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Neurological Rehabilitation

Community-Dwelling PPCS and Moderate to Severe TBI Patients Demonstrate Comparable Functional Outcomes

Thursday, October 23, 2025
5:00 PM - 6:30 PM MT
Location: Open Kiosks

    Co-Author(s)

  • GP

    Ginger Polich, MD

    Assistant Professor in Physical Medicine and Rehabilitation
    Spaulding Rehabilitation Hospital
    Cambridge, Massachusetts

    • Poster Presenter(s)

  • Grace Olson, Other

    Medical Student
    Boston University Chobanian & Avedisian School of Medicine
    Roxbury, Massachusetts

    • Co-Author(s)

  • RG

    Rishab Gupta, MD

    Instructor in Psychiatry
    Harvard Medical School
    Jamaica Plain, Massachusetts

Disclosure(s):
Grace Olson, Other: No financial relationships to disclose
Rishab Gupta, MD: No financial relationships to disclose
Background and/or Objectives: Traumatic brain injuries (TBI) of all severities have been associated with chronic functional impairment. This includes individuals who develop persistent post-concussion symptoms (PCS) after a mild TBI as well as individuals who sustain injuries classified as moderate to severe TBI (msTBI). This study aims to compare functional outcomes, as well as similarities and differences in demographic variables and clinical/psychological symptom burden, between community-dwelling PCS and msTBI patients.

Design: Retrospective observational cohort study

Setting : Outpatient

Participants : Adults ages 18-70 evaluated for TBI-related care at an urban academic center by both Physical Medicine and Rehabilitation (PM&R) and Neuropsychiatry between 2018 and 2024 (N=56 PCS, N=25 msTBI).

Interventions: None

Main Outcome Measures: Primary outcomes included functional status (relationship, driving, schooling, employment) and disability compensation at three time points (pre-injury, time at first evaluation, time at most recent evaluation). Secondary outcomes included demographic and clinical/psychological symptom profiles.

Results: With the exception of partnership at the time of injury (p=0.029), PCS and msTBI groups showed no significant differences in any functional outcome at any time point (p>0.05). PCS patients were predominantly female with higher rates of pre-injury anxiety, trauma, and somatoform conditions, and post-injury post-traumatic stress disorder and motor functional neurologic disorder. The msTBI patients were predominantly male with higher rates of pre-injury substance use disorder and higher rates of post-injury seizures, emotional lability, and disinhibition.

Conclusions: Despite significant differences in injury severity, community-dwelling PCS and msTBI patients presenting for multidisciplinary care demonstrated comparable levels of long-term functional impairments. PCS and msTBI showed overlapping yet distinct premorbid demographic and pre- and post-injury clinical/psychological symptom burden. In these populations, long-term disability may be driven more by demographic characteristics and symptom burden than injury severity.