In Reply We recently reported that many patients who presented to level 1 trauma centers after mild traumatic brain injury (mTBI) continued to report injury-related functional limitations at 1 year postinjury.¹ Our findings are from the TRACK-TBI study, one of the most comprehensive prospective investigations of civilian TBI to date. A recent Letter to the Editor suggested that our findings veer from seminal work by several of our coauthors that was published 20 or more years ago. We contend that our results reflect major advances in brain injury science over the past 2 decades, including our understanding of mTBI. Levin et al² and Dikmen et al³ focused on cognitive outcomes, not functional limitations, and analyzed narrower and broader TBI populations, respectively. Accordingly, they were not directly informative to cite in the present study. Our findings should also not be considered interchangeable with the research from McCrea et al⁴ on athletes with sport-related concussion. Factors, such as preinjury physical conditioning⁵ and TBI severity,³ are associated with recovery after mTBI; consequently, we should not assume that the rapid recovery experienced by most healthy athletes with sport-related concussion is generalizable to expected recovery in the broader neurotrauma population.

在回复中我们最近报告说，许多在轻度创伤性脑损伤 (mTBI) 后就诊于 1 级创伤中心的患者在受伤后 1 年继续报告与损伤相关的功能限制。¹我们的发现来自 TRACK-TBI 研究，这是迄今为止对平民 TBI 最全面的前瞻性调查之一。最近给编辑的一封信表明，我们的发现与我们的几位合著者在 20 年或更长时间前发表的开创性工作背道而驰。我们认为我们的结果反映了过去 20 年脑损伤科学的重大进展，包括我们对 mTBI 的理解。Levin 等人²和 Dikmen 等人³专注于认知结果，而不是功能限制，并分别分析了更窄和更广泛的 TBI 人群。因此，它们在本研究中没有直接引用的信息。我们的研究结果也不应被视为与 McCrea 等人⁴对患有运动相关脑震荡的运动员的研究可互换。伤前身体状况⁵和 TBI 严重程度³等因素与 mTBI后的恢复有关；因此，我们不应假设大多数患有运动相关脑震荡的健康运动员所经历的快速恢复可推广到更广泛的神经创伤人群的预期恢复。