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Doctors can now predict duration of a child's concussion symptoms

University researchers Keith Yeates and Stephen Freedman part of new Canada-wide concussion study

Paediatric neuropsychologist Keith Yeates is a co-author of the concussion study and lead of the University of Calgary’s Integrated Concussion Research Program and the Traumatic Brain Injury NeuroTeam, initiatives within the Brain and Mental Health research strategy. Photo by Riley Brandt

Doctors can now predict the duration of paediatric concussion symptoms from research in a ground-breaking study of children across Canada.

Calgary was one of nine sites participating in the study led by Dr. Roger Zemek of the Children’s Hospital of Eastern Ontario and University of Ottawa.

“Every concussion is unique; much like every child. It is important to set realistic expectations for recovery,” says Zemek, lead author. The research, based on the largest prospective concussion cohort of children in the world, was published in the Journal of the American Medical Association (JAMA).

Team developed risk score to predict future post-concussion symptoms 

“Families can now be provided with more accurate information about the likely outcomes of their child’s concussion and this should be reassuring to them,” says Keith Yeates, PhD and study co-author.

Yeates is holder of the Ronald and Irene Ward Chair in Pediatric Brain Injury and lead of the university's Integrated Concussion Research Program and the Traumatic Brain Injury Neuro Team, initiatives within the Brain and Mental Health research strategy.

The study, called the 5P study: Predicting and Preventing Post-concussive Problems in Paediatrics, enrolled more than 3,000 children between five and 18-years-old who were evaluated within the first 48-hours after a head injury.  

From the results, the team developed a persistent post-concussion symptoms (PPCS) risk score. When applied to a child within 48-hours of their head injury, the risk score was proven to be significantly better than the child’s physician at predicting future PPCS. 

University student still recovering from concussion

Ash Kolstad is an undergrad student at the University of Calgary who suffered a concussion while playing hockey when he was 12 years old. The injury forced him to leave school for one year and quit the sport.

“It changed my life completely, giving me headaches, depression and dizziness.  It forced me to live in a dark room,” says Kolstad. “This research is really important because it’s shedding light on the impact of a concussion.”

Concussion is a serious public health problem with children and adolescents enduring the greatest incidence. One-third of them sustain ongoing physical symptoms such as headache or dizziness, difficulty concentrating and emotional and behavioural symptoms beyond one month. Consequences may include missed school, depressed mood, loss of social activities, and lower quality of life.

Findings show girls have twice the odds of long-term symptoms than boys

Some of the study findings included that while boys sustained more concussions, girls had twice the odds of boys for having symptoms last at least one month. In addition, older children and teens have a higher risk of PPCS than children under the age of eight years.

“By predicting high or low risk of post-concussion symptoms, we can be more efficient in arranging follow-up. Those at low risk may not need specialty referral, whereas those at higher risk could be prioritized for early follow-up with concussion specialists,” says Dr. Stephen Freedman. He is an emergency physician at Alberta Children’s Hospital, Calgary site lead in the study and holder of the Alberta Children’s Hospital Foundation professorship in Child Health and Wellness.

The 5P sites include the Alberta Children’s Hospital, Children’s Hospital of Eastern Ontario, Stollery Children’s Hospital, Children’s Hospital of Winnipeg, Hospital for Sick Children, Children’s Hospital of Western Ontario, CHU Sainte-Justine, Montreal Children’s Hospital, and IWK Health Sciences Centre.

The Calgary researchers are from the Alberta Children's Hospital Research Institute, the Hotchkiss Brain Institute (HBI) at the Cumming School of Medicine and the faculties of Arts and Kinesiology.

The Canadian Institutes of Health Research (CIHR) and the Ontario Neurotrauma Foundation (ONF) funded this study. 

The Integrated Concussion Research Program is funded by peer-reviewed grants from Alberta Innovates - Health Solutions and CIHR, as well as by community donations through the University of Calgary and the Alberta Children’s Hospital Foundation.

Led by the HBIBrain and Mental Health is one of six strategic research themes guiding the University of Calgary toward its Eyes High goals.