Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {*Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {*Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Dretsch, M N; Slaboda, J C; Johnson, D E; Adam, O R; Tsao, J W
Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 280–286, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values
@article{Haran2016b,
title = {Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment},
author = {Haran, F J and Dretsch, M N and Slaboda, J C and Johnson, D E and Adam, O R and Tsao, J W},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {280--286},
abstract = {PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p \< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p \> 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.},
keywords = {*Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
Abstract | BibTeX | Tags: *Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {*Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
Abstract | BibTeX | Tags: *Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {*Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {*Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M; Bleiberg, J; Williams, K; Caban, J; Kelly, J; Grammer, G; DeGraba, T
Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 23–29, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare
@article{Dretsch2016,
title = {Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI},
author = {Dretsch, M and Bleiberg, J and Williams, K and Caban, J and Kelly, J and Grammer, G and DeGraba, T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {23--29},
abstract = {OBJECTIVE: To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. SETTING: A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. PARTICIPANTS: Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. DESIGN: Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. MAIN MEASURES: Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). RESULTS: All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. CONCLUSION: Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.},
keywords = {*Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization & Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
keywords = {*Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization \& Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
Abstract | Links | BibTeX | Tags: adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
Abstract | Links | BibTeX | Tags: adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {*Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Mez, J; Solomon, T M; Daneshvar, D H; Stein, T D; McKee, A C
Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player Journal Article
In: JAMA Neurology, vol. 73, no. 3, pp. 353–355, 2016.
BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections
@article{Mez2016,
title = {Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player},
author = {Mez, J and Solomon, T M and Daneshvar, D H and Stein, T D and McKee, A C},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {3},
pages = {353--355},
keywords = {*Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections},
pubstate = {published},
tppubtype = {article}
}
Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D
Association of football subconcussive head impacts with ocular near point of convergence Journal Article
In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.
Abstract | Links | BibTeX | Tags: Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult
@article{Kawata2016,
title = {Association of football subconcussive head impacts with ocular near point of convergence},
author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},
doi = {10.1001/jamaophthalmol.2016.1085},
year = {2016},
date = {2016-01-01},
journal = {JAMA Ophthalmology},
volume = {134},
number = {7},
pages = {763--769},
abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},
keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A
English professional football players concussion knowledge and attitude Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.
Abstract | Links | BibTeX | Tags: accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult
@article{Williams2016,
title = {English professional football players concussion knowledge and attitude},
author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},
doi = {10.1016/j.jshs.2015.01.009},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {197--204},
abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},
keywords = {accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Suicide/sn [Statistics & Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {*Brain Concussion/co [Complications], *Suicide/sn [Statistics \& Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
Abstract | BibTeX | Tags: *Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {*Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Auerbach, P S; Waggoner 2nd, W H
It's Time to Change the Rules Journal Article
In: JAMA, vol. 316, no. 12, pp. 1260–1261, 2016.
BibTeX | Tags: *Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States
@article{Auerbach2016,
title = {It's Time to Change the Rules},
author = {Auerbach, P S and {Waggoner 2nd}, W H},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {316},
number = {12},
pages = {1260--1261},
keywords = {*Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Cooper, D B; Vanderploeg, R D
The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension Journal Article
In: Applied Neuropsychology. Adult, vol. 23, no. 4, pp. 264–273, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult
@article{Armistead-Jehle2016,
title = {The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension},
author = {Armistead-Jehle, P and Cooper, D B and Vanderploeg, R D},
year = {2016},
date = {2016-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {23},
number = {4},
pages = {264--273},
abstract = {The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population.},
keywords = {*Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T
Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult
@article{Bailie2016,
title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},
author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {2--12},
abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},
keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},
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}
}
Wu, L C; Nangia, V; Bui, K; Hammoor, B; Kurt, M; Hernandez, F; Kuo, C; Camarillo, D B
In Vivo Evaluation of Wearable Head Impact Sensors Journal Article
In: Annals of Biomedical Engineering, vol. 44, no. 4, pp. 1234–1245, 2016.
Abstract | BibTeX | Tags: *Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording
@article{Wu2016,
title = {In Vivo Evaluation of Wearable Head Impact Sensors},
author = {Wu, L C and Nangia, V and Bui, K and Hammoor, B and Kurt, M and Hernandez, F and Kuo, C and Camarillo, D B},
year = {2016},
date = {2016-01-01},
journal = {Annals of Biomedical Engineering},
volume = {44},
number = {4},
pages = {1234--1245},
abstract = {Inertial sensors are commonly used to measure human head motion. Some sensors have been tested with dummy or cadaver experiments with mixed results, and methods to evaluate sensors in vivo are lacking. Here we present an in vivo method using high speed video to test teeth-mounted (mouthguard), soft tissue-mounted (skin patch), and headgear-mounted (skull cap) sensors during 6-13 g sagittal soccer head impacts. Sensor coupling to the skull was quantified by displacement from an ear-canal reference. Mouthguard displacements were within video measurement error (\<1 mm), while the skin patch and skull cap displaced up to 4 and 13 mm from the ear-canal reference, respectively. We used the mouthguard, which had the least displacement from skull, as the reference to assess 6-degree-of-freedom skin patch and skull cap measurements. Linear and rotational acceleration magnitudes were over-predicted by both the skin patch (with 120% NRMS error for a(mag), 290% for alpha(mag)) and the skull cap (320% NRMS error for a(mag), 500% for alpha(mag)). Such over-predictions were largely due to out-of-plane motion. To model sensor error, we found that in-plane skin patch linear acceleration in the anterior-posterior direction could be modeled by an underdamped viscoelastic system. In summary, the mouthguard showed tighter skull coupling than the other sensor mounting approaches. Furthermore, the in vivo methods presented are valuable for investigating skull acceleration sensor technologies.},
keywords = {*Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording},
pubstate = {published},
tppubtype = {article}
}
Calcagnile, O; Anell, A; Unden, J
The addition of S100B to guidelines for management of mild head injury is potentially cost saving Journal Article
In: BMC Neurology, vol. 16, no. 1, pp. 200, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult
@article{Calcagnile2016,
title = {The addition of S100B to guidelines for management of mild head injury is potentially cost saving},
author = {Calcagnile, O and Anell, A and Unden, J},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
number = {1},
pages = {200},
abstract = {BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study. Patients were followed up after 3 months with a standardized questionnaire. Theoretical and actual cost differences were calculated. RESULTS: Seven hundred twenty-six patients were included and 29 (4.7 %) showed traumatic abnormalities on CT. No further significant intracranial complications were discovered on follow-up. Two hundred twenty-nine patients (27 %) had normal S100B levels and 497 patients (73 %) showed elevated S100B levels. Over-triage occurred in 73 patients (32 %) and under-triage occurred in 39 patients (7 %). No significant intracranial complications were missed. The introduction of S100B could save 71 per patient if guidelines were strictly followed. As compliance to the guidelines was not perfect, the actual cost saving was 39 per patient. CONCLUSION: Adding S100B to existing guidelines for mild TBI seems to reduce CT usage and costs, especially if guideline compliance could be increased.},
keywords = {*Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stern, R A; Tripodis, Y; Baugh, C M; Fritts, N G; Martin, B M; Chaisson, C; Cantu, R C; Joyce, J A; Shah, S; Ikezu, T; Zhang, J; Gercel-Taylor, C; Taylor, D D
Preliminary Study of Plasma Exosomal Tau as a Potential Biomarker for Chronic Traumatic Encephalopathy Journal Article
In: Journal of Alzheimer's Disease, vol. 51, no. 4, pp. 1099–1109, 2016.
Abstract | BibTeX | Tags: *Chronic Traumatic Encephalopathy/bl [Blood], *Extracellular Vesicles/me [Metabolism], *Plasma/cy [Cytology], *tau Proteins/me [Metabolism], 0 (tau Proteins), adult, aged, ANALYSIS of variance, Case-Control Studies, Humans, Male, middle aged
@article{Stern2016,
title = {Preliminary Study of Plasma Exosomal Tau as a Potential Biomarker for Chronic Traumatic Encephalopathy},
author = {Stern, R A and Tripodis, Y and Baugh, C M and Fritts, N G and Martin, B M and Chaisson, C and Cantu, R C and Joyce, J A and Shah, S and Ikezu, T and Zhang, J and Gercel-Taylor, C and Taylor, D D},
year = {2016},
date = {2016-01-01},
journal = {Journal of Alzheimer's Disease},
volume = {51},
number = {4},
pages = {1099--1109},
abstract = {BACKGROUND: Chronic traumatic encephalopathy (CTE) is a tauopathy associated with prior exposure to repetitive head impacts, such as those incurred through American football and other collision sports. Diagnosis is made through neuropathological examination. Many of the clinical features of CTE are common in the general population, with and without a history of head impact exposure, making clinical diagnosis difficult. As is now common in the diagnosis of other neurodegenerative disorders, such as Alzheimer's disease, there is a need for methods to diagnose CTE during life through objective biomarkers. OBJECTIVE: The aim of this study was to examine tau-positive exosomes in plasma as a potential CTE biomarker. METHODS: Subjects were 78 former National Football League (NFL) players and 16 controls. Extracellular vesicles were isolated from plasma. Fluorescent nanoparticle tracking analysis was used to determine the number of vesicles staining positive for tau. RESULTS: The NFL group had higher exosomal tau than the control group (p \< 0.0001). Exosomal tau discriminated between the groups, with 82% sensitivity, 100% specificity, 100% positive predictive value, and 53% negative predictive value. Within the NFL group, higher exosomal tau was associated with worse performance on tests of memory (p = 0.0126) and psychomotor speed (p = 0.0093). CONCLUSION: These preliminary findings suggest that exosomal tau in plasma may be an accurate, noninvasive CTE biomarker.},
keywords = {*Chronic Traumatic Encephalopathy/bl [Blood], *Extracellular Vesicles/me [Metabolism], *Plasma/cy [Cytology], *tau Proteins/me [Metabolism], 0 (tau Proteins), adult, aged, ANALYSIS of variance, Case-Control Studies, Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Clark, J M; Hoshizaki, T B
The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1047–1055, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/pc [Prevention & Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male
@article{Clark2016,
title = {The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse},
author = {Clark, J M and Hoshizaki, T B},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1047--1055},
abstract = {BACKGROUND: Women's field lacrosse is described as a noncontact game relying primarily on rules to decrease the risk of head injuries. Despite not allowing head contact, however, concussions continue to be reported in women's field lacrosse. PURPOSE: To assess the ability of men's lacrosse helmets to decrease linear and angular acceleration for different striking techniques in women's field lacrosse. STUDY DESIGN: Controlled laboratory study. METHODS: A helmeted and unhelmeted Hybrid III 50th Percentile headform was attached to a Hybrid III neckform and were subjected to impacts by 8 striking techniques. Eleven athletic females completed 5 slashing techniques, while physical reconstruction equipment was used to simulate falls and shoulder and ball impacts to the head. Three trials were conducted for each condition, and peak resultant linear and angular accelerations of the headform were measured. RESULTS: Falls produced the highest linear and angular acceleration, followed by ball and high-velocity stick impacts. Low-velocity stick impacts were found to produce the lowest linear and angular accelerations. Men's lacrosse helmets significantly decreased linear and angular accelerations in all conditions, while unhelmeted impacts were associated with high accelerations. CONCLUSION: If women's field lacrosse is played within the rules, only falls were found to produce high linear and angular acceleration. However, ball and high-velocity stick impacts were found to produce high linear and angular accelerations. These linear and angular accelerations were found to be within the ranges reported for concussion. When the game is not played within the rules, men's lacrosse helmets provide an effective method of reducing linear and angular accelerations. Thus, women's field lacrosse may be able to reduce the occurrence of high linear and angular acceleration impacts by having governing bodies improving rules, implementing the use of helmets, or both. CLINICAL RELEVANCE: Identifying striking techniques that produce high linear and angular acceleration specific to women's lacrosse and measuring the capacity of a men's lacrosse helmet to reduce linear and angular acceleration.Copyright © 2016 The Author(s).},
keywords = {*Brain Injuries/pc [Prevention \& Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Lucke-Wold, B P; Turner, R C; Logsdon, A F; Nguyen, L; Bailes, J E; Lee, J M; Robson, M J; Omalu, B I; Huber, J D; Rosen, C L
Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy Journal Article
In: Journal of Neurosurgery, vol. 124, no. 3, pp. 687–702, 2016.
Abstract | BibTeX | Tags: *Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley
@article{Lucke-Wold2016,
title = {Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy},
author = {Lucke-Wold, B P and Turner, R C and Logsdon, A F and Nguyen, L and Bailes, J E and Lee, J M and Robson, M J and Omalu, B I and Huber, J D and Rosen, C L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery},
volume = {124},
number = {3},
pages = {687--702},
abstract = {OBJECTIVE: Chronic traumatic encephalopathy is a progressive neurodegenerative disease characterized by neurofibrillary tau tangles following repetitive neurotrauma. The underlying mechanism linking traumatic brain injury to chronic traumatic encephalopathy has not been elucidated. The authors investigate the role of endoplasmic reticulum stress as a link between acute neurotrauma and chronic neurodegeneration. METHODS: The authors used pharmacological, biochemical, and behavioral tools to assess the role of endoplasmic reticulum stress in linking acute repetitive traumatic brain injury to the development of chronic neurodegeneration. Data from the authors' clinically relevant and validated rodent blast model were compared with those obtained from postmortem human chronic traumatic encephalopathy specimens from a National Football League player and World Wrestling Entertainment wrestler. RESULTS: The results demonstrated strong correlation of endoplasmic reticulum stress activation with subsequent tau hyperphosphorylation. Various endoplasmic reticulum stress markers were increased in human chronic traumatic encephalopathy specimens, and the endoplasmic reticulum stress response was associated with an increase in the tau kinase, glycogen synthase kinase-3beta. Docosahexaenoic acid, an endoplasmic reticulum stress inhibitor, improved cognitive performance in the rat model 3 weeks after repetitive blast exposure. The data showed that docosahexaenoic acid administration substantially reduced tau hyperphosphorylation (t = 4.111, p \< 0.05), improved cognition (t = 6.532, p \< 0.001), and inhibited C/EBP homology protein activation (t = 5.631, p \< 0.01). Additionally the data showed, for the first time, that endoplasmic reticulum stress is involved in the pathophysiology of chronic traumatic encephalopathy. CONCLUSIONS: Docosahexaenoic acid therefore warrants further investigation as a potential therapeutic agent for the prevention of chronic traumatic encephalopathy.},
keywords = {*Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley},
pubstate = {published},
tppubtype = {article}
}
Underwood, E
NEUROSCIENCE. Can brain scans reveal concussion-linked disease? Journal Article
In: Science, vol. 352, no. 6288, pp. 881, 2016.
BibTeX | Tags: *Brain Concussion/co [Complications], *Brain Injury, *Neuroimaging/mt [Methods], *Positron-Emission Tomography/mt [Methods], *tau Proteins/an [Analysis], 0 (7-(6-fluoropyridin-3-yl)-5H-pyrido(4, 0 (Carbolines), 0 (tau Proteins), 3-b)indole, adult, Carbolines/pk [Pharmacokinetics], Chronic/di [Diagnosis], Chronic/et [Etiology], Humans
@article{Underwood2016,
title = {NEUROSCIENCE. Can brain scans reveal concussion-linked disease?},
author = {Underwood, E},
year = {2016},
date = {2016-01-01},
journal = {Science},
volume = {352},
number = {6288},
pages = {881},
keywords = {*Brain Concussion/co [Complications], *Brain Injury, *Neuroimaging/mt [Methods], *Positron-Emission Tomography/mt [Methods], *tau Proteins/an [Analysis], 0 (7-(6-fluoropyridin-3-yl)-5H-pyrido(4, 0 (Carbolines), 0 (tau Proteins), 3-b)indole, adult, Carbolines/pk [Pharmacokinetics], Chronic/di [Diagnosis], Chronic/et [Etiology], Humans},
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}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
Abstract | Links | BibTeX | Tags: adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L
In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.
Abstract | Links | BibTeX | Tags: 2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult
@article{Dretsch2015a,
title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},
author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},
doi = {10.1089/neu.2014.3637},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {16},
pages = {1217--1222},
abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},
keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Mayer, A R; Ling, J M; Dodd, A B; Gasparovic, C; Klimaj, S D; Meier, T B
A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters Journal Article
In: Journal of Neurotrauma, vol. 32, no. 22, pp. 1759–1767, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult
@article{Mayer2015b,
title = {A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters},
author = {Mayer, A R and Ling, J M and Dodd, A B and Gasparovic, C and Klimaj, S D and Meier, T B},
doi = {10.1089/neu.2014.3833},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {22},
pages = {1759--1767},
abstract = {Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p \> 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples. © Mary Ann Liebert, Inc. 2015.},
keywords = {Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
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}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Smith, A M; Stuart, M J; Dodick, D W; Roberts, W O; Alford, P W; Ashare, A B; Aubrey, M; Benson, B W; Burke, C J; Dick, R; Eickhoff, C; Emery, C A; Flashman, L A; Gaz, D; Giza, C C; Greenwald, R M; Herring, S; Hoshizaki, T B; Hudziak, J J; Huston 3rd, J; Krause, D; LaVoi, N; Leaf, M; Leddy, J J; MacPherson, A; McKee, A C; Mihalik, J P; Moessner, A M; Montelpare, W J; Putukian, M; Schneider, K J; Szalkowski, R; Tabrum, M; Whitehead, J; Wiese-Bjornstal, D M
Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379] Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 78–87, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/pc [Prevention & Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention & Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention & Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult
@article{Smith2015a,
title = {Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379]},
author = {Smith, A M and Stuart, M J and Dodick, D W and Roberts, W O and Alford, P W and Ashare, A B and Aubrey, M and Benson, B W and Burke, C J and Dick, R and Eickhoff, C and Emery, C A and Flashman, L A and Gaz, D and Giza, C C and Greenwald, R M and Herring, S and Hoshizaki, T B and Hudziak, J J and {Huston 3rd}, J and Krause, D and LaVoi, N and Leaf, M and Leddy, J J and MacPherson, A and McKee, A C and Mihalik, J P and Moessner, A M and Montelpare, W J and Putukian, M and Schneider, K J and Szalkowski, R and Tabrum, M and Whitehead, J and Wiese-Bjornstal, D M},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {78--87},
abstract = {OBJECTIVE: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards; and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit includes the following: (1) eliminate head hits from all levels of ice hockey, (2) change body-checking policies, and (3) eliminate fighting in all amateur and professional hockey.},
keywords = {*Brain Concussion/pc [Prevention \& Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention \& Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention \& Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Gardner, A J; Tan, C O; Ainslie, P N; Van Donkelaar, P; Stanwell, P; Levi, C R; Iverson, G L
Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 16, pp. 1050–1055, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Athletic Injuries, brain circulation, brain concussion, case control study, Case-Control Studies, Cerebrovascular Circulation, Doppler, echography, Female, human, Humans, Male, Pathophysiology, PHYSIOLOGY, sport injury, Transcranial, transcranial Doppler ultrasonography, Ultrasonography, Young Adult
@article{Gardner2015bb,
title = {Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review},
author = {Gardner, A J and Tan, C O and Ainslie, P N and {Van Donkelaar}, P and Stanwell, P and Levi, C R and Iverson, G L},
doi = {10.1136/bjsports-2014-093901},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {16},
pages = {1050--1055},
abstract = {Background: Traumatic brain injury influences regulation of cerebral blood flow in animal models and in human studies. We reviewed the use of transcranial Doppler ultrasound (US) to monitor cerebrovascular reactivity following sport-related concussion. Review method: A narrative and systematic review of articles published in the English language, from December 1982 to October 2013. Data sources: Articles were retrieved via numerous databases using relevant key terms. Observational, cohort, correlational, cross-sectional and longitudinal studies were included. Results: Three publications met the criteria for inclusion; these provided data from 42 athletes and 33 controls. All three studies reported reductions in cerebrovascular reactivity via transcranial Doppler US. Conclusions: These initial results support the use of cerebrovascular reactivity as a research tool for identifying altered neurophysiology and monitoring recovery in adult athletes. Larger cross-sectional, prospective and longitudinal studies are required to understand the sensitivity and prognostic value of cerebrovascular reactivity in sport-related concussion. © 2015, BMJ Publishing Group. All rights reserved.},
keywords = {Adolescent, adult, Athletic Injuries, brain circulation, brain concussion, case control study, Case-Control Studies, Cerebrovascular Circulation, Doppler, echography, Female, human, Humans, Male, Pathophysiology, PHYSIOLOGY, sport injury, Transcranial, transcranial Doppler ultrasonography, Ultrasonography, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Olivera, A; Lejbman, N; Jeromin, A; French, L M; Kim, H S; Cashion, A; Mysliwiec, V; Diaz-Arrastia, R; Gill, J
Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment Journal Article
In: JAMA Neurology, vol. 72, no. 10, pp. 1109–1116, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult
@article{Olivera2015,
title = {Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment},
author = {Olivera, A and Lejbman, N and Jeromin, A and French, L M and Kim, H S and Cashion, A and Mysliwiec, V and Diaz-Arrastia, R and Gill, J},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
number = {10},
pages = {1109--1116},
abstract = {IMPORTANCE: Approximately one-third of military personnel who deploy for combat operations sustain 1 or more traumatic brain injuries (TBIs), which increases the risk for chronic symptoms of postconcussive disorder, posttraumatic stress disorder, and depression and for the development of chronic traumatic encephalopathy. Elevated concentrations of tau are observed in blood shortly following a TBI, but, to our knowledge, the role of tau elevations in blood in the onset and maintenance of chronic symptoms after TBI has not been investigated. OBJECTIVES: To assess peripheral tau levels in military personnel exposed to TBI and to examine the relationship between chronic neurological symptoms and tau elevations. DESIGN, SETTING, AND PARTICIPANTS: Observational assessment from September 2012 to August 2014 of US military personnel at the Madigan Army Medical Center who had been deployed within the previous 18 months. Plasma total tau concentrations were measured using a novel ultrasensitive single-molecule enzyme-linked immunosorbent assay. Classification of participants with and without self-reported TBI was made using the Warrior Administered Retrospective Casualty Assessment Tool. Self-reported symptoms of postconcussive disorder, posttraumatic stress disorder, and depression were determined by the Neurobehavioral Symptom Inventory, the Posttraumatic Stress Disorder Checklist Military Version, and the Quick Inventory of Depressive Symptomatology, respectively. Group differences in tau concentrations were determined through analysis of variance models, and area under the receiver operating characteristic curve determined the sensitivity and specificity of tau concentrations in predicting TBI and chronic symptoms. Seventy participants with self-reported TBI on the Warrior Administered Retrospective Casualty Assessment Tool and 28 control participants with no TBI exposure were included. MAIN OUTCOMES AND MEASURES: Concentration of total tau in peripheral blood. RESULTS: Concentrations of plasma tau were significantly elevated in the 70 participants with self-reported TBI compared with the 28 controls (mean [SD], 1.13 [0.78] vs 0.63 [0.48] pg/mL, respectively; F1},
keywords = {*Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Waldron-Perrine, B; Tree, H A; Spencer, R J; Suhr, J; Bieliauskas, L
Informational literature influences symptom expression following mild head injury: An analog study Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1051–1055, 2015.
Abstract | BibTeX | Tags: *Brain Injuries/di [Diagnosis], *Brain Injuries/px [Psychology], *Information Dissemination, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/px [Psychology], adult, Female, Health Communication, Humans, Language, Male, middle aged, Neuropsychological Tests, Post-Traumatic/di [Diagnosis], Stress Disorders, Veterans/px [Psychology], Young Adult
@article{Waldron-Perrine2015,
title = {Informational literature influences symptom expression following mild head injury: An analog study},
author = {Waldron-Perrine, B and Tree, H A and Spencer, R J and Suhr, J and Bieliauskas, L},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1051--1055},
abstract = {PRIMARY OBJECTIVE: Many Veterans involved in recent OEF/OIF conflicts return with reports of having experienced an mTBI. The Veteran's Affairs (VA) and Department of Defense (DoD) have gone to great lengths to provide information to Veterans regarding possible effects of TBI. Although well intended, this information may possibly have an iatrogenic effect. Conversely, setting positive expectations for recovery from mTBI has been shown to result in decreased symptomatology. RESEARCH DESIGN: One-way ANOVA and Tukey post-hoc analyses were used to determine whether there were significant differences on reported severity and number of PCS symptoms (NSI) among the three experimental groups (recovery focused information; expectation for persistent symptoms; and no information given). METHODS AND PROCEDURES: Undergraduate students, who were told to imagine they had experienced a military-related TBI, reported varying levels of expected symptoms when given either positive or negative information about symptom expectation. MAIN OUTCOMES AND RESULTS: The results indicate that presenting recovery-oriented literature resulted in the lowest report of expected symptoms, whereas presenting no information resulted in the highest report of expected symptoms. CONCLUSIONS: Providing Veterans with information regarding a likely positive trajectory of recovery may result in less symptom persistence during rehabilitation.},
keywords = {*Brain Injuries/di [Diagnosis], *Brain Injuries/px [Psychology], *Information Dissemination, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/px [Psychology], adult, Female, Health Communication, Humans, Language, Male, middle aged, Neuropsychological Tests, Post-Traumatic/di [Diagnosis], Stress Disorders, Veterans/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lefebvre, G; Tremblay, S; Théoret, H
Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1032–1043, 2015.
Abstract | Links | BibTeX | Tags: 4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult
@article{Lefebvre2015,
title = {Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex},
author = {Lefebvre, G and Tremblay, S and Th\'{e}oret, H},
doi = {10.3109/02699052.2015.1028447},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1032--1043},
abstract = {Primary objective: The present paper systematically reviews studies using transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to assess cortical excitability, intra-cortical inhibition/facilitation and synaptic plasticity following mild traumatic brain injury (mTBI).Methods: Articles using TMS over M1 in patients with mTBI or sport-related concussion indexed in PubMed and published between 1998 and September 2014 were included in the present review.Main outcomes and results: From the 17 articles that matched search criteria, results from various TMS paradigms were summarized and divided in three main areas of interest: motor cortical excitability/facilitation, motor cortical inhibition and cortical plasticity. Although studies suggest a trend of abnormal intra-cortical inhibition following mTBI, no clear and specific pattern emerges from the surveyed data.Conclusions: At this time and with the possible exception of intra-cortical inhibitory measures, TMS cannot reliably detect changes in M1 excitability in individuals with mTBI or a concussion at both the acute and chronic stages of injury. This may be explained by the small number of studies and large variety of stimulation parameters. Additional longitudinal and multimodal studies are needed to better understand the nature of the excitability changes that may occur within M1 following mTBI. © 2015 Taylor \& Francis Group, LLC.},
keywords = {4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury},
pubstate = {published},
tppubtype = {article}
}
McDevitt, J; Tierney, R T; Phillips, J; Gaughan, J P; Torg, J S; Krynetskiy, E
Association between GRIN2A promoter polymorphism and recovery from concussion Journal Article
In: Brain Injury, vol. 29, no. 13-14, pp. 1674–1681, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat
@article{McDevitt2015,
title = {Association between GRIN2A promoter polymorphism and recovery from concussion},
author = {McDevitt, J and Tierney, R T and Phillips, J and Gaughan, J P and Torg, J S and Krynetskiy, E},
doi = {10.3109/02699052.2015.1075252},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {13-14},
pages = {1674--1681},
abstract = {Objective: To determine genetic variability within the N-methyl-D-aspartate receptor 2A sub-unit (GRIN2A) gene promoter and its association with concussion recovery time. The hypothesis tested was that there would be a difference in allele and/or genotype distribution between two groups of athletes with normal and prolonged recovery.Methods: DNA was extracted from saliva collected from a total of 87 athletes with a physician-diagnosed concussion. The (GT) variable number tandem repeats (VNTR) within the promoter region of GRIN2A was genotyped. The long (L) allele was an allele with ≥25 repeats and the short (S) allele was an allele with \<25 repeats in the GT tract. Participants recovery time was followed prospectively and was categorized as normal (≤60 days) or prolonged (\>60 days).Results: LL carriers were 6-times more likely to recover longer than 60 days following the concussive event (p = 0.0433) when compared to SS carriers. Additionally, L allele carriers were found more frequently in the prolonged recovery group (p = 0.048).Conclusion: Determining genetic influence on concussion recovery will aid in future development of genetic counselling. The clinical relevance of genotyping athletes could improve management of athletes who experience concussion injuries. © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
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}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Dretsch, M N; Slaboda, J C; Johnson, D E; Adam, O R; Tsao, J W
Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 280–286, 2016.
@article{Haran2016b,
title = {Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment},
author = {Haran, F J and Dretsch, M N and Slaboda, J C and Johnson, D E and Adam, O R and Tsao, J W},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {280--286},
abstract = {PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p \< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p \> 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M; Bleiberg, J; Williams, K; Caban, J; Kelly, J; Grammer, G; DeGraba, T
Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 23–29, 2016.
@article{Dretsch2016,
title = {Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI},
author = {Dretsch, M and Bleiberg, J and Williams, K and Caban, J and Kelly, J and Grammer, G and DeGraba, T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {23--29},
abstract = {OBJECTIVE: To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. SETTING: A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. PARTICIPANTS: Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. DESIGN: Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. MAIN MEASURES: Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). RESULTS: All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. CONCLUSION: Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Mez, J; Solomon, T M; Daneshvar, D H; Stein, T D; McKee, A C
Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player Journal Article
In: JAMA Neurology, vol. 73, no. 3, pp. 353–355, 2016.
@article{Mez2016,
title = {Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player},
author = {Mez, J and Solomon, T M and Daneshvar, D H and Stein, T D and McKee, A C},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {3},
pages = {353--355},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D
Association of football subconcussive head impacts with ocular near point of convergence Journal Article
In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.
@article{Kawata2016,
title = {Association of football subconcussive head impacts with ocular near point of convergence},
author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},
doi = {10.1001/jamaophthalmol.2016.1085},
year = {2016},
date = {2016-01-01},
journal = {JAMA Ophthalmology},
volume = {134},
number = {7},
pages = {763--769},
abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {*Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {*Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Dretsch, M N; Slaboda, J C; Johnson, D E; Adam, O R; Tsao, J W
Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 280–286, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values
@article{Haran2016b,
title = {Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment},
author = {Haran, F J and Dretsch, M N and Slaboda, J C and Johnson, D E and Adam, O R and Tsao, J W},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {280--286},
abstract = {PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p \< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p \> 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.},
keywords = {*Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
Abstract | BibTeX | Tags: *Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {*Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
Abstract | BibTeX | Tags: *Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {*Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {*Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M; Bleiberg, J; Williams, K; Caban, J; Kelly, J; Grammer, G; DeGraba, T
Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 23–29, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare
@article{Dretsch2016,
title = {Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI},
author = {Dretsch, M and Bleiberg, J and Williams, K and Caban, J and Kelly, J and Grammer, G and DeGraba, T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {23--29},
abstract = {OBJECTIVE: To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. SETTING: A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. PARTICIPANTS: Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. DESIGN: Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. MAIN MEASURES: Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). RESULTS: All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. CONCLUSION: Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.},
keywords = {*Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization & Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
keywords = {*Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization \& Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
Abstract | Links | BibTeX | Tags: adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
Abstract | Links | BibTeX | Tags: adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {*Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Mez, J; Solomon, T M; Daneshvar, D H; Stein, T D; McKee, A C
Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player Journal Article
In: JAMA Neurology, vol. 73, no. 3, pp. 353–355, 2016.
BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections
@article{Mez2016,
title = {Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player},
author = {Mez, J and Solomon, T M and Daneshvar, D H and Stein, T D and McKee, A C},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {3},
pages = {353--355},
keywords = {*Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections},
pubstate = {published},
tppubtype = {article}
}
Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D
Association of football subconcussive head impacts with ocular near point of convergence Journal Article
In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.
Abstract | Links | BibTeX | Tags: Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult
@article{Kawata2016,
title = {Association of football subconcussive head impacts with ocular near point of convergence},
author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},
doi = {10.1001/jamaophthalmol.2016.1085},
year = {2016},
date = {2016-01-01},
journal = {JAMA Ophthalmology},
volume = {134},
number = {7},
pages = {763--769},
abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},
keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A
English professional football players concussion knowledge and attitude Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.
Abstract | Links | BibTeX | Tags: accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult
@article{Williams2016,
title = {English professional football players concussion knowledge and attitude},
author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},
doi = {10.1016/j.jshs.2015.01.009},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {197--204},
abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},
keywords = {accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Suicide/sn [Statistics & Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {*Brain Concussion/co [Complications], *Suicide/sn [Statistics \& Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
Abstract | BibTeX | Tags: *Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {*Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Auerbach, P S; Waggoner 2nd, W H
It's Time to Change the Rules Journal Article
In: JAMA, vol. 316, no. 12, pp. 1260–1261, 2016.
BibTeX | Tags: *Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States
@article{Auerbach2016,
title = {It's Time to Change the Rules},
author = {Auerbach, P S and {Waggoner 2nd}, W H},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {316},
number = {12},
pages = {1260--1261},
keywords = {*Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Cooper, D B; Vanderploeg, R D
The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension Journal Article
In: Applied Neuropsychology. Adult, vol. 23, no. 4, pp. 264–273, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult
@article{Armistead-Jehle2016,
title = {The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension},
author = {Armistead-Jehle, P and Cooper, D B and Vanderploeg, R D},
year = {2016},
date = {2016-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {23},
number = {4},
pages = {264--273},
abstract = {The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population.},
keywords = {*Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T
Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult
@article{Bailie2016,
title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},
author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {2--12},
abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},
keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},
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}
}
Wu, L C; Nangia, V; Bui, K; Hammoor, B; Kurt, M; Hernandez, F; Kuo, C; Camarillo, D B
In Vivo Evaluation of Wearable Head Impact Sensors Journal Article
In: Annals of Biomedical Engineering, vol. 44, no. 4, pp. 1234–1245, 2016.
Abstract | BibTeX | Tags: *Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording
@article{Wu2016,
title = {In Vivo Evaluation of Wearable Head Impact Sensors},
author = {Wu, L C and Nangia, V and Bui, K and Hammoor, B and Kurt, M and Hernandez, F and Kuo, C and Camarillo, D B},
year = {2016},
date = {2016-01-01},
journal = {Annals of Biomedical Engineering},
volume = {44},
number = {4},
pages = {1234--1245},
abstract = {Inertial sensors are commonly used to measure human head motion. Some sensors have been tested with dummy or cadaver experiments with mixed results, and methods to evaluate sensors in vivo are lacking. Here we present an in vivo method using high speed video to test teeth-mounted (mouthguard), soft tissue-mounted (skin patch), and headgear-mounted (skull cap) sensors during 6-13 g sagittal soccer head impacts. Sensor coupling to the skull was quantified by displacement from an ear-canal reference. Mouthguard displacements were within video measurement error (\<1 mm), while the skin patch and skull cap displaced up to 4 and 13 mm from the ear-canal reference, respectively. We used the mouthguard, which had the least displacement from skull, as the reference to assess 6-degree-of-freedom skin patch and skull cap measurements. Linear and rotational acceleration magnitudes were over-predicted by both the skin patch (with 120% NRMS error for a(mag), 290% for alpha(mag)) and the skull cap (320% NRMS error for a(mag), 500% for alpha(mag)). Such over-predictions were largely due to out-of-plane motion. To model sensor error, we found that in-plane skin patch linear acceleration in the anterior-posterior direction could be modeled by an underdamped viscoelastic system. In summary, the mouthguard showed tighter skull coupling than the other sensor mounting approaches. Furthermore, the in vivo methods presented are valuable for investigating skull acceleration sensor technologies.},
keywords = {*Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording},
pubstate = {published},
tppubtype = {article}
}
Calcagnile, O; Anell, A; Unden, J
The addition of S100B to guidelines for management of mild head injury is potentially cost saving Journal Article
In: BMC Neurology, vol. 16, no. 1, pp. 200, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult
@article{Calcagnile2016,
title = {The addition of S100B to guidelines for management of mild head injury is potentially cost saving},
author = {Calcagnile, O and Anell, A and Unden, J},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
number = {1},
pages = {200},
abstract = {BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study. Patients were followed up after 3 months with a standardized questionnaire. Theoretical and actual cost differences were calculated. RESULTS: Seven hundred twenty-six patients were included and 29 (4.7 %) showed traumatic abnormalities on CT. No further significant intracranial complications were discovered on follow-up. Two hundred twenty-nine patients (27 %) had normal S100B levels and 497 patients (73 %) showed elevated S100B levels. Over-triage occurred in 73 patients (32 %) and under-triage occurred in 39 patients (7 %). No significant intracranial complications were missed. The introduction of S100B could save 71 per patient if guidelines were strictly followed. As compliance to the guidelines was not perfect, the actual cost saving was 39 per patient. CONCLUSION: Adding S100B to existing guidelines for mild TBI seems to reduce CT usage and costs, especially if guideline compliance could be increased.},
keywords = {*Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stern, R A; Tripodis, Y; Baugh, C M; Fritts, N G; Martin, B M; Chaisson, C; Cantu, R C; Joyce, J A; Shah, S; Ikezu, T; Zhang, J; Gercel-Taylor, C; Taylor, D D
Preliminary Study of Plasma Exosomal Tau as a Potential Biomarker for Chronic Traumatic Encephalopathy Journal Article
In: Journal of Alzheimer's Disease, vol. 51, no. 4, pp. 1099–1109, 2016.
Abstract | BibTeX | Tags: *Chronic Traumatic Encephalopathy/bl [Blood], *Extracellular Vesicles/me [Metabolism], *Plasma/cy [Cytology], *tau Proteins/me [Metabolism], 0 (tau Proteins), adult, aged, ANALYSIS of variance, Case-Control Studies, Humans, Male, middle aged
@article{Stern2016,
title = {Preliminary Study of Plasma Exosomal Tau as a Potential Biomarker for Chronic Traumatic Encephalopathy},
author = {Stern, R A and Tripodis, Y and Baugh, C M and Fritts, N G and Martin, B M and Chaisson, C and Cantu, R C and Joyce, J A and Shah, S and Ikezu, T and Zhang, J and Gercel-Taylor, C and Taylor, D D},
year = {2016},
date = {2016-01-01},
journal = {Journal of Alzheimer's Disease},
volume = {51},
number = {4},
pages = {1099--1109},
abstract = {BACKGROUND: Chronic traumatic encephalopathy (CTE) is a tauopathy associated with prior exposure to repetitive head impacts, such as those incurred through American football and other collision sports. Diagnosis is made through neuropathological examination. Many of the clinical features of CTE are common in the general population, with and without a history of head impact exposure, making clinical diagnosis difficult. As is now common in the diagnosis of other neurodegenerative disorders, such as Alzheimer's disease, there is a need for methods to diagnose CTE during life through objective biomarkers. OBJECTIVE: The aim of this study was to examine tau-positive exosomes in plasma as a potential CTE biomarker. METHODS: Subjects were 78 former National Football League (NFL) players and 16 controls. Extracellular vesicles were isolated from plasma. Fluorescent nanoparticle tracking analysis was used to determine the number of vesicles staining positive for tau. RESULTS: The NFL group had higher exosomal tau than the control group (p \< 0.0001). Exosomal tau discriminated between the groups, with 82% sensitivity, 100% specificity, 100% positive predictive value, and 53% negative predictive value. Within the NFL group, higher exosomal tau was associated with worse performance on tests of memory (p = 0.0126) and psychomotor speed (p = 0.0093). CONCLUSION: These preliminary findings suggest that exosomal tau in plasma may be an accurate, noninvasive CTE biomarker.},
keywords = {*Chronic Traumatic Encephalopathy/bl [Blood], *Extracellular Vesicles/me [Metabolism], *Plasma/cy [Cytology], *tau Proteins/me [Metabolism], 0 (tau Proteins), adult, aged, ANALYSIS of variance, Case-Control Studies, Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Clark, J M; Hoshizaki, T B
The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1047–1055, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/pc [Prevention & Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male
@article{Clark2016,
title = {The Ability of Men's Lacrosse Helmets to Reduce the Dynamic Impact Response for Different Striking Techniques in Women's Field Lacrosse},
author = {Clark, J M and Hoshizaki, T B},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1047--1055},
abstract = {BACKGROUND: Women's field lacrosse is described as a noncontact game relying primarily on rules to decrease the risk of head injuries. Despite not allowing head contact, however, concussions continue to be reported in women's field lacrosse. PURPOSE: To assess the ability of men's lacrosse helmets to decrease linear and angular acceleration for different striking techniques in women's field lacrosse. STUDY DESIGN: Controlled laboratory study. METHODS: A helmeted and unhelmeted Hybrid III 50th Percentile headform was attached to a Hybrid III neckform and were subjected to impacts by 8 striking techniques. Eleven athletic females completed 5 slashing techniques, while physical reconstruction equipment was used to simulate falls and shoulder and ball impacts to the head. Three trials were conducted for each condition, and peak resultant linear and angular accelerations of the headform were measured. RESULTS: Falls produced the highest linear and angular acceleration, followed by ball and high-velocity stick impacts. Low-velocity stick impacts were found to produce the lowest linear and angular accelerations. Men's lacrosse helmets significantly decreased linear and angular accelerations in all conditions, while unhelmeted impacts were associated with high accelerations. CONCLUSION: If women's field lacrosse is played within the rules, only falls were found to produce high linear and angular acceleration. However, ball and high-velocity stick impacts were found to produce high linear and angular accelerations. These linear and angular accelerations were found to be within the ranges reported for concussion. When the game is not played within the rules, men's lacrosse helmets provide an effective method of reducing linear and angular accelerations. Thus, women's field lacrosse may be able to reduce the occurrence of high linear and angular acceleration impacts by having governing bodies improving rules, implementing the use of helmets, or both. CLINICAL RELEVANCE: Identifying striking techniques that produce high linear and angular acceleration specific to women's lacrosse and measuring the capacity of a men's lacrosse helmet to reduce linear and angular acceleration.Copyright © 2016 The Author(s).},
keywords = {*Brain Injuries/pc [Prevention \& Control], *Head Protective Devices, *Materials Testing, *Racquet Sports/in [Injuries], *Sports Equipment, adult, Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Lucke-Wold, B P; Turner, R C; Logsdon, A F; Nguyen, L; Bailes, J E; Lee, J M; Robson, M J; Omalu, B I; Huber, J D; Rosen, C L
Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy Journal Article
In: Journal of Neurosurgery, vol. 124, no. 3, pp. 687–702, 2016.
Abstract | BibTeX | Tags: *Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley
@article{Lucke-Wold2016,
title = {Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy},
author = {Lucke-Wold, B P and Turner, R C and Logsdon, A F and Nguyen, L and Bailes, J E and Lee, J M and Robson, M J and Omalu, B I and Huber, J D and Rosen, C L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery},
volume = {124},
number = {3},
pages = {687--702},
abstract = {OBJECTIVE: Chronic traumatic encephalopathy is a progressive neurodegenerative disease characterized by neurofibrillary tau tangles following repetitive neurotrauma. The underlying mechanism linking traumatic brain injury to chronic traumatic encephalopathy has not been elucidated. The authors investigate the role of endoplasmic reticulum stress as a link between acute neurotrauma and chronic neurodegeneration. METHODS: The authors used pharmacological, biochemical, and behavioral tools to assess the role of endoplasmic reticulum stress in linking acute repetitive traumatic brain injury to the development of chronic neurodegeneration. Data from the authors' clinically relevant and validated rodent blast model were compared with those obtained from postmortem human chronic traumatic encephalopathy specimens from a National Football League player and World Wrestling Entertainment wrestler. RESULTS: The results demonstrated strong correlation of endoplasmic reticulum stress activation with subsequent tau hyperphosphorylation. Various endoplasmic reticulum stress markers were increased in human chronic traumatic encephalopathy specimens, and the endoplasmic reticulum stress response was associated with an increase in the tau kinase, glycogen synthase kinase-3beta. Docosahexaenoic acid, an endoplasmic reticulum stress inhibitor, improved cognitive performance in the rat model 3 weeks after repetitive blast exposure. The data showed that docosahexaenoic acid administration substantially reduced tau hyperphosphorylation (t = 4.111, p \< 0.05), improved cognition (t = 6.532, p \< 0.001), and inhibited C/EBP homology protein activation (t = 5.631, p \< 0.01). Additionally the data showed, for the first time, that endoplasmic reticulum stress is involved in the pathophysiology of chronic traumatic encephalopathy. CONCLUSIONS: Docosahexaenoic acid therefore warrants further investigation as a potential therapeutic agent for the prevention of chronic traumatic encephalopathy.},
keywords = {*Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley},
pubstate = {published},
tppubtype = {article}
}
Underwood, E
NEUROSCIENCE. Can brain scans reveal concussion-linked disease? Journal Article
In: Science, vol. 352, no. 6288, pp. 881, 2016.
BibTeX | Tags: *Brain Concussion/co [Complications], *Brain Injury, *Neuroimaging/mt [Methods], *Positron-Emission Tomography/mt [Methods], *tau Proteins/an [Analysis], 0 (7-(6-fluoropyridin-3-yl)-5H-pyrido(4, 0 (Carbolines), 0 (tau Proteins), 3-b)indole, adult, Carbolines/pk [Pharmacokinetics], Chronic/di [Diagnosis], Chronic/et [Etiology], Humans
@article{Underwood2016,
title = {NEUROSCIENCE. Can brain scans reveal concussion-linked disease?},
author = {Underwood, E},
year = {2016},
date = {2016-01-01},
journal = {Science},
volume = {352},
number = {6288},
pages = {881},
keywords = {*Brain Concussion/co [Complications], *Brain Injury, *Neuroimaging/mt [Methods], *Positron-Emission Tomography/mt [Methods], *tau Proteins/an [Analysis], 0 (7-(6-fluoropyridin-3-yl)-5H-pyrido(4, 0 (Carbolines), 0 (tau Proteins), 3-b)indole, adult, Carbolines/pk [Pharmacokinetics], Chronic/di [Diagnosis], Chronic/et [Etiology], Humans},
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}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
Abstract | Links | BibTeX | Tags: adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L
In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.
Abstract | Links | BibTeX | Tags: 2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult
@article{Dretsch2015a,
title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},
author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},
doi = {10.1089/neu.2014.3637},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {16},
pages = {1217--1222},
abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},
keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Mayer, A R; Ling, J M; Dodd, A B; Gasparovic, C; Klimaj, S D; Meier, T B
A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters Journal Article
In: Journal of Neurotrauma, vol. 32, no. 22, pp. 1759–1767, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult
@article{Mayer2015b,
title = {A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters},
author = {Mayer, A R and Ling, J M and Dodd, A B and Gasparovic, C and Klimaj, S D and Meier, T B},
doi = {10.1089/neu.2014.3833},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {22},
pages = {1759--1767},
abstract = {Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p \> 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples. © Mary Ann Liebert, Inc. 2015.},
keywords = {Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
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}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Smith, A M; Stuart, M J; Dodick, D W; Roberts, W O; Alford, P W; Ashare, A B; Aubrey, M; Benson, B W; Burke, C J; Dick, R; Eickhoff, C; Emery, C A; Flashman, L A; Gaz, D; Giza, C C; Greenwald, R M; Herring, S; Hoshizaki, T B; Hudziak, J J; Huston 3rd, J; Krause, D; LaVoi, N; Leaf, M; Leddy, J J; MacPherson, A; McKee, A C; Mihalik, J P; Moessner, A M; Montelpare, W J; Putukian, M; Schneider, K J; Szalkowski, R; Tabrum, M; Whitehead, J; Wiese-Bjornstal, D M
Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379] Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 78–87, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/pc [Prevention & Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention & Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention & Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult
@article{Smith2015a,
title = {Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379]},
author = {Smith, A M and Stuart, M J and Dodick, D W and Roberts, W O and Alford, P W and Ashare, A B and Aubrey, M and Benson, B W and Burke, C J and Dick, R and Eickhoff, C and Emery, C A and Flashman, L A and Gaz, D and Giza, C C and Greenwald, R M and Herring, S and Hoshizaki, T B and Hudziak, J J and {Huston 3rd}, J and Krause, D and LaVoi, N and Leaf, M and Leddy, J J and MacPherson, A and McKee, A C and Mihalik, J P and Moessner, A M and Montelpare, W J and Putukian, M and Schneider, K J and Szalkowski, R and Tabrum, M and Whitehead, J and Wiese-Bjornstal, D M},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {78--87},
abstract = {OBJECTIVE: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards; and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit includes the following: (1) eliminate head hits from all levels of ice hockey, (2) change body-checking policies, and (3) eliminate fighting in all amateur and professional hockey.},
keywords = {*Brain Concussion/pc [Prevention \& Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention \& Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention \& Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Gardner, A J; Tan, C O; Ainslie, P N; Van Donkelaar, P; Stanwell, P; Levi, C R; Iverson, G L
Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 16, pp. 1050–1055, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Athletic Injuries, brain circulation, brain concussion, case control study, Case-Control Studies, Cerebrovascular Circulation, Doppler, echography, Female, human, Humans, Male, Pathophysiology, PHYSIOLOGY, sport injury, Transcranial, transcranial Doppler ultrasonography, Ultrasonography, Young Adult
@article{Gardner2015bb,
title = {Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review},
author = {Gardner, A J and Tan, C O and Ainslie, P N and {Van Donkelaar}, P and Stanwell, P and Levi, C R and Iverson, G L},
doi = {10.1136/bjsports-2014-093901},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {16},
pages = {1050--1055},
abstract = {Background: Traumatic brain injury influences regulation of cerebral blood flow in animal models and in human studies. We reviewed the use of transcranial Doppler ultrasound (US) to monitor cerebrovascular reactivity following sport-related concussion. Review method: A narrative and systematic review of articles published in the English language, from December 1982 to October 2013. Data sources: Articles were retrieved via numerous databases using relevant key terms. Observational, cohort, correlational, cross-sectional and longitudinal studies were included. Results: Three publications met the criteria for inclusion; these provided data from 42 athletes and 33 controls. All three studies reported reductions in cerebrovascular reactivity via transcranial Doppler US. Conclusions: These initial results support the use of cerebrovascular reactivity as a research tool for identifying altered neurophysiology and monitoring recovery in adult athletes. Larger cross-sectional, prospective and longitudinal studies are required to understand the sensitivity and prognostic value of cerebrovascular reactivity in sport-related concussion. © 2015, BMJ Publishing Group. All rights reserved.},
keywords = {Adolescent, adult, Athletic Injuries, brain circulation, brain concussion, case control study, Case-Control Studies, Cerebrovascular Circulation, Doppler, echography, Female, human, Humans, Male, Pathophysiology, PHYSIOLOGY, sport injury, Transcranial, transcranial Doppler ultrasonography, Ultrasonography, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Olivera, A; Lejbman, N; Jeromin, A; French, L M; Kim, H S; Cashion, A; Mysliwiec, V; Diaz-Arrastia, R; Gill, J
Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment Journal Article
In: JAMA Neurology, vol. 72, no. 10, pp. 1109–1116, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult
@article{Olivera2015,
title = {Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment},
author = {Olivera, A and Lejbman, N and Jeromin, A and French, L M and Kim, H S and Cashion, A and Mysliwiec, V and Diaz-Arrastia, R and Gill, J},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
number = {10},
pages = {1109--1116},
abstract = {IMPORTANCE: Approximately one-third of military personnel who deploy for combat operations sustain 1 or more traumatic brain injuries (TBIs), which increases the risk for chronic symptoms of postconcussive disorder, posttraumatic stress disorder, and depression and for the development of chronic traumatic encephalopathy. Elevated concentrations of tau are observed in blood shortly following a TBI, but, to our knowledge, the role of tau elevations in blood in the onset and maintenance of chronic symptoms after TBI has not been investigated. OBJECTIVES: To assess peripheral tau levels in military personnel exposed to TBI and to examine the relationship between chronic neurological symptoms and tau elevations. DESIGN, SETTING, AND PARTICIPANTS: Observational assessment from September 2012 to August 2014 of US military personnel at the Madigan Army Medical Center who had been deployed within the previous 18 months. Plasma total tau concentrations were measured using a novel ultrasensitive single-molecule enzyme-linked immunosorbent assay. Classification of participants with and without self-reported TBI was made using the Warrior Administered Retrospective Casualty Assessment Tool. Self-reported symptoms of postconcussive disorder, posttraumatic stress disorder, and depression were determined by the Neurobehavioral Symptom Inventory, the Posttraumatic Stress Disorder Checklist Military Version, and the Quick Inventory of Depressive Symptomatology, respectively. Group differences in tau concentrations were determined through analysis of variance models, and area under the receiver operating characteristic curve determined the sensitivity and specificity of tau concentrations in predicting TBI and chronic symptoms. Seventy participants with self-reported TBI on the Warrior Administered Retrospective Casualty Assessment Tool and 28 control participants with no TBI exposure were included. MAIN OUTCOMES AND MEASURES: Concentration of total tau in peripheral blood. RESULTS: Concentrations of plasma tau were significantly elevated in the 70 participants with self-reported TBI compared with the 28 controls (mean [SD], 1.13 [0.78] vs 0.63 [0.48] pg/mL, respectively; F1},
keywords = {*Brain Concussion/me [Metabolism], *Brain Injuries/me [Metabolism], *Depression/me [Metabolism], *Military Personnel, *Stress Disorders, *tau Proteins/bl [Blood], 0 (tau Proteins), 2003-2011, adult, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Depression/co [Complications], Depression/di [Diagnosis], Female, Humans, Iraq War, Male, Post-Traumatic/di [Diagnosis], Post-Traumatic/me [Metabolism], Retrospective Studies, self report, Stress Disorders, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Waldron-Perrine, B; Tree, H A; Spencer, R J; Suhr, J; Bieliauskas, L
Informational literature influences symptom expression following mild head injury: An analog study Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1051–1055, 2015.
Abstract | BibTeX | Tags: *Brain Injuries/di [Diagnosis], *Brain Injuries/px [Psychology], *Information Dissemination, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/px [Psychology], adult, Female, Health Communication, Humans, Language, Male, middle aged, Neuropsychological Tests, Post-Traumatic/di [Diagnosis], Stress Disorders, Veterans/px [Psychology], Young Adult
@article{Waldron-Perrine2015,
title = {Informational literature influences symptom expression following mild head injury: An analog study},
author = {Waldron-Perrine, B and Tree, H A and Spencer, R J and Suhr, J and Bieliauskas, L},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1051--1055},
abstract = {PRIMARY OBJECTIVE: Many Veterans involved in recent OEF/OIF conflicts return with reports of having experienced an mTBI. The Veteran's Affairs (VA) and Department of Defense (DoD) have gone to great lengths to provide information to Veterans regarding possible effects of TBI. Although well intended, this information may possibly have an iatrogenic effect. Conversely, setting positive expectations for recovery from mTBI has been shown to result in decreased symptomatology. RESEARCH DESIGN: One-way ANOVA and Tukey post-hoc analyses were used to determine whether there were significant differences on reported severity and number of PCS symptoms (NSI) among the three experimental groups (recovery focused information; expectation for persistent symptoms; and no information given). METHODS AND PROCEDURES: Undergraduate students, who were told to imagine they had experienced a military-related TBI, reported varying levels of expected symptoms when given either positive or negative information about symptom expectation. MAIN OUTCOMES AND RESULTS: The results indicate that presenting recovery-oriented literature resulted in the lowest report of expected symptoms, whereas presenting no information resulted in the highest report of expected symptoms. CONCLUSIONS: Providing Veterans with information regarding a likely positive trajectory of recovery may result in less symptom persistence during rehabilitation.},
keywords = {*Brain Injuries/di [Diagnosis], *Brain Injuries/px [Psychology], *Information Dissemination, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/px [Psychology], adult, Female, Health Communication, Humans, Language, Male, middle aged, Neuropsychological Tests, Post-Traumatic/di [Diagnosis], Stress Disorders, Veterans/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lefebvre, G; Tremblay, S; Théoret, H
Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1032–1043, 2015.
Abstract | Links | BibTeX | Tags: 4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult
@article{Lefebvre2015,
title = {Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex},
author = {Lefebvre, G and Tremblay, S and Th\'{e}oret, H},
doi = {10.3109/02699052.2015.1028447},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1032--1043},
abstract = {Primary objective: The present paper systematically reviews studies using transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to assess cortical excitability, intra-cortical inhibition/facilitation and synaptic plasticity following mild traumatic brain injury (mTBI).Methods: Articles using TMS over M1 in patients with mTBI or sport-related concussion indexed in PubMed and published between 1998 and September 2014 were included in the present review.Main outcomes and results: From the 17 articles that matched search criteria, results from various TMS paradigms were summarized and divided in three main areas of interest: motor cortical excitability/facilitation, motor cortical inhibition and cortical plasticity. Although studies suggest a trend of abnormal intra-cortical inhibition following mTBI, no clear and specific pattern emerges from the surveyed data.Conclusions: At this time and with the possible exception of intra-cortical inhibitory measures, TMS cannot reliably detect changes in M1 excitability in individuals with mTBI or a concussion at both the acute and chronic stages of injury. This may be explained by the small number of studies and large variety of stimulation parameters. Additional longitudinal and multimodal studies are needed to better understand the nature of the excitability changes that may occur within M1 following mTBI. © 2015 Taylor \& Francis Group, LLC.},
keywords = {4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury},
pubstate = {published},
tppubtype = {article}
}
McDevitt, J; Tierney, R T; Phillips, J; Gaughan, J P; Torg, J S; Krynetskiy, E
Association between GRIN2A promoter polymorphism and recovery from concussion Journal Article
In: Brain Injury, vol. 29, no. 13-14, pp. 1674–1681, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat
@article{McDevitt2015,
title = {Association between GRIN2A promoter polymorphism and recovery from concussion},
author = {McDevitt, J and Tierney, R T and Phillips, J and Gaughan, J P and Torg, J S and Krynetskiy, E},
doi = {10.3109/02699052.2015.1075252},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {13-14},
pages = {1674--1681},
abstract = {Objective: To determine genetic variability within the N-methyl-D-aspartate receptor 2A sub-unit (GRIN2A) gene promoter and its association with concussion recovery time. The hypothesis tested was that there would be a difference in allele and/or genotype distribution between two groups of athletes with normal and prolonged recovery.Methods: DNA was extracted from saliva collected from a total of 87 athletes with a physician-diagnosed concussion. The (GT) variable number tandem repeats (VNTR) within the promoter region of GRIN2A was genotyped. The long (L) allele was an allele with ≥25 repeats and the short (S) allele was an allele with \<25 repeats in the GT tract. Participants recovery time was followed prospectively and was categorized as normal (≤60 days) or prolonged (\>60 days).Results: LL carriers were 6-times more likely to recover longer than 60 days following the concussive event (p = 0.0433) when compared to SS carriers. Additionally, L allele carriers were found more frequently in the prolonged recovery group (p = 0.048).Conclusion: Determining genetic influence on concussion recovery will aid in future development of genetic counselling. The clinical relevance of genotyping athletes could improve management of athletes who experience concussion injuries. © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat},
pubstate = {published},
tppubtype = {article}
}