Abstract
Background:
The Concussion Clinical Profile Screening Tool (CP Screen) organizes symptoms into clinically meaningful domains. These profiles serve to help clinicians stratify patients' symptom burden and guide treatment. In pediatric populations, recognizing elevated symptom profiles at initial presentation may support early intervention, improve outcomes, and mitigate development of persistent post-concussive symptoms (PPCS).
Hypothesis:
Pediatric patients who develop chronic concussion will exhibit different predominant symptom clusters on the initial CP Screen compared to those who recover within 3 months.
Methods:
A retrospective review was conducted on 56 pediatric concussion patients aged 8 to 19 who presented to a multidisciplinary sports medicine clinic between 2023 and 2024. Patients were classified as acute (symptoms <3 months post-injury) or chronic (symptoms ≥3 months) based on time since injury. Symptom burden was evaluated using the CP Screen, which includes clinical profile (CP) scores for migraine, mood, cognitive fatigue, vestibular, ocular, sleep and cervical profiles. Total symptom score and individual profile scores were compared between groups using unpaired t-tests.
Results:
The chronic group demonstrated a significantly higher mean total symptom score at presentation (8.89) compared to the acute group (2.87; p = 0.013).
Within the CP subdomains, notably, the migraine (chronic 0.32, acute 0.06; p=0.006), ocular (0.50 vs. 0.11; p = 0.007), and vestibular (0.23 vs. 0.05; p = 0.015) profiles were significantly elevated in the chronic group at the initial visit.
Additionally, the mood (chronic 0.37, acute 0.12; p = 0.029) profile reached statistical significance, though the magnitude of difference was smaller.
The cognitive fatigue (chronic 0.39, acute 0.23; p=0.193), cervical (0.08 chronic, acute 0.02; p=0.115), and sleep (chronic 0.11, acute 0.10; p = 0.418) domains did not differ significantly between groups.
Conclusion:
Pediatric patients who develop chronic symptoms (≥3 months) show higher initial migraine, visual, vestibular, and mood CP scores, indicating these profiles may help identify those at risk for prolonged recovery. Cognitive fatigue was the most commonly elevated CP in both groups, but its lack of difference at presentation suggests it reflects overall symptom burden rather than serving as a predictor of chronicity. These findings align with adult trends but highlight distinct pediatric symptom patterns. Using structured CP profiles at initial evaluation may enable early risk identification and guide targeted interventions to improve outcomes in children with concussion.