To the Editor.—
I would like to comment on the article Auditory Brain-stem Responses in Postconcussion Syndrome" by Noseworthy et al (ARCHIVES 1981;38:275-278).
In general, the research is noteworthy in its exploration of this phenomenon, and the aims of the authors were in good order. However, I would like to quibble about the methodological features of the study that serve to restrict useful conclusions from the data.
My criticisms center on two main points: (1) The authors did not control for neuroticism or other possible psychogenic factors in postconcussion syndrome. (2) Their sample size was too small to allow for the valid generalization of results.
Although Noseworthy et al propose that they are going to ferret out or perhaps clarify the various functional vs organic factors in postconcussion syndrome, they succeed only in demonstrating that patients who have had mild head injuries have some persistent, perhaps insignificant, mild neurologic deficit. They do not
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