{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:50:10Z","timestamp":1792183810516,"version":"4.4.0"},"reference-count":83,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004337","name":"St George\u2019s University of London","doi-asserted-by":"crossref","award":["SGL025\\1014"],"award-info":[{"award-number":["SGL025\\1014"]}],"id":[{"id":"10.13039\/501100004337","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Persistent symptoms following a minor head injury can cause significant morbidity, yet the underlying mechanisms for this are poorly understood. The shortcomings of the current terminology that refer to non-specific symptom clusters is discussed. This update considers the need for a multi-dimensional approach for the heterogenous mechanisms driving persistent symptoms after mild traumatic brain injury. Relevant pathophysiology is discussed to make the case for mild traumatic brain injury to be conceptualized as an interface disorder spanning neurology, psychiatry and psychology. The relevance of pre-injury factors, psychological co-morbidities and their interaction with the injury to produce persistent symptoms are reviewed. The interplay with psychiatric diagnoses, functional and somatic symptom disorder presentations and the influence of the medicolegal process is considered. The judicious use and interpretation of investigations given the above complexity is discussed, with suggestions of how the explanation of the diagnostic formulation to the patient can be tailored, including insight into the above processes, to aid recovery. Moving beyond the one-dimensional concept of \u2018postconcussional syndrome\u2019 and reframing the cause of persistent symptoms following mild traumatic brain injury in a bio-psycho-socio-ecological model will hopefully improve understanding of the underlying contributory mechanistic interactions and facilitate treatment.<\/jats:p>","DOI":"10.1093\/brain\/awac149","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T15:11:13Z","timestamp":1650899473000},"page":"1906-1915","source":"Crossref","is-referenced-by-count":45,"title":["Reframing postconcussional syndrome as an interface disorder of neurology, psychiatry and psychology"],"prefix":"10.1093","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2817-2352","authenticated-orcid":false,"given":"Camilla N","family":"Clark","sequence":"first","affiliation":[{"name":"Institute of Molecular & Clinical Sciences, St George\u2019s University of London , SW17 0RE London , UK"},{"name":"UK DRI Care Research and Technology Centre, Imperial College London , W12 0BZ London , UK"},{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J","family":"Edwards","sequence":"additional","affiliation":[{"name":"Institute of Molecular & Clinical Sciences, St George\u2019s University of London , SW17 0RE London , UK"},{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bee Eng","family":"Ong","sequence":"additional","affiliation":[{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Goodliffe","sequence":"additional","affiliation":[{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hena","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Dilley","sequence":"additional","affiliation":[{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Betteridge","sequence":"additional","affiliation":[{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colette","family":"Griffin","sequence":"additional","affiliation":[{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter O","family":"Jenkins","sequence":"additional","affiliation":[{"name":"UK DRI Care Research and Technology Centre, Imperial College London , W12 0BZ London , UK"},{"name":"Neurology department, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , SW17 0QT London , UK"},{"name":"Neurology Department, University Hospital Southampton NHS Foundation Trust , Southampton , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"2022070101361220500_awac149-B1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jad.2019.10.058","article-title":"Brain dysfunction underlying prolonged post-concussive syndrome: A systematic review","volume":"262","author":"Biagianti","year":"2020","journal-title":"J Affect Disord"},{"key":"2022070101361220500_awac149-B2","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1136\/bmj.320.7250.1631","article-title":"Disability in young people and adults one year after head injury: Prospective cohort study","volume":"320","author":"Thornhill","year":"2000","journal-title":"BMJ"},{"key":"2022070101361220500_awac149-B3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/arclin\/acp006","article-title":"NAN Policy and Planning Committee. 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