References – Sports Concussion Library

53 entries « ‹ 1 of 2 › »

2016

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}

}

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.

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 \&amp; Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},

pubstate = {published},

tppubtype = {article}

}

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.

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

Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D

Association of football subconcussive head impacts with ocular near point of convergence Journal Article

In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.

Abstract | Links | BibTeX | Tags: Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult

@article{Kawata2016,

title = {Association of football subconcussive head impacts with ocular near point of convergence},

author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},

doi = {10.1001/jamaophthalmol.2016.1085},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Ophthalmology},

volume = {134},

number = {7},

pages = {763--769},

abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},

keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},

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}

}

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

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}

}

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}

}

Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A

English professional football players concussion knowledge and attitude Journal Article

In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.

Abstract | Links | BibTeX | Tags: accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult

@article{Williams2016,

title = {English professional football players concussion knowledge and attitude},

author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},

doi = {10.1016/j.jshs.2015.01.009},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Sport and Health Science},

volume = {5},

number = {2},

pages = {197--204},

abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},

keywords = {accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult},

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}

}

Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T

Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article

In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.

Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult

@article{Bailie2016,

title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},

author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Head Trauma Rehabilitation},

volume = {31},

number = {1},

pages = {2--12},

abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},

keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},

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}

}

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}

}

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}

}

2015

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}

}

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.

Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L

No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers Journal Article

In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.

Abstract | Links | BibTeX | Tags: 2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult

@article{Dretsch2015a,

title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},

author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},

doi = {10.1089/neu.2014.3637},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurotrauma},

volume = {32},

number = {16},

pages = {1217--1222},

abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},

keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Kostyun, R

Sleep Disturbances in Concussed Athletes: A Review of the Literature Journal Article

In: Connecticut Medicine, vol. 79, no. 3, pp. 161–165, 2015.

Abstract | BibTeX | Tags: *Athletic Injuries, *Brain Concussion, *Disease Management, *Sleep Wake Disorders, Adolescent, Athletes/px [Psychology], Athletic Injuries/co [Complications], Athletic Injuries/px [Psychology], Brain Concussion/co [Complications], Brain Concussion/px [Psychology], Cognition/ph [Physiology], Humans, Neuropsychological Tests, Sleep Wake Disorders/et [Etiology], Sleep Wake Disorders/pp [Physiopathology], Sleep Wake Disorders/th [Therapy], Young Adult

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}

}

Mayer, A R; Ling, J M; Dodd, A B; Gasparovic, C; Klimaj, S D; Meier, T B

A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters Journal Article

In: Journal of Neurotrauma, vol. 32, no. 22, pp. 1759–1767, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult

@article{Mayer2015b,

title = {A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters},

author = {Mayer, A R and Ling, J M and Dodd, A B and Gasparovic, C and Klimaj, S D and Meier, T B},

doi = {10.1089/neu.2014.3833},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurotrauma},

volume = {32},

number = {22},

pages = {1759--1767},

abstract = {Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p \> 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples. © Mary Ann Liebert, Inc. 2015.},

keywords = {Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p > 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples. © Mary Ann Liebert, Inc. 2015.

Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D

A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma Journal Article

In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.

Abstract | Links | BibTeX | Tags: accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult

@article{Oeur2015,

title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},

author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},

doi = {10.3171/2014.10.JNS14440},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery},

volume = {123},

number = {2},

pages = {415--422},

abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},

keywords = {accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p < 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p < 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.

Smith, A M; Stuart, M J; Dodick, D W; Roberts, W O; Alford, P W; Ashare, A B; Aubrey, M; Benson, B W; Burke, C J; Dick, R; Eickhoff, C; Emery, C A; Flashman, L A; Gaz, D; Giza, C C; Greenwald, R M; Herring, S; Hoshizaki, T B; Hudziak, J J; Huston 3rd, J; Krause, D; LaVoi, N; Leaf, M; Leddy, J J; MacPherson, A; McKee, A C; Mihalik, J P; Moessner, A M; Montelpare, W J; Putukian, M; Schneider, K J; Szalkowski, R; Tabrum, M; Whitehead, J; Wiese-Bjornstal, D M

Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379] Journal Article

In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 78–87, 2015.

Abstract | BibTeX | Tags: *Brain Concussion/pc [Prevention & Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention & Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention & Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult

@article{Smith2015a,

title = {Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379]},

author = {Smith, A M and Stuart, M J and Dodick, D W and Roberts, W O and Alford, P W and Ashare, A B and Aubrey, M and Benson, B W and Burke, C J and Dick, R and Eickhoff, C and Emery, C A and Flashman, L A and Gaz, D and Giza, C C and Greenwald, R M and Herring, S and Hoshizaki, T B and Hudziak, J J and {Huston 3rd}, J and Krause, D and LaVoi, N and Leaf, M and Leddy, J J and MacPherson, A and McKee, A C and Mihalik, J P and Moessner, A M and Montelpare, W J and Putukian, M and Schneider, K J and Szalkowski, R and Tabrum, M and Whitehead, J and Wiese-Bjornstal, D M},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {25},

number = {2},

pages = {78--87},

abstract = {OBJECTIVE: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards; and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit includes the following: (1) eliminate head hits from all levels of ice hockey, (2) change body-checking policies, and (3) eliminate fighting in all amateur and professional hockey.},

keywords = {*Brain Concussion/pc [Prevention \&amp; Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention \&amp; Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention \&amp; Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Gardner, A J; Tan, C O; Ainslie, P N; Van Donkelaar, P; Stanwell, P; Levi, C R; Iverson, G L

Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review Journal Article

In: British Journal of Sports Medicine, vol. 49, no. 16, pp. 1050–1055, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, adult, Athletic Injuries, brain circulation, brain concussion, case control study, Case-Control Studies, Cerebrovascular Circulation, Doppler, echography, Female, human, Humans, Male, Pathophysiology, PHYSIOLOGY, sport injury, Transcranial, transcranial Doppler ultrasonography, Ultrasonography, Young Adult

@article{Gardner2015bb,

title = {Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review},

author = {Gardner, A J and Tan, C O and Ainslie, P N and {Van Donkelaar}, P and Stanwell, P and Levi, C R and Iverson, G L},

doi = {10.1136/bjsports-2014-093901},

year  = {2015},

date = {2015-01-01},

journal = {British Journal of Sports Medicine},

volume = {49},

number = {16},

pages = {1050--1055},

abstract = {Background: Traumatic brain injury influences regulation of cerebral blood flow in animal models and in human studies. We reviewed the use of transcranial Doppler ultrasound (US) to monitor cerebrovascular reactivity following sport-related concussion. Review method: A narrative and systematic review of articles published in the English language, from December 1982 to October 2013. Data sources: Articles were retrieved via numerous databases using relevant key terms. Observational, cohort, correlational, cross-sectional and longitudinal studies were included. Results: Three publications met the criteria for inclusion; these provided data from 42 athletes and 33 controls. All three studies reported reductions in cerebrovascular reactivity via transcranial Doppler US. Conclusions: These initial results support the use of cerebrovascular reactivity as a research tool for identifying altered neurophysiology and monitoring recovery in adult athletes. Larger cross-sectional, prospective and longitudinal studies are required to understand the sensitivity and prognostic value of cerebrovascular reactivity in sport-related concussion. © 2015, BMJ Publishing Group. All rights reserved.},

keywords = {Adolescent, adult, Athletic Injuries, brain circulation, brain concussion, case control study, Case-Control Studies, Cerebrovascular Circulation, Doppler, echography, Female, human, Humans, Male, Pathophysiology, PHYSIOLOGY, sport injury, Transcranial, transcranial Doppler ultrasonography, Ultrasonography, 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}

}

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.

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}

}

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

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}

}

Rao, A L; Asif, I M; Drezner, J A; Toresdahl, B G; Harmon, K G

Suicide in National Collegiate Athletic Association (NCAA) Athletes: A 9-Year Analysis of the NCAA Resolutions Database Journal Article

In: Sports & Health, vol. 7, no. 5, pp. 452–457, 2015.

Abstract | BibTeX | Tags: *Sports/sn [Statistics & Numerical Data], *Suicide/sn [Statistics & Numerical Data], African Continental Ancestry Group/sn [Statistics, European Continental Ancestry Group/sn [Statistics, Female, Humans, Incidence, Male, Retrospective Studies, Sex Distribution, Suicide/eh [Ethnology], United States/ep [Epidemiology], Young Adult

@article{Rao2015,

title = {Suicide in National Collegiate Athletic Association (NCAA) Athletes: A 9-Year Analysis of the NCAA Resolutions Database},

author = {Rao, A L and Asif, I M and Drezner, J A and Toresdahl, B G and Harmon, K G},

year  = {2015},

date = {2015-01-01},

journal = {Sports \& Health},

volume = {7},

number = {5},

pages = {452--457},

abstract = {BACKGROUND: The National Collegiate Athletic Association (NCAA) has recently highlighted mental health concerns in student athletes, though the incidence of suicide among NCAA athletes is unclear. The purpose of this study was to determine the rate of suicide among NCAA athletes. HYPOTHESIS: The incidence of suicide in NCAA athletes differs by sex, race, sport, and division. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: NCAA Memorial Resolutions list and published NCAA demographic data were used to identify student-athlete deaths and total participant seasons from 2003-2004 through 2011-2012. Deaths were analyzed by age, sex, race, division, and sport. RESULTS: Over the 9-year study period, 35 cases of suicide were identified from a review of 477 student-athlete deaths during 3,773,309 individual participant seasons. The overall suicide rate was 0.93/100,000 per year. Suicide represented 7.3% (35/477) of all-cause mortality among NCAA student athletes. The annual incidence of suicide in male athletes was 1.35/100,000 and in female athletes was 0.37/100,000 (relative risk [RR], 3.7; P \< 0.01). The incidence in African American athletes was 1.22/100,000 and in white athletes was 0.87/100,000 (RR, 1.4; P = 0.45). The highest rate of suicide occurred in men's football (2.25/100,000), and football athletes had a relative risk of 2.2 (P = 0.03) of committing suicide compared with other male, nonfootball athletes. CONCLUSION: The suicide rate in NCAA athletes appears to be lower than that of the general and collegiate population of similar age. NCAA male athletes have a significantly higher rate of suicide compared with female athletes, and football athletes appear to be at greatest risk. CLINICAL RELEVANCE: Suicide represents a preventable cause of death, and development of effective prevention programs is recommended. Copyright © 2015 The Author(s).},

keywords = {*Sports/sn [Statistics \&amp; Numerical Data], *Suicide/sn [Statistics \&amp; Numerical Data], African Continental Ancestry Group/sn [Statistics, European Continental Ancestry Group/sn [Statistics, Female, Humans, Incidence, Male, Retrospective Studies, Sex Distribution, Suicide/eh [Ethnology], United States/ep [Epidemiology], Young Adult},

pubstate = {published},

tppubtype = {article}

}

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},

pubstate = {published},

tppubtype = {article}

}

Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.

Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M

Systematic review of rugby injuries in children and adolescents under 21 years Journal Article

In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.

Abstract | BibTeX | Tags: *Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult

@article{Freitag2015a,

title = {Systematic review of rugby injuries in children and adolescents under 21 years},

author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},

year  = {2015},

date = {2015-01-01},

journal = {British Journal of Sports Medicine},

volume = {49},

number = {8},

pages = {511--519},

abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},

keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},

pubstate = {published},

tppubtype = {article}

}

Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J

A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article

In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.

Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics & Numerical, Hockey/sn [Statistics & Numerical Data], Humans, Male, Sports Equipment/sn [Statistics & Numerical Data], VIDEO recording, Young Adult

@article{Hutchison2015,

title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},

author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},

year  = {2015},

date = {2015-01-01},

journal = {British Journal of Sports Medicine},

volume = {49},

number = {8},

pages = {547--551},

abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},

keywords = {*Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics \&amp; Numerical, Hockey/sn [Statistics \&amp; Numerical Data], Humans, Male, Sports Equipment/sn [Statistics \&amp; Numerical Data], VIDEO recording, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Asplund, C A; Kutcher, J S

Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections Journal Article

In: Current Sports Medicine Reports, vol. 14, no. 3, pp. 256–257, 2015.

BibTeX | Tags: *Athletes, *Brain Concussion/di [Diagnosis], *Heat Stroke/di [Diagnosis], *Psychophysiologic Disorders/di [Diagnosis], *Seizures/di [Diagnosis], *Syncope, Accidental Falls, Adolescent, Brain Concussion/co [Complications], DIAGNOSIS, Differential, Female, football, Heat Stroke/co [Complications], Humans, Male, MEDICAL history taking, Psychophysiologic Disorders/co [Complications], Running, Seizures/co [Complications], Vasovagal/et [Etiology], Young Adult

Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S

Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article

In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.

Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult

@article{Baker2015,

title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},

author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},

doi = {10.1177/0009922815588820},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Pediatrics},

volume = {54},

number = {10},

pages = {961--968},

abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},

keywords = {Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Neselius, S; Brisby, H; Granholm, F; Zetterberg, H; Blennow, K

Monitoring concussion in a knocked-out boxer by CSF biomarker analysis Journal Article

In: Knee Surgery, Sports Traumatology, Arthroscopy, vol. 23, no. 9, pp. 2536–2539, 2015.

Abstract | BibTeX | Tags: *Boxing/in [Injuries], *Brain Concussion/di [Diagnosis], *Neurofilament Proteins/cf [Cerebrospinal Fluid], 0 (Biomarkers), 0 (neurofilament protein L), 0 (Neurofilament Proteins), Biomarkers/cf [Cerebrospinal Fluid], Brain Concussion/cf [Cerebrospinal Fluid], Brain Concussion/et [Etiology], Humans, Male, Young Adult

Lefebvre, G; Tremblay, S; Théoret, H

Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex Journal Article

In: Brain Injury, vol. 29, no. 9, pp. 1032–1043, 2015.

Abstract | Links | BibTeX | Tags: 4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult

@article{Lefebvre2015,

title = {Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex},

author = {Lefebvre, G and Tremblay, S and Th\'{e}oret, H},

doi = {10.3109/02699052.2015.1028447},

year  = {2015},

date = {2015-01-01},

journal = {Brain Injury},

volume = {29},

number = {9},

pages = {1032--1043},

abstract = {Primary objective: The present paper systematically reviews studies using transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to assess cortical excitability, intra-cortical inhibition/facilitation and synaptic plasticity following mild traumatic brain injury (mTBI).Methods: Articles using TMS over M1 in patients with mTBI or sport-related concussion indexed in PubMed and published between 1998 and September 2014 were included in the present review.Main outcomes and results: From the 17 articles that matched search criteria, results from various TMS paradigms were summarized and divided in three main areas of interest: motor cortical excitability/facilitation, motor cortical inhibition and cortical plasticity. Although studies suggest a trend of abnormal intra-cortical inhibition following mTBI, no clear and specific pattern emerges from the surveyed data.Conclusions: At this time and with the possible exception of intra-cortical inhibitory measures, TMS cannot reliably detect changes in M1 excitability in individuals with mTBI or a concussion at both the acute and chronic stages of injury. This may be explained by the small number of studies and large variety of stimulation parameters. Additional longitudinal and multimodal studies are needed to better understand the nature of the excitability changes that may occur within M1 following mTBI. © 2015 Taylor \& Francis Group, LLC.},

keywords = {4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Fitch, T; Villanueva, G; Quadir, M M; Sagiraju, H K; Alamgir, H

The prevalence and risk factors of Post-Traumatic Stress Disorder among workers injured in Rana Plaza building collapse in Bangladesh Journal Article

In: American Journal of Industrial Medicine, vol. 58, no. 7, pp. 756–763, 2015.

Abstract | BibTeX | Tags: *Occupational Diseases/ep [Epidemiology], *Stress Disorders, *Structure Collapse, *Survivors/px [Psychology], *Textile Industry, adult, Bangladesh/ep [Epidemiology], Employment/px [Psychology], Female, Humans, Logistic Models, Male, Marital Status, Occupational Diseases/et [Etiology], ODDS ratio, Post-Traumatic/ep [Epidemiology, Post-Traumatic/et [Etiology], Prevalence, Risk Factors, Stress Disorders, Work/px [Psychology], Young Adult

Nelson, L D; Pfaller, A Y; Rein, L E; McCrea, M A

Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT Journal Article

In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2018–2026, 2015.

Abstract | BibTeX | Tags: *Athletes/px [Psychology], *Neuropsychological Tests, Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/px [Psychology], Attention Deficit Disorder with Hyperactivity/co [, Brain Concussion/di [Diagnosis], Brain Concussion/px [Psychology], Female, Humans, intelligence, Male, Reproducibility of Results, Students/px [Psychology], Young Adult

@article{Nelson2015,

title = {Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT},

author = {Nelson, L D and Pfaller, A Y and Rein, L E and McCrea, M A},

year  = {2015},

date = {2015-01-01},

journal = {American Journal of Sports Medicine},

volume = {43},

number = {8},

pages = {2018--2026},

abstract = {BACKGROUND: Preseason baseline testing using computerized neurocognitive tests (CNTs) is increasingly performed on athletes. Adequate effort is critical to establish valid estimates of ability, but many users do not evaluate performance validity, and the conditions that affect validity are not well understood across the available CNTs. PURPOSE: To examine the rates and predictors of invalid baseline performance for 3 popular CNTs: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports, and Immediate Post-Concussion and Cognitive Testing (ImPACT). STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate athletes (N = 2063) completed 2 of 3 CNTs each during preseason evaluations. All possible pairings were present across the sample, and the order of administration was randomized. Examiners provided 1-on-1, scripted pretest instructions, emphasizing the importance of good effort. Profile validity was determined by the manufacturers' standard criteria. RESULTS: The overall percentage of tests flagged as of questionable validity was lowest for ImPACT (2.7%) and higher for ANAM and Axon (10.7% and 11.3%, respectively). The majority of invalid baseline profiles were flagged as such because of failure on only 1 validity criterion. Several athlete and testing factors (eg, attention deficit hyperactivity disorder [ADHD], estimated general intellectual ability, administration order) predicted validity status for 1 or more CNTs. Considering only first CNT administrations and participants without ADHD and/or a learning disability (n = 1835) brought the rates of invalid baseline performances to 2.1%, 8.8%, and 7.0% for ImPACT, ANAM, and Axon, respectively. Invalid profiles on the Medical Symptom Validity Test (MSVT) were rare (1.8% of participants) and demonstrated poor correspondence to CNT validity outcomes. CONCLUSION: The validity criteria for these CNTs may not identify the same causes of invalidity or be equally sensitive to effort. The validity indicators may not be equally appropriate for some athletes (eg, those with neurodevelopmental disorders). CLINICAL RELEVANCE: The data suggest that athletes do not put forth widespread low effort or that some validity criteria are more sensitive to invalid performance than others. It is important for examiners to be aware of the conditions that maximize the quality of baseline assessments and to understand what sources of invalid performance are captured by the validity criteria that they obtain.Copyright © 2015 The Author(s).},

keywords = {*Athletes/px [Psychology], *Neuropsychological Tests, Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/px [Psychology], Attention Deficit Disorder with Hyperactivity/co [, Brain Concussion/di [Diagnosis], Brain Concussion/px [Psychology], Female, Humans, intelligence, Male, Reproducibility of Results, Students/px [Psychology], Young Adult},

pubstate = {published},

tppubtype = {article}

}

BACKGROUND: Preseason baseline testing using computerized neurocognitive tests (CNTs) is increasingly performed on athletes. Adequate effort is critical to establish valid estimates of ability, but many users do not evaluate performance validity, and the conditions that affect validity are not well understood across the available CNTs. PURPOSE: To examine the rates and predictors of invalid baseline performance for 3 popular CNTs: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports, and Immediate Post-Concussion and Cognitive Testing (ImPACT). STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate athletes (N = 2063) completed 2 of 3 CNTs each during preseason evaluations. All possible pairings were present across the sample, and the order of administration was randomized. Examiners provided 1-on-1, scripted pretest instructions, emphasizing the importance of good effort. Profile validity was determined by the manufacturers' standard criteria. RESULTS: The overall percentage of tests flagged as of questionable validity was lowest for ImPACT (2.7%) and higher for ANAM and Axon (10.7% and 11.3%, respectively). The majority of invalid baseline profiles were flagged as such because of failure on only 1 validity criterion. Several athlete and testing factors (eg, attention deficit hyperactivity disorder [ADHD], estimated general intellectual ability, administration order) predicted validity status for 1 or more CNTs. Considering only first CNT administrations and participants without ADHD and/or a learning disability (n = 1835) brought the rates of invalid baseline performances to 2.1%, 8.8%, and 7.0% for ImPACT, ANAM, and Axon, respectively. Invalid profiles on the Medical Symptom Validity Test (MSVT) were rare (1.8% of participants) and demonstrated poor correspondence to CNT validity outcomes. CONCLUSION: The validity criteria for these CNTs may not identify the same causes of invalidity or be equally sensitive to effort. The validity indicators may not be equally appropriate for some athletes (eg, those with neurodevelopmental disorders). CLINICAL RELEVANCE: The data suggest that athletes do not put forth widespread low effort or that some validity criteria are more sensitive to invalid performance than others. It is important for examiners to be aware of the conditions that maximize the quality of baseline assessments and to understand what sources of invalid performance are captured by the validity criteria that they obtain.Copyright © 2015 The Author(s).

Dretsch, M N; Silverberg, N D; Iverson, G L

Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers Journal Article

In: Journal of Neurotrauma, vol. 32, no. 17, pp. 1301–1306, 2015.

Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Cognition Disorders/di [Diagnosis], *Military Personnel/sn [Statistics & Numerical Dat, *Post-Concussion Syndrome/di [Diagnosis], adult, Brain Concussion/ep [Epidemiology], Cognition Disorders/ep [Epidemiology], Cognition Disorders/et [Etiology], Female, Humans, Male, Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], United States/ep [Epidemiology], Young Adult

@article{Dretsch2015,

title = {Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers},

author = {Dretsch, M N and Silverberg, N D and Iverson, G L},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurotrauma},

volume = {32},

number = {17},

pages = {1301--1306},

abstract = {The extent to which multiple past concussions are associated with lingering symptoms or mental health problems in military service members is not well understood. The purpose of this study was to examine the association between lifetime concussion history, cognitive functioning, general health, and psychological health in a large sample of fit-for-duty U.S. Army soldiers preparing for deployment. Data on 458 active-duty soldiers were collected and analyzed. A computerized cognitive screening battery (CNS-Vital Signs()) was used to assess complex attention (CA), reaction time (RT), processing speed (PS), cognitive flexibility (CF), and memory. Health questionnaires included the Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Military Version (PCL-M), Zung Depression and Anxiety Scales (ZDS; ZAS), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Alcohol Use and Dependency Identification Test (AUDIT). Soldiers with a history of multiple concussions (i.e., three or more concussions) had significantly greater post-concussive symptom scores compared with those with zero (d=1.83, large effect), one (d=0.64, medium effect), and two (d=0.64, medium effect) prior concussions. Although the group with three or more concussions also reported more traumatic stress symptoms, the results revealed that traumatic stress was a mediator between concussions and post-concussive symptom severity. There were no significant differences on neurocognitive testing between the number of concussions. These results add to the accumulating evidence suggesting that most individuals recover from one or two prior concussions, but there is a greater risk for ongoing symptoms if one exceeds this number of injuries.},

keywords = {*Brain Concussion/co [Complications], *Cognition Disorders/di [Diagnosis], *Military Personnel/sn [Statistics \&amp; Numerical Dat, *Post-Concussion Syndrome/di [Diagnosis], adult, Brain Concussion/ep [Epidemiology], Cognition Disorders/ep [Epidemiology], Cognition Disorders/et [Etiology], Female, Humans, Male, Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], United States/ep [Epidemiology], Young Adult},

pubstate = {published},

tppubtype = {article}

}

Biederman, J; Feinberg, L; Chan, J; Adeyemo, B O; Woodworth, K Y; Panis, W; McGrath, N; Bhatnagar, S; Spencer, T J; Uchida, M; Kenworthy, T; Grossman, R; Zafonte, R; Faraone, S V

Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes Journal Article

In: Journal of Nervous & Mental Disease, vol. 203, no. 11, pp. 813–819, 2015.

Abstract | BibTeX | Tags: *Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult

Nauman, E A; Breedlove, K M; Breedlove, E L; Talavage, T M; Robinson, M E; Leverenz, L J

Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football Journal Article

In: Developmental Neuropsychology, vol. 40, no. 2, pp. 85–91, 2015.

Abstract | BibTeX | Tags: *Athletes, *Brain Concussion/pp [Physiopathology], *Football/in [Injuries], *MAGNETIC resonance imaging, Adolescent, Brain Concussion/pa [Pathology], Head, Humans, Male, Neurophysiology, Neuropsychological Tests, Schools, Seasons, Surveys and Questionnaires, UNITED States, Young Adult

Waldron-Perrine, B; Tree, H A; Spencer, R J; Suhr, J; Bieliauskas, L

Informational literature influences symptom expression following mild head injury: An analog study Journal Article

In: Brain Injury, vol. 29, no. 9, pp. 1051–1055, 2015.

Abstract | BibTeX | Tags: *Brain Injuries/di [Diagnosis], *Brain Injuries/px [Psychology], *Information Dissemination, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/px [Psychology], adult, Female, Health Communication, Humans, Language, Male, middle aged, Neuropsychological Tests, Post-Traumatic/di [Diagnosis], Stress Disorders, Veterans/px [Psychology], Young Adult

@article{Waldron-Perrine2015,

title = {Informational literature influences symptom expression following mild head injury: An analog study},

author = {Waldron-Perrine, B and Tree, H A and Spencer, R J and Suhr, J and Bieliauskas, L},

year  = {2015},

date = {2015-01-01},

journal = {Brain Injury},

volume = {29},

number = {9},

pages = {1051--1055},

abstract = {PRIMARY OBJECTIVE: Many Veterans involved in recent OEF/OIF conflicts return with reports of having experienced an mTBI. The Veteran's Affairs (VA) and Department of Defense (DoD) have gone to great lengths to provide information to Veterans regarding possible effects of TBI. Although well intended, this information may possibly have an iatrogenic effect. Conversely, setting positive expectations for recovery from mTBI has been shown to result in decreased symptomatology. RESEARCH DESIGN: One-way ANOVA and Tukey post-hoc analyses were used to determine whether there were significant differences on reported severity and number of PCS symptoms (NSI) among the three experimental groups (recovery focused information; expectation for persistent symptoms; and no information given). METHODS AND PROCEDURES: Undergraduate students, who were told to imagine they had experienced a military-related TBI, reported varying levels of expected symptoms when given either positive or negative information about symptom expectation. MAIN OUTCOMES AND RESULTS: The results indicate that presenting recovery-oriented literature resulted in the lowest report of expected symptoms, whereas presenting no information resulted in the highest report of expected symptoms. CONCLUSIONS: Providing Veterans with information regarding a likely positive trajectory of recovery may result in less symptom persistence during rehabilitation.},

keywords = {*Brain Injuries/di [Diagnosis], *Brain Injuries/px [Psychology], *Information Dissemination, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/px [Psychology], adult, Female, Health Communication, Humans, Language, Male, middle aged, Neuropsychological Tests, Post-Traumatic/di [Diagnosis], Stress Disorders, Veterans/px [Psychology], Young Adult},

pubstate = {published},

tppubtype = {article}

}

Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A

In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.

Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury

@article{Billock2015,

title = {Zipline-related injuries treated in US EDs, 1997-2012},

author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},

doi = {10.1016/j.ajem.2015.08.022},

year  = {2015},

date = {2015-01-01},

journal = {American Journal of Emergency Medicine},

volume = {33},

number = {12},

pages = {1745--1749},

abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},

keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},

pubstate = {published},

tppubtype = {article}

}

Merritt, V C; Meyer, J E; Arnett, P A

A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale Journal Article

In: Journal of Clinical and Experimental Neuropsychology, vol. 37, no. 7, pp. 764–775, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult

@article{Merritt2015b,

title = {A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale},

author = {Merritt, V C and Meyer, J E and Arnett, P A},

doi = {10.1080/13803395.2015.1060950},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Clinical and Experimental Neuropsychology},

volume = {37},

number = {7},

pages = {764--775},

abstract = {Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor \& Francis.},

keywords = {Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor & Francis.

2014

Kettner, M; Ramsthaler, F; Potente, S; Bockenheimer, A; Schmidt, P H; Schrodt, M

Blunt force impact to the head using a teeball bat: systematic comparison of physical and finite element modeling Journal Article

In: Forensic Science, Medicine & Pathology, vol. 10, no. 4, pp. 513–517, 2014.

Abstract | BibTeX | Tags: *Computer Simulation, *Forensic Pathology/mt [Methods], *HEAD injuries, *Models, *Skull Fractures/pa [Pathology], *Skull/pa [Pathology], *Sports Equipment, *Weapons, Anatomic, Biological, Biomechanical Phenomena, Closed/pa [Pathology], Equipment Design, finite element analysis, Humans, Skull/in [Injuries], violence, Wood, Young Adult

@article{Kettner2014,

title = {Blunt force impact to the head using a teeball bat: systematic comparison of physical and finite element modeling},

author = {Kettner, M and Ramsthaler, F and Potente, S and Bockenheimer, A and Schmidt, P H and Schrodt, M},

year  = {2014},

date = {2014-01-01},

journal = {Forensic Science, Medicine \& Pathology},

volume = {10},

number = {4},

pages = {513--517},

abstract = {Blunt head trauma secondary to violent actions with various weapons is frequently a cause of injury in forensic casework; differing striking tools have varying degrees of injury capacity. The systematic approach used to examine a 19-year-old student who was beaten with a wooden teeball bat will be described. The assailant stopped beating the student when the teeball bat broke into two pieces. The surviving victim sustained bruises and a forehead laceration. The State's Attorney assigned a forensic expert to examine whether the forces exerted on the victim's head (leading to the fracture of the bat) were potentially life threatening (e.g. causing cranial bone fractures). Physical modeling was conducted using a pigskin-covered polyethylene end cap cushioned by cellulose that was connected to a piezoelectric force gauge. Experiments with teeball bats weighing 295-485 g demonstrated that 12-20 kN forces were necessary to cause a comparable bat fracture. In addition to physical testing, a computer-aided simulation was conducted, utilizing a finite-element (FE) method. In the FE approach, after selecting for wood properties, a virtual bat was swung against a hemisphere comprising two layers that represented bone and soft tissue. Employing this model, a 17.6 kN force was calculated, with the highest fracture probability points resembling the fracture patterns of the physically tested bats.},

keywords = {*Computer Simulation, *Forensic Pathology/mt [Methods], *HEAD injuries, *Models, *Skull Fractures/pa [Pathology], *Skull/pa [Pathology], *Sports Equipment, *Weapons, Anatomic, Biological, Biomechanical Phenomena, Closed/pa [Pathology], Equipment Design, finite element analysis, Humans, Skull/in [Injuries], violence, Wood, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Crowley, P J; Crowley, M J

Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme Journal Article

In: British Journal of Sports Medicine, vol. 48, no. 2, pp. 147–150, 2014.

Abstract | BibTeX | Tags: *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization & Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation & Jurisprudence], Track and Field/sn [Statistics & Numerical Data], Young Adult

@article{Crowley2014,

title = {Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme},

author = {Crowley, P J and Crowley, M J},

year  = {2014},

date = {2014-01-01},

journal = {British Journal of Sports Medicine},

volume = {48},

number = {2},

pages = {147--150},

abstract = {BACKGROUND: Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn. METHODS: We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and (5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools. RESULTS: One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard). CONCLUSION: The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.},

keywords = {*Craniocerebral Trauma/pc [Prevention \&amp; Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \&amp; Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization \&amp; Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation \&amp; Jurisprudence], Track and Field/sn [Statistics \&amp; Numerical Data], Young Adult},

pubstate = {published},

tppubtype = {article}

}

2013

Anonymous,

Concussion in sport: fair play for young people Journal Article

In: Lancet, vol. 382, no. 9904, pp. 1536, 2013.

BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult

Fife, Gabriel P; O'Sullivan, David M; Pieter, Willy; Cook, David P; Kaminski, Thomas W

Effects of Olympic-style taekwondo kicks on an instrumented head-form and resultant injury measures Journal Article

In: British Journal of Sports Medicine, vol. 47, no. 18, pp. 1161–1165, 2013, ISBN: 0306-3674.

Abstract | Links | BibTeX | Tags: Anatomic, Brain Concussion -- Etiology, Brain Concussion -- Physiopathology, Equipment Design, Foot -- Physiology, human, Kinematics -- Physiology, Male, Martial Arts, Models, Motion, Movement -- Physiology, Sports Medicine -- Equipment and Supplies, Young Adult

Resch, Jacob; Driscoll, Aoife; McCaffrey, Noel; Brown, Cathleen; Ferrara, Michael S; Macciocchi, Stephen; Baumgartner, Ted; Walpert, Kimberly

ImPact Test-Retest Reliability: Reliably Unreliable? Journal Article

In: Journal of Athletic Training, vol. 48, no. 4, pp. 506–511, 2013, ISBN: 1062-6050.

Abstract | Links | BibTeX | Tags: ANALYSIS of variance, Body Weights and Measures, Cognition -- Evaluation, college, Computer Assisted, Continuing (Credit), Cross Sectional Studies, Data Analysis Software, DESCRIPTIVE statistics, DIAGNOSIS, Education, Effect Size, Female, human, Instrument Validation, Intraclass Correlation Coefficient, Ireland, Male, Multicenter Studies, Neuropsychological Tests, ONE-way analysis of variance, Post Hoc Analysis, Repeated Measures, Scales, Students, test-retest reliability, UNITED States, Validation Studies, Young Adult

@article{Resch2013b,

title = {ImPact Test-Retest Reliability: Reliably Unreliable?},

author = {Resch, Jacob and Driscoll, Aoife and McCaffrey, Noel and Brown, Cathleen and Ferrara, Michael S and Macciocchi, Stephen and Baumgartner, Ted and Walpert, Kimberly},

doi = {10.4085/1062-6050-48.3.09},

isbn = {1062-6050},

year  = {2013},

date = {2013-01-01},

journal = {Journal of Athletic Training},

volume = {48},

number = {4},

pages = {506--511},

abstract = {Context: Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion. Objective: To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals. Design: Cross-sectional study. Setting: Two research laboratories. Patients or Other Participants: Group 1 (n=46) consisted of 25 men and 21 women (age=22.4 ± 1.89 years). Group 2 (n = 45) consisted of 17 men and 28 women (age = 20.9 ± 1.72 years). Intervention(s): Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort. Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time. Results: The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively. Conclusions: We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.},

keywords = {ANALYSIS of variance, Body Weights and Measures, Cognition -- Evaluation, college, Computer Assisted, Continuing (Credit), Cross Sectional Studies, Data Analysis Software, DESCRIPTIVE statistics, DIAGNOSIS, Education, Effect Size, Female, human, Instrument Validation, Intraclass Correlation Coefficient, Ireland, Male, Multicenter Studies, Neuropsychological Tests, ONE-way analysis of variance, Post Hoc Analysis, Repeated Measures, Scales, Students, test-retest reliability, UNITED States, Validation Studies, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Context: Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion. Objective: To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals. Design: Cross-sectional study. Setting: Two research laboratories. Patients or Other Participants: Group 1 (n=46) consisted of 25 men and 21 women (age=22.4 ± 1.89 years). Group 2 (n = 45) consisted of 17 men and 28 women (age = 20.9 ± 1.72 years). Intervention(s): Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort. Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time. Results: The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively. Conclusions: We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.

Jadischke, R; Viano, D C; Dau, N; King, A I; McCarthy, J

On the accuracy of the Head Impact Telemetry (HIT) System used in football helmets Journal Article

In: Journal of Biomechanics, vol. 46, no. 13, pp. 2310–2315, 2013.

Abstract | BibTeX | Tags: *Head Protective Devices/st [Standards], *Materials Testing, *Sports Equipment/st [Standards], *Telemetry/is [Instrumentation], Adolescent, adult, Equipment Design, football, Humans, Male, Pressure, Young Adult

@article{Jadischke2013,

title = {On the accuracy of the Head Impact Telemetry (HIT) System used in football helmets},

author = {Jadischke, R and Viano, D C and Dau, N and King, A I and McCarthy, J},

year  = {2013},

date = {2013-01-01},

journal = {Journal of Biomechanics},

volume = {46},

number = {13},

pages = {2310--2315},

abstract = {On-field measurement of head impacts has relied on the Head Impact Telemetry (HIT) System, which uses helmet mounted accelerometers to determine linear and angular head accelerations. HIT is used in youth and collegiate football to assess the frequency and severity of helmet impacts. This paper evaluates the accuracy of HIT for individual head impacts. Most HIT validations used a medium helmet on a Hybrid III head. However, the appropriate helmet is large based on the Hybrid III head circumference (58 cm) and manufacturer's fitting instructions. An instrumented skull cap was used to measure the pressure between the head of football players (n=63) and their helmet. The average pressure with a large helmet on the Hybrid III was comparable to the average pressure from helmets used by players. A medium helmet on the Hybrid III produced average pressures greater than the 99th percentile volunteer pressure level. Linear impactor tests were conducted using a large and medium helmet on the Hybrid III. Testing was conducted by two independent laboratories. HIT data were compared to data from the Hybrid III equipped with a 3-2-2-2 accelerometer array. The absolute and root mean square error (RMSE) for HIT were computed for each impact (n=90). Fifty-five percent (n=49) had an absolute error greater than 15% while the RMSE was 59.1% for peak linear acceleration. Copyright © 2013 Elsevier Ltd. All rights reserved.},

keywords = {*Head Protective Devices/st [Standards], *Materials Testing, *Sports Equipment/st [Standards], *Telemetry/is [Instrumentation], Adolescent, adult, Equipment Design, football, Humans, Male, Pressure, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Schupp, Christian M; Bedgood, Alysia

Sideline management from head to toe of the skeletally immature athlete Journal Article

In: Current Sports Medicine Reports, vol. 12, no. 3, pp. 162–169, 2013, ISBN: 1537-890X.

Links | BibTeX | Tags: ADOLESCENCE, Athletic Injuries -- Diagnosis, Athletic Injuries -- Therapy, Bone Development, Brain Concussion -- Diagnosis, Brain Concussion -- Therapy, Child, Fractures -- Diagnosis, Fractures -- Therapy, Preschool, Sports Medicine -- Methods, Young Adult

Beckwith, J G; Greenwald, R M; Chu, J J; Crisco, J J; Rowson, S; Duma, S M; Broglio, S P; McAllister, T W; Guskiewicz, K M; Mihalik, J P; Anderson, S; Schnebel, B; Brolinson, P G; Collins, M W

Timing of concussion diagnosis is related to head impact exposure prior to injury Journal Article

In: Medicine & Science in Sports & Exercise, vol. 45, no. 4, pp. 747–754, 2013.

Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult

@article{Beckwith2013a,

title = {Timing of concussion diagnosis is related to head impact exposure prior to injury},

author = {Beckwith, J G and Greenwald, R M and Chu, J J and Crisco, J J and Rowson, S and Duma, S M and Broglio, S P and McAllister, T W and Guskiewicz, K M and Mihalik, J P and Anderson, S and Schnebel, B and Brolinson, P G and Collins, M W},

year  = {2013},

date = {2013-01-01},

journal = {Medicine \& Science in Sports \& Exercise},

volume = {45},

number = {4},

pages = {747--754},

abstract = {PURPOSE: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. METHODS: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (DELTAv). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). RESULTS: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P \< 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P \< 0.001) and within 7 d of injury (69.7 +/- 43.3},

keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult},

pubstate = {published},

tppubtype = {article}

}

53 entries « ‹ 1 of 2 › »

Reference Search

53 entries « ‹ 1 of 3 › »

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

@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 = {},

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

In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.

Abstract | BibTeX

@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}

}

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

@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}

}

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

Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D

Association of football subconcussive head impacts with ocular near point of convergence Journal Article

In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.

Abstract | Links | BibTeX

@article{Kawata2016,

title = {Association of football subconcussive head impacts with ocular near point of convergence},

author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},

doi = {10.1001/jamaophthalmol.2016.1085},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Ophthalmology},

volume = {134},

number = {7},

pages = {763--769},

abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},

keywords = {},

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

@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 = {},

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

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

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

@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 = {},

pubstate = {published},

tppubtype = {article}

}

10.

Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A

English professional football players concussion knowledge and attitude Journal Article

In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.

Abstract | Links | BibTeX

@article{Williams2016,

title = {English professional football players concussion knowledge and attitude},

author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},

doi = {10.1016/j.jshs.2015.01.009},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Sport and Health Science},

volume = {5},

number = {2},

pages = {197--204},

abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

11.

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

12.

Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T

Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article

In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.

Abstract | BibTeX

13.

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

14.

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

@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}

}

15.

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

16.

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

@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 = {},

pubstate = {published},

tppubtype = {article}

}

17.

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

@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 = {},

pubstate = {published},

tppubtype = {article}

}

18.

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

@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 = {},

pubstate = {published},

tppubtype = {article}

}

19.

Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L

No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers Journal Article

In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.

Abstract | Links | BibTeX

@article{Dretsch2015a,

title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},

author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},

doi = {10.1089/neu.2014.3637},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurotrauma},

volume = {32},

number = {16},

pages = {1217--1222},

abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

20.

Kostyun, R

Sleep Disturbances in Concussed Athletes: A Review of the Literature Journal Article

In: Connecticut Medicine, vol. 79, no. 3, pp. 161–165, 2015.

Abstract | BibTeX

53 entries « ‹ 1 of 3 › »

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2016

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.

@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}

}

Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R

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 = {*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 \&amp; Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},

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 = {*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.

Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D

Association of football subconcussive head impacts with ocular near point of convergence Journal Article

In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.

@article{Kawata2016,

title = {Association of football subconcussive head impacts with ocular near point of convergence},

author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},

doi = {10.1001/jamaophthalmol.2016.1085},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Ophthalmology},

volume = {134},

number = {7},

pages = {763--769},

abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},

keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},

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.

@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}

}

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.

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.

@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}

}

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.

@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}

}

Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A

English professional football players concussion knowledge and attitude Journal Article

In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.

@article{Williams2016,

title = {English professional football players concussion knowledge and attitude},

author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},

doi = {10.1016/j.jshs.2015.01.009},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Sport and Health Science},

volume = {5},

number = {2},

pages = {197--204},

abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},

keywords = {accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult},

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.

@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}

}

Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T

Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article

In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.

@article{Bailie2016,

title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},

author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Head Trauma Rehabilitation},

volume = {31},

number = {1},

pages = {2--12},

abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},

keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},

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.

@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}

}

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 = {*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}

}

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 = {*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}

}

2015

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.

@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}

}

Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L

No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers Journal Article

In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.

@article{Dretsch2015a,

title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},

author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},

doi = {10.1089/neu.2014.3637},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurotrauma},

volume = {32},

number = {16},

pages = {1217--1222},

abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},

keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Kostyun, R

Sleep Disturbances in Concussed Athletes: A Review of the Literature Journal Article

In: Connecticut Medicine, vol. 79, no. 3, pp. 161–165, 2015.

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.

@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}

}

Mayer, A R; Ling, J M; Dodd, A B; Gasparovic, C; Klimaj, S D; Meier, T B

A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters Journal Article

In: Journal of Neurotrauma, vol. 32, no. 22, pp. 1759–1767, 2015.

@article{Mayer2015b,

title = {A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters},

author = {Mayer, A R and Ling, J M and Dodd, A B and Gasparovic, C and Klimaj, S D and Meier, T B},

doi = {10.1089/neu.2014.3833},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurotrauma},

volume = {32},

number = {22},

pages = {1759--1767},

abstract = {Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p \> 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples. © Mary Ann Liebert, Inc. 2015.},

keywords = {Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D

In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.

@article{Oeur2015,

title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},

author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},

doi = {10.3171/2014.10.JNS14440},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery},

volume = {123},

number = {2},

pages = {415--422},

abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},

keywords = {accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379] Journal Article

In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 78–87, 2015.

@article{Smith2015a,

title = {Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379]},

author = {Smith, A M and Stuart, M J and Dodick, D W and Roberts, W O and Alford, P W and Ashare, A B and Aubrey, M and Benson, B W and Burke, C J and Dick, R and Eickhoff, C and Emery, C A and Flashman, L A and Gaz, D and Giza, C C and Greenwald, R M and Herring, S and Hoshizaki, T B and Hudziak, J J and {Huston 3rd}, J and Krause, D and LaVoi, N and Leaf, M and Leddy, J J and MacPherson, A and McKee, A C and Mihalik, J P and Moessner, A M and Montelpare, W J and Putukian, M and Schneider, K J and Szalkowski, R and Tabrum, M and Whitehead, J and Wiese-Bjornstal, D M},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {25},

number = {2},

pages = {78--87},

abstract = {OBJECTIVE: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards; and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit includes the following: (1) eliminate head hits from all levels of ice hockey, (2) change body-checking policies, and (3) eliminate fighting in all amateur and professional hockey.},

keywords = {*Brain Concussion/pc [Prevention \&amp; Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention \&amp; Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention \&amp; Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Gardner, A J; Tan, C O; Ainslie, P N; Van Donkelaar, P; Stanwell, P; Levi, C R; Iverson, G L

Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review Journal Article

In: British Journal of Sports Medicine, vol. 49, no. 16, pp. 1050–1055, 2015.

@article{Gardner2015bb,

title = {Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review},

author = {Gardner, A J and Tan, C O and Ainslie, P N and {Van Donkelaar}, P and Stanwell, P and Levi, C R and Iverson, G L},

doi = {10.1136/bjsports-2014-093901},

year  = {2015},

date = {2015-01-01},

journal = {British Journal of Sports Medicine},

volume = {49},

number = {16},

pages = {1050--1055},

abstract = {Background: Traumatic brain injury influences regulation of cerebral blood flow in animal models and in human studies. We reviewed the use of transcranial Doppler ultrasound (US) to monitor cerebrovascular reactivity following sport-related concussion. Review method: A narrative and systematic review of articles published in the English language, from December 1982 to October 2013. Data sources: Articles were retrieved via numerous databases using relevant key terms. Observational, cohort, correlational, cross-sectional and longitudinal studies were included. Results: Three publications met the criteria for inclusion; these provided data from 42 athletes and 33 controls. All three studies reported reductions in cerebrovascular reactivity via transcranial Doppler US. Conclusions: These initial results support the use of cerebrovascular reactivity as a research tool for identifying altered neurophysiology and monitoring recovery in adult athletes. Larger cross-sectional, prospective and longitudinal studies are required to understand the sensitivity and prognostic value of cerebrovascular reactivity in sport-related concussion. © 2015, BMJ Publishing Group. All rights reserved.},

keywords = {Adolescent, adult, Athletic Injuries, brain circulation, brain concussion, case control study, Case-Control Studies, Cerebrovascular Circulation, Doppler, echography, Female, human, Humans, Male, Pathophysiology, PHYSIOLOGY, sport injury, Transcranial, transcranial Doppler ultrasonography, Ultrasonography, 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.

@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}

}

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.

@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}

}

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.

@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}

}

Rao, A L; Asif, I M; Drezner, J A; Toresdahl, B G; Harmon, K G

Suicide in National Collegiate Athletic Association (NCAA) Athletes: A 9-Year Analysis of the NCAA Resolutions Database Journal Article

In: Sports & Health, vol. 7, no. 5, pp. 452–457, 2015.

@article{Rao2015,

title = {Suicide in National Collegiate Athletic Association (NCAA) Athletes: A 9-Year Analysis of the NCAA Resolutions Database},

author = {Rao, A L and Asif, I M and Drezner, J A and Toresdahl, B G and Harmon, K G},

year  = {2015},

date = {2015-01-01},

journal = {Sports \& Health},

volume = {7},

number = {5},

pages = {452--457},

abstract = {BACKGROUND: The National Collegiate Athletic Association (NCAA) has recently highlighted mental health concerns in student athletes, though the incidence of suicide among NCAA athletes is unclear. The purpose of this study was to determine the rate of suicide among NCAA athletes. HYPOTHESIS: The incidence of suicide in NCAA athletes differs by sex, race, sport, and division. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: NCAA Memorial Resolutions list and published NCAA demographic data were used to identify student-athlete deaths and total participant seasons from 2003-2004 through 2011-2012. Deaths were analyzed by age, sex, race, division, and sport. RESULTS: Over the 9-year study period, 35 cases of suicide were identified from a review of 477 student-athlete deaths during 3,773,309 individual participant seasons. The overall suicide rate was 0.93/100,000 per year. Suicide represented 7.3% (35/477) of all-cause mortality among NCAA student athletes. The annual incidence of suicide in male athletes was 1.35/100,000 and in female athletes was 0.37/100,000 (relative risk [RR], 3.7; P \< 0.01). The incidence in African American athletes was 1.22/100,000 and in white athletes was 0.87/100,000 (RR, 1.4; P = 0.45). The highest rate of suicide occurred in men's football (2.25/100,000), and football athletes had a relative risk of 2.2 (P = 0.03) of committing suicide compared with other male, nonfootball athletes. CONCLUSION: The suicide rate in NCAA athletes appears to be lower than that of the general and collegiate population of similar age. NCAA male athletes have a significantly higher rate of suicide compared with female athletes, and football athletes appear to be at greatest risk. CLINICAL RELEVANCE: Suicide represents a preventable cause of death, and development of effective prevention programs is recommended. Copyright © 2015 The Author(s).},

keywords = {*Sports/sn [Statistics \&amp; Numerical Data], *Suicide/sn [Statistics \&amp; Numerical Data], African Continental Ancestry Group/sn [Statistics, European Continental Ancestry Group/sn [Statistics, Female, Humans, Incidence, Male, Retrospective Studies, Sex Distribution, Suicide/eh [Ethnology], United States/ep [Epidemiology], Young Adult},

pubstate = {published},

tppubtype = {article}

}

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},

pubstate = {published},

tppubtype = {article}

}

Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M

Systematic review of rugby injuries in children and adolescents under 21 years Journal Article

In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.

@article{Freitag2015a,

title = {Systematic review of rugby injuries in children and adolescents under 21 years},

author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},

year  = {2015},

date = {2015-01-01},

journal = {British Journal of Sports Medicine},

volume = {49},

number = {8},

pages = {511--519},

abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},

keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},

pubstate = {published},

tppubtype = {article}

}

Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J

A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article

In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.

@article{Hutchison2015,

title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},

author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},

year  = {2015},

date = {2015-01-01},

journal = {British Journal of Sports Medicine},

volume = {49},

number = {8},

pages = {547--551},

abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},

keywords = {*Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics \&amp; Numerical, Hockey/sn [Statistics \&amp; Numerical Data], Humans, Male, Sports Equipment/sn [Statistics \&amp; Numerical Data], VIDEO recording, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Asplund, C A; Kutcher, J S

Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections Journal Article

In: Current Sports Medicine Reports, vol. 14, no. 3, pp. 256–257, 2015.

Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S

Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article

In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.

@article{Baker2015,

title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},

author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},

doi = {10.1177/0009922815588820},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Pediatrics},

volume = {54},

number = {10},

pages = {961--968},

abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},

keywords = {Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Neselius, S; Brisby, H; Granholm, F; Zetterberg, H; Blennow, K

Monitoring concussion in a knocked-out boxer by CSF biomarker analysis Journal Article

In: Knee Surgery, Sports Traumatology, Arthroscopy, vol. 23, no. 9, pp. 2536–2539, 2015.

Lefebvre, G; Tremblay, S; Théoret, H

Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex Journal Article

In: Brain Injury, vol. 29, no. 9, pp. 1032–1043, 2015.

@article{Lefebvre2015,

title = {Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex},

author = {Lefebvre, G and Tremblay, S and Th\'{e}oret, H},

doi = {10.3109/02699052.2015.1028447},

year  = {2015},

date = {2015-01-01},

journal = {Brain Injury},

volume = {29},

number = {9},

pages = {1032--1043},

abstract = {Primary objective: The present paper systematically reviews studies using transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to assess cortical excitability, intra-cortical inhibition/facilitation and synaptic plasticity following mild traumatic brain injury (mTBI).Methods: Articles using TMS over M1 in patients with mTBI or sport-related concussion indexed in PubMed and published between 1998 and September 2014 were included in the present review.Main outcomes and results: From the 17 articles that matched search criteria, results from various TMS paradigms were summarized and divided in three main areas of interest: motor cortical excitability/facilitation, motor cortical inhibition and cortical plasticity. Although studies suggest a trend of abnormal intra-cortical inhibition following mTBI, no clear and specific pattern emerges from the surveyed data.Conclusions: At this time and with the possible exception of intra-cortical inhibitory measures, TMS cannot reliably detect changes in M1 excitability in individuals with mTBI or a concussion at both the acute and chronic stages of injury. This may be explained by the small number of studies and large variety of stimulation parameters. Additional longitudinal and multimodal studies are needed to better understand the nature of the excitability changes that may occur within M1 following mTBI. © 2015 Taylor \& Francis Group, LLC.},

keywords = {4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Fitch, T; Villanueva, G; Quadir, M M; Sagiraju, H K; Alamgir, H

The prevalence and risk factors of Post-Traumatic Stress Disorder among workers injured in Rana Plaza building collapse in Bangladesh Journal Article

In: American Journal of Industrial Medicine, vol. 58, no. 7, pp. 756–763, 2015.

Nelson, L D; Pfaller, A Y; Rein, L E; McCrea, M A

Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT Journal Article

In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2018–2026, 2015.

@article{Nelson2015,

title = {Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT},

author = {Nelson, L D and Pfaller, A Y and Rein, L E and McCrea, M A},

year  = {2015},

date = {2015-01-01},

journal = {American Journal of Sports Medicine},

volume = {43},

number = {8},

pages = {2018--2026},

abstract = {BACKGROUND: Preseason baseline testing using computerized neurocognitive tests (CNTs) is increasingly performed on athletes. Adequate effort is critical to establish valid estimates of ability, but many users do not evaluate performance validity, and the conditions that affect validity are not well understood across the available CNTs. PURPOSE: To examine the rates and predictors of invalid baseline performance for 3 popular CNTs: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports, and Immediate Post-Concussion and Cognitive Testing (ImPACT). STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate athletes (N = 2063) completed 2 of 3 CNTs each during preseason evaluations. All possible pairings were present across the sample, and the order of administration was randomized. Examiners provided 1-on-1, scripted pretest instructions, emphasizing the importance of good effort. Profile validity was determined by the manufacturers' standard criteria. RESULTS: The overall percentage of tests flagged as of questionable validity was lowest for ImPACT (2.7%) and higher for ANAM and Axon (10.7% and 11.3%, respectively). The majority of invalid baseline profiles were flagged as such because of failure on only 1 validity criterion. Several athlete and testing factors (eg, attention deficit hyperactivity disorder [ADHD], estimated general intellectual ability, administration order) predicted validity status for 1 or more CNTs. Considering only first CNT administrations and participants without ADHD and/or a learning disability (n = 1835) brought the rates of invalid baseline performances to 2.1%, 8.8%, and 7.0% for ImPACT, ANAM, and Axon, respectively. Invalid profiles on the Medical Symptom Validity Test (MSVT) were rare (1.8% of participants) and demonstrated poor correspondence to CNT validity outcomes. CONCLUSION: The validity criteria for these CNTs may not identify the same causes of invalidity or be equally sensitive to effort. The validity indicators may not be equally appropriate for some athletes (eg, those with neurodevelopmental disorders). CLINICAL RELEVANCE: The data suggest that athletes do not put forth widespread low effort or that some validity criteria are more sensitive to invalid performance than others. It is important for examiners to be aware of the conditions that maximize the quality of baseline assessments and to understand what sources of invalid performance are captured by the validity criteria that they obtain.Copyright © 2015 The Author(s).},

keywords = {*Athletes/px [Psychology], *Neuropsychological Tests, Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/px [Psychology], Attention Deficit Disorder with Hyperactivity/co [, Brain Concussion/di [Diagnosis], Brain Concussion/px [Psychology], Female, Humans, intelligence, Male, Reproducibility of Results, Students/px [Psychology], Young Adult},

pubstate = {published},

tppubtype = {article}

}

Dretsch, M N; Silverberg, N D; Iverson, G L

Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers Journal Article

In: Journal of Neurotrauma, vol. 32, no. 17, pp. 1301–1306, 2015.

@article{Dretsch2015,

title = {Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers},

author = {Dretsch, M N and Silverberg, N D and Iverson, G L},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurotrauma},

volume = {32},

number = {17},

pages = {1301--1306},

abstract = {The extent to which multiple past concussions are associated with lingering symptoms or mental health problems in military service members is not well understood. The purpose of this study was to examine the association between lifetime concussion history, cognitive functioning, general health, and psychological health in a large sample of fit-for-duty U.S. Army soldiers preparing for deployment. Data on 458 active-duty soldiers were collected and analyzed. A computerized cognitive screening battery (CNS-Vital Signs()) was used to assess complex attention (CA), reaction time (RT), processing speed (PS), cognitive flexibility (CF), and memory. Health questionnaires included the Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Military Version (PCL-M), Zung Depression and Anxiety Scales (ZDS; ZAS), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Alcohol Use and Dependency Identification Test (AUDIT). Soldiers with a history of multiple concussions (i.e., three or more concussions) had significantly greater post-concussive symptom scores compared with those with zero (d=1.83, large effect), one (d=0.64, medium effect), and two (d=0.64, medium effect) prior concussions. Although the group with three or more concussions also reported more traumatic stress symptoms, the results revealed that traumatic stress was a mediator between concussions and post-concussive symptom severity. There were no significant differences on neurocognitive testing between the number of concussions. These results add to the accumulating evidence suggesting that most individuals recover from one or two prior concussions, but there is a greater risk for ongoing symptoms if one exceeds this number of injuries.},

keywords = {*Brain Concussion/co [Complications], *Cognition Disorders/di [Diagnosis], *Military Personnel/sn [Statistics \&amp; Numerical Dat, *Post-Concussion Syndrome/di [Diagnosis], adult, Brain Concussion/ep [Epidemiology], Cognition Disorders/ep [Epidemiology], Cognition Disorders/et [Etiology], Female, Humans, Male, Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], United States/ep [Epidemiology], Young Adult},

pubstate = {published},

tppubtype = {article}

}