Traumatic Brain Injuries Revealed as Chronic Conditions: Long-term Effects and the Need for Ongoing Care

A recent study has unveiled that traumatic brain injuries (TBI) should be recognized as chronic conditions due to their long-lasting impact. The research indicates that the effects of TBI can continue to evolve, either progressing or regressing, for several years following the initial injury. The study involved individuals with varying degrees of TBI and found that a significant portion experienced changes in cognitive abilities and daily functioning for up to seven years post-injury. These findings underscore the necessity for ongoing care that caters to the evolving needs of individuals with TBI.

According to a study published in Neurology, the medical journal of the American Academy of Neurology, individuals who have sustained traumatic brain injuries (TBI) may undergo ongoing changes in their condition, showing improvements or declines over the course of several years. This challenges the prevailing notion that TBI is a one-time event with a fixed outcome after a brief recovery period. Benjamin L. Brett, Ph.D., from the Medical College of Wisconsin in Milwaukee and the study’s author, states, “Our results dispute the notion that TBI is a one-time event with a stagnant outcome after a short period of recovery. Rather, people with TBI continue to show improvement and decline across a range of areas including their ability to function and their thinking skills.”

The study encompassed individuals from 18 level 1 trauma center hospitals, with an average age of 41. Among the participants, 917 had mild TBI, 193 had moderate to severe TBI, and 154 had orthopedic injuries without head trauma. The subjects were followed for a period of up to seven years.

Annually, from two to seven years after the injury, the participants underwent three tests assessing their cognitive abilities, memory, mental health, and daily functioning. Additionally, they provided information through interviews regarding their symptoms and abilities, such as headaches, fatigue, and sleep disturbances.

When analyzing the combined test scores, the researchers observed that 21% of individuals with mild TBI experienced decline, compared to 26% of those with moderate to severe TBI, and 15% of individuals with orthopedic injuries but no head trauma.

Of the three tests conducted, the most significant decline over the years was observed in the participants’ ability to perform daily activities. On average, during the 2- to 7-year post-injury period, 29% of individuals with mild TBI experienced a decline in their abilities, while the same was true for 23% of those with moderate to severe TBI.

However, a portion of the participants demonstrated improvement in this area. Over time, 22% of those with mild TBI showed progress, along with 36% of individuals with moderate to severe TBI.

“These findings point out the need to recognize TBI as a chronic condition in order to establish adequate care that supports the evolving needs of people with this condition,” highlighted Brett. “This type of care should place a greater emphasis on helping people who have shown improvement continue to improve and implementing greater levels of support for those who have shown decline.”

It is worth noting that the study’s scope was limited to participants seen at level 1 trauma center hospitals within 24 hours of their injury. Therefore, the findings may not be universally applicable to other populations.

Reference: “Long-term Multi-domain Patterns of Change Following Traumatic Brain Injury: A TRACK-TBI LONG Study” by Benjamin L Brett, Nancy Temkin, Jason K. Barber, David O. Okonkwo, Murray Stein, Yelena G Bodien, John Corrigan, Ramon Diaz-Arrastia, Joseph T. Giacino, Michael A McCrea, Geoffrey T. Manleyand Lindsay Nelson, for TRACK-TBI Investigators, 21 June 2023, Neurology.
DOI: 10.1212/WNL.0000000000207501

The study received funding from the National Institute of Neurological Disorders and Stroke, the National Institute on Aging, the National Football League Scientific Advisory Board, and the U.S. Department of Defense.

Frequently Asked Questions (FAQs) about chronic traumatic brain injuries

More about chronic traumatic brain injuries

• Neurology: Long-term Multi-domain Patterns of Change Following Traumatic Brain Injury: A TRACK-TBI LONG Study
• National Institute of Neurological Disorders and Stroke: Traumatic Brain Injury Information Page
• American Academy of Neurology: Neurology Journal
• Medical College of Wisconsin: Department of Neurology