Factors in post traumatic headache and recovery following mild traumatic brain injury: The role of personality, genetics, and diagnostic assessment
Restricted (Penn State Only)
- Author:
- Greenberg, Liora Shaw
- Graduate Program:
- Psychology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- June 04, 2021
- Committee Members:
- Frank Hillary, Major Field Member
Peter Arnett, Chair & Dissertation Advisor
David Conroy, Outside Unit & Field Member
Kristin Buss (She/Her), Program Head/Chair
Jose Soto, Major Field Member - Keywords:
- Mild Traumatic Brain Injury
Sports Related Concussion
Headache
APOE
Neurocognitive Functioning
Performance Validity
Post-Traumatic Headache
Personality
Concussion
Head Injury
Genetics - Abstract:
- Sport-related concussion (SRC) is the most common type of traumatic brain injury occurring up to nearly four million times annually. Related sequelae are heterogeneous, wide-ranging, and rates of outcome vary. Typical recovery times can range from seven to 90 days post-concussion with symptoms spanning cognitive, somatic, behavioral, physical, emotional, and sleep-related domains. There appears to be a wide disparity between typical and atypical recovery timeframes, whereby some concussion patients experience prolonged recovery that persists years post-injury. Further, the individualized presentation of post-concussion symptomatology and their base rates are high in non-injured populations. This has provided a challenge for the evaluation of sport-related concussion and the need for diagnostic clarity persists. Of the common concussion-related sequelae, post-traumatic headache (PTH) has been shown to be frequently the last, or among the last, remaining symptoms. Identifying the cause(s) of this important, and often debilitating, post-concussion symptom may provide important clinical information that could help to inform diagnostic capability. Therefore, it would be helpful to elucidate key factors in the recovery of SRC. Three areas of etiology that show promise are personality, genetics and neurocognitive test interpretation. This dissertation aimed to explore these factors in effort to clarify and inform clinical practice, especially with respect to diagnosis and concussion management. Results indicate that PTH following SRC may be influenced by, or related to, clinical elevations in certain personality profiles, by the presence of the APOE e4 allele, as well as strategic motivation at baseline concussion evaluation.