Ellis, M J; Mutch, W A C; Ryner, L N; Graham, M R; Dufault, B; Gregson, B; Hall, T; Bunge, M; Essig, M; Fisher, J A; Duffin, J; Mikulis, D J
Brain magnetic resonance imaging CO2 stress testing in adolescent postconcussion syndrome Journal Article
In: Journal of Neurosurgery, vol. 125, no. 3, pp. 648–660, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Blood oxygen level-dependent imaging, Magnetic Resonance Imaging, postconcussion syndrome, Sports-related concussion, Trauma
@article{Ellis2016a,
title = {Brain magnetic resonance imaging CO2 stress testing in adolescent postconcussion syndrome},
author = {Ellis, M J and Mutch, W A C and Ryner, L N and Graham, M R and Dufault, B and Gregson, B and Hall, T and Bunge, M and Essig, M and Fisher, J A and Duffin, J and Mikulis, D J},
doi = {10.3171/2015.6.JNS15972},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery},
volume = {125},
number = {3},
pages = {648--660},
abstract = {OBJECTIVE: A Neuroimaging Assessment tool to visualize global and regional impairments in cerebral blood flow (CBF) and cerebrovascular responsiveness in individual patients with concussion remains elusive. Here the authors summarize the safety, feasibility, and results of brain CO2 stress testing in adolescents with postconcussion syndrome (PCS) and healthy controls. METHODS: This study was approved by the Biomedical Research Ethics Board at the University of Manitoba. Fifteen adolescents with PCS and 17 healthy control subjects underwent anatomical MRI, pseudo-continuous arterial spin labeling MRI, and brain stress testing using controlled CO2 challenge and blood oxygen level-dependent (BOLD) MRI. Post hoc processing was performed using statistical parametric mapping to determine voxel-by-voxel regional resting CBF and cerebrovascular responsiveness of the brain to the CO2 stimulus (increase in BOLD signal) or the inverse (decrease in BOLD signal). Receiver operating characteristic (ROC) curves were generated to compare voxel counts categorized by control (0) or PCS (1). RESULTS: Studies were well tolerated without any serious adverse events. Anatomical MRI was normal in all study participants. No differences in CO2 stimuli were seen between the 2 participant groups. No group differences in global mean CBF were detected between PCS patients and healthy controls. Patient-specific differences in mean regional CBF and CO2 BOLD responsiveness were observed in all PCS patients. The ROC curve analysis for brain regions manifesting a voxel response greater than and less than the control atlas (that is, abnormal voxel counts) produced an area under the curve of 0.87 (p \< 0.0001) and 0.80 (p = 0.0003), respectively, consistent with a clinically useful predictive model. CONCLUSIONS: Adolescent PCS is associated with patient-specific abnormalities in regional mean CBF and BOLD cerebrovascular responsiveness that occur in the setting of normal global resting CBF. Future prospective studies are warranted to examine the utility of brain MRI CO2 stress testing in the longitudinal assessment of acute sports-related concussion and PCS. © AANS, 2016.},
keywords = {Adolescent, Blood oxygen level-dependent imaging, Magnetic Resonance Imaging, postconcussion syndrome, Sports-related concussion, Trauma},
pubstate = {published},
tppubtype = {article}
}
Aomura, S; Zhang, Y; Nakadate, H; Koyama, T; Nishimura, A
Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident Journal Article
In: Journal of Biomechanical Science and Engineering, vol. 11, no. 4, 2016.
Abstract | Links | BibTeX | Tags: Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion
@article{Aomura2016,
title = {Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident},
author = {Aomura, S and Zhang, Y and Nakadate, H and Koyama, T and Nishimura, A},
doi = {10.1299/jbse.16-00393},
year = {2016},
date = {2016-01-01},
journal = {Journal of Biomechanical Science and Engineering},
volume = {11},
number = {4},
abstract = {The collision accident in collegiate football game was simulated based on the game video and the concussive impact on the head was analyzed. First, the collision motion of players was reproduced based on the video by using motion analysis, and the translational and rotational velocities, relative position and contact location of the struck and the striking players' heads just before the collision were calculated. Then the data obtained were input to two helmeted finite element (FE) human head models as the initial condition, and the brain injury risk was evaluated by using the impact analysis. The FE helmet model was validated by a drop test of the helmet in which the head impactor was embedded. In the present study, two concussion suspected accident cases were analyzed; then the concussion was evaluated by ten mechanical parameters generated inside the skull caused by the collision. The injury risk evaluated by multi parameters belonged to the dangerous range that may cause concussion and was consistent with the diagnosis of the medical team doctor. The brain injury risk can be successfully estimated by the reconstructed simulation of the game video and FE analysis. To our knowledge, this study is the first attempt in Japan to estimate the brain injury risk systematically by a combination of game video analysis which is originally introduced for the players' health care and FE analysis by helmeted human head model. In the future, brain injury risk caused by an accident can be evaluated with higher accuracy by analyzing more accident cases. © 2016 The Japan Society of Mechanical Engineers.},
keywords = {Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion},
pubstate = {published},
tppubtype = {article}
}
Bigler, E D; Abildskov, T J; Goodrich-Hunsaker, N J; Black, G; Christensen, Z P; Huff, T; Wood, D M G; Hesselink, J R; Wilde, E A; Max, J E
Structural Neuroimaging Findings in Mild Traumatic Brain Injury Journal Article
In: Sports Medicine & Arthroscopy Review, vol. 24, no. 3, pp. e42–e52, 2016.
Abstract | Links | BibTeX | Tags: advanced neuroimaging, Computed tomography (CT), Magnetic resonance imaging (MRI), Mild traumatic brain injury (mTBI), Sports-related concussion, structural neuroimaging
@article{Bigler2016,
title = {Structural Neuroimaging Findings in Mild Traumatic Brain Injury},
author = {Bigler, E D and Abildskov, T J and Goodrich-Hunsaker, N J and Black, G and Christensen, Z P and Huff, T and Wood, D M G and Hesselink, J R and Wilde, E A and Max, J E},
doi = {10.1097/JSA.0000000000000119},
year = {2016},
date = {2016-01-01},
journal = {Sports Medicine \& Arthroscopy Review},
volume = {24},
number = {3},
pages = {e42--e52},
abstract = {Common neuroimaging findings in mild traumatic brain injury (mTBI), including sport-related concussion (SRC), are reviewed based on computed tomography and magnetic resonance imaging (MRI). Common abnormalities radiologically identified on the day of injury, typically a computed tomographic scan, are in the form of contusions, small subarachnoid or intraparenchymal hemorrhages as well as subdural and epidural collections, edema, and skull fractures. Common follow-up neuroimaging findings with MRI include white matter hyperintensities, hypointense signal abnormalities that reflect prior hemorrhage, focal encephalomalacia, presence of atrophy and/or dilated Virchow-Robins perivascular space. The MRI findings from a large pediatric mTBI study show low frequency of positive MRI findings at 6 months postinjury. The review concludes with an examination of some of the advanced MRI-based image analysis methods that can be performed in the patient who has sustained an mTBI. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {advanced neuroimaging, Computed tomography (CT), Magnetic resonance imaging (MRI), Mild traumatic brain injury (mTBI), Sports-related concussion, structural neuroimaging},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K
Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport
@article{Ellis2015,
title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},
author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},
doi = {10.3171/2015.1.PEDS14524},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {16},
number = {3},
pages = {248--255},
abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},
keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},
pubstate = {published},
tppubtype = {article}
}
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}
}
Merritt, V C; Meyer, J E; Arnett, P A
A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale Journal Article
In: Journal of Clinical and Experimental Neuropsychology, vol. 37, no. 7, pp. 764–775, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult
@article{Merritt2015b,
title = {A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale},
author = {Merritt, V C and Meyer, J E and Arnett, P A},
doi = {10.1080/13803395.2015.1060950},
year = {2015},
date = {2015-01-01},
journal = {Journal of Clinical and Experimental Neuropsychology},
volume = {37},
number = {7},
pages = {764--775},
abstract = {Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor \& Francis.},
keywords = {Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Mutch, W A C; Ryner, L N; Graham, M R; Dufault, B; Gregson, B; Hall, T; Bunge, M; Essig, M; Fisher, J A; Duffin, J; Mikulis, D J
Brain magnetic resonance imaging CO2 stress testing in adolescent postconcussion syndrome Journal Article
In: Journal of Neurosurgery, vol. 125, no. 3, pp. 648–660, 2016.
@article{Ellis2016a,
title = {Brain magnetic resonance imaging CO2 stress testing in adolescent postconcussion syndrome},
author = {Ellis, M J and Mutch, W A C and Ryner, L N and Graham, M R and Dufault, B and Gregson, B and Hall, T and Bunge, M and Essig, M and Fisher, J A and Duffin, J and Mikulis, D J},
doi = {10.3171/2015.6.JNS15972},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery},
volume = {125},
number = {3},
pages = {648--660},
abstract = {OBJECTIVE: A Neuroimaging Assessment tool to visualize global and regional impairments in cerebral blood flow (CBF) and cerebrovascular responsiveness in individual patients with concussion remains elusive. Here the authors summarize the safety, feasibility, and results of brain CO2 stress testing in adolescents with postconcussion syndrome (PCS) and healthy controls. METHODS: This study was approved by the Biomedical Research Ethics Board at the University of Manitoba. Fifteen adolescents with PCS and 17 healthy control subjects underwent anatomical MRI, pseudo-continuous arterial spin labeling MRI, and brain stress testing using controlled CO2 challenge and blood oxygen level-dependent (BOLD) MRI. Post hoc processing was performed using statistical parametric mapping to determine voxel-by-voxel regional resting CBF and cerebrovascular responsiveness of the brain to the CO2 stimulus (increase in BOLD signal) or the inverse (decrease in BOLD signal). Receiver operating characteristic (ROC) curves were generated to compare voxel counts categorized by control (0) or PCS (1). RESULTS: Studies were well tolerated without any serious adverse events. Anatomical MRI was normal in all study participants. No differences in CO2 stimuli were seen between the 2 participant groups. No group differences in global mean CBF were detected between PCS patients and healthy controls. Patient-specific differences in mean regional CBF and CO2 BOLD responsiveness were observed in all PCS patients. The ROC curve analysis for brain regions manifesting a voxel response greater than and less than the control atlas (that is, abnormal voxel counts) produced an area under the curve of 0.87 (p \< 0.0001) and 0.80 (p = 0.0003), respectively, consistent with a clinically useful predictive model. CONCLUSIONS: Adolescent PCS is associated with patient-specific abnormalities in regional mean CBF and BOLD cerebrovascular responsiveness that occur in the setting of normal global resting CBF. Future prospective studies are warranted to examine the utility of brain MRI CO2 stress testing in the longitudinal assessment of acute sports-related concussion and PCS. © AANS, 2016.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Aomura, S; Zhang, Y; Nakadate, H; Koyama, T; Nishimura, A
Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident Journal Article
In: Journal of Biomechanical Science and Engineering, vol. 11, no. 4, 2016.
@article{Aomura2016,
title = {Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident},
author = {Aomura, S and Zhang, Y and Nakadate, H and Koyama, T and Nishimura, A},
doi = {10.1299/jbse.16-00393},
year = {2016},
date = {2016-01-01},
journal = {Journal of Biomechanical Science and Engineering},
volume = {11},
number = {4},
abstract = {The collision accident in collegiate football game was simulated based on the game video and the concussive impact on the head was analyzed. First, the collision motion of players was reproduced based on the video by using motion analysis, and the translational and rotational velocities, relative position and contact location of the struck and the striking players' heads just before the collision were calculated. Then the data obtained were input to two helmeted finite element (FE) human head models as the initial condition, and the brain injury risk was evaluated by using the impact analysis. The FE helmet model was validated by a drop test of the helmet in which the head impactor was embedded. In the present study, two concussion suspected accident cases were analyzed; then the concussion was evaluated by ten mechanical parameters generated inside the skull caused by the collision. The injury risk evaluated by multi parameters belonged to the dangerous range that may cause concussion and was consistent with the diagnosis of the medical team doctor. The brain injury risk can be successfully estimated by the reconstructed simulation of the game video and FE analysis. To our knowledge, this study is the first attempt in Japan to estimate the brain injury risk systematically by a combination of game video analysis which is originally introduced for the players' health care and FE analysis by helmeted human head model. In the future, brain injury risk caused by an accident can be evaluated with higher accuracy by analyzing more accident cases. © 2016 The Japan Society of Mechanical Engineers.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bigler, E D; Abildskov, T J; Goodrich-Hunsaker, N J; Black, G; Christensen, Z P; Huff, T; Wood, D M G; Hesselink, J R; Wilde, E A; Max, J E
Structural Neuroimaging Findings in Mild Traumatic Brain Injury Journal Article
In: Sports Medicine & Arthroscopy Review, vol. 24, no. 3, pp. e42–e52, 2016.
@article{Bigler2016,
title = {Structural Neuroimaging Findings in Mild Traumatic Brain Injury},
author = {Bigler, E D and Abildskov, T J and Goodrich-Hunsaker, N J and Black, G and Christensen, Z P and Huff, T and Wood, D M G and Hesselink, J R and Wilde, E A and Max, J E},
doi = {10.1097/JSA.0000000000000119},
year = {2016},
date = {2016-01-01},
journal = {Sports Medicine \& Arthroscopy Review},
volume = {24},
number = {3},
pages = {e42--e52},
abstract = {Common neuroimaging findings in mild traumatic brain injury (mTBI), including sport-related concussion (SRC), are reviewed based on computed tomography and magnetic resonance imaging (MRI). Common abnormalities radiologically identified on the day of injury, typically a computed tomographic scan, are in the form of contusions, small subarachnoid or intraparenchymal hemorrhages as well as subdural and epidural collections, edema, and skull fractures. Common follow-up neuroimaging findings with MRI include white matter hyperintensities, hypointense signal abnormalities that reflect prior hemorrhage, focal encephalomalacia, presence of atrophy and/or dilated Virchow-Robins perivascular space. The MRI findings from a large pediatric mTBI study show low frequency of positive MRI findings at 6 months postinjury. The review concludes with an examination of some of the advanced MRI-based image analysis methods that can be performed in the patient who has sustained an mTBI. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K
Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.
@article{Ellis2015,
title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},
author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},
doi = {10.3171/2015.1.PEDS14524},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {16},
number = {3},
pages = {248--255},
abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},
keywords = {},
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}
}
Merritt, V C; Meyer, J E; Arnett, P A
A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale Journal Article
In: Journal of Clinical and Experimental Neuropsychology, vol. 37, no. 7, pp. 764–775, 2015.
@article{Merritt2015b,
title = {A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale},
author = {Merritt, V C and Meyer, J E and Arnett, P A},
doi = {10.1080/13803395.2015.1060950},
year = {2015},
date = {2015-01-01},
journal = {Journal of Clinical and Experimental Neuropsychology},
volume = {37},
number = {7},
pages = {764--775},
abstract = {Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor \& Francis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Mutch, W A C; Ryner, L N; Graham, M R; Dufault, B; Gregson, B; Hall, T; Bunge, M; Essig, M; Fisher, J A; Duffin, J; Mikulis, D J
Brain magnetic resonance imaging CO2 stress testing in adolescent postconcussion syndrome Journal Article
In: Journal of Neurosurgery, vol. 125, no. 3, pp. 648–660, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Blood oxygen level-dependent imaging, Magnetic Resonance Imaging, postconcussion syndrome, Sports-related concussion, Trauma
@article{Ellis2016a,
title = {Brain magnetic resonance imaging CO2 stress testing in adolescent postconcussion syndrome},
author = {Ellis, M J and Mutch, W A C and Ryner, L N and Graham, M R and Dufault, B and Gregson, B and Hall, T and Bunge, M and Essig, M and Fisher, J A and Duffin, J and Mikulis, D J},
doi = {10.3171/2015.6.JNS15972},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery},
volume = {125},
number = {3},
pages = {648--660},
abstract = {OBJECTIVE: A Neuroimaging Assessment tool to visualize global and regional impairments in cerebral blood flow (CBF) and cerebrovascular responsiveness in individual patients with concussion remains elusive. Here the authors summarize the safety, feasibility, and results of brain CO2 stress testing in adolescents with postconcussion syndrome (PCS) and healthy controls. METHODS: This study was approved by the Biomedical Research Ethics Board at the University of Manitoba. Fifteen adolescents with PCS and 17 healthy control subjects underwent anatomical MRI, pseudo-continuous arterial spin labeling MRI, and brain stress testing using controlled CO2 challenge and blood oxygen level-dependent (BOLD) MRI. Post hoc processing was performed using statistical parametric mapping to determine voxel-by-voxel regional resting CBF and cerebrovascular responsiveness of the brain to the CO2 stimulus (increase in BOLD signal) or the inverse (decrease in BOLD signal). Receiver operating characteristic (ROC) curves were generated to compare voxel counts categorized by control (0) or PCS (1). RESULTS: Studies were well tolerated without any serious adverse events. Anatomical MRI was normal in all study participants. No differences in CO2 stimuli were seen between the 2 participant groups. No group differences in global mean CBF were detected between PCS patients and healthy controls. Patient-specific differences in mean regional CBF and CO2 BOLD responsiveness were observed in all PCS patients. The ROC curve analysis for brain regions manifesting a voxel response greater than and less than the control atlas (that is, abnormal voxel counts) produced an area under the curve of 0.87 (p \< 0.0001) and 0.80 (p = 0.0003), respectively, consistent with a clinically useful predictive model. CONCLUSIONS: Adolescent PCS is associated with patient-specific abnormalities in regional mean CBF and BOLD cerebrovascular responsiveness that occur in the setting of normal global resting CBF. Future prospective studies are warranted to examine the utility of brain MRI CO2 stress testing in the longitudinal assessment of acute sports-related concussion and PCS. © AANS, 2016.},
keywords = {Adolescent, Blood oxygen level-dependent imaging, Magnetic Resonance Imaging, postconcussion syndrome, Sports-related concussion, Trauma},
pubstate = {published},
tppubtype = {article}
}
Aomura, S; Zhang, Y; Nakadate, H; Koyama, T; Nishimura, A
Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident Journal Article
In: Journal of Biomechanical Science and Engineering, vol. 11, no. 4, 2016.
Abstract | Links | BibTeX | Tags: Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion
@article{Aomura2016,
title = {Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident},
author = {Aomura, S and Zhang, Y and Nakadate, H and Koyama, T and Nishimura, A},
doi = {10.1299/jbse.16-00393},
year = {2016},
date = {2016-01-01},
journal = {Journal of Biomechanical Science and Engineering},
volume = {11},
number = {4},
abstract = {The collision accident in collegiate football game was simulated based on the game video and the concussive impact on the head was analyzed. First, the collision motion of players was reproduced based on the video by using motion analysis, and the translational and rotational velocities, relative position and contact location of the struck and the striking players' heads just before the collision were calculated. Then the data obtained were input to two helmeted finite element (FE) human head models as the initial condition, and the brain injury risk was evaluated by using the impact analysis. The FE helmet model was validated by a drop test of the helmet in which the head impactor was embedded. In the present study, two concussion suspected accident cases were analyzed; then the concussion was evaluated by ten mechanical parameters generated inside the skull caused by the collision. The injury risk evaluated by multi parameters belonged to the dangerous range that may cause concussion and was consistent with the diagnosis of the medical team doctor. The brain injury risk can be successfully estimated by the reconstructed simulation of the game video and FE analysis. To our knowledge, this study is the first attempt in Japan to estimate the brain injury risk systematically by a combination of game video analysis which is originally introduced for the players' health care and FE analysis by helmeted human head model. In the future, brain injury risk caused by an accident can be evaluated with higher accuracy by analyzing more accident cases. © 2016 The Japan Society of Mechanical Engineers.},
keywords = {Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion},
pubstate = {published},
tppubtype = {article}
}
Bigler, E D; Abildskov, T J; Goodrich-Hunsaker, N J; Black, G; Christensen, Z P; Huff, T; Wood, D M G; Hesselink, J R; Wilde, E A; Max, J E
Structural Neuroimaging Findings in Mild Traumatic Brain Injury Journal Article
In: Sports Medicine & Arthroscopy Review, vol. 24, no. 3, pp. e42–e52, 2016.
Abstract | Links | BibTeX | Tags: advanced neuroimaging, Computed tomography (CT), Magnetic resonance imaging (MRI), Mild traumatic brain injury (mTBI), Sports-related concussion, structural neuroimaging
@article{Bigler2016,
title = {Structural Neuroimaging Findings in Mild Traumatic Brain Injury},
author = {Bigler, E D and Abildskov, T J and Goodrich-Hunsaker, N J and Black, G and Christensen, Z P and Huff, T and Wood, D M G and Hesselink, J R and Wilde, E A and Max, J E},
doi = {10.1097/JSA.0000000000000119},
year = {2016},
date = {2016-01-01},
journal = {Sports Medicine \& Arthroscopy Review},
volume = {24},
number = {3},
pages = {e42--e52},
abstract = {Common neuroimaging findings in mild traumatic brain injury (mTBI), including sport-related concussion (SRC), are reviewed based on computed tomography and magnetic resonance imaging (MRI). Common abnormalities radiologically identified on the day of injury, typically a computed tomographic scan, are in the form of contusions, small subarachnoid or intraparenchymal hemorrhages as well as subdural and epidural collections, edema, and skull fractures. Common follow-up neuroimaging findings with MRI include white matter hyperintensities, hypointense signal abnormalities that reflect prior hemorrhage, focal encephalomalacia, presence of atrophy and/or dilated Virchow-Robins perivascular space. The MRI findings from a large pediatric mTBI study show low frequency of positive MRI findings at 6 months postinjury. The review concludes with an examination of some of the advanced MRI-based image analysis methods that can be performed in the patient who has sustained an mTBI. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {advanced neuroimaging, Computed tomography (CT), Magnetic resonance imaging (MRI), Mild traumatic brain injury (mTBI), Sports-related concussion, structural neuroimaging},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K
Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport
@article{Ellis2015,
title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},
author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},
doi = {10.3171/2015.1.PEDS14524},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {16},
number = {3},
pages = {248--255},
abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},
keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},
pubstate = {published},
tppubtype = {article}
}
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}
}
Merritt, V C; Meyer, J E; Arnett, P A
A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale Journal Article
In: Journal of Clinical and Experimental Neuropsychology, vol. 37, no. 7, pp. 764–775, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult
@article{Merritt2015b,
title = {A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale},
author = {Merritt, V C and Meyer, J E and Arnett, P A},
doi = {10.1080/13803395.2015.1060950},
year = {2015},
date = {2015-01-01},
journal = {Journal of Clinical and Experimental Neuropsychology},
volume = {37},
number = {7},
pages = {764--775},
abstract = {Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor \& Francis.},
keywords = {Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult},
pubstate = {published},
tppubtype = {article}
}