Journal of the International Neuropsychological Society



CRITICAL REVIEW

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome


ERIN D.  BIGLER  a1 c1
a1 Departments of Psychology and Neuroscience, Brigham Young University, Provo, Utah and Department of Psychiatry and the Utah Brain Institute, University of Utah, Salt Lake City, Utah

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Abstract

On the mild end of the acquired brain injury spectrum, the terms concussion and mild traumatic brain injury (mTBI) have been used interchangeably, where persistent post-concussive syndrome (PPCS) has been a label given when symptoms persist for more than three months post-concussion. Whereas a brief history of concussion research is overviewed, the focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of concussion in human and animal studies, particularly directed at a better understanding of the neuropathology associated with concussion. These studies implicate common regions of injury, including the upper brainstem, base of the frontal lobe, hypothalamic-pituitary axis, medial temporal lobe, fornix, and corpus callosum. Limitations of current neuropsychological techniques for the clinical assessment of memory and executive function are explored and recommendations for improved research designs offered, that may enhance the study of long-term neuropsychological sequelae of concussion. (JINS, 2008, 14, 1–22.)

(Received March 6 2007)
(Revised August 16 2007)
(Accepted August 16 2007)


Key Words: Concussion; Mild TBI; Biomechanics; Neuroimaging; Neuropathology; Neuropsychology.

Correspondence:
c1 Correspondence and reprint request to: Erin D. Bigler, Ph.D., Departments of Psychology and Neuroscience, 1190D SWKT, Brigham Young University, Provo, Utah 84602. E-mail: erin_bigler@byu.edu


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