References

2016

Raikes, A C; Schaefer, S Y

Phasic electrodermal activity during the standardized assessment of concussion (SAC) Journal Article

In: Journal of Athletic Training, vol. 51, no. 7, pp. 533–539, 2016.

Abstract | Links | BibTeX | Tags: Memory, Traumatic Brain Injuries, Wireless technology

Naeser, M A; Martin, P I; Ho, M D; Krengel, M H; Bogdanova, Y; Knight, J A; Yee, M K; Zafonte, R; Frazier, J; Hamblin, M R; Koo, B B

Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury Journal Article

In: Photomedicine and Laser Surgery, vol. 34, no. 12, pp. 610–626, 2016.

Abstract | Links | BibTeX | Tags: Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury

@article{Naeser2016,

title = {Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury},

author = {Naeser, M A and Martin, P I and Ho, M D and Krengel, M H and Bogdanova, Y and Knight, J A and Yee, M K and Zafonte, R and Frazier, J and Hamblin, M R and Koo, B B},

doi = {10.1089/pho.2015.4037},

year  = {2016},

date = {2016-01-01},

journal = {Photomedicine and Laser Surgery},

volume = {34},

number = {12},

pages = {610--626},

abstract = {Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.},

keywords = {Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.

Johnson, K L; Chowdhury, S; Lawrimore, W B; Mao, Y; Mehmani, A; Prabhu, R; Rush, G A; Horstemeyer, M F

Constrained topological optimization of a football helmet facemask based on brain response Journal Article

In: Materials and Design, vol. 111, pp. 108–118, 2016.

Abstract | Links | BibTeX | Tags: Accident prevention, ALGORITHMS, brain, Concussion, Constrained optimization, Design, Design optimization, finite element analysis, Finite element method, football helmet, Fuel additives, Genetic algorithms, Multiobjective optimization, Optimization, Safety devices, Shear strain, Sports, Surrogate model, Surrogate modeling, Topology, Traumatic Brain Injuries, traumatic brain injury

@article{Johnson2016a,

title = {Constrained topological optimization of a football helmet facemask based on brain response},

author = {Johnson, K L and Chowdhury, S and Lawrimore, W B and Mao, Y and Mehmani, A and Prabhu, R and Rush, G A and Horstemeyer, M F},

doi = {10.1016/j.matdes.2016.08.064},

year  = {2016},

date = {2016-01-01},

journal = {Materials and Design},

volume = {111},

pages = {108--118},

abstract = {Surrogate model-based multi-objective design optimization was performed to reduce concussion risk during frontal football helmet impacts. In particular, a topological decomposition of the football helmet facemask was performed to formulate the design problem, and brain injury metrics were exploited as objective functions. A validated finite element model of a helmeted human head was used to recreate facemask impacts. Due to the prohibitive computational expense of the full scale simulations, a surrogate modeling approach was employed. An optimal surrogate model selection framework, called Concurrent Surrogate Model Selection, or COSMOS, was utilized to identify the surrogate models best suited to approximate each objective function. The resulting surrogate models were implemented in the Non-dominated Sorting Genetic Algorithm II (NSGA-II) optimization algorithm. Constraints were implemented to control the solid material fraction in the facemask design space, and binary variables were used to control the placement of the facemask bars. The optimized facemask designs reduced the maximum tensile pressure in the brain by 7.5% and the maximum shear strain by a remarkable 39.5%. This research represents a first-of-its-kind approach to multi-objective design optimization on a football helmet, and demonstrates the possibilities that are achievable in improving human safety by using such a simulation-based design optimization. © 2016 Elsevier Ltd},

keywords = {Accident prevention, ALGORITHMS, brain, Concussion, Constrained optimization, Design, Design optimization, finite element analysis, Finite element method, football helmet, Fuel additives, Genetic algorithms, Multiobjective optimization, Optimization, Safety devices, Shear strain, Sports, Surrogate model, Surrogate modeling, Topology, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

2015

Dang, H; Stayman, J W; Sisniega, A; Xu, J; Zbijewski, W; Wang, X; Foos, D H; Aygun, N; Koliatsos, V E; Siewerdsen, J H

Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging Journal Article

In: Physics in Medicine and Biology, vol. 60, no. 16, pp. 6153–6175, 2015.

Abstract | Links | BibTeX | Tags: artifact correction, brain, Computerized tomography, cone-beam CT, Flat panel displays, image processing, Image quality, Image reconstruction, Intensive care units, intracranial hemorrhage, Intracranial hemorrhages, Iterative methods, Least squares approximations, Measurement Noise, measurement noise model, Model based iterative reconstruction, model-based iterative reconstruction, Soft tissue, soft-tissue image quality, Tissue, Traumatic Brain Injuries, traumatic brain injury

@article{Dang2015,

title = {Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging},

author = {Dang, H and Stayman, J W and Sisniega, A and Xu, J and Zbijewski, W and Wang, X and Foos, D H and Aygun, N and Koliatsos, V E and Siewerdsen, J H},

doi = {10.1088/0031-9155/60/16/6153},

year  = {2015},

date = {2015-01-01},

journal = {Physics in Medicine and Biology},

volume = {60},

number = {16},

pages = {6153--6175},

abstract = {Non-contrast CT reliably detects fresh blood in the brain and is the current front-line imaging modality for intracranial hemorrhage such as that occurring in acute traumatic brain injury (contrast ∼40-80 HU, size \> 1 mm). We are developing flat-panel detector (FPD) cone-beam CT (CBCT) to facilitate such diagnosis in a low-cost, mobile platform suitable for point-of-care deployment. Such a system may offer benefits in the ICU, urgent care/concussion clinic, ambulance, and sports and military theatres. However, current FPD-CBCT systems face significant challenges that confound low-contrast, soft-tissue imaging. Artifact correction can overcome major sources of bias in FPD-CBCT but imparts noise amplification in filtered backprojection (FBP). Model-based reconstruction improves soft-tissue image quality compared to FBP by leveraging a high-fidelity forward model and image regularization. In this work, we develop a novel penalized weighted least-squares (PWLS) image reconstruction method with a noise model that includes accurate modeling of the noise characteristics associated with the two dominant artifact corrections (scatter and beam-hardening) in CBCT and utilizes modified weights to compensate for noise amplification imparted by each correction. Experiments included real data acquired on a FPD-CBCT test-bench and an anthropomorphic head phantom emulating intra-parenchymal hemorrhage. The proposed PWLS method demonstrated superior noise-resolution tradeoffs in comparison to FBP and PWLS with conventional weights (viz. at matched 0.50 mm spatial resolution},

keywords = {artifact correction, brain, Computerized tomography, cone-beam CT, Flat panel displays, image processing, Image quality, Image reconstruction, Intensive care units, intracranial hemorrhage, Intracranial hemorrhages, Iterative methods, Least squares approximations, Measurement Noise, measurement noise model, Model based iterative reconstruction, model-based iterative reconstruction, Soft tissue, soft-tissue image quality, Tissue, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

Stemper, B D; Shah, A S; Pintar, F A; McCrea, M; Kurpad, S N; Glavaski-Joksimovic, A; Olsen, C; Budde, M D

Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion Journal Article

In: Annals of Biomedical Engineering, vol. 43, no. 5, pp. 1071–1088, 2015.

Abstract | Links | BibTeX | Tags: Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)

@article{Stemper2015,

title = {Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion},

author = {Stemper, B D and Shah, A S and Pintar, F A and McCrea, M and Kurpad, S N and Glavaski-Joksimovic, A and Olsen, C and Budde, M D},

doi = {10.1007/s10439-014-1171-9},

year  = {2015},

date = {2015-01-01},

journal = {Annals of Biomedical Engineering},

volume = {43},

number = {5},

pages = {1071--1088},

abstract = {A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague\textendashDawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).},

keywords = {Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)},

pubstate = {published},

tppubtype = {article}

}

A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague–Dawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).

2013

van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje

Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article

In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.

Abstract | BibTeX | Tags: *ANXIETY, *BRAIN -- Wounds & injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work

@article{VanderHorn2013,

title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},

author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},

isbn = {00039993},

year  = {2013},

date = {2013-01-01},

journal = {Archives of Physical Medicine \& Rehabilitation},

volume = {94},

number = {5},

pages = {867--874},

abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},

keywords = {*ANXIETY, *BRAIN -- Wounds \&amp; injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},

pubstate = {published},

tppubtype = {article}

}

Reference Search

Raikes, A C; Schaefer, S Y

Phasic electrodermal activity during the standardized assessment of concussion (SAC) Journal Article

In: Journal of Athletic Training, vol. 51, no. 7, pp. 533–539, 2016.

Abstract | Links | BibTeX

Naeser, M A; Martin, P I; Ho, M D; Krengel, M H; Bogdanova, Y; Knight, J A; Yee, M K; Zafonte, R; Frazier, J; Hamblin, M R; Koo, B B

Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury Journal Article

In: Photomedicine and Laser Surgery, vol. 34, no. 12, pp. 610–626, 2016.

Abstract | Links | BibTeX

@article{Naeser2016,

title = {Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury},

author = {Naeser, M A and Martin, P I and Ho, M D and Krengel, M H and Bogdanova, Y and Knight, J A and Yee, M K and Zafonte, R and Frazier, J and Hamblin, M R and Koo, B B},

doi = {10.1089/pho.2015.4037},

year  = {2016},

date = {2016-01-01},

journal = {Photomedicine and Laser Surgery},

volume = {34},

number = {12},

pages = {610--626},

abstract = {Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Johnson, K L; Chowdhury, S; Lawrimore, W B; Mao, Y; Mehmani, A; Prabhu, R; Rush, G A; Horstemeyer, M F

Constrained topological optimization of a football helmet facemask based on brain response Journal Article

In: Materials and Design, vol. 111, pp. 108–118, 2016.

Abstract | Links | BibTeX

Dang, H; Stayman, J W; Sisniega, A; Xu, J; Zbijewski, W; Wang, X; Foos, D H; Aygun, N; Koliatsos, V E; Siewerdsen, J H

Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging Journal Article

In: Physics in Medicine and Biology, vol. 60, no. 16, pp. 6153–6175, 2015.

Abstract | Links | BibTeX

@article{Dang2015,

title = {Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging},

author = {Dang, H and Stayman, J W and Sisniega, A and Xu, J and Zbijewski, W and Wang, X and Foos, D H and Aygun, N and Koliatsos, V E and Siewerdsen, J H},

doi = {10.1088/0031-9155/60/16/6153},

year  = {2015},

date = {2015-01-01},

journal = {Physics in Medicine and Biology},

volume = {60},

number = {16},

pages = {6153--6175},

abstract = {Non-contrast CT reliably detects fresh blood in the brain and is the current front-line imaging modality for intracranial hemorrhage such as that occurring in acute traumatic brain injury (contrast ∼40-80 HU, size \> 1 mm). We are developing flat-panel detector (FPD) cone-beam CT (CBCT) to facilitate such diagnosis in a low-cost, mobile platform suitable for point-of-care deployment. Such a system may offer benefits in the ICU, urgent care/concussion clinic, ambulance, and sports and military theatres. However, current FPD-CBCT systems face significant challenges that confound low-contrast, soft-tissue imaging. Artifact correction can overcome major sources of bias in FPD-CBCT but imparts noise amplification in filtered backprojection (FBP). Model-based reconstruction improves soft-tissue image quality compared to FBP by leveraging a high-fidelity forward model and image regularization. In this work, we develop a novel penalized weighted least-squares (PWLS) image reconstruction method with a noise model that includes accurate modeling of the noise characteristics associated with the two dominant artifact corrections (scatter and beam-hardening) in CBCT and utilizes modified weights to compensate for noise amplification imparted by each correction. Experiments included real data acquired on a FPD-CBCT test-bench and an anthropomorphic head phantom emulating intra-parenchymal hemorrhage. The proposed PWLS method demonstrated superior noise-resolution tradeoffs in comparison to FBP and PWLS with conventional weights (viz. at matched 0.50 mm spatial resolution},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Stemper, B D; Shah, A S; Pintar, F A; McCrea, M; Kurpad, S N; Glavaski-Joksimovic, A; Olsen, C; Budde, M D

Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion Journal Article

In: Annals of Biomedical Engineering, vol. 43, no. 5, pp. 1071–1088, 2015.

Abstract | Links | BibTeX

@article{Stemper2015,

title = {Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion},

author = {Stemper, B D and Shah, A S and Pintar, F A and McCrea, M and Kurpad, S N and Glavaski-Joksimovic, A and Olsen, C and Budde, M D},

doi = {10.1007/s10439-014-1171-9},

year  = {2015},

date = {2015-01-01},

journal = {Annals of Biomedical Engineering},

volume = {43},

number = {5},

pages = {1071--1088},

abstract = {A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague\textendashDawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje

Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article

In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.

Abstract | BibTeX

@article{VanderHorn2013,

title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},

author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},

isbn = {00039993},

year  = {2013},

date = {2013-01-01},

journal = {Archives of Physical Medicine \& Rehabilitation},

volume = {94},

number = {5},

pages = {867--874},

abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

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2016

Raikes, A C; Schaefer, S Y

Phasic electrodermal activity during the standardized assessment of concussion (SAC) Journal Article

In: Journal of Athletic Training, vol. 51, no. 7, pp. 533–539, 2016.

Abstract | Links | BibTeX | Tags: Memory, Traumatic Brain Injuries, Wireless technology

Naeser, M A; Martin, P I; Ho, M D; Krengel, M H; Bogdanova, Y; Knight, J A; Yee, M K; Zafonte, R; Frazier, J; Hamblin, M R; Koo, B B

Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury Journal Article

In: Photomedicine and Laser Surgery, vol. 34, no. 12, pp. 610–626, 2016.

@article{Naeser2016,

title = {Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury},

author = {Naeser, M A and Martin, P I and Ho, M D and Krengel, M H and Bogdanova, Y and Knight, J A and Yee, M K and Zafonte, R and Frazier, J and Hamblin, M R and Koo, B B},

doi = {10.1089/pho.2015.4037},

year  = {2016},

date = {2016-01-01},

journal = {Photomedicine and Laser Surgery},

volume = {34},

number = {12},

pages = {610--626},

abstract = {Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.},

keywords = {Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

Johnson, K L; Chowdhury, S; Lawrimore, W B; Mao, Y; Mehmani, A; Prabhu, R; Rush, G A; Horstemeyer, M F

Constrained topological optimization of a football helmet facemask based on brain response Journal Article

In: Materials and Design, vol. 111, pp. 108–118, 2016.

@article{Johnson2016a,

title = {Constrained topological optimization of a football helmet facemask based on brain response},

author = {Johnson, K L and Chowdhury, S and Lawrimore, W B and Mao, Y and Mehmani, A and Prabhu, R and Rush, G A and Horstemeyer, M F},

doi = {10.1016/j.matdes.2016.08.064},

year  = {2016},

date = {2016-01-01},

journal = {Materials and Design},

volume = {111},

pages = {108--118},

abstract = {Surrogate model-based multi-objective design optimization was performed to reduce concussion risk during frontal football helmet impacts. In particular, a topological decomposition of the football helmet facemask was performed to formulate the design problem, and brain injury metrics were exploited as objective functions. A validated finite element model of a helmeted human head was used to recreate facemask impacts. Due to the prohibitive computational expense of the full scale simulations, a surrogate modeling approach was employed. An optimal surrogate model selection framework, called Concurrent Surrogate Model Selection, or COSMOS, was utilized to identify the surrogate models best suited to approximate each objective function. The resulting surrogate models were implemented in the Non-dominated Sorting Genetic Algorithm II (NSGA-II) optimization algorithm. Constraints were implemented to control the solid material fraction in the facemask design space, and binary variables were used to control the placement of the facemask bars. The optimized facemask designs reduced the maximum tensile pressure in the brain by 7.5% and the maximum shear strain by a remarkable 39.5%. This research represents a first-of-its-kind approach to multi-objective design optimization on a football helmet, and demonstrates the possibilities that are achievable in improving human safety by using such a simulation-based design optimization. © 2016 Elsevier Ltd},

keywords = {Accident prevention, ALGORITHMS, brain, Concussion, Constrained optimization, Design, Design optimization, finite element analysis, Finite element method, football helmet, Fuel additives, Genetic algorithms, Multiobjective optimization, Optimization, Safety devices, Shear strain, Sports, Surrogate model, Surrogate modeling, Topology, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

2015

Dang, H; Stayman, J W; Sisniega, A; Xu, J; Zbijewski, W; Wang, X; Foos, D H; Aygun, N; Koliatsos, V E; Siewerdsen, J H

Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging Journal Article

In: Physics in Medicine and Biology, vol. 60, no. 16, pp. 6153–6175, 2015.

@article{Dang2015,

title = {Statistical reconstruction for cone-beam CT with a post-artifact-correction noise model: Application to high-quality head imaging},

author = {Dang, H and Stayman, J W and Sisniega, A and Xu, J and Zbijewski, W and Wang, X and Foos, D H and Aygun, N and Koliatsos, V E and Siewerdsen, J H},

doi = {10.1088/0031-9155/60/16/6153},

year  = {2015},

date = {2015-01-01},

journal = {Physics in Medicine and Biology},

volume = {60},

number = {16},

pages = {6153--6175},

abstract = {Non-contrast CT reliably detects fresh blood in the brain and is the current front-line imaging modality for intracranial hemorrhage such as that occurring in acute traumatic brain injury (contrast ∼40-80 HU, size \> 1 mm). We are developing flat-panel detector (FPD) cone-beam CT (CBCT) to facilitate such diagnosis in a low-cost, mobile platform suitable for point-of-care deployment. Such a system may offer benefits in the ICU, urgent care/concussion clinic, ambulance, and sports and military theatres. However, current FPD-CBCT systems face significant challenges that confound low-contrast, soft-tissue imaging. Artifact correction can overcome major sources of bias in FPD-CBCT but imparts noise amplification in filtered backprojection (FBP). Model-based reconstruction improves soft-tissue image quality compared to FBP by leveraging a high-fidelity forward model and image regularization. In this work, we develop a novel penalized weighted least-squares (PWLS) image reconstruction method with a noise model that includes accurate modeling of the noise characteristics associated with the two dominant artifact corrections (scatter and beam-hardening) in CBCT and utilizes modified weights to compensate for noise amplification imparted by each correction. Experiments included real data acquired on a FPD-CBCT test-bench and an anthropomorphic head phantom emulating intra-parenchymal hemorrhage. The proposed PWLS method demonstrated superior noise-resolution tradeoffs in comparison to FBP and PWLS with conventional weights (viz. at matched 0.50 mm spatial resolution},

keywords = {artifact correction, brain, Computerized tomography, cone-beam CT, Flat panel displays, image processing, Image quality, Image reconstruction, Intensive care units, intracranial hemorrhage, Intracranial hemorrhages, Iterative methods, Least squares approximations, Measurement Noise, measurement noise model, Model based iterative reconstruction, model-based iterative reconstruction, Soft tissue, soft-tissue image quality, Tissue, Traumatic Brain Injuries, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

Stemper, B D; Shah, A S; Pintar, F A; McCrea, M; Kurpad, S N; Glavaski-Joksimovic, A; Olsen, C; Budde, M D

Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion Journal Article

In: Annals of Biomedical Engineering, vol. 43, no. 5, pp. 1071–1088, 2015.

@article{Stemper2015,

title = {Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion},

author = {Stemper, B D and Shah, A S and Pintar, F A and McCrea, M and Kurpad, S N and Glavaski-Joksimovic, A and Olsen, C and Budde, M D},

doi = {10.1007/s10439-014-1171-9},

year  = {2015},

date = {2015-01-01},

journal = {Annals of Biomedical Engineering},

volume = {43},

number = {5},

pages = {1071--1088},

abstract = {A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague\textendashDawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).},

keywords = {Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)},

pubstate = {published},

tppubtype = {article}

}

2013

van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje

Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article

In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.

@article{VanderHorn2013,

title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},

author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},

isbn = {00039993},

year  = {2013},

date = {2013-01-01},

journal = {Archives of Physical Medicine \& Rehabilitation},

volume = {94},

number = {5},

pages = {867--874},

abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},

keywords = {*ANXIETY, *BRAIN -- Wounds \&amp; injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},

pubstate = {published},

tppubtype = {article}

}

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