Publication

An integrated perspective linking physiological and psychological consequences of mild traumatic brain injury

van der Horn, H. J., Out, M. L., de Koning, M. E., Mayer, A. R., Spikman, J. M., Sommer, I. E. & van der Naalt, J., Sep-2020, In : Journal of Neurology. 267, 9, p. 2497-2506 10 p.

Research output: Contribution to journalReview articleAcademicpeer-review

Despite the often seemingly innocuous nature of a mild traumatic brain injury (mTBI), its consequences can be devastating, comprising debilitating symptoms that interfere with daily functioning. Currently, it is still difficult to pinpoint the exact cause of adverse outcome after mTBI. In fact, extensive research suggests that the underlying etiology is multifactorial. In the acute and early sub-acute stages, the pathophysiology of mTBI is likely to be dominated by complex physiological alterations including cellular injury, inflammation, and the acute stress response, which could lead to neural network dysfunction. In this stage, patients often report symptoms such as fatigue, headache, unstable mood and poor concentration. When time passes, psychological processes, such as coping styles, personality and emotion regulation, become increasingly influential. Disadvantageous, maladaptive, psychological mechanisms likely result in chronic stress which facilitates the development of long-lasting symptoms, possibly via persistent neural network dysfunction. So far, a systemic understanding of the coupling between these physiological and psychological factors that in concert define outcome after mTBI is lacking. The purpose of this narrative review article is to address how psychophysiological interactions may lead to poor outcome after mTBI. In addition, a framework is presented that may serve as a template for future studies on this subject.

Original languageEnglish
Pages (from-to)2497-2506
Number of pages10
JournalJournal of Neurology
Volume267
Issue number9
Early online date27-Apr-2019
Publication statusPublished - Sep-2020

    Keywords

  • Mild traumatic brain injury, Biomarkers, Cytokines, Cortisol, Psychology, HEART-RATE-VARIABILITY, COGNITIVE EMOTION REGULATION, DEFAULT MODE NETWORK, FUNCTIONAL CONNECTIVITY, NEUROVISCERAL INTEGRATION, OUTCOME PREDICTION, NEURAL MECHANISMS, STRESS, SYMPTOMS, INFLAMMATION

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