Iverson, G L
Suicide and Chronic Traumatic Encephalopathy Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 28, no. 1, pp. 9–16, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]
@article{Iverson2016a,
title = {Suicide and Chronic Traumatic Encephalopathy},
author = {Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {28},
number = {1},
pages = {9--16},
abstract = {For nearly 80 years, suicidality was not considered to be a core clinical feature of chronic traumatic encephalopathy (CTE). In recent years, suicide has been widely cited as being associated with CTE, and now depression has been proposed to be one of three core diagnostic features alongside cognitive impairment and anger control problems. This evolution of the clinical features has been reinforced by thousands of media stories reporting a connection between mental health problems in former athletes and military veterans, repetitive neurotrauma, and CTE. At present, the science underlying the causal assumption between repetitive neurotrauma, depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive. Epidemiological evidence indicates that former National Football League players, for example, are at lower, not greater, risk for suicide than men in the general population. This article aims to discuss the critical issues and literature relating to these possible relationships.},
keywords = {*Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
Abstract | BibTeX | Tags: *Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J
A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics & Numerical, Hockey/sn [Statistics & Numerical Data], Humans, Male, Sports Equipment/sn [Statistics & Numerical Data], VIDEO recording, Young Adult
@article{Hutchison2015,
title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},
author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {547--551},
abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics \& Numerical, Hockey/sn [Statistics \& Numerical Data], Humans, Male, Sports Equipment/sn [Statistics \& Numerical Data], VIDEO recording, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Walter, K D; Halstead, M E
Concussion in Teenage Athletes Journal Article
In: Adolescent Medicine, vol. 26, no. 1, pp. 39–52, 2015.
BibTeX | Tags: *Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed
@article{Walter2015,
title = {Concussion in Teenage Athletes},
author = {Walter, K D and Halstead, M E},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {1},
pages = {39--52},
keywords = {*Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports},
pubstate = {published},
tppubtype = {article}
}
Stein, T D; Montenigro, P H; Alvarez, V E; Xia, W; Crary, J F; Tripodis, Y; Daneshvar, D H; Mez, J; Solomon, T; Meng, G; Kubilus, C A; Cormier, K A; Meng, S; Babcock, K; Kiernan, P; Murphy, L; Nowinski, C J; Martin, B; Dixon, D; Stern, R A; Cantu, R C; Kowall, N W; McKee, A C
Beta-amyloid deposition in chronic traumatic encephalopathy Journal Article
In: Acta Neuropathologica, vol. 130, no. 1, pp. 21–34, 2015.
Abstract | BibTeX | Tags: *Amyloid beta-Peptides/me [Metabolism], *Brain Injury, *Brain/pa [Pathology], *Neurodegenerative Diseases/pa [Pathology], *tau Proteins/me [Metabolism], 0 (Amyloid beta-Peptides), 0 (Apolipoprotein E4), 0 (MAPT protein, 0 (tau Proteins), 80 and over, adult, Age Factors, aged, Amyloid/et [Etiology], Amyloid/me [Metabolism], Amyloid/pa [Pathology], Apolipoprotein E4/ge [Genetics], Athletes, Athletic Injuries/ep [Epidemiology], Athletic Injuries/ge [Genetics], Athletic Injuries/me [Metabolism], Athletic Injuries/pa [Pathology], Brain Injury, Brain/me [Metabolism], Chronic/ep [Epidemiology], Chronic/ge [Genetics], Chronic/me [Metabolism], Chronic/pa [Pathology], Cohort Studies, comorbidity, human), Humans, middle aged, Neurodegenerative Diseases/ep [Epidemiology], Neurodegenerative Diseases/ge [Genetics], Neurodegenerative Diseases/me [Metabolism], Plaque, SEVERITY of illness index, veterans, War-Related Injuries/ep [Epidemiology], War-Related Injuries/ge [Genetics], War-Related Injuries/me [Metabolism], War-Related Injuries/pa [Pathology]
@article{Stein2015b,
title = {Beta-amyloid deposition in chronic traumatic encephalopathy},
author = {Stein, T D and Montenigro, P H and Alvarez, V E and Xia, W and Crary, J F and Tripodis, Y and Daneshvar, D H and Mez, J and Solomon, T and Meng, G and Kubilus, C A and Cormier, K A and Meng, S and Babcock, K and Kiernan, P and Murphy, L and Nowinski, C J and Martin, B and Dixon, D and Stern, R A and Cantu, R C and Kowall, N W and McKee, A C},
year = {2015},
date = {2015-01-01},
journal = {Acta Neuropathologica},
volume = {130},
number = {1},
pages = {21--34},
abstract = {Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive mild traumatic brain injury. It is defined pathologically by the abnormal accumulation of tau in a unique pattern that is distinct from other tauopathies, including Alzheimer's disease (AD). Although trauma has been suggested to increase amyloid beta peptide (Abeta) levels, the extent of Abeta deposition in CTE has not been thoroughly characterized. We studied a heterogeneous cohort of deceased athletes and military veterans with neuropathologically diagnosed CTE (n = 114, mean age at death = 60) to test the hypothesis that Abeta deposition is altered in CTE and associated with more severe pathology and worse clinical outcomes. We found that Abeta deposition, either as diffuse or neuritic plaques, was present in 52 % of CTE subjects. Moreover, Abeta deposition in CTE occurred at an accelerated rate and with altered dynamics in CTE compared to a normal aging population (OR = 3.8, p \< 0.001). We also found a clear pathological and clinical dichotomy between those CTE cases with Abeta plaques and those without. Abeta deposition was significantly associated with the presence of the APOE epsilon4 allele (p = 0.035), older age at symptom onset (p \< 0.001), and older age at death (p \< 0.001). In addition, when controlling for age, neuritic plaques were significantly associated with increased CTE tauopathy stage (beta = 2.43},
keywords = {*Amyloid beta-Peptides/me [Metabolism], *Brain Injury, *Brain/pa [Pathology], *Neurodegenerative Diseases/pa [Pathology], *tau Proteins/me [Metabolism], 0 (Amyloid beta-Peptides), 0 (Apolipoprotein E4), 0 (MAPT protein, 0 (tau Proteins), 80 and over, adult, Age Factors, aged, Amyloid/et [Etiology], Amyloid/me [Metabolism], Amyloid/pa [Pathology], Apolipoprotein E4/ge [Genetics], Athletes, Athletic Injuries/ep [Epidemiology], Athletic Injuries/ge [Genetics], Athletic Injuries/me [Metabolism], Athletic Injuries/pa [Pathology], Brain Injury, Brain/me [Metabolism], Chronic/ep [Epidemiology], Chronic/ge [Genetics], Chronic/me [Metabolism], Chronic/pa [Pathology], Cohort Studies, comorbidity, human), Humans, middle aged, Neurodegenerative Diseases/ep [Epidemiology], Neurodegenerative Diseases/ge [Genetics], Neurodegenerative Diseases/me [Metabolism], Plaque, SEVERITY of illness index, veterans, War-Related Injuries/ep [Epidemiology], War-Related Injuries/ge [Genetics], War-Related Injuries/me [Metabolism], War-Related Injuries/pa [Pathology]},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Crowley, P J; Crowley, M J
Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme Journal Article
In: British Journal of Sports Medicine, vol. 48, no. 2, pp. 147–150, 2014.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization & Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation & Jurisprudence], Track and Field/sn [Statistics & Numerical Data], Young Adult
@article{Crowley2014,
title = {Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme},
author = {Crowley, P J and Crowley, M J},
year = {2014},
date = {2014-01-01},
journal = {British Journal of Sports Medicine},
volume = {48},
number = {2},
pages = {147--150},
abstract = {BACKGROUND: Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn. METHODS: We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and (5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools. RESULTS: One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard). CONCLUSION: The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.},
keywords = {*Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization \& Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation \& Jurisprudence], Track and Field/sn [Statistics \& Numerical Data], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Jordan, B D
Neurologic aspects of boxing Journal Article
In: Archives of Neurology, vol. 44, no. 4, pp. 453–459, 1987.
Abstract | BibTeX | Tags: *Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention & Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention & Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed
@article{Jordan1987,
title = {Neurologic aspects of boxing},
author = {Jordan, B D},
year = {1987},
date = {1987-01-01},
journal = {Archives of Neurology},
volume = {44},
number = {4},
pages = {453--459},
abstract = {The assessment and prevention of potentially adverse neurologic consequences of boxing requires two important considerations. Acute neurologic injuries should be distinguished from chronic brain injuries and the level of competitive boxing (ie, amateur vs professional) must also be taken into account. Acute neurologic injuries such as concussion, post-concussion syndrome, intracranial hemorrhage, and brain contusion are more readily identified than chronic neurologic injuries because of their immediate devastation of the nervous system. In contrast, chronic neurologic injuries differ in their pathophysiologic mechanisms that are exemplified by an insidious onset and progression after the cessation of boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses the most serious neurologic threat of boxing. Amateur boxing differs from professional boxing in the duration of fights, rules and regulatory policies, medical evaluation, and protective devices. These factors could produce a differential effect on the risk of injury to the brain. The prevention of neurologic injuries in boxing requires the integration of proper neurologic evaluation by qualified ring-side physicians, the design and utilization of effective protective devices, and the establishment of national regulatory agencies.},
keywords = {*Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention \& Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention \& Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Iverson, G L
Suicide and Chronic Traumatic Encephalopathy Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 28, no. 1, pp. 9–16, 2016.
@article{Iverson2016a,
title = {Suicide and Chronic Traumatic Encephalopathy},
author = {Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {28},
number = {1},
pages = {9--16},
abstract = {For nearly 80 years, suicidality was not considered to be a core clinical feature of chronic traumatic encephalopathy (CTE). In recent years, suicide has been widely cited as being associated with CTE, and now depression has been proposed to be one of three core diagnostic features alongside cognitive impairment and anger control problems. This evolution of the clinical features has been reinforced by thousands of media stories reporting a connection between mental health problems in former athletes and military veterans, repetitive neurotrauma, and CTE. At present, the science underlying the causal assumption between repetitive neurotrauma, depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive. Epidemiological evidence indicates that former National Football League players, for example, are at lower, not greater, risk for suicide than men in the general population. This article aims to discuss the critical issues and literature relating to these possible relationships.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J
A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.
@article{Hutchison2015,
title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},
author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {547--551},
abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Walter, K D; Halstead, M E
Concussion in Teenage Athletes Journal Article
In: Adolescent Medicine, vol. 26, no. 1, pp. 39–52, 2015.
@article{Walter2015,
title = {Concussion in Teenage Athletes},
author = {Walter, K D and Halstead, M E},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {1},
pages = {39--52},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stein, T D; Montenigro, P H; Alvarez, V E; Xia, W; Crary, J F; Tripodis, Y; Daneshvar, D H; Mez, J; Solomon, T; Meng, G; Kubilus, C A; Cormier, K A; Meng, S; Babcock, K; Kiernan, P; Murphy, L; Nowinski, C J; Martin, B; Dixon, D; Stern, R A; Cantu, R C; Kowall, N W; McKee, A C
Beta-amyloid deposition in chronic traumatic encephalopathy Journal Article
In: Acta Neuropathologica, vol. 130, no. 1, pp. 21–34, 2015.
@article{Stein2015b,
title = {Beta-amyloid deposition in chronic traumatic encephalopathy},
author = {Stein, T D and Montenigro, P H and Alvarez, V E and Xia, W and Crary, J F and Tripodis, Y and Daneshvar, D H and Mez, J and Solomon, T and Meng, G and Kubilus, C A and Cormier, K A and Meng, S and Babcock, K and Kiernan, P and Murphy, L and Nowinski, C J and Martin, B and Dixon, D and Stern, R A and Cantu, R C and Kowall, N W and McKee, A C},
year = {2015},
date = {2015-01-01},
journal = {Acta Neuropathologica},
volume = {130},
number = {1},
pages = {21--34},
abstract = {Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive mild traumatic brain injury. It is defined pathologically by the abnormal accumulation of tau in a unique pattern that is distinct from other tauopathies, including Alzheimer's disease (AD). Although trauma has been suggested to increase amyloid beta peptide (Abeta) levels, the extent of Abeta deposition in CTE has not been thoroughly characterized. We studied a heterogeneous cohort of deceased athletes and military veterans with neuropathologically diagnosed CTE (n = 114, mean age at death = 60) to test the hypothesis that Abeta deposition is altered in CTE and associated with more severe pathology and worse clinical outcomes. We found that Abeta deposition, either as diffuse or neuritic plaques, was present in 52 % of CTE subjects. Moreover, Abeta deposition in CTE occurred at an accelerated rate and with altered dynamics in CTE compared to a normal aging population (OR = 3.8, p \< 0.001). We also found a clear pathological and clinical dichotomy between those CTE cases with Abeta plaques and those without. Abeta deposition was significantly associated with the presence of the APOE epsilon4 allele (p = 0.035), older age at symptom onset (p \< 0.001), and older age at death (p \< 0.001). In addition, when controlling for age, neuritic plaques were significantly associated with increased CTE tauopathy stage (beta = 2.43},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Crowley, P J; Crowley, M J
Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme Journal Article
In: British Journal of Sports Medicine, vol. 48, no. 2, pp. 147–150, 2014.
@article{Crowley2014,
title = {Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme},
author = {Crowley, P J and Crowley, M J},
year = {2014},
date = {2014-01-01},
journal = {British Journal of Sports Medicine},
volume = {48},
number = {2},
pages = {147--150},
abstract = {BACKGROUND: Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn. METHODS: We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and (5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools. RESULTS: One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard). CONCLUSION: The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Jordan, B D
Neurologic aspects of boxing Journal Article
In: Archives of Neurology, vol. 44, no. 4, pp. 453–459, 1987.
@article{Jordan1987,
title = {Neurologic aspects of boxing},
author = {Jordan, B D},
year = {1987},
date = {1987-01-01},
journal = {Archives of Neurology},
volume = {44},
number = {4},
pages = {453--459},
abstract = {The assessment and prevention of potentially adverse neurologic consequences of boxing requires two important considerations. Acute neurologic injuries should be distinguished from chronic brain injuries and the level of competitive boxing (ie, amateur vs professional) must also be taken into account. Acute neurologic injuries such as concussion, post-concussion syndrome, intracranial hemorrhage, and brain contusion are more readily identified than chronic neurologic injuries because of their immediate devastation of the nervous system. In contrast, chronic neurologic injuries differ in their pathophysiologic mechanisms that are exemplified by an insidious onset and progression after the cessation of boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses the most serious neurologic threat of boxing. Amateur boxing differs from professional boxing in the duration of fights, rules and regulatory policies, medical evaluation, and protective devices. These factors could produce a differential effect on the risk of injury to the brain. The prevention of neurologic injuries in boxing requires the integration of proper neurologic evaluation by qualified ring-side physicians, the design and utilization of effective protective devices, and the establishment of national regulatory agencies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Iverson, G L
Suicide and Chronic Traumatic Encephalopathy Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 28, no. 1, pp. 9–16, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]
@article{Iverson2016a,
title = {Suicide and Chronic Traumatic Encephalopathy},
author = {Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {28},
number = {1},
pages = {9--16},
abstract = {For nearly 80 years, suicidality was not considered to be a core clinical feature of chronic traumatic encephalopathy (CTE). In recent years, suicide has been widely cited as being associated with CTE, and now depression has been proposed to be one of three core diagnostic features alongside cognitive impairment and anger control problems. This evolution of the clinical features has been reinforced by thousands of media stories reporting a connection between mental health problems in former athletes and military veterans, repetitive neurotrauma, and CTE. At present, the science underlying the causal assumption between repetitive neurotrauma, depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive. Epidemiological evidence indicates that former National Football League players, for example, are at lower, not greater, risk for suicide than men in the general population. This article aims to discuss the critical issues and literature relating to these possible relationships.},
keywords = {*Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
Abstract | BibTeX | Tags: *Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J
A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics & Numerical, Hockey/sn [Statistics & Numerical Data], Humans, Male, Sports Equipment/sn [Statistics & Numerical Data], VIDEO recording, Young Adult
@article{Hutchison2015,
title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},
author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {547--551},
abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics \& Numerical, Hockey/sn [Statistics \& Numerical Data], Humans, Male, Sports Equipment/sn [Statistics \& Numerical Data], VIDEO recording, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Walter, K D; Halstead, M E
Concussion in Teenage Athletes Journal Article
In: Adolescent Medicine, vol. 26, no. 1, pp. 39–52, 2015.
BibTeX | Tags: *Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed
@article{Walter2015,
title = {Concussion in Teenage Athletes},
author = {Walter, K D and Halstead, M E},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {1},
pages = {39--52},
keywords = {*Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports},
pubstate = {published},
tppubtype = {article}
}
Stein, T D; Montenigro, P H; Alvarez, V E; Xia, W; Crary, J F; Tripodis, Y; Daneshvar, D H; Mez, J; Solomon, T; Meng, G; Kubilus, C A; Cormier, K A; Meng, S; Babcock, K; Kiernan, P; Murphy, L; Nowinski, C J; Martin, B; Dixon, D; Stern, R A; Cantu, R C; Kowall, N W; McKee, A C
Beta-amyloid deposition in chronic traumatic encephalopathy Journal Article
In: Acta Neuropathologica, vol. 130, no. 1, pp. 21–34, 2015.
Abstract | BibTeX | Tags: *Amyloid beta-Peptides/me [Metabolism], *Brain Injury, *Brain/pa [Pathology], *Neurodegenerative Diseases/pa [Pathology], *tau Proteins/me [Metabolism], 0 (Amyloid beta-Peptides), 0 (Apolipoprotein E4), 0 (MAPT protein, 0 (tau Proteins), 80 and over, adult, Age Factors, aged, Amyloid/et [Etiology], Amyloid/me [Metabolism], Amyloid/pa [Pathology], Apolipoprotein E4/ge [Genetics], Athletes, Athletic Injuries/ep [Epidemiology], Athletic Injuries/ge [Genetics], Athletic Injuries/me [Metabolism], Athletic Injuries/pa [Pathology], Brain Injury, Brain/me [Metabolism], Chronic/ep [Epidemiology], Chronic/ge [Genetics], Chronic/me [Metabolism], Chronic/pa [Pathology], Cohort Studies, comorbidity, human), Humans, middle aged, Neurodegenerative Diseases/ep [Epidemiology], Neurodegenerative Diseases/ge [Genetics], Neurodegenerative Diseases/me [Metabolism], Plaque, SEVERITY of illness index, veterans, War-Related Injuries/ep [Epidemiology], War-Related Injuries/ge [Genetics], War-Related Injuries/me [Metabolism], War-Related Injuries/pa [Pathology]
@article{Stein2015b,
title = {Beta-amyloid deposition in chronic traumatic encephalopathy},
author = {Stein, T D and Montenigro, P H and Alvarez, V E and Xia, W and Crary, J F and Tripodis, Y and Daneshvar, D H and Mez, J and Solomon, T and Meng, G and Kubilus, C A and Cormier, K A and Meng, S and Babcock, K and Kiernan, P and Murphy, L and Nowinski, C J and Martin, B and Dixon, D and Stern, R A and Cantu, R C and Kowall, N W and McKee, A C},
year = {2015},
date = {2015-01-01},
journal = {Acta Neuropathologica},
volume = {130},
number = {1},
pages = {21--34},
abstract = {Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive mild traumatic brain injury. It is defined pathologically by the abnormal accumulation of tau in a unique pattern that is distinct from other tauopathies, including Alzheimer's disease (AD). Although trauma has been suggested to increase amyloid beta peptide (Abeta) levels, the extent of Abeta deposition in CTE has not been thoroughly characterized. We studied a heterogeneous cohort of deceased athletes and military veterans with neuropathologically diagnosed CTE (n = 114, mean age at death = 60) to test the hypothesis that Abeta deposition is altered in CTE and associated with more severe pathology and worse clinical outcomes. We found that Abeta deposition, either as diffuse or neuritic plaques, was present in 52 % of CTE subjects. Moreover, Abeta deposition in CTE occurred at an accelerated rate and with altered dynamics in CTE compared to a normal aging population (OR = 3.8, p \< 0.001). We also found a clear pathological and clinical dichotomy between those CTE cases with Abeta plaques and those without. Abeta deposition was significantly associated with the presence of the APOE epsilon4 allele (p = 0.035), older age at symptom onset (p \< 0.001), and older age at death (p \< 0.001). In addition, when controlling for age, neuritic plaques were significantly associated with increased CTE tauopathy stage (beta = 2.43},
keywords = {*Amyloid beta-Peptides/me [Metabolism], *Brain Injury, *Brain/pa [Pathology], *Neurodegenerative Diseases/pa [Pathology], *tau Proteins/me [Metabolism], 0 (Amyloid beta-Peptides), 0 (Apolipoprotein E4), 0 (MAPT protein, 0 (tau Proteins), 80 and over, adult, Age Factors, aged, Amyloid/et [Etiology], Amyloid/me [Metabolism], Amyloid/pa [Pathology], Apolipoprotein E4/ge [Genetics], Athletes, Athletic Injuries/ep [Epidemiology], Athletic Injuries/ge [Genetics], Athletic Injuries/me [Metabolism], Athletic Injuries/pa [Pathology], Brain Injury, Brain/me [Metabolism], Chronic/ep [Epidemiology], Chronic/ge [Genetics], Chronic/me [Metabolism], Chronic/pa [Pathology], Cohort Studies, comorbidity, human), Humans, middle aged, Neurodegenerative Diseases/ep [Epidemiology], Neurodegenerative Diseases/ge [Genetics], Neurodegenerative Diseases/me [Metabolism], Plaque, SEVERITY of illness index, veterans, War-Related Injuries/ep [Epidemiology], War-Related Injuries/ge [Genetics], War-Related Injuries/me [Metabolism], War-Related Injuries/pa [Pathology]},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Crowley, P J; Crowley, M J
Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme Journal Article
In: British Journal of Sports Medicine, vol. 48, no. 2, pp. 147–150, 2014.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization & Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation & Jurisprudence], Track and Field/sn [Statistics & Numerical Data], Young Adult
@article{Crowley2014,
title = {Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme},
author = {Crowley, P J and Crowley, M J},
year = {2014},
date = {2014-01-01},
journal = {British Journal of Sports Medicine},
volume = {48},
number = {2},
pages = {147--150},
abstract = {BACKGROUND: Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn. METHODS: We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and (5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools. RESULTS: One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard). CONCLUSION: The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.},
keywords = {*Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization \& Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation \& Jurisprudence], Track and Field/sn [Statistics \& Numerical Data], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Jordan, B D
Neurologic aspects of boxing Journal Article
In: Archives of Neurology, vol. 44, no. 4, pp. 453–459, 1987.
Abstract | BibTeX | Tags: *Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention & Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention & Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed
@article{Jordan1987,
title = {Neurologic aspects of boxing},
author = {Jordan, B D},
year = {1987},
date = {1987-01-01},
journal = {Archives of Neurology},
volume = {44},
number = {4},
pages = {453--459},
abstract = {The assessment and prevention of potentially adverse neurologic consequences of boxing requires two important considerations. Acute neurologic injuries should be distinguished from chronic brain injuries and the level of competitive boxing (ie, amateur vs professional) must also be taken into account. Acute neurologic injuries such as concussion, post-concussion syndrome, intracranial hemorrhage, and brain contusion are more readily identified than chronic neurologic injuries because of their immediate devastation of the nervous system. In contrast, chronic neurologic injuries differ in their pathophysiologic mechanisms that are exemplified by an insidious onset and progression after the cessation of boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses the most serious neurologic threat of boxing. Amateur boxing differs from professional boxing in the duration of fights, rules and regulatory policies, medical evaluation, and protective devices. These factors could produce a differential effect on the risk of injury to the brain. The prevention of neurologic injuries in boxing requires the integration of proper neurologic evaluation by qualified ring-side physicians, the design and utilization of effective protective devices, and the establishment of national regulatory agencies.},
keywords = {*Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention \& Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention \& Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}