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Echemendia, R J; Putukian, M; Mackin, R S; Julian, L; Shoss, N
Neuropsychological test performance prior to and following sports-related mild traumatic brain injury Journal Article
In: Clinical Journal of Sport Medicine, vol. 11, pp. 23–31, 2001.
@article{Echemendia2001a,
title = {Neuropsychological test performance prior to and following sports-related mild traumatic brain injury},
author = {Echemendia, R J and Putukian, M and Mackin, R S and Julian, L and Shoss, N},
year = {2001},
date = {2001-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {11},
pages = {23--31},
address = {Department of Psychology, The Pennsylvania State University, University Park 16802, USA. RJE2@PSU.EDU},
abstract = {OBJECTIVE: To examine the utility of neuropsychological tests in assessing college athletes prior to and following a sports-related mild Traumatic Brain Injury (mTBI). DESIGN: A prospective study of college athletes who sustained mTBI while engaged in sport. Preinjury baseline neuropsychological test data were obtained for athletes at risk for mTBI. Following an mTBI, the athlete and his or her matched noninjured control were evaluated at 2 hours, 48 hours, 1 week, and I month postinjury. SETTING: Male and female athletes from a Division I college. PARTICIPANTS: Male and female athletes from the football, men's ice hockey, men's and women's soccer, and men's and women's basketball teams at Penn State University. A total of 29 injured and 20 noninjured athletes participated in the study. INTERVENTIONS: Neuropsychological test batteries were administered at baseline and serially following mTBI. MAIN OUTCOME MEASURES: Post-Concussion Symptom Checklist, Hopkins Verbal Learning Test, Symbol Digit Modalities Test, Stroop Color-Word Test, Trail Making Test, VIGIL/W, List Learning, Digit Span, Penn State Cancellation Test, and Controlled Oral Word Association. RESULTS: Neuropsychological test data yielded significant differences between injured athletes and controls at 2 hours and 48 hours following cerebral concussion; injured athletes performing significantly worse than controls. Injured athletes reported a significantly greater number of postconcussion symptoms 2 hours following injury but not at the 48-hour assessment. No multivariate group differences were found at 1 week, but univariate analyses suggested significant differences on a few measures. At 1 month postinjury, a statistically significant difference was found on one measure with injured athletes marginally outperforming controls. CONCLUSIONS: Neuropsychological tests are useful in the detection of cognitive impairment following mTBI. The test data appear to be more effective than subjective report of symptoms in differentiating between injured and noninjured athletes at 48 hours postinjury. Although significant individual variability existed, most injured athletes recovered within 1 week of injury. A battery of tests, rather than any single test, is necessary to capture the variability that exists among injured athletes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kabat, M H; Kane, R L; Jefferson, A L; DiPino, R K
Construct validity of selected Automated Neuropsychological Assessment Metrics (ANAM) battery measures. Journal Article
In: Clinical Neuropsychologist, vol. 15, pp. 498–507, 2001.
@article{Kabat2001,
title = {Construct validity of selected Automated Neuropsychological Assessment Metrics (ANAM) battery measures.},
author = {Kabat, M H and Kane, R L and Jefferson, A L and DiPino, R K},
year = {2001},
date = {2001-01-01},
journal = {Clinical Neuropsychologist},
volume = {15},
pages = {498--507},
abstract = {The Automated Neuropsychological Assessment Metrics (ANAM) is a computerized library of tests designed to assess neurocognitive functioning across administrations (Kane \& Reeves, 1997). This study was designed to examine neuropsychological constructs measured by selected ANAM measures and to compare them with traditional measures putatively assessing similar domains. The sample consisted of 191 outpatients with suspected neurocognitive dysfunction. Correlations and regressions indicated significant relationships between traditional and computerized tests measuring similar constructs. PCA results yielded a three-factor solution: Factor I (Processing Speed/Efficiency), Factor II (Retention/Memory), and Factor III (Working Memory).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Grindel, S H; Lovell, M R; Collins, M W
The assessment of sport-related concussion: the evidence behind neuropsychological testing and management Journal Article
In: Clinical Journal of Sport Medicine, vol. 11, pp. 134–143, 2001.
@article{Grindel2001,
title = {The assessment of sport-related concussion: the evidence behind neuropsychological testing and management},
author = {Grindel, S H and Lovell, M R and Collins, M W},
year = {2001},
date = {2001-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {11},
pages = {134--143},
address = {Saint Vincent Sports Medicine Fellowship, Erie, Pennsylvania 16502, USA. sgrindel@svhs.org},
abstract = {Because of the lack of valid evidence to support the current recommendations for the management of mild traumatic brain injury (concussion), many physicians, athletic trainers, coaches, and athletes have called into question the way concussions are treated in athletics. This review article discusses the current evidence for the management of concussion in high school, college, and professional sports. A complete review of the epidemiologic and neuropsychological studies to date is presented and critically reviewed, as are other assessment and management tools in concussion. The appropriate use of neuropsychological testing, grading scales, and return-to-play recommendations are discussed in depth based on the current evidence. Additionally, areas requiring further research are identified and future trends are briefly discussed. [References: 75]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Maroon, J C; Lovell, M R; Norwig, J; Podell, K; Powell, J W; Hartl, R
Cerebral concussion in athletes: evaluation and neuropsychological testing Journal Article
In: Neurosurgery, vol. 47, pp. 659–672, 2000.
@article{Maroon2000,
title = {Cerebral concussion in athletes: evaluation and neuropsychological testing},
author = {Maroon, J C and Lovell, M R and Norwig, J and Podell, K and Powell, J W and Hartl, R},
year = {2000},
date = {2000-01-01},
journal = {Neurosurgery},
volume = {47},
pages = {659--672},
address = {Department of Neurosurgery, University of Pittsburgh Medical Center, Pennsylvania 15213, USA. maroonjc@msx.upmc.edu},
abstract = {OBJECTIVE: To conduct a topic review of studies related to cerebral concussion in athletes, as an aid to improving decision-making and outcomes. METHODS: We review the literature to provide an historical perspective on the incidence and definition of and the management guidelines for mild traumatic brain injury in sports. In addition, metabolic changes resulting from cerebral concussion and the second-impact syndrome are reviewed, to provide additional principles for decision-making. Neuropsychological testing, as it applies to athletes, is discussed in detail, to delineate baseline assessments, the characteristics of the neuropsychological evaluation, the neuropsychological tests used, and the methods for in-season identification of cerebral concussion. Future directions in the management of concussions are presented. RESULTS: The incidence of cerebral concussions has been reduced from approximately 19 per 100 participants in football per season to approximately 4 per 100, i.e., 40,000 to 50,000 concussions per year in football alone. The most commonly used definitions of concussion are those proposed by Cantu and the American Academy of Neurology. Each has associated management guidelines. Concussion or loss of consciousness occurs when the extracellular potassium concentration increases beyond the upper normal limit of approximately 4 to 5 mmol/L, to levels of 20 to 50 mmol/L, inhibiting the action potential and leading to loss of consciousness. This phenomenon helps to explain the delayed effects of symptoms after trauma. CONCLUSION: Neuropsychological testing seems to be an effective way to obtain useful data on the short-term and long-term effects of mild traumatic brain injury. Moreover, knowledge of the various definitions and management strategies, as well as the utility of neuropsychological testing, is essential for those involved in decision-making with athletes with mild traumatic brain injuries. [References: 50]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Riemann, B L; Guskiewicz, K M
Effects of mild head injury on postural stability as measured through clinical balance testing Journal Article
In: Journal of Athletic Training, vol. 35, pp. 19–25, 2000, ISSN: 1062-6050.
@article{Riemann2000,
title = {Effects of mild head injury on postural stability as measured through clinical balance testing},
author = {Riemann, B L and Guskiewicz, K M},
issn = {1062-6050},
year = {2000},
date = {2000-01-01},
journal = {Journal of Athletic Training},
volume = {35},
pages = {19--25},
abstract = {Objective: Although force-platform measures of postural stability provide objective information concerning mild head injury (MHI) resolution, their application has remained limited due to the high costs and impracticality for sideline use. Therefore, we investigated the efficacy of a clinical balance testing procedure for the detection of acute postural stability disruptions after MHI. Design and Setting: We used a posttest control group design with repeated measures. Postural stability was tested at 3 postinjury time intervals (days 1, 3, and 5) using 2 procedures in a sports medicine laboratory: 1) a clinical balance battery consisting of 3 stances (double leg, single leg, and tandem) on 2 surfaces (firm and foam), and 2) the Sensory Organization Test using a sophisticated force-platform system. Subjects: Sixteen MHI and 16 matched control subjects participated in this study. Measurements: We measured performance with the Balance Error Scoring System for each of the clinical balance tests and the NeuroCom Smart Balance Master for Sensory Organization Testing. Results: We found significantly higher postural instability in the MHI subjects revealed through the clinical test battery, with the 3 stances on the foam surface eliciting significant differences through day 3 postinjury. Results of the Sensory Organization Test revealed significant group differences on day 1 postinjury. Conclusions: Our results revealed that the Balance Error Scoring System may be a useful clinical procedure to assist clinicians in making return-to-play decisions in athletes with Mi-ii in the absence of force-platform equipment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rayls, K R; Mittenberg, W; Burns, W J; Theroux, S
Prospective study of the MMPI-2 correction factor after mild head injury Journal Article
In: Clinical Neuropsychologist, vol. 14, pp. 546–550, 2000.
@article{Rayls2000,
title = {Prospective study of the MMPI-2 correction factor after mild head injury},
author = {Rayls, K R and Mittenberg, W and Burns, W J and Theroux, S},
year = {2000},
date = {2000-01-01},
journal = {Clinical Neuropsychologist},
volume = {14},
pages = {546--550},
address = {Utah State Hospital, Provo, USA.},
abstract = {Gass (1991) proposed a correction factor composed of 14 MMPI-2 items that were characteristically endorsed by patients with closed-head injury. Their frequency of occurrence suggested that the items reflected the neurological rather than emotional consequences of head injury. The current study was designed to evaluate the interpretive significance of correction factor items after mild head trauma. Patients were examined immediately upon hospitalization and followed prospectively for at least 3 months. Correction factor items were endorsed more frequently during acute hospitalization than in the MMPI-2 standardization sample. At follow-up, none of the items were endorsed more often by patients with chronic mild head injury than by uninjured controls. These results suggest that the correction factor is sensitive to the acute neurological consequences of mild head trauma, but that these symptoms can typically be expected to resolve. Chronic endorsement of the items in this population is therefore most likely related to psychological factors.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lovell, M R; Iverson, G L; Collins, M W; McKeag, D; Maroon, J C
Does loss of consciousness predict neuropsychological decrements after concussion? Journal Article
In: Clinical Journal of Sport Medicine, vol. 9, pp. 193–198, 1999.
@article{Lovell1999,
title = {Does loss of consciousness predict neuropsychological decrements after concussion?},
author = {Lovell, M R and Iverson, G L and Collins, M W and McKeag, D and Maroon, J C},
year = {1999},
date = {1999-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {9},
pages = {193--198},
address = {Division of Neuropsychology, Henry Ford Health System, Detroit, Michigan 48202, USA.},
abstract = {OBJECTIVE: To investigate the importance of loss of consciousness (LOC) in predicting neuropsychological test performance in a large sample of patients with head injury. DESIGN: Retrospective comparison of neuropsychological test results for patients who suffered traumatic LOC, no LOC, or uncertain LOC. SETTING: Allegheny General Hospital, Pittsburgh, Pennsylvania. PATIENTS: The total number of patients included in this study was 383. MAIN OUTCOME MEASURES: Neuropsychological test measures, including the visual reproduction, digit span, and logical memory subtests of the Wechsler memory scale (revised), the Trail Making test, Wisconsin Card Sorting test, Hopkins Verbal Learning test, Controlled Oral Word Association, and the Galveston Orientation and Amnesia test (GOAT). RESULTS: No significant differences were found between the LOC, no LOC, or uncertain LOC groups for any of the neuropsychological measures used. Patients who had experienced traumatic LOC did not perform more poorly on neuropsychological testing than those with no LOC or uncertain LOC. All three groups demonstrated mildly decreased performance on formal tests of speed of information processing, attentional process, and memory. CONCLUSION: The results of this study cast doubt on the importance of LOC as a predictor of neuropsychological test performance during the acute phase of recovery from mild traumatic brain injury. Neuropsychological testing procedures have been shown to be sensitive in measuring cognitive sequelae of mild traumatic brain injury (concussion) in athletes. The failure of this study to find any relationship between LOC and neuropsychological functioning in a large sample of patients with mild head trauma calls into question the assignment of primary importance to LOC in grading severity of concussion. This study also does not provide support for the use of guidelines that rely heavily on LOC in making return-to-play decisions. Continued research is necessary to determine the relative importance of markers of concussion in athletes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bleiberg, J; Halpern, E L; Reeves, D; Daniel, J C
Future directions for the neuropsychological assessment of sports concussion Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 13, pp. 36–44, 1998.
@article{Bleiberg1998,
title = {Future directions for the neuropsychological assessment of sports concussion},
author = {Bleiberg, J and Halpern, E L and Reeves, D and Daniel, J C},
year = {1998},
date = {1998-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {13},
pages = {36--44},
address = {Assistive Technology Center, Nutritional Rehabilitation Center, Washington, DC, USA.},
abstract = {This article argues in favor of using newly developed computerized, complex reaction time (RT)-based neuropsychological procedures for the study of sports-related concussion. Recent studies show that by using these complex RT procedures, significant differences between concussed and control samples can be observed. The magnitude of RT differences is 110 ms or less, levels that are not meaningfully measured with stopwatch-based procedures. RT-based procedures also have the advantage of permitting analysis of variability of RT, and several recent studies have shown that brain dysfunction is accompanied by erratic and inconsistent RT. A currently ongoing sports concussion study using measures of complex RT and variability of RT is described. [References: 19]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bohnen, N; Twijnstra, A; Kroeze, J; Jolles, J
A psychophysical method for assessing visual and acoustic hyperaesthesia in patients with mild head injury Journal Article
In: British Journal of Psychiatry, vol. 159, pp. 860–863, 1991.
@article{Bohnen1991,
title = {A psychophysical method for assessing visual and acoustic hyperaesthesia in patients with mild head injury},
author = {Bohnen, N and Twijnstra, A and Kroeze, J and Jolles, J},
year = {1991},
date = {1991-01-01},
journal = {British Journal of Psychiatry},
volume = {159},
pages = {860--863},
address = {Department of Neuropsychology \& Psychobiology, University of Limburg, Maastricht, The Netherlands.},
abstract = {Although it is well known that patients with mild head injury (MHI) are less able to endure intense light and sound stimuli than normal people, there are few psychophysical studies that have objectively measured this type of hyperaesthesia. In the present study, using a computerised rating scale technique, both the maximal and submaximal levels of reduced tolerance to light and sound were assessed for a wide range of stimuli. Three to six days after the trauma, 40 MHI patients were significantly less tolerant to stimuli of intensities over 71 dB and 500 lux levels than controls. These intensities are common, and MHI patients may suffer as a consequence.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Leininger, B E; Gramling, S E; Farrell, A D; Kreutzer, J S; Peck 3rd, E A
Neuropsychological deficits in symptomatic minor head injury patients after concussion and mild concussion Journal Article
In: Journal of Neurology, Neurosurgery & Psychiatry, vol. 53, pp. 293–296, 1990.
@article{Leininger1990,
title = {Neuropsychological deficits in symptomatic minor head injury patients after concussion and mild concussion},
author = {Leininger, B E and Gramling, S E and Farrell, A D and Kreutzer, J S and {Peck 3rd}, E A},
year = {1990},
date = {1990-01-01},
journal = {Journal of Neurology, Neurosurgery \& Psychiatry},
volume = {53},
pages = {293--296},
address = {Virginia Commonwealth University, Department of Psychology, Richmond 23284.},
abstract = {Recent studies have concluded that most individuals who sustain minor head injury are free of persistent neuropsychological dysfunction. Nevertheless, a subgroup of patients experience continuing post-concussive difficulties and neuropsychological deficits. This study examined 53 symptomatic minor head injury patients referred for neuropsychological evaluation between one and 22 months after injury. These individuals performed significantly poorer than uninjured controls on four of eight neuropsychological tests. Patients who lost consciousness during injury obtained test scores similar to persons who experienced disorientation or confusion but no loss of consciousness. The results indicate that minor head injury patients who report post-concussive symptoms possess measurable neuropsychological deficits and the severity of these deficits is independent of neurological status immediately following injury.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hugenholtz, H; Richard, M T
On-site management of athletes with head injuries Journal Article
In: Physician & Sportsmedicine, vol. 11, no. 6, pp. 71, 1983, ISBN: 00913847.
@article{Hugenholtz1983,
title = {On-site management of athletes with head injuries},
author = {Hugenholtz, H and Richard, M T},
isbn = {00913847},
year = {1983},
date = {1983-01-01},
journal = {Physician \& Sportsmedicine},
volume = {11},
number = {6},
pages = {71},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Scharf, R
When is a head injury concussion? Journal Article
In: Canadian Family Physician, vol. 26, pp. 948–951, 1980.
@article{Scharf1980,
title = {When is a head injury concussion?},
author = {Scharf, R},
year = {1980},
date = {1980-01-01},
journal = {Canadian Family Physician},
volume = {26},
pages = {948--951},
abstract = {The patient with concussion is one who, with or without brief unconsciousness, has recovered to nearly normal in a limited time. Just which patients are apt to do this is a process of exclusion. This article is a mixture of what to look for, what to do and what findings rule out simple concussion. While repeated observation of level of consciousness, airway control and careful assessment of vital signs usually rule out serious injury, we must be on our toes to avoid serious mistakes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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