Personality Changes Can Signal Incomplete Recovery After Traumatic Brain Injury Interview with:

Prof.dr. J van der Naalt PhD Department of Neurology University Medical Center Groningen Groningen, The Netherlands

Prof J van der Naalt

Prof.dr. J van der Naalt PhD
Department of Neurology University Medical Center Groningen
Groningen, The Netherlands What is the background for this study? What are the main findings?

Response: Mild traumatic brain injury occurs frequently and is one of the leading cause of morbidity in adults worldwide. It is a major social-economic problem with one in three patients had persistent complaints several months after injury that interfere with resumption of daily activities and work.

One of the most important questions concerns the finding that some patients recover without complaints and others do not after sustaining a mild traumatic brain injury. In a follow-up study with more than 1000 participants we found that personality factors are a major factor in the recovery process. In particular coping, that is the way patients adapt to persistent complaints, is important next to emotional distress and impact of the injury.

In an add-on study with fMRI we found that in the early phase after injury, the interaction between specific brain networks was temporarily changed. However, when regarding persistent posttraumatic complaints , specific personality characteristics significantly determine long term outcome. What should clinicians and patients take away from your report?

Response: Most doctors do not recognize that patients after sustaining a mild traumatic brain injury can have very disabling complaints because they do not have visible impairment. Our research has shown that the complaints are related to the impact of the injury and that it is important to determine which patients are at-risk for incomplete recovery in an early stage after injury to provide adequate therapy. What recommendations do you have for future research as a result of this study?

Response: It is mandatory to identify patients at risk for incomplete recovery in an early stage. Psycho-education is necessary. After discharge from the ED, patients could be contacted by phone or mail to inform whether complaints are present that interfere with daily activities. Additionally, a screening could be done by a checklist whether they have certain personality characteristics or have emotional distress. If so, these patients could be offered further follow-up and support.

No disclosures Thank you for your contribution to the community.


Early predictors of outcome after mild traumatic brain injury (UPFRONT): an observational cohort study
van der Naalt, Joukje et al.
The Lancet Neurology , Volume 16 , Issue 7 , 532 – 540

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. 

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Last Updated on November 9, 2017 by Marie Benz MD FAAD