Haran, F J; Dretsch, M N; Slaboda, J C; Johnson, D E; Adam, O R; Tsao, J W
Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 280–286, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values
@article{Haran2016b,
title = {Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment},
author = {Haran, F J and Dretsch, M N and Slaboda, J C and Johnson, D E and Adam, O R and Tsao, J W},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {280--286},
abstract = {PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p \< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p \> 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.},
keywords = {*Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {*Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stieg, P E; Perrine, K
Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article
In: World Neurosurgery, vol. 86, pp. 65–68, 2016.
Links | BibTeX | Tags: brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport
@article{Stieg2016,
title = {Helmet Use and Traumatic Brain Injury in Snowboarding},
author = {Stieg, P E and Perrine, K},
doi = {10.1016/j.wneu.2015.07.044},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {86},
pages = {65--68},
keywords = {brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {*Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Babcock, L; Kurowski, B G
Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms Journal Article
In: JAMA, vol. 315, no. 10, pp. 987–988, 2016.
BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male
@article{Babcock2016,
title = {Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms},
author = {Babcock, L and Kurowski, B G},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {987--988},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Zonfrillo, M R; Kim, K H; Arbogast, K B
In Reply Journal Article
In: Academic Emergency Medicine, vol. 23, no. 1, pp. 109, 2016.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics & Nume, Humans, Male, X-Ray Computed/ut [Utilization]
@article{Zonfrillo2016a,
title = {In Reply},
author = {Zonfrillo, M R and Kim, K H and Arbogast, K B},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {1},
pages = {109},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics \& Nume, Humans, Male, X-Ray Computed/ut [Utilization]},
pubstate = {published},
tppubtype = {article}
}
Comrie, D
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 399–400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Comrie2016,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure},
author = {Comrie, D},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {399--400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Kazemi, Mohsen
Concussion assessment and management knowledge among chiropractic fourth year interns and residents Journal Article
In: Journal of the Canadian Chiropractic Association, vol. 60, no. 4, pp. 273–285, 2016, ISBN: 0008-3194.
BibTeX | Tags: Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis
@article{Kazemi2016,
title = {Concussion assessment and management knowledge among chiropractic fourth year interns and residents},
author = {Kazemi, Mohsen},
isbn = {0008-3194},
year = {2016},
date = {2016-01-01},
journal = {Journal of the Canadian Chiropractic Association},
volume = {60},
number = {4},
pages = {273--285},
publisher = {Canadian Chiropractic Association},
address = {Toronto, Ontario},
keywords = {Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Suicide/sn [Statistics & Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {*Brain Concussion/co [Complications], *Suicide/sn [Statistics \& Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M; Bleiberg, J; Williams, K; Caban, J; Kelly, J; Grammer, G; DeGraba, T
Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 23–29, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare
@article{Dretsch2016,
title = {Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI},
author = {Dretsch, M and Bleiberg, J and Williams, K and Caban, J and Kelly, J and Grammer, G and DeGraba, T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {23--29},
abstract = {OBJECTIVE: To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. SETTING: A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. PARTICIPANTS: Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. DESIGN: Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. MAIN MEASURES: Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). RESULTS: All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. CONCLUSION: Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.},
keywords = {*Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare},
pubstate = {published},
tppubtype = {article}
}
Astafiev, S V; Zinn, K L; Shulman, G L; Corbetta, M
Exploring the physiological correlates of chronic mild traumatic brain injury symptoms Journal Article
In: NeuroImage Clinical, vol. 11, pp. 10–19, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests
@article{Astafiev2016,
title = {Exploring the physiological correlates of chronic mild traumatic brain injury symptoms},
author = {Astafiev, S V and Zinn, K L and Shulman, G L and Corbetta, M},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {10--19},
abstract = {We report on the results of a multimodal imaging study involving behavioral assessments, evoked and resting-state BOLD fMRI, and DTI in chronic mTBI subjects. We found that larger task-evoked BOLD activity in the MT+/LO region in extra-striate visual cortex correlated with mTBI and PTSD symptoms, especially light sensitivity. Moreover, higher FA values near the left optic radiation (OR) were associated with both light sensitivity and higher BOLD activity in the MT+/LO region. The MT+/LO region was localized as a region of abnormal functional connectivity with central white matter regions previously found to have abnormal physiological signals during visual eye movement tracking (Astafiev et al., 2015). We conclude that mTBI symptoms and light sensitivity may be related to excessive responsiveness of visual cortex to sensory stimuli. This abnormal sensitivity may be related to chronic remodeling of white matter visual pathways acutely injured.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {*Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Mannix, R; Iverson, G L
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Silverberg2016b,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply},
author = {Silverberg, N D and Mannix, R and Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
Abstract | Links | BibTeX | Tags: adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization & Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
keywords = {*Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization \& Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
Abstract | BibTeX | Tags: *Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {*Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
Abstract | BibTeX | Tags: *Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {*Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {*Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
Abstract | BibTeX | Tags: *Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {*Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Halim, A; Lamikanra, O E; Sutton, K
Female Athletes: Unique Challenges Facing Women Warriors Journal Article
In: American Journal of Orthopedics, vol. 45, no. 1, pp. 12–15, 2016.
BibTeX | Tags: adverse effects, anterior cruciate ligament, Athletic Injuries, Bone Diseases, brain concussion, caloric restriction, Female, human, Humans, Injuries, legislation and jurisprudence, malnutrition, Menstruation Disturbances, Metabolic, Nutrition Disorders, patient safety, pregnancy, prevention and control, sexism, SOCIAL justice, social problem, Social Problems, Sport, Sports, standards, Syndrome, UNITED States
@article{Halim2016,
title = {Female Athletes: Unique Challenges Facing Women Warriors},
author = {Halim, A and Lamikanra, O E and Sutton, K},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Orthopedics},
volume = {45},
number = {1},
pages = {12--15},
keywords = {adverse effects, anterior cruciate ligament, Athletic Injuries, Bone Diseases, brain concussion, caloric restriction, Female, human, Humans, Injuries, legislation and jurisprudence, malnutrition, Menstruation Disturbances, Metabolic, Nutrition Disorders, patient safety, pregnancy, prevention and control, sexism, SOCIAL justice, social problem, Social Problems, Sport, Sports, standards, Syndrome, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Covassin, T; Moran, R; Elbin, R J
Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009 Journal Article
In: Journal of Athletic Training, vol. 51, no. 3, pp. 189–194, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities
@article{Covassin2016,
title = {Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009},
author = {Covassin, T and Moran, R and Elbin, R J},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {3},
pages = {189--194},
abstract = {CONTEXT: Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. OBJECTIVE: To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. DESIGN: Descriptive epidemiologic study. SETTING: National Collegiate Athletic Association athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. MAIN OUTCOME MEASURE(S): Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. RESULTS: During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. CONCLUSIONS: Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Cooper, D B; Vanderploeg, R D
The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension Journal Article
In: Applied Neuropsychology. Adult, vol. 23, no. 4, pp. 264–273, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult
@article{Armistead-Jehle2016,
title = {The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension},
author = {Armistead-Jehle, P and Cooper, D B and Vanderploeg, R D},
year = {2016},
date = {2016-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {23},
number = {4},
pages = {264--273},
abstract = {The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population.},
keywords = {*Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Calcagnile, O; Anell, A; Unden, J
The addition of S100B to guidelines for management of mild head injury is potentially cost saving Journal Article
In: BMC Neurology, vol. 16, no. 1, pp. 200, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult
@article{Calcagnile2016,
title = {The addition of S100B to guidelines for management of mild head injury is potentially cost saving},
author = {Calcagnile, O and Anell, A and Unden, J},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
number = {1},
pages = {200},
abstract = {BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study. Patients were followed up after 3 months with a standardized questionnaire. Theoretical and actual cost differences were calculated. RESULTS: Seven hundred twenty-six patients were included and 29 (4.7 %) showed traumatic abnormalities on CT. No further significant intracranial complications were discovered on follow-up. Two hundred twenty-nine patients (27 %) had normal S100B levels and 497 patients (73 %) showed elevated S100B levels. Over-triage occurred in 73 patients (32 %) and under-triage occurred in 39 patients (7 %). No significant intracranial complications were missed. The introduction of S100B could save 71 per patient if guidelines were strictly followed. As compliance to the guidelines was not perfect, the actual cost saving was 39 per patient. CONCLUSION: Adding S100B to existing guidelines for mild TBI seems to reduce CT usage and costs, especially if guideline compliance could be increased.},
keywords = {*Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Clark, J M; Hoshizaki, T B
The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1047–1055, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/pc [Prevention & Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male
@article{Clark2016,
title = {The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse},
author = {Clark, J M and Hoshizaki, T B},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1047--1055},
abstract = {BACKGROUND: Women's field lacrosse is described as a noncontact game relying primarily on rules to decrease the risk of head injuries. Despite not allowing head contact, however, concussions continue to be reported in women's field lacrosse. PURPOSE: To assess the ability of men's lacrosse helmets to decrease linear and angular acceleration for different striking techniques in women's field lacrosse. STUDY DESIGN: Controlled laboratory study. METHODS: A helmeted and unhelmeted Hybrid III 50th Percentile headform was attached to a Hybrid III neckform and were subjected to impacts by 8 striking techniques. Eleven athletic females completed 5 slashing techniques, while physical reconstruction equipment was used to simulate falls and shoulder and ball impacts to the head. Three trials were conducted for each condition, and peak resultant linear and angular accelerations of the headform were measured. RESULTS: Falls produced the highest linear and angular acceleration, followed by ball and high-velocity stick impacts. Low-velocity stick impacts were found to produce the lowest linear and angular accelerations. Men's lacrosse helmets significantly decreased linear and angular accelerations in all conditions, while unhelmeted impacts were associated with high accelerations. CONCLUSION: If women's field lacrosse is played within the rules, only falls were found to produce high linear and angular acceleration. However, ball and high-velocity stick impacts were found to produce high linear and angular accelerations. These linear and angular accelerations were found to be within the ranges reported for concussion. When the game is not played within the rules, men's lacrosse helmets provide an effective method of reducing linear and angular accelerations. Thus, women's field lacrosse may be able to reduce the occurrence of high linear and angular acceleration impacts by having governing bodies improving rules, implementing the use of helmets, or both. CLINICAL RELEVANCE: Identifying striking techniques that produce high linear and angular acceleration specific to women's lacrosse and measuring the capacity of a men's lacrosse helmet to reduce linear and angular acceleration.Copyright © 2016 The Author(s).},
keywords = {*Brain Injuries/pc [Prevention \& Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Custer, A; Sufrinko, A; Elbin, R J; Covassin, T; Collins, M; Kontos, A
High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 136–141, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students
@article{Custer2016,
title = {High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes},
author = {Custer, A and Sufrinko, A and Elbin, R J and Covassin, T and Collins, M and Kontos, A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {136--141},
abstract = {CONTEXT: Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined. OBJECTIVE: To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC. DESIGN: Cohort study. SETTING: High school and collegiate athletic programs. PATIENTS OR OTHER PARTICIPANTS: A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Geh, N; Selzer, B J; Bower, R; Himedan, M; Strahle, M; Wetjen, N M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with Chiari I malformation Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 403–409, 2016.
Abstract | BibTeX | Tags: *Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool
@article{Strahle2016,
title = {Sports participation with Chiari I malformation},
author = {Strahle, J and Geh, N and Selzer, B J and Bower, R and Himedan, M and Strahle, M and Wetjen, N M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {403--409},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with Chiari I malformation (CM-I). The authors' goal was to define the risk of sports participation for children with the imaging finding of CM-I. METHODS A prospective survey was administered to 503 CM-I patients at 2 sites over a 46-month period. Data were gathered on imaging characteristics, treatment, sports participation, and any sport-related injuries. Additionally, 81 patients completed at least 1 subsequent survey following their initial entry into the registry and were included in a prospective group, with a mean prospective follow-up period of 11 months. RESULTS Of the 503 CM-I patients, 328 participated in sports for a cumulative duration of 4641 seasons; 205 of these patients participated in contact sports. There were no serious or catastrophic neurological injuries. One patient had temporary extremity paresthesias that resolved within hours, and this was not definitely considered to be related to the CM-I. In the prospective cohort, there were no permanent neurological injuries. CONCLUSIONS No permanent or catastrophic neurological injuries were observed in CM-I patients participating in athletic activities. The authors believe that the risk of such injuries is low and that, in most cases, sports participation by children with CM-I is safe.},
keywords = {*Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool},
pubstate = {published},
tppubtype = {article}
}
Liu, C Y; Law, M; Romano, R
Rational approach to understanding and preventing sports-related traumatic brain injuries Journal Article
In: World Neurosurgery, vol. 84, no. 6, pp. 1556–1557, 2015.
Links | BibTeX | Tags: accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance
@article{Liu2015,
title = {Rational approach to understanding and preventing sports-related traumatic brain injuries},
author = {Liu, C Y and Law, M and Romano, R},
doi = {10.1016/j.wneu.2015.07.076},
year = {2015},
date = {2015-01-01},
journal = {World Neurosurgery},
volume = {84},
number = {6},
pages = {1556--1557},
keywords = {accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance},
pubstate = {published},
tppubtype = {article}
}
Czerniak, S M; Sikoglu, E M; Liso Navarro, A A; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
A resting state functional magnetic resonance imaging study of concussion in collegiate athletes.[Erratum appears in Brain Imaging Behav. 2015 Sep;9(3):650; PMID: 25326270] Journal Article
In: Brain Imaging & Behavior, vol. 9, no. 2, pp. 323–332, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/pp [Physiopathology], *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], Adolescent, Athletes, BRAIN mapping, Female, Humans, interview, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Psychological, rest, Young Adult
@article{Czerniak2015b,
title = {A resting state functional magnetic resonance imaging study of concussion in collegiate athletes.[Erratum appears in Brain Imaging Behav. 2015 Sep;9(3):650; PMID: 25326270]},
author = {Czerniak, S M and Sikoglu, E M and {Liso Navarro}, A A and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
year = {2015},
date = {2015-01-01},
journal = {Brain Imaging \& Behavior},
volume = {9},
number = {2},
pages = {323--332},
abstract = {Sports-related concussions are currently diagnosed through multi-domain assessment by a medical professional and may utilize neurocognitive testing as an aid. However, these tests have only been able to detect differences in the days to week post-concussion. Here, we investigate a measure of brain function, namely resting state functional connectivity, which may detect residual brain differences in the weeks to months after concussion. Twenty-one student athletes (9 concussed within 6 months of enrollment; 12 non-concussed; between ages 18 and 22 years) were recruited for this study. All participants completed the Wisconsin Card Sorting Task and the Color-Word Interference Test. Neuroimaging data, specifically resting state functional Magnetic Resonance Imaging data, were acquired to examine resting state functional connectivity. Two sample t-tests were used to compare the neurocognitive scores and resting state functional connectivity patterns among concussed and non-concussed participants. Correlations between neurocognitive scores and resting state functional connectivity measures were also determined across all subjects. There were no significant differences in neurocognitive performance between concussed and non-concussed groups. Concussed subjects had significantly increased connections between areas of the brain that underlie executive function. Across all subjects, better neurocognitive performance corresponded to stronger brain connectivity. Even at rest, brains of concussed athletes may have to 'work harder' than their healthy peers to achieve similar neurocognitive results. Resting state brain connectivity may be able to detect prolonged brain differences in concussed athletes in a more quantitative manner than neurocognitive test scores.},
keywords = {*Athletic Injuries/pp [Physiopathology], *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], Adolescent, Athletes, BRAIN mapping, Female, Humans, interview, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Psychological, rest, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Marinides, Z; Galetta, K M; Andrews, C N; Wilson, J A; Herman, D C; Robinson, C D; Smith, M S; Bentley, B C; Galetta, S L; Balcer, L J; Clugston, J R
Vision testing is additive to the sideline assessment of sports-related concussion Journal Article
In: Neurology: Clinical Practice, vol. 5, no. 1, pp. 25–34, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test
@article{Marinides2015,
title = {Vision testing is additive to the sideline assessment of sports-related concussion},
author = {Marinides, Z and Galetta, K M and Andrews, C N and Wilson, J A and Herman, D C and Robinson, C D and Smith, M S and Bentley, B C and Galetta, S L and Balcer, L J and Clugston, J R},
doi = {10.1212/CPJ.0000000000000060},
year = {2015},
date = {2015-01-01},
journal = {Neurology: Clinical Practice},
volume = {5},
number = {1},
pages = {25--34},
abstract = {We examined the King-Devick (K-D) test, a vision-based test of rapid number naming, as a complement to components of the Sport Concussion Assessment Tool, 3rd edition (SCAT3) for diagnosis of concussion. Baseline and postconcussion data for the University of Florida men's football, women's soccer, and women's lacrosse teams were collected, including the K-D test, Standardized Assessment of Concussion (SAC), and Balance Error Scoring System (BESS). Among 30 athletes with first concussion during their athletic season (n 5 217 total), differences from baseline to postinjury showed worsening of K-D time scores in 79%, while SAC showed a ≥2- point worsening in 52%. Combining K-D and SAC captured abnormalities in 89%; adding the BESS identified 100% of concussions. Adding a vision-based test may enhance the detection of athletes with concussion. © 2015 American Academy of Neurology.},
keywords = {Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Olivera, A; Lejbman, N; Jeromin, A; French, L M; Kim, H S; Cashion, A; Mysliwiec, V; Diaz-Arrastia, R; Gill, J
Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment Journal Article
In: JAMA Neurology, vol. 72, no. 10, pp. 1109–1116, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult
@article{Olivera2015,
title = {Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment},
author = {Olivera, A and Lejbman, N and Jeromin, A and French, L M and Kim, H S and Cashion, A and Mysliwiec, V and Diaz-Arrastia, R and Gill, J},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
number = {10},
pages = {1109--1116},
abstract = {IMPORTANCE: Approximately one-third of military personnel who deploy for combat operations sustain 1 or more traumatic brain injuries (TBIs), which increases the risk for chronic symptoms of postconcussive disorder, posttraumatic stress disorder, and depression and for the development of chronic traumatic encephalopathy. Elevated concentrations of tau are observed in blood shortly following a TBI, but, to our knowledge, the role of tau elevations in blood in the onset and maintenance of chronic symptoms after TBI has not been investigated. OBJECTIVES: To assess peripheral tau levels in military personnel exposed to TBI and to examine the relationship between chronic neurological symptoms and tau elevations. DESIGN, SETTING, AND PARTICIPANTS: Observational assessment from September 2012 to August 2014 of US military personnel at the Madigan Army Medical Center who had been deployed within the previous 18 months. Plasma total tau concentrations were measured using a novel ultrasensitive single-molecule enzyme-linked immunosorbent assay. Classification of participants with and without self-reported TBI was made using the Warrior Administered Retrospective Casualty Assessment Tool. Self-reported symptoms of postconcussive disorder, posttraumatic stress disorder, and depression were determined by the Neurobehavioral Symptom Inventory, the Posttraumatic Stress Disorder Checklist Military Version, and the Quick Inventory of Depressive Symptomatology, respectively. Group differences in tau concentrations were determined through analysis of variance models, and area under the receiver operating characteristic curve determined the sensitivity and specificity of tau concentrations in predicting TBI and chronic symptoms. Seventy participants with self-reported TBI on the Warrior Administered Retrospective Casualty Assessment Tool and 28 control participants with no TBI exposure were included. MAIN OUTCOMES AND MEASURES: Concentration of total tau in peripheral blood. RESULTS: Concentrations of plasma tau were significantly elevated in the 70 participants with self-reported TBI compared with the 28 controls (mean [SD], 1.13 [0.78] vs 0.63 [0.48] pg/mL, respectively; F1},
keywords = {*Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Kriz, P K; Zurakowski, R D; Almquist, J L; Reynolds, J; Ruggieri, D; Collins, C L; D'Hemecourt, P A; Comstock, R D
Eye Protection and Risk of Eye Injuries in High School Field Hockey Journal Article
In: Pediatrics, vol. 136, no. 3, pp. 521–527, 2015.
Abstract | BibTeX | Tags: *Eye Injuries/pc [Prevention & Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention & Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention & Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]
@article{Kriz2015,
title = {Eye Protection and Risk of Eye Injuries in High School Field Hockey},
author = {Kriz, P K and Zurakowski, R D and Almquist, J L and Reynolds, J and Ruggieri, D and Collins, C L and D'Hemecourt, P A and Comstock, R D},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {3},
pages = {521--527},
abstract = {OBJECTIVE: To determine if injury rates among female field hockey players differ before and after implementation of a national mandate for protective eyewear (MPE). METHODS: We analyzed girls' field hockey exposure and injury data collected from national (High School Reporting Information Online [RIO]) and regional (Fairfax County Public Schools) high school sports injury databases in 2 seasons before (2009/10 and 2010/11) and 2 seasons after (2011/12 and 2012/13) a national MPE. RESULTS: The incidence of eye/orbital injuries was significantly higher in states without MPE (0.080 injuries per 1000 athletic exposures [AEs]) than in states with MPE (before the 2011/12 mandate) and the postmandate group (0.025 injuries per 1000 AEs) (odds ratio 3.20, 95% confidence interval 1.47-6.99},
keywords = {*Eye Injuries/pc [Prevention \& Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention \& Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention \& Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Strand, S; Lechuga, D; Zachariah, T; Beaulieu, K
Relative risk for concussions in young female soccer players Journal Article
In: Applied Neuropsychology. Child, vol. 4, no. 1, pp. 58–64, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]
@article{Strand2015,
title = {Relative risk for concussions in young female soccer players},
author = {Strand, S and Lechuga, D and Zachariah, T and Beaulieu, K},
year = {2015},
date = {2015-01-01},
journal = {Applied Neuropsychology. Child},
volume = {4},
number = {1},
pages = {58--64},
abstract = {The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p \< .001},
keywords = {*Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Astafiev, S V; Zinn, K L; Shulman, G L; Corbetta, M
Exploring the physiological correlates of chronic mild traumatic brain injury symptoms Journal Article
In: NeuroImage Clinical, vol. 11, pp. 10–19, 2016.
@article{Astafiev2016,
title = {Exploring the physiological correlates of chronic mild traumatic brain injury symptoms},
author = {Astafiev, S V and Zinn, K L and Shulman, G L and Corbetta, M},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {10--19},
abstract = {We report on the results of a multimodal imaging study involving behavioral assessments, evoked and resting-state BOLD fMRI, and DTI in chronic mTBI subjects. We found that larger task-evoked BOLD activity in the MT+/LO region in extra-striate visual cortex correlated with mTBI and PTSD symptoms, especially light sensitivity. Moreover, higher FA values near the left optic radiation (OR) were associated with both light sensitivity and higher BOLD activity in the MT+/LO region. The MT+/LO region was localized as a region of abnormal functional connectivity with central white matter regions previously found to have abnormal physiological signals during visual eye movement tracking (Astafiev et al., 2015). We conclude that mTBI symptoms and light sensitivity may be related to excessive responsiveness of visual cortex to sensory stimuli. This abnormal sensitivity may be related to chronic remodeling of white matter visual pathways acutely injured.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Mannix, R; Iverson, G L
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 400, 2016.
@article{Silverberg2016b,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply},
author = {Silverberg, N D and Mannix, R and Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {400},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zonfrillo, M R; Kim, K H; Arbogast, K B
In Reply Journal Article
In: Academic Emergency Medicine, vol. 23, no. 1, pp. 109, 2016.
@article{Zonfrillo2016a,
title = {In Reply},
author = {Zonfrillo, M R and Kim, K H and Arbogast, K B},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {1},
pages = {109},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stieg, P E; Perrine, K
Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article
In: World Neurosurgery, vol. 86, pp. 65–68, 2016.
@article{Stieg2016,
title = {Helmet Use and Traumatic Brain Injury in Snowboarding},
author = {Stieg, P E and Perrine, K},
doi = {10.1016/j.wneu.2015.07.044},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {86},
pages = {65--68},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Babcock, L; Kurowski, B G
Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms Journal Article
In: JAMA, vol. 315, no. 10, pp. 987–988, 2016.
@article{Babcock2016,
title = {Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms},
author = {Babcock, L and Kurowski, B G},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {987--988},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Dretsch, M N; Slaboda, J C; Johnson, D E; Adam, O R; Tsao, J W
Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 280–286, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values
@article{Haran2016b,
title = {Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment},
author = {Haran, F J and Dretsch, M N and Slaboda, J C and Johnson, D E and Adam, O R and Tsao, J W},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {280--286},
abstract = {PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p \< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p \> 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.},
keywords = {*Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {*Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stieg, P E; Perrine, K
Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article
In: World Neurosurgery, vol. 86, pp. 65–68, 2016.
Links | BibTeX | Tags: brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport
@article{Stieg2016,
title = {Helmet Use and Traumatic Brain Injury in Snowboarding},
author = {Stieg, P E and Perrine, K},
doi = {10.1016/j.wneu.2015.07.044},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {86},
pages = {65--68},
keywords = {brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {*Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Babcock, L; Kurowski, B G
Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms Journal Article
In: JAMA, vol. 315, no. 10, pp. 987–988, 2016.
BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male
@article{Babcock2016,
title = {Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms},
author = {Babcock, L and Kurowski, B G},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {987--988},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Zonfrillo, M R; Kim, K H; Arbogast, K B
In Reply Journal Article
In: Academic Emergency Medicine, vol. 23, no. 1, pp. 109, 2016.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics & Nume, Humans, Male, X-Ray Computed/ut [Utilization]
@article{Zonfrillo2016a,
title = {In Reply},
author = {Zonfrillo, M R and Kim, K H and Arbogast, K B},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {1},
pages = {109},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics \& Nume, Humans, Male, X-Ray Computed/ut [Utilization]},
pubstate = {published},
tppubtype = {article}
}
Comrie, D
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 399–400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Comrie2016,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure},
author = {Comrie, D},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {399--400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Kazemi, Mohsen
Concussion assessment and management knowledge among chiropractic fourth year interns and residents Journal Article
In: Journal of the Canadian Chiropractic Association, vol. 60, no. 4, pp. 273–285, 2016, ISBN: 0008-3194.
BibTeX | Tags: Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis
@article{Kazemi2016,
title = {Concussion assessment and management knowledge among chiropractic fourth year interns and residents},
author = {Kazemi, Mohsen},
isbn = {0008-3194},
year = {2016},
date = {2016-01-01},
journal = {Journal of the Canadian Chiropractic Association},
volume = {60},
number = {4},
pages = {273--285},
publisher = {Canadian Chiropractic Association},
address = {Toronto, Ontario},
keywords = {Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Suicide/sn [Statistics & Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {*Brain Concussion/co [Complications], *Suicide/sn [Statistics \& Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M; Bleiberg, J; Williams, K; Caban, J; Kelly, J; Grammer, G; DeGraba, T
Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 23–29, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare
@article{Dretsch2016,
title = {Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI},
author = {Dretsch, M and Bleiberg, J and Williams, K and Caban, J and Kelly, J and Grammer, G and DeGraba, T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {23--29},
abstract = {OBJECTIVE: To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. SETTING: A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. PARTICIPANTS: Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. DESIGN: Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. MAIN MEASURES: Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). RESULTS: All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. CONCLUSION: Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.},
keywords = {*Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare},
pubstate = {published},
tppubtype = {article}
}
Astafiev, S V; Zinn, K L; Shulman, G L; Corbetta, M
Exploring the physiological correlates of chronic mild traumatic brain injury symptoms Journal Article
In: NeuroImage Clinical, vol. 11, pp. 10–19, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests
@article{Astafiev2016,
title = {Exploring the physiological correlates of chronic mild traumatic brain injury symptoms},
author = {Astafiev, S V and Zinn, K L and Shulman, G L and Corbetta, M},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {10--19},
abstract = {We report on the results of a multimodal imaging study involving behavioral assessments, evoked and resting-state BOLD fMRI, and DTI in chronic mTBI subjects. We found that larger task-evoked BOLD activity in the MT+/LO region in extra-striate visual cortex correlated with mTBI and PTSD symptoms, especially light sensitivity. Moreover, higher FA values near the left optic radiation (OR) were associated with both light sensitivity and higher BOLD activity in the MT+/LO region. The MT+/LO region was localized as a region of abnormal functional connectivity with central white matter regions previously found to have abnormal physiological signals during visual eye movement tracking (Astafiev et al., 2015). We conclude that mTBI symptoms and light sensitivity may be related to excessive responsiveness of visual cortex to sensory stimuli. This abnormal sensitivity may be related to chronic remodeling of white matter visual pathways acutely injured.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {*Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Mannix, R; Iverson, G L
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Silverberg2016b,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply},
author = {Silverberg, N D and Mannix, R and Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
Abstract | Links | BibTeX | Tags: adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization & Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
keywords = {*Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization \& Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
Abstract | BibTeX | Tags: *Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {*Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
Abstract | BibTeX | Tags: *Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {*Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {*Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
Abstract | BibTeX | Tags: *Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {*Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Halim, A; Lamikanra, O E; Sutton, K
Female Athletes: Unique Challenges Facing Women Warriors Journal Article
In: American Journal of Orthopedics, vol. 45, no. 1, pp. 12–15, 2016.
BibTeX | Tags: adverse effects, anterior cruciate ligament, Athletic Injuries, Bone Diseases, brain concussion, caloric restriction, Female, human, Humans, Injuries, legislation and jurisprudence, malnutrition, Menstruation Disturbances, Metabolic, Nutrition Disorders, patient safety, pregnancy, prevention and control, sexism, SOCIAL justice, social problem, Social Problems, Sport, Sports, standards, Syndrome, UNITED States
@article{Halim2016,
title = {Female Athletes: Unique Challenges Facing Women Warriors},
author = {Halim, A and Lamikanra, O E and Sutton, K},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Orthopedics},
volume = {45},
number = {1},
pages = {12--15},
keywords = {adverse effects, anterior cruciate ligament, Athletic Injuries, Bone Diseases, brain concussion, caloric restriction, Female, human, Humans, Injuries, legislation and jurisprudence, malnutrition, Menstruation Disturbances, Metabolic, Nutrition Disorders, patient safety, pregnancy, prevention and control, sexism, SOCIAL justice, social problem, Social Problems, Sport, Sports, standards, Syndrome, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Covassin, T; Moran, R; Elbin, R J
Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009 Journal Article
In: Journal of Athletic Training, vol. 51, no. 3, pp. 189–194, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities
@article{Covassin2016,
title = {Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009},
author = {Covassin, T and Moran, R and Elbin, R J},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {3},
pages = {189--194},
abstract = {CONTEXT: Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. OBJECTIVE: To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. DESIGN: Descriptive epidemiologic study. SETTING: National Collegiate Athletic Association athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. MAIN OUTCOME MEASURE(S): Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. RESULTS: During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. CONCLUSIONS: Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Cooper, D B; Vanderploeg, R D
The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension Journal Article
In: Applied Neuropsychology. Adult, vol. 23, no. 4, pp. 264–273, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult
@article{Armistead-Jehle2016,
title = {The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension},
author = {Armistead-Jehle, P and Cooper, D B and Vanderploeg, R D},
year = {2016},
date = {2016-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {23},
number = {4},
pages = {264--273},
abstract = {The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population.},
keywords = {*Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Calcagnile, O; Anell, A; Unden, J
The addition of S100B to guidelines for management of mild head injury is potentially cost saving Journal Article
In: BMC Neurology, vol. 16, no. 1, pp. 200, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult
@article{Calcagnile2016,
title = {The addition of S100B to guidelines for management of mild head injury is potentially cost saving},
author = {Calcagnile, O and Anell, A and Unden, J},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
number = {1},
pages = {200},
abstract = {BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study. Patients were followed up after 3 months with a standardized questionnaire. Theoretical and actual cost differences were calculated. RESULTS: Seven hundred twenty-six patients were included and 29 (4.7 %) showed traumatic abnormalities on CT. No further significant intracranial complications were discovered on follow-up. Two hundred twenty-nine patients (27 %) had normal S100B levels and 497 patients (73 %) showed elevated S100B levels. Over-triage occurred in 73 patients (32 %) and under-triage occurred in 39 patients (7 %). No significant intracranial complications were missed. The introduction of S100B could save 71 per patient if guidelines were strictly followed. As compliance to the guidelines was not perfect, the actual cost saving was 39 per patient. CONCLUSION: Adding S100B to existing guidelines for mild TBI seems to reduce CT usage and costs, especially if guideline compliance could be increased.},
keywords = {*Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Clark, J M; Hoshizaki, T B
The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1047–1055, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/pc [Prevention & Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male
@article{Clark2016,
title = {The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse},
author = {Clark, J M and Hoshizaki, T B},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1047--1055},
abstract = {BACKGROUND: Women's field lacrosse is described as a noncontact game relying primarily on rules to decrease the risk of head injuries. Despite not allowing head contact, however, concussions continue to be reported in women's field lacrosse. PURPOSE: To assess the ability of men's lacrosse helmets to decrease linear and angular acceleration for different striking techniques in women's field lacrosse. STUDY DESIGN: Controlled laboratory study. METHODS: A helmeted and unhelmeted Hybrid III 50th Percentile headform was attached to a Hybrid III neckform and were subjected to impacts by 8 striking techniques. Eleven athletic females completed 5 slashing techniques, while physical reconstruction equipment was used to simulate falls and shoulder and ball impacts to the head. Three trials were conducted for each condition, and peak resultant linear and angular accelerations of the headform were measured. RESULTS: Falls produced the highest linear and angular acceleration, followed by ball and high-velocity stick impacts. Low-velocity stick impacts were found to produce the lowest linear and angular accelerations. Men's lacrosse helmets significantly decreased linear and angular accelerations in all conditions, while unhelmeted impacts were associated with high accelerations. CONCLUSION: If women's field lacrosse is played within the rules, only falls were found to produce high linear and angular acceleration. However, ball and high-velocity stick impacts were found to produce high linear and angular accelerations. These linear and angular accelerations were found to be within the ranges reported for concussion. When the game is not played within the rules, men's lacrosse helmets provide an effective method of reducing linear and angular accelerations. Thus, women's field lacrosse may be able to reduce the occurrence of high linear and angular acceleration impacts by having governing bodies improving rules, implementing the use of helmets, or both. CLINICAL RELEVANCE: Identifying striking techniques that produce high linear and angular acceleration specific to women's lacrosse and measuring the capacity of a men's lacrosse helmet to reduce linear and angular acceleration.Copyright © 2016 The Author(s).},
keywords = {*Brain Injuries/pc [Prevention \& Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Custer, A; Sufrinko, A; Elbin, R J; Covassin, T; Collins, M; Kontos, A
High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 136–141, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students
@article{Custer2016,
title = {High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes},
author = {Custer, A and Sufrinko, A and Elbin, R J and Covassin, T and Collins, M and Kontos, A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {136--141},
abstract = {CONTEXT: Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined. OBJECTIVE: To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC. DESIGN: Cohort study. SETTING: High school and collegiate athletic programs. PATIENTS OR OTHER PARTICIPANTS: A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Geh, N; Selzer, B J; Bower, R; Himedan, M; Strahle, M; Wetjen, N M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with Chiari I malformation Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 403–409, 2016.
Abstract | BibTeX | Tags: *Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool
@article{Strahle2016,
title = {Sports participation with Chiari I malformation},
author = {Strahle, J and Geh, N and Selzer, B J and Bower, R and Himedan, M and Strahle, M and Wetjen, N M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {403--409},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with Chiari I malformation (CM-I). The authors' goal was to define the risk of sports participation for children with the imaging finding of CM-I. METHODS A prospective survey was administered to 503 CM-I patients at 2 sites over a 46-month period. Data were gathered on imaging characteristics, treatment, sports participation, and any sport-related injuries. Additionally, 81 patients completed at least 1 subsequent survey following their initial entry into the registry and were included in a prospective group, with a mean prospective follow-up period of 11 months. RESULTS Of the 503 CM-I patients, 328 participated in sports for a cumulative duration of 4641 seasons; 205 of these patients participated in contact sports. There were no serious or catastrophic neurological injuries. One patient had temporary extremity paresthesias that resolved within hours, and this was not definitely considered to be related to the CM-I. In the prospective cohort, there were no permanent neurological injuries. CONCLUSIONS No permanent or catastrophic neurological injuries were observed in CM-I patients participating in athletic activities. The authors believe that the risk of such injuries is low and that, in most cases, sports participation by children with CM-I is safe.},
keywords = {*Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool},
pubstate = {published},
tppubtype = {article}
}
Liu, C Y; Law, M; Romano, R
Rational approach to understanding and preventing sports-related traumatic brain injuries Journal Article
In: World Neurosurgery, vol. 84, no. 6, pp. 1556–1557, 2015.
Links | BibTeX | Tags: accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance
@article{Liu2015,
title = {Rational approach to understanding and preventing sports-related traumatic brain injuries},
author = {Liu, C Y and Law, M and Romano, R},
doi = {10.1016/j.wneu.2015.07.076},
year = {2015},
date = {2015-01-01},
journal = {World Neurosurgery},
volume = {84},
number = {6},
pages = {1556--1557},
keywords = {accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance},
pubstate = {published},
tppubtype = {article}
}
Czerniak, S M; Sikoglu, E M; Liso Navarro, A A; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
A resting state functional magnetic resonance imaging study of concussion in collegiate athletes.[Erratum appears in Brain Imaging Behav. 2015 Sep;9(3):650; PMID: 25326270] Journal Article
In: Brain Imaging & Behavior, vol. 9, no. 2, pp. 323–332, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/pp [Physiopathology], *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], Adolescent, Athletes, BRAIN mapping, Female, Humans, interview, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Psychological, rest, Young Adult
@article{Czerniak2015b,
title = {A resting state functional magnetic resonance imaging study of concussion in collegiate athletes.[Erratum appears in Brain Imaging Behav. 2015 Sep;9(3):650; PMID: 25326270]},
author = {Czerniak, S M and Sikoglu, E M and {Liso Navarro}, A A and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
year = {2015},
date = {2015-01-01},
journal = {Brain Imaging \& Behavior},
volume = {9},
number = {2},
pages = {323--332},
abstract = {Sports-related concussions are currently diagnosed through multi-domain assessment by a medical professional and may utilize neurocognitive testing as an aid. However, these tests have only been able to detect differences in the days to week post-concussion. Here, we investigate a measure of brain function, namely resting state functional connectivity, which may detect residual brain differences in the weeks to months after concussion. Twenty-one student athletes (9 concussed within 6 months of enrollment; 12 non-concussed; between ages 18 and 22 years) were recruited for this study. All participants completed the Wisconsin Card Sorting Task and the Color-Word Interference Test. Neuroimaging data, specifically resting state functional Magnetic Resonance Imaging data, were acquired to examine resting state functional connectivity. Two sample t-tests were used to compare the neurocognitive scores and resting state functional connectivity patterns among concussed and non-concussed participants. Correlations between neurocognitive scores and resting state functional connectivity measures were also determined across all subjects. There were no significant differences in neurocognitive performance between concussed and non-concussed groups. Concussed subjects had significantly increased connections between areas of the brain that underlie executive function. Across all subjects, better neurocognitive performance corresponded to stronger brain connectivity. Even at rest, brains of concussed athletes may have to 'work harder' than their healthy peers to achieve similar neurocognitive results. Resting state brain connectivity may be able to detect prolonged brain differences in concussed athletes in a more quantitative manner than neurocognitive test scores.},
keywords = {*Athletic Injuries/pp [Physiopathology], *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], Adolescent, Athletes, BRAIN mapping, Female, Humans, interview, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Psychological, rest, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Marinides, Z; Galetta, K M; Andrews, C N; Wilson, J A; Herman, D C; Robinson, C D; Smith, M S; Bentley, B C; Galetta, S L; Balcer, L J; Clugston, J R
Vision testing is additive to the sideline assessment of sports-related concussion Journal Article
In: Neurology: Clinical Practice, vol. 5, no. 1, pp. 25–34, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test
@article{Marinides2015,
title = {Vision testing is additive to the sideline assessment of sports-related concussion},
author = {Marinides, Z and Galetta, K M and Andrews, C N and Wilson, J A and Herman, D C and Robinson, C D and Smith, M S and Bentley, B C and Galetta, S L and Balcer, L J and Clugston, J R},
doi = {10.1212/CPJ.0000000000000060},
year = {2015},
date = {2015-01-01},
journal = {Neurology: Clinical Practice},
volume = {5},
number = {1},
pages = {25--34},
abstract = {We examined the King-Devick (K-D) test, a vision-based test of rapid number naming, as a complement to components of the Sport Concussion Assessment Tool, 3rd edition (SCAT3) for diagnosis of concussion. Baseline and postconcussion data for the University of Florida men's football, women's soccer, and women's lacrosse teams were collected, including the K-D test, Standardized Assessment of Concussion (SAC), and Balance Error Scoring System (BESS). Among 30 athletes with first concussion during their athletic season (n 5 217 total), differences from baseline to postinjury showed worsening of K-D time scores in 79%, while SAC showed a ≥2- point worsening in 52%. Combining K-D and SAC captured abnormalities in 89%; adding the BESS identified 100% of concussions. Adding a vision-based test may enhance the detection of athletes with concussion. © 2015 American Academy of Neurology.},
keywords = {Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Olivera, A; Lejbman, N; Jeromin, A; French, L M; Kim, H S; Cashion, A; Mysliwiec, V; Diaz-Arrastia, R; Gill, J
Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment Journal Article
In: JAMA Neurology, vol. 72, no. 10, pp. 1109–1116, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult
@article{Olivera2015,
title = {Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment},
author = {Olivera, A and Lejbman, N and Jeromin, A and French, L M and Kim, H S and Cashion, A and Mysliwiec, V and Diaz-Arrastia, R and Gill, J},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
number = {10},
pages = {1109--1116},
abstract = {IMPORTANCE: Approximately one-third of military personnel who deploy for combat operations sustain 1 or more traumatic brain injuries (TBIs), which increases the risk for chronic symptoms of postconcussive disorder, posttraumatic stress disorder, and depression and for the development of chronic traumatic encephalopathy. Elevated concentrations of tau are observed in blood shortly following a TBI, but, to our knowledge, the role of tau elevations in blood in the onset and maintenance of chronic symptoms after TBI has not been investigated. OBJECTIVES: To assess peripheral tau levels in military personnel exposed to TBI and to examine the relationship between chronic neurological symptoms and tau elevations. DESIGN, SETTING, AND PARTICIPANTS: Observational assessment from September 2012 to August 2014 of US military personnel at the Madigan Army Medical Center who had been deployed within the previous 18 months. Plasma total tau concentrations were measured using a novel ultrasensitive single-molecule enzyme-linked immunosorbent assay. Classification of participants with and without self-reported TBI was made using the Warrior Administered Retrospective Casualty Assessment Tool. Self-reported symptoms of postconcussive disorder, posttraumatic stress disorder, and depression were determined by the Neurobehavioral Symptom Inventory, the Posttraumatic Stress Disorder Checklist Military Version, and the Quick Inventory of Depressive Symptomatology, respectively. Group differences in tau concentrations were determined through analysis of variance models, and area under the receiver operating characteristic curve determined the sensitivity and specificity of tau concentrations in predicting TBI and chronic symptoms. Seventy participants with self-reported TBI on the Warrior Administered Retrospective Casualty Assessment Tool and 28 control participants with no TBI exposure were included. MAIN OUTCOMES AND MEASURES: Concentration of total tau in peripheral blood. RESULTS: Concentrations of plasma tau were significantly elevated in the 70 participants with self-reported TBI compared with the 28 controls (mean [SD], 1.13 [0.78] vs 0.63 [0.48] pg/mL, respectively; F1},
keywords = {*Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Kriz, P K; Zurakowski, R D; Almquist, J L; Reynolds, J; Ruggieri, D; Collins, C L; D'Hemecourt, P A; Comstock, R D
Eye Protection and Risk of Eye Injuries in High School Field Hockey Journal Article
In: Pediatrics, vol. 136, no. 3, pp. 521–527, 2015.
Abstract | BibTeX | Tags: *Eye Injuries/pc [Prevention & Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention & Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention & Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]
@article{Kriz2015,
title = {Eye Protection and Risk of Eye Injuries in High School Field Hockey},
author = {Kriz, P K and Zurakowski, R D and Almquist, J L and Reynolds, J and Ruggieri, D and Collins, C L and D'Hemecourt, P A and Comstock, R D},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {3},
pages = {521--527},
abstract = {OBJECTIVE: To determine if injury rates among female field hockey players differ before and after implementation of a national mandate for protective eyewear (MPE). METHODS: We analyzed girls' field hockey exposure and injury data collected from national (High School Reporting Information Online [RIO]) and regional (Fairfax County Public Schools) high school sports injury databases in 2 seasons before (2009/10 and 2010/11) and 2 seasons after (2011/12 and 2012/13) a national MPE. RESULTS: The incidence of eye/orbital injuries was significantly higher in states without MPE (0.080 injuries per 1000 athletic exposures [AEs]) than in states with MPE (before the 2011/12 mandate) and the postmandate group (0.025 injuries per 1000 AEs) (odds ratio 3.20, 95% confidence interval 1.47-6.99},
keywords = {*Eye Injuries/pc [Prevention \& Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention \& Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention \& Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Strand, S; Lechuga, D; Zachariah, T; Beaulieu, K
Relative risk for concussions in young female soccer players Journal Article
In: Applied Neuropsychology. Child, vol. 4, no. 1, pp. 58–64, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]
@article{Strand2015,
title = {Relative risk for concussions in young female soccer players},
author = {Strand, S and Lechuga, D and Zachariah, T and Beaulieu, K},
year = {2015},
date = {2015-01-01},
journal = {Applied Neuropsychology. Child},
volume = {4},
number = {1},
pages = {58--64},
abstract = {The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p \< .001},
keywords = {*Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}