Introduction

Various manifestations ranging from physical symptoms to cognitive and emotional impairments could often be seen following head concussions that lead to mild traumatic brain injury (mTBI). These symptoms are commonly comprising the post-concussion syndrome (PCS) and their resolution could be influenced by multiple factors. Personality traits have been suggested as potential risk factors for the emergence and persistence of PCS. In this study, we aimed to investigate the possible predisposition to PCS given by certain personality traits.

Methods

Prospective cohort studies, observational studies, and cross-phenotype polygenic risk score analyses were selected from the main scientific databases (PubMed/Medline, Scopus, EMBASE, Web of Science) based on multiple-step screening, using keywords (such as “personality traits”, “post-concussion syndrome”, “traumatic brain injury”, “anxiety”, “depression”, “resilience”, and “somatization”) and inclusion/exclusion criteria (English written studies available in full text presenting relevant data on TBI patients and their personality traits; reviews, animal studies, and studies not written in English, not available in full text, or not presenting full demographical and clinical data were excluded). The investigated personality traits included emotional reserve, somatic trait anxiety, embitterment, mistrust, parental anxiety, state anxiety, trait anxiety, anxiety sensitivity, pain catastrophizing, helplessness, sports-concussion symptom load, and cognitive resilience.

Results

The reviewed data from 16 selected studies suggested that personality traits play an essential role in the development and persistence of PCS. Emotional reserve, cognitive resilience, and lower levels of somatic trait anxiety were associated with better outcomes in PCS. However, higher levels of anxiety sensitivity, pain catastrophizing, helplessness, and sports-concussion symptom load were associated with worse outcomes in PCS. Parental anxiety was not associated with persistent symptoms in children following concussion. Despite the statistical analysis regarding the included publications bias was low, further studies should further investigate the correlation between TBI and some personality traits, as some of the selected studies did not included healthy individuals and their psychological profiles for comparison and correlation analysis.

Conclusion

Personality traits may help predict the development and persistence of PCS following mTBI. Understanding the personality traits roles in PCS could assist the development of targeted interventions for the prevention and treatment of PCS. Further research is needed to better understand the complex interactions between personality traits, neurobiological factors, and psychosocial factors in PCS.

中文翻译：

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脑震荡后综合症人格特征的回顾

介绍

头部脑震荡导致轻度创伤性脑损伤 (mTBI) 后，经常会出现从身体症状到认知和情感障碍等各种表现。这些症状通常包括脑震荡后综合症 (PCS)，其缓解可能受到多种因素的影响。人格特质被认为是 PCS 出现和持续的潜在危险因素。在这项研究中，我们旨在调查某些性格特征可能导致 PCS 的倾向。

方法

前瞻性队列研究、观察性研究和跨表型多基因风险评分分析是根据多步骤筛选，使用关键词（例如“人格特质”、“脑震荡后综合症”、“创伤性脑损伤”、“焦虑”、“抑郁”、“复原力”和“躯体化”）和纳入/排除标准（英文书面研究全文提供有关 TBI 的相关数据患者及其性格特征；评论、动物研究以及非英文撰写、没有全文或未提供完整的人口统计和临床数据的研究被排除在外）。调查的人格特征包括情绪保守、躯体特质焦虑、怨恨、不信任、父母焦虑、状态焦虑、特质焦虑、焦虑敏感性、疼痛灾难化、无助、运动脑震荡症状负荷和认知弹性。

结果

16 项选定研究的回顾数据表明，人格特质在 PCS 的发展和持续过程中发挥着重要作用。情绪储备、认知弹性和较低水平的躯体特质焦虑与 PCS 的更好预后相关。然而，较高水平的焦虑敏感性、灾难性疼痛、无助感和运动脑震荡症状负荷与 PCS 的较差预后相关。父母的焦虑与脑震荡后儿童的持续症状无关。尽管纳入的出版物偏差的统计分析较低，但进一步的研究应进一步探讨 TBI 与某些人格特征之间的相关性，因为一些选定的研究并未纳入健康个体及其心理概况进行比较和相关性分析。

结论

人格特质可能有助于预测 mTBI 后 PCS 的发展和持续。了解人格特质在 PCS 中的作用有助于制定预防和治疗 PCS 的有针对性的干预措施。需要进一步的研究来更好地理解 PCS 中人格特质、神经生物学因素和心理社会因素之间复杂的相互作用。