A recent study has highlighted a link between pre-injury somatization scores with post-concussion symptom duration. Baseline symptom scores have also been shown to worsen post-injury verbal and visual memory.
Some suggest that these pre-injury somatic complaints alter how someone experiences their concussion or how they report their symptoms afterward. I would like to suggest an alternative explanation.
I believe the correlation of pre-injury somatic complaints with prolonged recovery reflects unresolved prior brain injury from sub-concussive events as a result of pre-existing microglia neuroinflammation.
As has been described, impaired recovery from brain injury can result from underlying neuroinflammatory due to primed-microglia. I believe many individuals in the general population have chronically primed-microglia as a result of underlying LPS priming from bacterial dysbiosis and/or linoleic neurotoxicity.
I believe this chronic low-grade neuroinflammatory state is responsible for impaired recovery from concussive and sub-concussive injuries, and may be the reason for the epidemic of unresolved concussions we are presently experiencing. The residual damage from these sub-concussive traumatic brain injuries accumulates, and results in what I describe as cumulative brain injury or CBI.
When taking a detailed symptoms history from my patients, I commonly find patient’s reporting the development of long-lasting symptoms such as occasional lightheadedness or fatigue after relatively minor injuries such as hitting their head on the hatch of the car or a cabinet in the kitchen.
Many patients report having had mild motor vehicle accidents that did not result in an emergency room visit but resulted in chronic neck pain that improves with activity and worsens with rest (i.e. coat hanger pain). They often are seeing the chiropractor repeatedly for the pain.
Autonomic evaluation by spectral analysis of these patients often reveals sympathetic and parasympathetic damage. I am able to reverse the autonomic dysfunction though a multifaceted regimen targeted at the reduction of neuroinflammation. Normalization of autonomic function often results in complete reversal of their somatic complaints.
The pre-injury somatic complaints being detected in these studies are real, and represent incomplete recovery from prior brain injuries (concussive and sub-concussive), most likely from underlying neuroinflammation.
Individuals without neuroinflammation would normally recover without any residual symptoms or underlying autonomic impairment from sub-concussive injuries but he presence of neuroinflammation results in residual damage and somatic symptoms.
My view is that pre-injury somatic complaints may actually be a marker for underlying neuroinflammation that then would predict more prolonged and incomplete recovery because of the dysfunctional microglia and stem cell functioning.