyclists (90%): uncomplicated mTBI, n=201; complicated mTBI, n=84. Ethnic distribution consisted of 204 Malays, 58 Indians and 23 Chinese. MoCA detected cognitive deficits (mean=23.11, SD=3.41) within 72 hours of injury. At two weeks, somatic manifestations, physical injuries, cognitive deficits and psychological symptoms were detected. At three months of injury, the language domain was persistently impaired, with a lower score on most cognitive domains in the complicated mTBI category than the uncomplicated mTBI. Psychological and somatic symptoms had improved. Almost 50% of patients had returned to a functional baseline within two weeks of injury and a further 24% within three months. A small proportion of patients made active lifestyle changes (<25%), financial injury claims (38%) and were involved in litigation (11%). In conclusion, mTBI in multi-ethnic Malaysia has multifaceted deficits and outcomes. Early management of symptoms may promote maximum recovery.