Asken, B M; Snyder, A R; Smith, M S; Zaremski, J L; Bauer, R M
Concussion-like symptom reporting in non-concussed adolescent athletes Journal Article
In: Clinical Neuropsychologist, vol. 31, no. 1, pp. 138–153, 2017.
Abstract | Links | BibTeX | Tags: Adolescent, biopsychosocial, Brain Injury, high school, Sport-related concussion
@article{Asken2017,
title = {Concussion-like symptom reporting in non-concussed adolescent athletes},
author = {Asken, B M and Snyder, A R and Smith, M S and Zaremski, J L and Bauer, R M},
doi = {10.1080/13854046.2016.1246672},
year = {2017},
date = {2017-01-01},
journal = {Clinical Neuropsychologist},
volume = {31},
number = {1},
pages = {138--153},
abstract = {Objective: The primary goals of this study were (1) to report rates of concussion-like symptoms in healthy adolescent student athletes assessed using the Sport Concussion Assessment Tool, 3rd edition (SCAT3) at baseline, (2) to examine rates of psychiatric diagnoses in this population, and (3) to evaluate effects of baseline symptoms on SCAT3 cognitive and balance performance. Methods: 349 adolescent student athletes (245 male) were administered the SCAT3 during pre-participation physical examinations. We described the prevalence rate of student athletes meeting criteria for International Classification of Diseases, 10th revision, post-concussional syndrome (ICD-10 PCS) diagnosis at baseline, and evaluated associations between symptom reporting and demographic/medical history factors using chi-square tests. Rates of self-reported psychiatric diagnosis were compared to general population estimates with one-sample binomial tests. We also compared SCAT3 cognitive and balance performance between adolescents with and without baseline ICD-10 PCS symptoms. Results: Overall, 20.3% of participants met ICD-10 PCS criteria at baseline. Rates were similar across sexes and age groups. We found no statistical association with medical history factors. The proportion of student athletes reporting a history of psychiatric diagnosis (5.2%) was significantly lower than general population estimates (14.0%; p \<.001), and this effect was consistent across sexes and age groups. SCAT3 cognitive and balance performance did not differ based on baseline symptom reporting. Conclusions: Healthy adolescent student athletes frequently report concussion-like symptoms at baseline. Clinicians should factor pre-injury symptomatology and medical history into concussion management when determining symptom etiology throughout the course of recovery. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Adolescent, biopsychosocial, Brain Injury, high school, Sport-related concussion},
pubstate = {published},
tppubtype = {article}
}
Kuhn, A W; Zuckerman, S L; Solomon, G S; Casson, I R; Viano, D C
In: Sports Health, vol. 9, no. 1, pp. 30–40, 2017.
Abstract | Links | BibTeX | Tags: chronic impairment, Cognitive function, NATIONAL Football League, neuroimaging, Neuropsychological testing, neuroradiology, Sport-related concussion
@article{Kuhn2017,
title = {Interrelationships Among Neuroimaging Biomarkers, Neuropsychological Test Data, and Symptom Reporting in a Cohort of Retired National Football League Players},
author = {Kuhn, A W and Zuckerman, S L and Solomon, G S and Casson, I R and Viano, D C},
doi = {10.1177/1941738116674006},
year = {2017},
date = {2017-01-01},
journal = {Sports Health},
volume = {9},
number = {1},
pages = {30--40},
abstract = {Background: Structural brain changes, potentially resulting from repetitive brain trauma (RBT), have been correlated with neurocognitive decline and increased symptom reporting in retired athletes. Hypothesis: In a cohort of retired National Football League (NFL) players, the relationships between 3 neuroimaging parameters, neuropsychological testing, and symptom scores will be significantly correlated. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Comprehensive magnetic resonance imaging was performed in 45 retired NFL players. Three neuroanatomical parameters were assessed by board-certified radiologists blinded to the purpose of the study: (1) the absence or presence of small or large cavum septum pellucidum, (2) a global mean score of fractional anisotropy (FA), and (3) the presence or absence of microhemorrhages. The subjects underwent a battery of 9 paper-and-pencil neuropsychological tests, a computerized neurocognitive test, and multiple symptom and depression scales. The associations among the neuroimaging results with these outcome measures were assessed utilizing Pearson, Spearman rank, and point-biserial correlations. Results: The 45 subjects (mean age, 46.7 ± 9.1 years) reported a mean 6.9 (±6.2) concussions and 13.0 (±7.9) “dings” in the NFL. Ten (22%) did not have a cavum septum pellucidum, while 32 (71%) had a small and 3 (7%) had a large one. Four (9%) had microhemorrhages. Global FA mean was 0.459 (±0.035). The majority (50.8%) of correlations among the neuroimaging parameters and neurocognitive/symptom scores fell below the threshold of “small” effect size (r \< 0.10). The remaining (49.2%) correlations were between “small” and “medium” effect sizes (0.1 \< r \< 0.3). However, all correlations were statistically nonsignificant. Conclusion: There were minimal and statistically nonsignificant correlations among the neuroimaging, neurocognitive, and symptom scores examined in this cohort of NFL retirees. Clinical Relevance: Associating the severity of structural brain changes to neurocognitive performance and symptom burden after RBT is complex may involve other moderating variables or biomarkers, and demands further study. © 2016, © 2016 The Author(s).},
keywords = {chronic impairment, Cognitive function, NATIONAL Football League, neuroimaging, Neuropsychological testing, neuroradiology, Sport-related concussion},
pubstate = {published},
tppubtype = {article}
}
Laker, S R; Meron, A; Greher, M R; Wilson, J
Retirement and Activity Restrictions Following Concussion Journal Article
In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.
Links | BibTeX | Tags: Activity restrictions, athlete, attention deficit disorder, brain concussion, Concussion, CONVALESCENCE, depression, human, learning disorder, migraine, neuropsychological test, nonhuman, PHYSICAL ACTIVITY, postconcussion syndrome, practice guideline, priority journal, Retirement, return to sport, Review, risk factor, sleep disorder, sport injury, Sport-related concussion, subarachnoid hemorrhage, symptom, traumatic brain injury, unconsciousness
@article{Laker2016,
title = {Retirement and Activity Restrictions Following Concussion},
author = {Laker, S R and Meron, A and Greher, M R and Wilson, J},
doi = {10.1016/j.pmr.2016.01.001},
year = {2016},
date = {2016-01-01},
journal = {Physical Medicine \& Rehabilitation Clinics of North America},
volume = {27},
number = {2},
pages = {487--501},
keywords = {Activity restrictions, athlete, attention deficit disorder, brain concussion, Concussion, CONVALESCENCE, depression, human, learning disorder, migraine, neuropsychological test, nonhuman, PHYSICAL ACTIVITY, postconcussion syndrome, practice guideline, priority journal, Retirement, return to sport, Review, risk factor, sleep disorder, sport injury, Sport-related concussion, subarachnoid hemorrhage, symptom, traumatic brain injury, unconsciousness},
pubstate = {published},
tppubtype = {article}
}
Kontos, A P; Reches, A; Elbin, R J; Dickman, D; Laufer, I; Geva, A B; Shacham, G; DeWolf, R; Collins, M W
Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion Journal Article
In: Brain Imaging & Behavior, vol. 10, no. 2, pp. 594–603, 2016.
Abstract | Links | BibTeX | Tags: Brain network activation, Electroencephalography, Post-traumatic migraine, Sport-related concussion
@article{Kontos2016d,
title = {Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion},
author = {Kontos, A P and Reches, A and Elbin, R J and Dickman, D and Laufer, I and Geva, A B and Shacham, G and DeWolf, R and Collins, M W},
doi = {10.1007/s11682-015-9412-6},
year = {2016},
date = {2016-01-01},
journal = {Brain Imaging \& Behavior},
volume = {10},
number = {2},
pages = {594--603},
abstract = {Post-traumatic migraine (PTM) (i.e., headache, nausea, light and/or noise sensitivity) is an emerging risk factor for prolonged recovery following concussion. Concussions and migraine share similar pathophysiology characterized by specific ionic imbalances in the brain. Given these similarities, patients with PTM following concussion may exhibit distinct electrophysiological patterns, although researchers have yet to examine the electrophysiological brain activation in patients with PTM following concussion. A novel approach that may help differentiate brain activation in patients with and without PTM is brain network activation (BNA) analysis. BNA involves an algorithmic analysis applied to multichannel EEG-ERP data that provides a network map of cortical activity and quantitative data during specific tasks. A prospective, repeated measures design was used to evaluate BNA (during Go/NoGo task), EEG-ERP, cognitive performance, and concussion related symptoms at 1, 2, 3, and 4 weeks post-injury intervals among athletes with a medically diagnosed concussion with PTM (n = 15) and without (NO-PTM) (n = 22); and age, sex, and concussion history matched controls without concussion (CONTROL) (n = 20). Participants with PTM had significantly reduced BNA compared to NO-PTM and CONTROLS for Go and NoGo components at 3 weeks and for NoGo component at 4 weeks post-injury. The PTM group also demonstrated a more prominent deviation of network activity compared to the other two groups over a longer period of time. The composite BNA algorithm may be a more sensitive measure of electrophysiological change in the brain that can augment established cognitive assessment tools for detecting impairment in individuals with PTM. © 2015, Springer Science+Business Media New York.},
keywords = {Brain network activation, Electroencephalography, Post-traumatic migraine, Sport-related concussion},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S
Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article
In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult
@article{Baker2015,
title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},
author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},
doi = {10.1177/0009922815588820},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {54},
number = {10},
pages = {961--968},
abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},
keywords = {Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Asken, B M; Snyder, A R; Smith, M S; Zaremski, J L; Bauer, R M
Concussion-like symptom reporting in non-concussed adolescent athletes Journal Article
In: Clinical Neuropsychologist, vol. 31, no. 1, pp. 138–153, 2017.
@article{Asken2017,
title = {Concussion-like symptom reporting in non-concussed adolescent athletes},
author = {Asken, B M and Snyder, A R and Smith, M S and Zaremski, J L and Bauer, R M},
doi = {10.1080/13854046.2016.1246672},
year = {2017},
date = {2017-01-01},
journal = {Clinical Neuropsychologist},
volume = {31},
number = {1},
pages = {138--153},
abstract = {Objective: The primary goals of this study were (1) to report rates of concussion-like symptoms in healthy adolescent student athletes assessed using the Sport Concussion Assessment Tool, 3rd edition (SCAT3) at baseline, (2) to examine rates of psychiatric diagnoses in this population, and (3) to evaluate effects of baseline symptoms on SCAT3 cognitive and balance performance. Methods: 349 adolescent student athletes (245 male) were administered the SCAT3 during pre-participation physical examinations. We described the prevalence rate of student athletes meeting criteria for International Classification of Diseases, 10th revision, post-concussional syndrome (ICD-10 PCS) diagnosis at baseline, and evaluated associations between symptom reporting and demographic/medical history factors using chi-square tests. Rates of self-reported psychiatric diagnosis were compared to general population estimates with one-sample binomial tests. We also compared SCAT3 cognitive and balance performance between adolescents with and without baseline ICD-10 PCS symptoms. Results: Overall, 20.3% of participants met ICD-10 PCS criteria at baseline. Rates were similar across sexes and age groups. We found no statistical association with medical history factors. The proportion of student athletes reporting a history of psychiatric diagnosis (5.2%) was significantly lower than general population estimates (14.0%; p \<.001), and this effect was consistent across sexes and age groups. SCAT3 cognitive and balance performance did not differ based on baseline symptom reporting. Conclusions: Healthy adolescent student athletes frequently report concussion-like symptoms at baseline. Clinicians should factor pre-injury symptomatology and medical history into concussion management when determining symptom etiology throughout the course of recovery. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kuhn, A W; Zuckerman, S L; Solomon, G S; Casson, I R; Viano, D C
In: Sports Health, vol. 9, no. 1, pp. 30–40, 2017.
@article{Kuhn2017,
title = {Interrelationships Among Neuroimaging Biomarkers, Neuropsychological Test Data, and Symptom Reporting in a Cohort of Retired National Football League Players},
author = {Kuhn, A W and Zuckerman, S L and Solomon, G S and Casson, I R and Viano, D C},
doi = {10.1177/1941738116674006},
year = {2017},
date = {2017-01-01},
journal = {Sports Health},
volume = {9},
number = {1},
pages = {30--40},
abstract = {Background: Structural brain changes, potentially resulting from repetitive brain trauma (RBT), have been correlated with neurocognitive decline and increased symptom reporting in retired athletes. Hypothesis: In a cohort of retired National Football League (NFL) players, the relationships between 3 neuroimaging parameters, neuropsychological testing, and symptom scores will be significantly correlated. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Comprehensive magnetic resonance imaging was performed in 45 retired NFL players. Three neuroanatomical parameters were assessed by board-certified radiologists blinded to the purpose of the study: (1) the absence or presence of small or large cavum septum pellucidum, (2) a global mean score of fractional anisotropy (FA), and (3) the presence or absence of microhemorrhages. The subjects underwent a battery of 9 paper-and-pencil neuropsychological tests, a computerized neurocognitive test, and multiple symptom and depression scales. The associations among the neuroimaging results with these outcome measures were assessed utilizing Pearson, Spearman rank, and point-biserial correlations. Results: The 45 subjects (mean age, 46.7 ± 9.1 years) reported a mean 6.9 (±6.2) concussions and 13.0 (±7.9) “dings” in the NFL. Ten (22%) did not have a cavum septum pellucidum, while 32 (71%) had a small and 3 (7%) had a large one. Four (9%) had microhemorrhages. Global FA mean was 0.459 (±0.035). The majority (50.8%) of correlations among the neuroimaging parameters and neurocognitive/symptom scores fell below the threshold of “small” effect size (r \< 0.10). The remaining (49.2%) correlations were between “small” and “medium” effect sizes (0.1 \< r \< 0.3). However, all correlations were statistically nonsignificant. Conclusion: There were minimal and statistically nonsignificant correlations among the neuroimaging, neurocognitive, and symptom scores examined in this cohort of NFL retirees. Clinical Relevance: Associating the severity of structural brain changes to neurocognitive performance and symptom burden after RBT is complex may involve other moderating variables or biomarkers, and demands further study. © 2016, © 2016 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Laker, S R; Meron, A; Greher, M R; Wilson, J
Retirement and Activity Restrictions Following Concussion Journal Article
In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.
@article{Laker2016,
title = {Retirement and Activity Restrictions Following Concussion},
author = {Laker, S R and Meron, A and Greher, M R and Wilson, J},
doi = {10.1016/j.pmr.2016.01.001},
year = {2016},
date = {2016-01-01},
journal = {Physical Medicine \& Rehabilitation Clinics of North America},
volume = {27},
number = {2},
pages = {487--501},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kontos, A P; Reches, A; Elbin, R J; Dickman, D; Laufer, I; Geva, A B; Shacham, G; DeWolf, R; Collins, M W
Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion Journal Article
In: Brain Imaging & Behavior, vol. 10, no. 2, pp. 594–603, 2016.
@article{Kontos2016d,
title = {Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion},
author = {Kontos, A P and Reches, A and Elbin, R J and Dickman, D and Laufer, I and Geva, A B and Shacham, G and DeWolf, R and Collins, M W},
doi = {10.1007/s11682-015-9412-6},
year = {2016},
date = {2016-01-01},
journal = {Brain Imaging \& Behavior},
volume = {10},
number = {2},
pages = {594--603},
abstract = {Post-traumatic migraine (PTM) (i.e., headache, nausea, light and/or noise sensitivity) is an emerging risk factor for prolonged recovery following concussion. Concussions and migraine share similar pathophysiology characterized by specific ionic imbalances in the brain. Given these similarities, patients with PTM following concussion may exhibit distinct electrophysiological patterns, although researchers have yet to examine the electrophysiological brain activation in patients with PTM following concussion. A novel approach that may help differentiate brain activation in patients with and without PTM is brain network activation (BNA) analysis. BNA involves an algorithmic analysis applied to multichannel EEG-ERP data that provides a network map of cortical activity and quantitative data during specific tasks. A prospective, repeated measures design was used to evaluate BNA (during Go/NoGo task), EEG-ERP, cognitive performance, and concussion related symptoms at 1, 2, 3, and 4 weeks post-injury intervals among athletes with a medically diagnosed concussion with PTM (n = 15) and without (NO-PTM) (n = 22); and age, sex, and concussion history matched controls without concussion (CONTROL) (n = 20). Participants with PTM had significantly reduced BNA compared to NO-PTM and CONTROLS for Go and NoGo components at 3 weeks and for NoGo component at 4 weeks post-injury. The PTM group also demonstrated a more prominent deviation of network activity compared to the other two groups over a longer period of time. The composite BNA algorithm may be a more sensitive measure of electrophysiological change in the brain that can augment established cognitive assessment tools for detecting impairment in individuals with PTM. © 2015, Springer Science+Business Media New York.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S
Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article
In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.
@article{Baker2015,
title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},
author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},
doi = {10.1177/0009922815588820},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {54},
number = {10},
pages = {961--968},
abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Asken, B M; Snyder, A R; Smith, M S; Zaremski, J L; Bauer, R M
Concussion-like symptom reporting in non-concussed adolescent athletes Journal Article
In: Clinical Neuropsychologist, vol. 31, no. 1, pp. 138–153, 2017.
Abstract | Links | BibTeX | Tags: Adolescent, biopsychosocial, Brain Injury, high school, Sport-related concussion
@article{Asken2017,
title = {Concussion-like symptom reporting in non-concussed adolescent athletes},
author = {Asken, B M and Snyder, A R and Smith, M S and Zaremski, J L and Bauer, R M},
doi = {10.1080/13854046.2016.1246672},
year = {2017},
date = {2017-01-01},
journal = {Clinical Neuropsychologist},
volume = {31},
number = {1},
pages = {138--153},
abstract = {Objective: The primary goals of this study were (1) to report rates of concussion-like symptoms in healthy adolescent student athletes assessed using the Sport Concussion Assessment Tool, 3rd edition (SCAT3) at baseline, (2) to examine rates of psychiatric diagnoses in this population, and (3) to evaluate effects of baseline symptoms on SCAT3 cognitive and balance performance. Methods: 349 adolescent student athletes (245 male) were administered the SCAT3 during pre-participation physical examinations. We described the prevalence rate of student athletes meeting criteria for International Classification of Diseases, 10th revision, post-concussional syndrome (ICD-10 PCS) diagnosis at baseline, and evaluated associations between symptom reporting and demographic/medical history factors using chi-square tests. Rates of self-reported psychiatric diagnosis were compared to general population estimates with one-sample binomial tests. We also compared SCAT3 cognitive and balance performance between adolescents with and without baseline ICD-10 PCS symptoms. Results: Overall, 20.3% of participants met ICD-10 PCS criteria at baseline. Rates were similar across sexes and age groups. We found no statistical association with medical history factors. The proportion of student athletes reporting a history of psychiatric diagnosis (5.2%) was significantly lower than general population estimates (14.0%; p \<.001), and this effect was consistent across sexes and age groups. SCAT3 cognitive and balance performance did not differ based on baseline symptom reporting. Conclusions: Healthy adolescent student athletes frequently report concussion-like symptoms at baseline. Clinicians should factor pre-injury symptomatology and medical history into concussion management when determining symptom etiology throughout the course of recovery. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Adolescent, biopsychosocial, Brain Injury, high school, Sport-related concussion},
pubstate = {published},
tppubtype = {article}
}
Kuhn, A W; Zuckerman, S L; Solomon, G S; Casson, I R; Viano, D C
In: Sports Health, vol. 9, no. 1, pp. 30–40, 2017.
Abstract | Links | BibTeX | Tags: chronic impairment, Cognitive function, NATIONAL Football League, neuroimaging, Neuropsychological testing, neuroradiology, Sport-related concussion
@article{Kuhn2017,
title = {Interrelationships Among Neuroimaging Biomarkers, Neuropsychological Test Data, and Symptom Reporting in a Cohort of Retired National Football League Players},
author = {Kuhn, A W and Zuckerman, S L and Solomon, G S and Casson, I R and Viano, D C},
doi = {10.1177/1941738116674006},
year = {2017},
date = {2017-01-01},
journal = {Sports Health},
volume = {9},
number = {1},
pages = {30--40},
abstract = {Background: Structural brain changes, potentially resulting from repetitive brain trauma (RBT), have been correlated with neurocognitive decline and increased symptom reporting in retired athletes. Hypothesis: In a cohort of retired National Football League (NFL) players, the relationships between 3 neuroimaging parameters, neuropsychological testing, and symptom scores will be significantly correlated. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Comprehensive magnetic resonance imaging was performed in 45 retired NFL players. Three neuroanatomical parameters were assessed by board-certified radiologists blinded to the purpose of the study: (1) the absence or presence of small or large cavum septum pellucidum, (2) a global mean score of fractional anisotropy (FA), and (3) the presence or absence of microhemorrhages. The subjects underwent a battery of 9 paper-and-pencil neuropsychological tests, a computerized neurocognitive test, and multiple symptom and depression scales. The associations among the neuroimaging results with these outcome measures were assessed utilizing Pearson, Spearman rank, and point-biserial correlations. Results: The 45 subjects (mean age, 46.7 ± 9.1 years) reported a mean 6.9 (±6.2) concussions and 13.0 (±7.9) “dings” in the NFL. Ten (22%) did not have a cavum septum pellucidum, while 32 (71%) had a small and 3 (7%) had a large one. Four (9%) had microhemorrhages. Global FA mean was 0.459 (±0.035). The majority (50.8%) of correlations among the neuroimaging parameters and neurocognitive/symptom scores fell below the threshold of “small” effect size (r \< 0.10). The remaining (49.2%) correlations were between “small” and “medium” effect sizes (0.1 \< r \< 0.3). However, all correlations were statistically nonsignificant. Conclusion: There were minimal and statistically nonsignificant correlations among the neuroimaging, neurocognitive, and symptom scores examined in this cohort of NFL retirees. Clinical Relevance: Associating the severity of structural brain changes to neurocognitive performance and symptom burden after RBT is complex may involve other moderating variables or biomarkers, and demands further study. © 2016, © 2016 The Author(s).},
keywords = {chronic impairment, Cognitive function, NATIONAL Football League, neuroimaging, Neuropsychological testing, neuroradiology, Sport-related concussion},
pubstate = {published},
tppubtype = {article}
}
Laker, S R; Meron, A; Greher, M R; Wilson, J
Retirement and Activity Restrictions Following Concussion Journal Article
In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.
Links | BibTeX | Tags: Activity restrictions, athlete, attention deficit disorder, brain concussion, Concussion, CONVALESCENCE, depression, human, learning disorder, migraine, neuropsychological test, nonhuman, PHYSICAL ACTIVITY, postconcussion syndrome, practice guideline, priority journal, Retirement, return to sport, Review, risk factor, sleep disorder, sport injury, Sport-related concussion, subarachnoid hemorrhage, symptom, traumatic brain injury, unconsciousness
@article{Laker2016,
title = {Retirement and Activity Restrictions Following Concussion},
author = {Laker, S R and Meron, A and Greher, M R and Wilson, J},
doi = {10.1016/j.pmr.2016.01.001},
year = {2016},
date = {2016-01-01},
journal = {Physical Medicine \& Rehabilitation Clinics of North America},
volume = {27},
number = {2},
pages = {487--501},
keywords = {Activity restrictions, athlete, attention deficit disorder, brain concussion, Concussion, CONVALESCENCE, depression, human, learning disorder, migraine, neuropsychological test, nonhuman, PHYSICAL ACTIVITY, postconcussion syndrome, practice guideline, priority journal, Retirement, return to sport, Review, risk factor, sleep disorder, sport injury, Sport-related concussion, subarachnoid hemorrhage, symptom, traumatic brain injury, unconsciousness},
pubstate = {published},
tppubtype = {article}
}
Kontos, A P; Reches, A; Elbin, R J; Dickman, D; Laufer, I; Geva, A B; Shacham, G; DeWolf, R; Collins, M W
Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion Journal Article
In: Brain Imaging & Behavior, vol. 10, no. 2, pp. 594–603, 2016.
Abstract | Links | BibTeX | Tags: Brain network activation, Electroencephalography, Post-traumatic migraine, Sport-related concussion
@article{Kontos2016d,
title = {Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion},
author = {Kontos, A P and Reches, A and Elbin, R J and Dickman, D and Laufer, I and Geva, A B and Shacham, G and DeWolf, R and Collins, M W},
doi = {10.1007/s11682-015-9412-6},
year = {2016},
date = {2016-01-01},
journal = {Brain Imaging \& Behavior},
volume = {10},
number = {2},
pages = {594--603},
abstract = {Post-traumatic migraine (PTM) (i.e., headache, nausea, light and/or noise sensitivity) is an emerging risk factor for prolonged recovery following concussion. Concussions and migraine share similar pathophysiology characterized by specific ionic imbalances in the brain. Given these similarities, patients with PTM following concussion may exhibit distinct electrophysiological patterns, although researchers have yet to examine the electrophysiological brain activation in patients with PTM following concussion. A novel approach that may help differentiate brain activation in patients with and without PTM is brain network activation (BNA) analysis. BNA involves an algorithmic analysis applied to multichannel EEG-ERP data that provides a network map of cortical activity and quantitative data during specific tasks. A prospective, repeated measures design was used to evaluate BNA (during Go/NoGo task), EEG-ERP, cognitive performance, and concussion related symptoms at 1, 2, 3, and 4 weeks post-injury intervals among athletes with a medically diagnosed concussion with PTM (n = 15) and without (NO-PTM) (n = 22); and age, sex, and concussion history matched controls without concussion (CONTROL) (n = 20). Participants with PTM had significantly reduced BNA compared to NO-PTM and CONTROLS for Go and NoGo components at 3 weeks and for NoGo component at 4 weeks post-injury. The PTM group also demonstrated a more prominent deviation of network activity compared to the other two groups over a longer period of time. The composite BNA algorithm may be a more sensitive measure of electrophysiological change in the brain that can augment established cognitive assessment tools for detecting impairment in individuals with PTM. © 2015, Springer Science+Business Media New York.},
keywords = {Brain network activation, Electroencephalography, Post-traumatic migraine, Sport-related concussion},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S
Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article
In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult
@article{Baker2015,
title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},
author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},
doi = {10.1177/0009922815588820},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {54},
number = {10},
pages = {961--968},
abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},
keywords = {Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}