Blennow, K; Brody, D L; Kochanek, P M; Levin, H; McKee, A; Ribbers, G M; Yaffe, K; Zetterberg, H
Traumatic brain injuries Journal Article
In: Nature Reviews Disease Primers, vol. 2, 2016.
Abstract | Links | BibTeX | Tags: amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury
@article{Blennow2016,
title = {Traumatic brain injuries},
author = {Blennow, K and Brody, D L and Kochanek, P M and Levin, H and McKee, A and Ribbers, G M and Yaffe, K and Zetterberg, H},
doi = {10.1038/nrdp.2016.84},
year = {2016},
date = {2016-01-01},
journal = {Nature Reviews Disease Primers},
volume = {2},
abstract = {Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury-the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available. Most patients with mild TBI will recover quickly, but others report persistent symptoms, called post-concussive syndrome, the underlying pathophysiology of which is largely unknown. Repeated concussive and subconcussive head injuries have been linked to the neurodegenerative condition chronic traumatic encephalopathy (CTE), which has been reported post-mortem in contact sports athletes and soldiers exposed to blasts. Insights from severe injuries and CTE plausibly shed light on the underlying cellular and molecular processes involved in mild TBI. MRI techniques and blood tests for axonal proteins to identify and grade axonal injury, in addition to PET for tau pathology, show promise as tools to explore CTE pathophysiology in longitudinal clinical studies, and might be developed into diagnostic tools for CTE. Given that CTE is attributed to repeated head trauma, prevention might be possible through rule changes by sports organizations and legislators. © 2016 Macmillan Publishers Limited, part of Springer Nature.},
keywords = {amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Beiske, K K; Kostov, K H; Kostov, H
Rhythmic midtemporal discharge in a youth during light sleep Journal Article
In: Neurodiagnostic Journal, vol. 56, no. 1, pp. 32–36, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness
@article{Beiske2016,
title = {Rhythmic midtemporal discharge in a youth during light sleep},
author = {Beiske, K K and Kostov, K H and Kostov, H},
doi = {10.1080/21646821.2015.1119579},
year = {2016},
date = {2016-01-01},
journal = {Neurodiagnostic Journal},
volume = {56},
number = {1},
pages = {32--36},
abstract = {Rhythmic midtemporal discharge (RMTD) is a rare, benign EEG pattern that may have epileptic morphology. Recognizing variations of RMTD is important in order to avoid over- or misinterpretation of EEG findings, which may lead to inappropriate treatment and negative consequences for the patient in question. We present a case report of RTMDs during light sleep where initial erroneous description necessitated repeat EEGs and additional diagnostic exams and led to the postponement of obtaining a drivers licence for this young patient. Copyright © ASET - The Neurodiagnostic Society.},
keywords = {Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Andre, J B
Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials Journal Article
In: Topics in Magnetic Resonance Imaging, vol. 24, no. 5, pp. 275–287, 2015.
Abstract | BibTeX | Tags: Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter
@article{Andre2015,
title = {Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials},
author = {Andre, J B},
year = {2015},
date = {2015-01-01},
journal = {Topics in Magnetic Resonance Imaging},
volume = {24},
number = {5},
pages = {275--287},
abstract = {Traumatic brain injury (TBI), including concussion, is a public health concern, as it affects over 1.7 million persons in the United States per year. Yet, the diagnosis of TBI, particularly mild TBI (mTBI), can be controversial, as neuroimaging findings can be sparse on conventional magnetic resonance and computed tomography examinations, and when present, often poorly correlate with clinical signs and symptoms. Furthermore, the discussion of TBI, concussion, and head impact exposure is immediately complicated by the many differing opinions of what constitutes each, their respective severities, and how the underlying biomechanics of the inciting head impact might alter the distribution, severity, and prognosis of the underlying brain injury. Advanced imaging methodologies hold promise in improving the sensitivity and detectability of associated imaging biomarkers that might better correlate with patient outcome and prognostication, allowing for improved triage and therapeutic guidance in the setting of TBI, particularly in mTBI. This work will examine the defining symptom complex associated with mTBI and explore changes in cerebral blood flow measured by arterial spin labeling, as a potential imaging biomarker for TBI, and briefly correlate these observations with findings identified by single photon emission computed tomography and positron emission tomography imaging.. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter},
pubstate = {published},
tppubtype = {article}
}
Phillips, S; Woessner, D
Sports-Related Traumatic Brain Injury Journal Article
In: Primary Care - Clinics in Office Practice, vol. 42, no. 2, pp. 243–248, 2015.
Abstract | Links | BibTeX | Tags: Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed
@article{Phillips2015b,
title = {Sports-Related Traumatic Brain Injury},
author = {Phillips, S and Woessner, D},
doi = {10.1016/j.pop.2015.01.010},
year = {2015},
date = {2015-01-01},
journal = {Primary Care - Clinics in Office Practice},
volume = {42},
number = {2},
pages = {243--248},
abstract = {Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools. © 2015 Elsevier Inc.},
keywords = {Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed},
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}
}
Liu, C Y; Law, M; Romano, R
Rational approach to understanding and preventing sports-related traumatic brain injuries Journal Article
In: World Neurosurgery, vol. 84, no. 6, pp. 1556–1557, 2015.
Links | BibTeX | Tags: accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance
@article{Liu2015,
title = {Rational approach to understanding and preventing sports-related traumatic brain injuries},
author = {Liu, C Y and Law, M and Romano, R},
doi = {10.1016/j.wneu.2015.07.076},
year = {2015},
date = {2015-01-01},
journal = {World Neurosurgery},
volume = {84},
number = {6},
pages = {1556--1557},
keywords = {accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance},
pubstate = {published},
tppubtype = {article}
}
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}
}
Rapp, P E; Keyser, D O; Albano, A; Hernandez, R; Gibson, D B; Zambon, R A; David Hairston, W; Hughes, J D; Krystal, A; Nichols, A S
Traumatic brain injury detection using electrophysiological methods Journal Article
In: Frontiers in Human Neuroscience, vol. 9, no. FEB, 2015.
Abstract | Links | BibTeX | Tags: Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury
@article{Rapp2015,
title = {Traumatic brain injury detection using electrophysiological methods},
author = {Rapp, P E and Keyser, D O and Albano, A and Hernandez, R and Gibson, D B and Zambon, R A and {David Hairston}, W and Hughes, J D and Krystal, A and Nichols, A S},
doi = {10.3389/fnhum.2015.00011},
year = {2015},
date = {2015-01-01},
journal = {Frontiers in Human Neuroscience},
volume = {9},
number = {FEB},
abstract = {Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI).This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3)The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5)The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system. © 2015 Rapp, Keyser , Albano, Hernandez, Gibson, Zambon, Hairston, Hughes, Krystal and Nichols.},
keywords = {Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Gandy, S; Ikonomovic, M D; Mitsis, E; Elder, G; Ahlers, S T; Barth, J; Stone, J R; Dekosky, S T
Chronic traumatic encephalopathy: Clinical-biomarker correlations and current concepts in pathogenesis Journal Article
In: Molecular Neurodegeneration, vol. 9, no. 1, 2014.
Abstract | Links | BibTeX | Tags: animal model, army, Article, blast injury, body fluid, Boxing, chronic disease, Chronic traumatic encephalopathy, Chronic Traumatic Encephalopathy biological marker, Dementia, dementia pugilistica, Diffusion Tensor Imaging, executive function, experimental animal, fluorine 18, football, functional magnetic resonance imaging, functional neuroimaging, human, molecular pathology, neuropathology, neuropsychology, nonhuman, nuclear magnetic resonance imaging, Occupational Exposure, positron emission tomography, punch drunk syndrome, systematic review (topic), traumatic brain injury, white matter, working memory
@article{Gandy2014a,
title = {Chronic traumatic encephalopathy: Clinical-biomarker correlations and current concepts in pathogenesis},
author = {Gandy, S and Ikonomovic, M D and Mitsis, E and Elder, G and Ahlers, S T and Barth, J and Stone, J R and Dekosky, S T},
url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84907464163\&partnerID=40\&md5=109c916e926417c11bab99fd7b44065c},
doi = {10.1186/1750-1326-9-37},
year = {2014},
date = {2014-01-01},
journal = {Molecular Neurodegeneration},
volume = {9},
number = {1},
abstract = {Background: Chronic traumatic encephalopathy (CTE) is a recently revived term used to describe a neurodegenerative process that occurs as a long term complication of repetitive mild traumatic brain injury (TBI). Corsellis provided one of the classic descriptions of CTE in boxers under the name "dementia pugilistica" (DP). Much recent attention has been drawn to the apparent association of CTE with contact sports (football, soccer, hockey) and with frequent battlefield exposure to blast waves generated by improvised explosive devices (IEDs). Recently, a promising serum biomarker has been identified by measurement of serum levels of the neuronal microtubule associated protein tau. New positron emission tomography (PET) ligands (e.g., [18F] T807) that identify brain tauopathy have been successfully deployed for the in vitro and in vivo detection of presumptive tauopathy in the brains of subjects with clinically probable CTE. Methods. Major academic and lay publications on DP/CTE were reviewed beginning with the 1928 paper describing the initial use of the term CTE by Martland. Results: The major current concepts in the neurological, psychiatric, neuropsychological, neuroimaging, and body fluid biomarker science of DP/CTE have been summarized. Newer achievements, such as serum tau and [18F] T807 tauopathy imaging, are also introduced and their significance has been explained. Conclusion: Recent advances in the science of DP/CTE hold promise for elucidating a long sought accurate determination of the true prevalence of CTE. This information holds potentially important public health implications for estimating the risk of contact sports in inflicting permanent and/or progressive brain damage on children, adolescents, and adults. © 2014Gandy et al.; licensee BioMed Central Ltd.},
keywords = {animal model, army, Article, blast injury, body fluid, Boxing, chronic disease, Chronic traumatic encephalopathy, Chronic Traumatic Encephalopathy biological marker, Dementia, dementia pugilistica, Diffusion Tensor Imaging, executive function, experimental animal, fluorine 18, football, functional magnetic resonance imaging, functional neuroimaging, human, molecular pathology, neuropathology, neuropsychology, nonhuman, nuclear magnetic resonance imaging, Occupational Exposure, positron emission tomography, punch drunk syndrome, systematic review (topic), traumatic brain injury, white matter, working memory},
pubstate = {published},
tppubtype = {article}
}
Blennow, K; Brody, D L; Kochanek, P M; Levin, H; McKee, A; Ribbers, G M; Yaffe, K; Zetterberg, H
Traumatic brain injuries Journal Article
In: Nature Reviews Disease Primers, vol. 2, 2016.
@article{Blennow2016,
title = {Traumatic brain injuries},
author = {Blennow, K and Brody, D L and Kochanek, P M and Levin, H and McKee, A and Ribbers, G M and Yaffe, K and Zetterberg, H},
doi = {10.1038/nrdp.2016.84},
year = {2016},
date = {2016-01-01},
journal = {Nature Reviews Disease Primers},
volume = {2},
abstract = {Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury-the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available. Most patients with mild TBI will recover quickly, but others report persistent symptoms, called post-concussive syndrome, the underlying pathophysiology of which is largely unknown. Repeated concussive and subconcussive head injuries have been linked to the neurodegenerative condition chronic traumatic encephalopathy (CTE), which has been reported post-mortem in contact sports athletes and soldiers exposed to blasts. Insights from severe injuries and CTE plausibly shed light on the underlying cellular and molecular processes involved in mild TBI. MRI techniques and blood tests for axonal proteins to identify and grade axonal injury, in addition to PET for tau pathology, show promise as tools to explore CTE pathophysiology in longitudinal clinical studies, and might be developed into diagnostic tools for CTE. Given that CTE is attributed to repeated head trauma, prevention might be possible through rule changes by sports organizations and legislators. © 2016 Macmillan Publishers Limited, part of Springer Nature.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Beiske, K K; Kostov, K H; Kostov, H
Rhythmic midtemporal discharge in a youth during light sleep Journal Article
In: Neurodiagnostic Journal, vol. 56, no. 1, pp. 32–36, 2016.
@article{Beiske2016,
title = {Rhythmic midtemporal discharge in a youth during light sleep},
author = {Beiske, K K and Kostov, K H and Kostov, H},
doi = {10.1080/21646821.2015.1119579},
year = {2016},
date = {2016-01-01},
journal = {Neurodiagnostic Journal},
volume = {56},
number = {1},
pages = {32--36},
abstract = {Rhythmic midtemporal discharge (RMTD) is a rare, benign EEG pattern that may have epileptic morphology. Recognizing variations of RMTD is important in order to avoid over- or misinterpretation of EEG findings, which may lead to inappropriate treatment and negative consequences for the patient in question. We present a case report of RTMDs during light sleep where initial erroneous description necessitated repeat EEGs and additional diagnostic exams and led to the postponement of obtaining a drivers licence for this young patient. Copyright © ASET - The Neurodiagnostic Society.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Andre, J B
Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials Journal Article
In: Topics in Magnetic Resonance Imaging, vol. 24, no. 5, pp. 275–287, 2015.
@article{Andre2015,
title = {Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials},
author = {Andre, J B},
year = {2015},
date = {2015-01-01},
journal = {Topics in Magnetic Resonance Imaging},
volume = {24},
number = {5},
pages = {275--287},
abstract = {Traumatic brain injury (TBI), including concussion, is a public health concern, as it affects over 1.7 million persons in the United States per year. Yet, the diagnosis of TBI, particularly mild TBI (mTBI), can be controversial, as neuroimaging findings can be sparse on conventional magnetic resonance and computed tomography examinations, and when present, often poorly correlate with clinical signs and symptoms. Furthermore, the discussion of TBI, concussion, and head impact exposure is immediately complicated by the many differing opinions of what constitutes each, their respective severities, and how the underlying biomechanics of the inciting head impact might alter the distribution, severity, and prognosis of the underlying brain injury. Advanced imaging methodologies hold promise in improving the sensitivity and detectability of associated imaging biomarkers that might better correlate with patient outcome and prognostication, allowing for improved triage and therapeutic guidance in the setting of TBI, particularly in mTBI. This work will examine the defining symptom complex associated with mTBI and explore changes in cerebral blood flow measured by arterial spin labeling, as a potential imaging biomarker for TBI, and briefly correlate these observations with findings identified by single photon emission computed tomography and positron emission tomography imaging.. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Phillips, S; Woessner, D
Sports-Related Traumatic Brain Injury Journal Article
In: Primary Care - Clinics in Office Practice, vol. 42, no. 2, pp. 243–248, 2015.
@article{Phillips2015b,
title = {Sports-Related Traumatic Brain Injury},
author = {Phillips, S and Woessner, D},
doi = {10.1016/j.pop.2015.01.010},
year = {2015},
date = {2015-01-01},
journal = {Primary Care - Clinics in Office Practice},
volume = {42},
number = {2},
pages = {243--248},
abstract = {Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools. © 2015 Elsevier Inc.},
keywords = {},
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 = {},
pubstate = {published},
tppubtype = {article}
}
Liu, C Y; Law, M; Romano, R
Rational approach to understanding and preventing sports-related traumatic brain injuries Journal Article
In: World Neurosurgery, vol. 84, no. 6, pp. 1556–1557, 2015.
@article{Liu2015,
title = {Rational approach to understanding and preventing sports-related traumatic brain injuries},
author = {Liu, C Y and Law, M and Romano, R},
doi = {10.1016/j.wneu.2015.07.076},
year = {2015},
date = {2015-01-01},
journal = {World Neurosurgery},
volume = {84},
number = {6},
pages = {1556--1557},
keywords = {},
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 = {},
pubstate = {published},
tppubtype = {article}
}
Rapp, P E; Keyser, D O; Albano, A; Hernandez, R; Gibson, D B; Zambon, R A; David Hairston, W; Hughes, J D; Krystal, A; Nichols, A S
Traumatic brain injury detection using electrophysiological methods Journal Article
In: Frontiers in Human Neuroscience, vol. 9, no. FEB, 2015.
@article{Rapp2015,
title = {Traumatic brain injury detection using electrophysiological methods},
author = {Rapp, P E and Keyser, D O and Albano, A and Hernandez, R and Gibson, D B and Zambon, R A and {David Hairston}, W and Hughes, J D and Krystal, A and Nichols, A S},
doi = {10.3389/fnhum.2015.00011},
year = {2015},
date = {2015-01-01},
journal = {Frontiers in Human Neuroscience},
volume = {9},
number = {FEB},
abstract = {Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI).This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3)The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5)The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system. © 2015 Rapp, Keyser , Albano, Hernandez, Gibson, Zambon, Hairston, Hughes, Krystal and Nichols.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gandy, S; Ikonomovic, M D; Mitsis, E; Elder, G; Ahlers, S T; Barth, J; Stone, J R; Dekosky, S T
Chronic traumatic encephalopathy: Clinical-biomarker correlations and current concepts in pathogenesis Journal Article
In: Molecular Neurodegeneration, vol. 9, no. 1, 2014.
@article{Gandy2014a,
title = {Chronic traumatic encephalopathy: Clinical-biomarker correlations and current concepts in pathogenesis},
author = {Gandy, S and Ikonomovic, M D and Mitsis, E and Elder, G and Ahlers, S T and Barth, J and Stone, J R and Dekosky, S T},
url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84907464163\&partnerID=40\&md5=109c916e926417c11bab99fd7b44065c},
doi = {10.1186/1750-1326-9-37},
year = {2014},
date = {2014-01-01},
journal = {Molecular Neurodegeneration},
volume = {9},
number = {1},
abstract = {Background: Chronic traumatic encephalopathy (CTE) is a recently revived term used to describe a neurodegenerative process that occurs as a long term complication of repetitive mild traumatic brain injury (TBI). Corsellis provided one of the classic descriptions of CTE in boxers under the name "dementia pugilistica" (DP). Much recent attention has been drawn to the apparent association of CTE with contact sports (football, soccer, hockey) and with frequent battlefield exposure to blast waves generated by improvised explosive devices (IEDs). Recently, a promising serum biomarker has been identified by measurement of serum levels of the neuronal microtubule associated protein tau. New positron emission tomography (PET) ligands (e.g., [18F] T807) that identify brain tauopathy have been successfully deployed for the in vitro and in vivo detection of presumptive tauopathy in the brains of subjects with clinically probable CTE. Methods. Major academic and lay publications on DP/CTE were reviewed beginning with the 1928 paper describing the initial use of the term CTE by Martland. Results: The major current concepts in the neurological, psychiatric, neuropsychological, neuroimaging, and body fluid biomarker science of DP/CTE have been summarized. Newer achievements, such as serum tau and [18F] T807 tauopathy imaging, are also introduced and their significance has been explained. Conclusion: Recent advances in the science of DP/CTE hold promise for elucidating a long sought accurate determination of the true prevalence of CTE. This information holds potentially important public health implications for estimating the risk of contact sports in inflicting permanent and/or progressive brain damage on children, adolescents, and adults. © 2014Gandy et al.; licensee BioMed Central Ltd.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Blennow, K; Brody, D L; Kochanek, P M; Levin, H; McKee, A; Ribbers, G M; Yaffe, K; Zetterberg, H
Traumatic brain injuries Journal Article
In: Nature Reviews Disease Primers, vol. 2, 2016.
Abstract | Links | BibTeX | Tags: amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury
@article{Blennow2016,
title = {Traumatic brain injuries},
author = {Blennow, K and Brody, D L and Kochanek, P M and Levin, H and McKee, A and Ribbers, G M and Yaffe, K and Zetterberg, H},
doi = {10.1038/nrdp.2016.84},
year = {2016},
date = {2016-01-01},
journal = {Nature Reviews Disease Primers},
volume = {2},
abstract = {Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury-the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available. Most patients with mild TBI will recover quickly, but others report persistent symptoms, called post-concussive syndrome, the underlying pathophysiology of which is largely unknown. Repeated concussive and subconcussive head injuries have been linked to the neurodegenerative condition chronic traumatic encephalopathy (CTE), which has been reported post-mortem in contact sports athletes and soldiers exposed to blasts. Insights from severe injuries and CTE plausibly shed light on the underlying cellular and molecular processes involved in mild TBI. MRI techniques and blood tests for axonal proteins to identify and grade axonal injury, in addition to PET for tau pathology, show promise as tools to explore CTE pathophysiology in longitudinal clinical studies, and might be developed into diagnostic tools for CTE. Given that CTE is attributed to repeated head trauma, prevention might be possible through rule changes by sports organizations and legislators. © 2016 Macmillan Publishers Limited, part of Springer Nature.},
keywords = {amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Beiske, K K; Kostov, K H; Kostov, H
Rhythmic midtemporal discharge in a youth during light sleep Journal Article
In: Neurodiagnostic Journal, vol. 56, no. 1, pp. 32–36, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness
@article{Beiske2016,
title = {Rhythmic midtemporal discharge in a youth during light sleep},
author = {Beiske, K K and Kostov, K H and Kostov, H},
doi = {10.1080/21646821.2015.1119579},
year = {2016},
date = {2016-01-01},
journal = {Neurodiagnostic Journal},
volume = {56},
number = {1},
pages = {32--36},
abstract = {Rhythmic midtemporal discharge (RMTD) is a rare, benign EEG pattern that may have epileptic morphology. Recognizing variations of RMTD is important in order to avoid over- or misinterpretation of EEG findings, which may lead to inappropriate treatment and negative consequences for the patient in question. We present a case report of RTMDs during light sleep where initial erroneous description necessitated repeat EEGs and additional diagnostic exams and led to the postponement of obtaining a drivers licence for this young patient. Copyright © ASET - The Neurodiagnostic Society.},
keywords = {Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Andre, J B
Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials Journal Article
In: Topics in Magnetic Resonance Imaging, vol. 24, no. 5, pp. 275–287, 2015.
Abstract | BibTeX | Tags: Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter
@article{Andre2015,
title = {Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials},
author = {Andre, J B},
year = {2015},
date = {2015-01-01},
journal = {Topics in Magnetic Resonance Imaging},
volume = {24},
number = {5},
pages = {275--287},
abstract = {Traumatic brain injury (TBI), including concussion, is a public health concern, as it affects over 1.7 million persons in the United States per year. Yet, the diagnosis of TBI, particularly mild TBI (mTBI), can be controversial, as neuroimaging findings can be sparse on conventional magnetic resonance and computed tomography examinations, and when present, often poorly correlate with clinical signs and symptoms. Furthermore, the discussion of TBI, concussion, and head impact exposure is immediately complicated by the many differing opinions of what constitutes each, their respective severities, and how the underlying biomechanics of the inciting head impact might alter the distribution, severity, and prognosis of the underlying brain injury. Advanced imaging methodologies hold promise in improving the sensitivity and detectability of associated imaging biomarkers that might better correlate with patient outcome and prognostication, allowing for improved triage and therapeutic guidance in the setting of TBI, particularly in mTBI. This work will examine the defining symptom complex associated with mTBI and explore changes in cerebral blood flow measured by arterial spin labeling, as a potential imaging biomarker for TBI, and briefly correlate these observations with findings identified by single photon emission computed tomography and positron emission tomography imaging.. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter},
pubstate = {published},
tppubtype = {article}
}
Phillips, S; Woessner, D
Sports-Related Traumatic Brain Injury Journal Article
In: Primary Care - Clinics in Office Practice, vol. 42, no. 2, pp. 243–248, 2015.
Abstract | Links | BibTeX | Tags: Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed
@article{Phillips2015b,
title = {Sports-Related Traumatic Brain Injury},
author = {Phillips, S and Woessner, D},
doi = {10.1016/j.pop.2015.01.010},
year = {2015},
date = {2015-01-01},
journal = {Primary Care - Clinics in Office Practice},
volume = {42},
number = {2},
pages = {243--248},
abstract = {Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools. © 2015 Elsevier Inc.},
keywords = {Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed},
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}
}
Liu, C Y; Law, M; Romano, R
Rational approach to understanding and preventing sports-related traumatic brain injuries Journal Article
In: World Neurosurgery, vol. 84, no. 6, pp. 1556–1557, 2015.
Links | BibTeX | Tags: accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance
@article{Liu2015,
title = {Rational approach to understanding and preventing sports-related traumatic brain injuries},
author = {Liu, C Y and Law, M and Romano, R},
doi = {10.1016/j.wneu.2015.07.076},
year = {2015},
date = {2015-01-01},
journal = {World Neurosurgery},
volume = {84},
number = {6},
pages = {1556--1557},
keywords = {accelerometer, ACCELEROMETRY, biological marker, brain, brain concussion, brain hemorrhage, cognitive defect, Diffusion Tensor Imaging, Electroencephalography, emergency health service, Female, Head Protective Devices, Helmet, high risk patient, human, Humans, Injuries, Male, neuroimaging, neuromodulation, neuroprotective agent, nuclear magnetic resonance imaging, Occupational Exposure, protective equipment, Review, risk factor, risk reduction, SAFETY, skiing, Snowboarding, sport injury, Traumatic, traumatic brain injury, viscoelastic substance},
pubstate = {published},
tppubtype = {article}
}
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}
}
Rapp, P E; Keyser, D O; Albano, A; Hernandez, R; Gibson, D B; Zambon, R A; David Hairston, W; Hughes, J D; Krystal, A; Nichols, A S
Traumatic brain injury detection using electrophysiological methods Journal Article
In: Frontiers in Human Neuroscience, vol. 9, no. FEB, 2015.
Abstract | Links | BibTeX | Tags: Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury
@article{Rapp2015,
title = {Traumatic brain injury detection using electrophysiological methods},
author = {Rapp, P E and Keyser, D O and Albano, A and Hernandez, R and Gibson, D B and Zambon, R A and {David Hairston}, W and Hughes, J D and Krystal, A and Nichols, A S},
doi = {10.3389/fnhum.2015.00011},
year = {2015},
date = {2015-01-01},
journal = {Frontiers in Human Neuroscience},
volume = {9},
number = {FEB},
abstract = {Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI).This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3)The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5)The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system. © 2015 Rapp, Keyser , Albano, Hernandez, Gibson, Zambon, Hairston, Hughes, Krystal and Nichols.},
keywords = {Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Gandy, S; Ikonomovic, M D; Mitsis, E; Elder, G; Ahlers, S T; Barth, J; Stone, J R; Dekosky, S T
Chronic traumatic encephalopathy: Clinical-biomarker correlations and current concepts in pathogenesis Journal Article
In: Molecular Neurodegeneration, vol. 9, no. 1, 2014.
Abstract | Links | BibTeX | Tags: animal model, army, Article, blast injury, body fluid, Boxing, chronic disease, Chronic traumatic encephalopathy, Chronic Traumatic Encephalopathy biological marker, Dementia, dementia pugilistica, Diffusion Tensor Imaging, executive function, experimental animal, fluorine 18, football, functional magnetic resonance imaging, functional neuroimaging, human, molecular pathology, neuropathology, neuropsychology, nonhuman, nuclear magnetic resonance imaging, Occupational Exposure, positron emission tomography, punch drunk syndrome, systematic review (topic), traumatic brain injury, white matter, working memory
@article{Gandy2014a,
title = {Chronic traumatic encephalopathy: Clinical-biomarker correlations and current concepts in pathogenesis},
author = {Gandy, S and Ikonomovic, M D and Mitsis, E and Elder, G and Ahlers, S T and Barth, J and Stone, J R and Dekosky, S T},
url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84907464163\&partnerID=40\&md5=109c916e926417c11bab99fd7b44065c},
doi = {10.1186/1750-1326-9-37},
year = {2014},
date = {2014-01-01},
journal = {Molecular Neurodegeneration},
volume = {9},
number = {1},
abstract = {Background: Chronic traumatic encephalopathy (CTE) is a recently revived term used to describe a neurodegenerative process that occurs as a long term complication of repetitive mild traumatic brain injury (TBI). Corsellis provided one of the classic descriptions of CTE in boxers under the name "dementia pugilistica" (DP). Much recent attention has been drawn to the apparent association of CTE with contact sports (football, soccer, hockey) and with frequent battlefield exposure to blast waves generated by improvised explosive devices (IEDs). Recently, a promising serum biomarker has been identified by measurement of serum levels of the neuronal microtubule associated protein tau. New positron emission tomography (PET) ligands (e.g., [18F] T807) that identify brain tauopathy have been successfully deployed for the in vitro and in vivo detection of presumptive tauopathy in the brains of subjects with clinically probable CTE. Methods. Major academic and lay publications on DP/CTE were reviewed beginning with the 1928 paper describing the initial use of the term CTE by Martland. Results: The major current concepts in the neurological, psychiatric, neuropsychological, neuroimaging, and body fluid biomarker science of DP/CTE have been summarized. Newer achievements, such as serum tau and [18F] T807 tauopathy imaging, are also introduced and their significance has been explained. Conclusion: Recent advances in the science of DP/CTE hold promise for elucidating a long sought accurate determination of the true prevalence of CTE. This information holds potentially important public health implications for estimating the risk of contact sports in inflicting permanent and/or progressive brain damage on children, adolescents, and adults. © 2014Gandy et al.; licensee BioMed Central Ltd.},
keywords = {animal model, army, Article, blast injury, body fluid, Boxing, chronic disease, Chronic traumatic encephalopathy, Chronic Traumatic Encephalopathy biological marker, Dementia, dementia pugilistica, Diffusion Tensor Imaging, executive function, experimental animal, fluorine 18, football, functional magnetic resonance imaging, functional neuroimaging, human, molecular pathology, neuropathology, neuropsychology, nonhuman, nuclear magnetic resonance imaging, Occupational Exposure, positron emission tomography, punch drunk syndrome, systematic review (topic), traumatic brain injury, white matter, working memory},
pubstate = {published},
tppubtype = {article}
}