Background: Mild traumatic brain injury (mTBI) is an increasing public health problem, because of its persistent symptoms and several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help to guide the prevention of persistent symptoms following mTBI. The prognosis of mTBI has stimulated several empirical primary research papers and many systematic reviews leading to the identification of a wide range of factors. We aim to synthesize these factors to get a better understanding of their breadth and scope. Methods: We conducted an overview of systematic reviews. We searched in databases systematic reviews synthesizing evidence about the prognosis of persistent symptoms after mTBI in the adult population. Two reviewers independently screened all references and selected eligible reviews based on eligibility criteria. They extracted relevant information using an extraction grid. They also rated independently the risk of bias using the ROBIS tool. We synthesized evidence into a comprehensive conceptual map to facilitate the understanding of prognostic factors that have an impact on persistent post-concussion symptoms. Results: From the 3857 references retrieved in a database search, we included 25 systematic reviews integrating the results of 312 primary articles published between 1957 and 2019. We examined 35 prognostic factors from the systematics reviews. No single prognostic factor demonstrated convincing and conclusive results. However, age, sex, and multiple concussions showed an affirmatory association with persistent post-concussion outcomes in systematic reviews. Conclusion: We highlighted the need for a comprehensive picture of prognostic factors related to persistent post-concussion symptoms. We believe that these prognostic factors would guide clinical decisions and research related to prevention and intervention regarding persistent post-concussion symptoms. Systematic review registration: PROSPERO CRD42020176676

The aim of the study was to determine if the Rivermead Postconcussion Symptoms Questionnaire (RPQ) is a better tool for outcome prediction than an objective neuropsychological assessment following mild traumatic brain injury (mTBI). The study included 47 patients with mTBI referred to an outpatient rehabilitation clinic. The RPQ and a brief neuropsychological battery were performed in the first few days following the trauma. The outcome measure used was the Mayo-Portland Adaptability Inventory-4 (MPAI-4) which was completed within the first 3 months. The only variable associated with results on the MPAI-4 was the RPQ score (p < .001). The predictive outcome model including age, education, and the results of the Trail-Making Test-Parts A and B (TMT) had a pseudo-R² of .02. When the RPQ score was added, the pseudo-R² climbed to .19. This model indicates that the usefulness of the RPQ score and the TMT in predicting moderate-to-severe limitations, while controlling for confounders, is substantial as suggested by a significant increase in the model chi-square value, delta _(1df) = 6.517, p < .001. The RPQ and the TMT provide clinicians with a brief and reliable tool for predicting outcome functioning and can help target the need for further intervention and rehabilitation following mTBI.

Converging evidence has shown that domain-general cognitive abilities, especially executive functions (EF), tend to be superior in sport experts. However, recent studies have questioned this cognitive advantage and found inconsistent findings when comparing sport type and sex. This study aimed to compare the impact of sport expertise, sport type, and sex on various domains of cognitive functions. Two hundred and thirty elite athletes (n_Female = 124, n_Male = 106) representing three sport categories (Team [n = 91], Precision-skill dependent [n = 63], and Speed-strength [n = 76] sports) were assessed using a computerized neuropsychological test battery including tests of EF (working memory, inhibition, cognitive flexibility and planning), as well as tests of selective and sustained attention. T-scores and raw values were used to analyze performance through t-tests and ANCOVA with age as covariate. Athletes demonstrated better performance than the normative mean on 5 out of 11 cognitive test variables (p < 0.005). However, their performance fell within the average range when considering the results along a normative scale, except for sustained attention and working memory where they performed just above average (<1 SD). There was a significant main effect of sport category on only one EF variable (p = 0.003). Males performed significantly faster than females on motor reaction time measures of attention and inhibition (all p < 0.001). In this study, the 'expert advantage' on domain-general cognitive tests was less prominent when utilizing a normative scale and controlling for age or speed-accuracy trade-offs, except for sustained attention and working-memory. Cognitive functions did not appear to differ meaningfully based on athletes' sport type or sex.