Treatment for Patients With Chronic Post-Concussion Symptoms

University of California, Los Angeles40 enrolled

Overview

The current project will examine the effect of a brief psychological intervention on post-concussion symptoms, neurocognitive function, cerebral blood flow (CBF), and psychophysiological and salivary cortisol markers of autonomic nervous system (ANS) in a sample of 20 participants between 13-25 years of age who experience long-term post-concussive (PC) symptoms 2-9 months post-injury as well as 20 age- and sex-matched controls (non-injured) participants to provide normative data on all the above measures except for concussive symptoms.

Participants with concussion will participate in six, home-based interventions designed to treat cognitive-behavioral factors that are maintaining their symptoms. The investigators hypothesize that the prolonged PC symptoms are in part due to disruption of autonomic nervous system function post-injury as well as exacerbation by the psychological response to the injury. This hypothesis is based on evidence showing that PC symptoms, including headache, fatigue, dizziness, and heightened anxiety overlap with upregulated sympathetic activity and elevated levels of salivary cortisol. There is evidence linking cognitive-behavioral factors (e.g., catastrophizing) to prolonged symptoms of autonomic overactivation after injury (e.g., anxiety, pain, etc.). The participants are taught shallow breathing techniques to normalize parasympathetic activity and provide cognitive-behavioral treatment to reduce psychological reactions to the injury that exacerbate the autonomic disruption and prolong recovery.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Mild Traumatic Brain Injury Concussion Post Syndrome

Interventions

Psychological InterventionBEHAVIORAL

Psychological treatment protocol designed to treat anxiety and avoidance in an adolescent/young adult population. The focus of treatment will be to address cognitive and behavioral factors associated with prolonged symptoms. Cognitive factors that may be addressed include, but are not limited to, catastrophizing, black or white thinking, and false expectations. Behavior factors that may be addressed include, but are not limited to, avoidance, relaxation, and behavioral activation. The psychological intervention is also designed to help reduce psychophysiological arousal associated with anxiety and stress. Participants will also be taught controlled shallow breathing exercises designed to normalize the ratio of sympathetic/parasympathetic activity.

Eligibility

Sex: ALLMin age: 13 YearsMax age: 25 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion criteria for patients: * Between the ages of 13-25 * Diagnosed with a concussion or mild traumatic brain injury by a physician * Currently experiencing post-concussive symptoms for at least two months after their injury but no longer than 9 months. * Fluent English speaker Exclusion Criteria: * History of/or comorbid neurological conditions that might affect performance (including history of stroke, seizure disorder, moderate to severe traumatic brain injury, anoxia) * Severe cardiovascular conditions. * History of psychosis and current substance abuse or dependence. * Current severe symptoms of depression and/or anxiety. Additional Exclusion Criteria for Controls: \* No history of concussion in the past year.

Locations (1)

University of California, Los Angeles

Los Angeles, California, United States

RECRUITING