Mica Gabrielle Marbil, Jean-Michel Galarneau, Keith Owen Yeates, Nori Mercuri Minich, Andrew D Hershey, Serena L Orr, Dana M Defta, H Gerry Taylor, Erin D Bigler, Daniel M Cohen, Ann Bacevice, Barbara A Bangert, Ashley L Ware
{"title":"儿童脑震荡后创伤后头痛及临床康复。","authors":"Mica Gabrielle Marbil, Jean-Michel Galarneau, Keith Owen Yeates, Nori Mercuri Minich, Andrew D Hershey, Serena L Orr, Dana M Defta, H Gerry Taylor, Erin D Bigler, Daniel M Cohen, Ann Bacevice, Barbara A Bangert, Ashley L Ware","doi":"10.1017/S1355617725000128","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To examine the association of posttraumatic headache (PTH) type with postconcussive symptoms (PCS), pain intensity, and fluid cognitive function across recovery after pediatric concussion.</p><p><strong>Methods: </strong>This prospective, longitudinal study recruited children (aged 8-16.99 years) within 24 hours of sustaining a concussion or mild orthopedic injury (OI) from two pediatric hospital emergency departments. Based on parent-proxy ratings of pre- and postinjury headache, children were classified as concussion with no PTH (<i>n</i> = 18), new PTH (<i>n</i> = 43), worse PTH (<i>n</i> = 58), or non-worsening chronic PTH (<i>n</i> = 19), and children with OI with no PTH (<i>n</i> = 58). Children and parents rated PCS and children rated pain intensity weekly up to 6 months. Children completed computerized testing of fluid cognition 10 days, 3 months, and 6- months postinjury. Mixed effects models compared groups across time on PCS, pain intensity, and cognition, controlling for preinjury scores and covariates.</p><p><strong>Results: </strong>Group differences in PCS decreased over time. Cognitive and somatic PCS were higher in new, chronic, and worse PTH relative to no PTH (up to 8 weeks postinjury; <i>d</i> = 0.34 to 0.87 when significant) and OI (up to 5 weeks postinjury; <i>d</i> = 0.30 to 1.28 when significant). Pain intensity did not differ by group but declined with time postinjury. Fluid cognition was lower across time in chronic PTH versus no PTH (<i>d</i> = -0.76) and OI (<i>d</i> = -0.61) and in new PTH versus no PTH (<i>d</i> = -0.51).</p><p><strong>Conclusions: </strong>Onset of PTH was associated with worse PCS up to 8 weeks after pediatric concussion. Chronic PTH and new PTH were associated with moderately poorer fluid cognitive functioning up to 6 months postinjury. Pain declined over time regardless of PTH type.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-13"},"PeriodicalIF":2.6000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Posttraumatic headache and clinical recovery after pediatric concussion.\",\"authors\":\"Mica Gabrielle Marbil, Jean-Michel Galarneau, Keith Owen Yeates, Nori Mercuri Minich, Andrew D Hershey, Serena L Orr, Dana M Defta, H Gerry Taylor, Erin D Bigler, Daniel M Cohen, Ann Bacevice, Barbara A Bangert, Ashley L Ware\",\"doi\":\"10.1017/S1355617725000128\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To examine the association of posttraumatic headache (PTH) type with postconcussive symptoms (PCS), pain intensity, and fluid cognitive function across recovery after pediatric concussion.</p><p><strong>Methods: </strong>This prospective, longitudinal study recruited children (aged 8-16.99 years) within 24 hours of sustaining a concussion or mild orthopedic injury (OI) from two pediatric hospital emergency departments. Based on parent-proxy ratings of pre- and postinjury headache, children were classified as concussion with no PTH (<i>n</i> = 18), new PTH (<i>n</i> = 43), worse PTH (<i>n</i> = 58), or non-worsening chronic PTH (<i>n</i> = 19), and children with OI with no PTH (<i>n</i> = 58). Children and parents rated PCS and children rated pain intensity weekly up to 6 months. Children completed computerized testing of fluid cognition 10 days, 3 months, and 6- months postinjury. Mixed effects models compared groups across time on PCS, pain intensity, and cognition, controlling for preinjury scores and covariates.</p><p><strong>Results: </strong>Group differences in PCS decreased over time. Cognitive and somatic PCS were higher in new, chronic, and worse PTH relative to no PTH (up to 8 weeks postinjury; <i>d</i> = 0.34 to 0.87 when significant) and OI (up to 5 weeks postinjury; <i>d</i> = 0.30 to 1.28 when significant). Pain intensity did not differ by group but declined with time postinjury. Fluid cognition was lower across time in chronic PTH versus no PTH (<i>d</i> = -0.76) and OI (<i>d</i> = -0.61) and in new PTH versus no PTH (<i>d</i> = -0.51).</p><p><strong>Conclusions: </strong>Onset of PTH was associated with worse PCS up to 8 weeks after pediatric concussion. Chronic PTH and new PTH were associated with moderately poorer fluid cognitive functioning up to 6 months postinjury. Pain declined over time regardless of PTH type.</p>\",\"PeriodicalId\":49995,\"journal\":{\"name\":\"Journal of the International Neuropsychological Society\",\"volume\":\" \",\"pages\":\"1-13\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the International Neuropsychological Society\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1017/S1355617725000128\",\"RegionNum\":4,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the International Neuropsychological Society","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1017/S1355617725000128","RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Posttraumatic headache and clinical recovery after pediatric concussion.
Objective: To examine the association of posttraumatic headache (PTH) type with postconcussive symptoms (PCS), pain intensity, and fluid cognitive function across recovery after pediatric concussion.
Methods: This prospective, longitudinal study recruited children (aged 8-16.99 years) within 24 hours of sustaining a concussion or mild orthopedic injury (OI) from two pediatric hospital emergency departments. Based on parent-proxy ratings of pre- and postinjury headache, children were classified as concussion with no PTH (n = 18), new PTH (n = 43), worse PTH (n = 58), or non-worsening chronic PTH (n = 19), and children with OI with no PTH (n = 58). Children and parents rated PCS and children rated pain intensity weekly up to 6 months. Children completed computerized testing of fluid cognition 10 days, 3 months, and 6- months postinjury. Mixed effects models compared groups across time on PCS, pain intensity, and cognition, controlling for preinjury scores and covariates.
Results: Group differences in PCS decreased over time. Cognitive and somatic PCS were higher in new, chronic, and worse PTH relative to no PTH (up to 8 weeks postinjury; d = 0.34 to 0.87 when significant) and OI (up to 5 weeks postinjury; d = 0.30 to 1.28 when significant). Pain intensity did not differ by group but declined with time postinjury. Fluid cognition was lower across time in chronic PTH versus no PTH (d = -0.76) and OI (d = -0.61) and in new PTH versus no PTH (d = -0.51).
Conclusions: Onset of PTH was associated with worse PCS up to 8 weeks after pediatric concussion. Chronic PTH and new PTH were associated with moderately poorer fluid cognitive functioning up to 6 months postinjury. Pain declined over time regardless of PTH type.
期刊介绍：
The Journal of the International Neuropsychological Society is the official journal of the International Neuropsychological Society, an organization of over 4,500 international members from a variety of disciplines. The Journal of the International Neuropsychological Society welcomes original, creative, high quality research papers covering all areas of neuropsychology. The focus of articles may be primarily experimental, applied, or clinical. Contributions will broadly reflect the interest of all areas of neuropsychology, including but not limited to: development of cognitive processes, brain-behavior relationships, adult and pediatric neuropsychology, neurobehavioral syndromes (such as aphasia or apraxia), and the interfaces of neuropsychology with related areas such as behavioral neurology, neuropsychiatry, genetics, and cognitive neuroscience. Papers that utilize behavioral, neuroimaging, and electrophysiological measures are appropriate.
To assure maximum flexibility and to promote diverse mechanisms of scholarly communication, the following formats are available in addition to a Regular Research Article: Brief Communication is a shorter research article; Rapid Communication is intended for "fast breaking" new work that does not yet justify a full length article and is placed on a fast review track; Case Report is a theoretically important and unique case study; Critical Review and Short Review are thoughtful considerations of topics of importance to neuropsychology and include meta-analyses; Dialogue provides a forum for publishing two distinct positions on controversial issues in a point-counterpoint format; Special Issue and Special Section consist of several articles linked thematically; Letter to the Editor responds to recent articles published in the Journal of the International Neuropsychological Society; and Book Review, which is considered but is no longer solicited.
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