References – Sports Concussion Library

2016

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}

}

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.

Laker, S R; Meron, A; Greher, M R; Wilson, J

Retirement and Activity Restrictions Following Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.

Links | BibTeX | Tags: Activity restrictions, athlete, attention deficit disorder, brain concussion, Concussion, CONVALESCENCE, depression, human, learning disorder, migraine, neuropsychological test, nonhuman, PHYSICAL ACTIVITY, postconcussion syndrome, practice guideline, priority journal, Retirement, return to sport, Review, risk factor, sleep disorder, sport injury, Sport-related concussion, subarachnoid hemorrhage, symptom, traumatic brain injury, unconsciousness

Kontos, A P; Sufrinko, A; Womble, M; Kegel, N

Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion Journal Article

In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.

Abstract | Links | BibTeX | Tags: Baseline, brain function, Computerized assessment battery, computerized neuropsychological test, Concussion, evidence based practice, human, MEDICAL research, Neurocognitive tests, Neuropsychological evaluation, neuropsychological test, paper and pencil neuropsychological test, psychologic assessment, reliability, Review, Sport, TASK performance

@article{Kontos2016b,

title = {Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion},

author = {Kontos, A P and Sufrinko, A and Womble, M and Kegel, N},

doi = {10.1007/s11916-016-0571-y},

year  = {2016},

date = {2016-01-01},

journal = {Current Pain \& Headache Reports},

volume = {20},

number = {6},

abstract = {Neuropsychological evaluation is one component of a comprehensive and multifaceted assessment following concussion. Although some neuropsychologists use a “hybrid” assessment approach integrating computerized neurocognitive testing batteries with traditional paper and pencil tests, computerized neurocognitive test batteries are the predominant testing modality for assessment of athletes from the youth to professional level. This review summarizes the most recent research supporting the utility of neuropsychological evaluation and highlights the strengths and weaknesses of both computerized and traditional neuropsychological testing approaches. The most up to date research and guidelines on baseline neurocognitive testing is also discussed. This paper addresses concerns regarding reliability of neuropsychological testing while providing an overview of factors that influence test performance, both transient situational factors (e.g., pain level, anxiety) and characteristics of particular subgroups (e.g., age, preexisting learning disabilities), warranting the expertise of an experienced neuropsychologist for interpretation. Currently, research is moving forward by integrating neuropsychological evaluation with emerging assessment approaches for other domains of brain function (e.g., vestibular function) vulnerable to concussion. © 2016, Springer Science+Business Media New York.},

keywords = {Baseline, brain function, Computerized assessment battery, computerized neuropsychological test, Concussion, evidence based practice, human, MEDICAL research, Neurocognitive tests, Neuropsychological evaluation, neuropsychological test, paper and pencil neuropsychological test, psychologic assessment, reliability, Review, Sport, TASK performance},

pubstate = {published},

tppubtype = {article}

}

Hyden, J; Petty, B

Sideline Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 395–409, 2016.

Links | BibTeX | Tags: anamnesis, athlete, Balance, Balance Error Scoring System, brain concussion, Concussion, Electroencephalography, human, King Devick Test, neurologic examination, neuropsychological test, Physical Examination, priority journal, response time, Review, SCAT3, scoring system, sensor, Sensory Organization Test, Sideline, sport concussion assessment tool, Standardized Assessment of Concussion, symptom, Symptom scale, virtual reality, Vision

Connery, A K; Peterson, R L; Baker, D A; Randolph, C; Kirkwood, M W

The Role of Neuropsychological Evaluation in the Clinical Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 475–486, 2016.

Links | BibTeX | Tags: brain concussion, childhood injury, CONVALESCENCE, health care access, health care delivery, human, medical history, mild TBI, Neuropsychological assessment, neuropsychological test, postconcussion syndrome, priority journal, return to sport, Review, risk factor, traumatic brain injury, validity

2015

Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K

Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article

In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends

@article{Vassilyadi2015,

title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},

author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},

doi = {10.1159/000431232},

year  = {2015},

date = {2015-01-01},

journal = {Pediatric Neurosurgery},

volume = {50},

number = {4},

pages = {196--203},

abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},

keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},

pubstate = {published},

tppubtype = {article}

}

Bondi, C O; Semple, B D; Noble-Haeusslein, L J; Osier, N D; Carlson, S W; Dixon, C E; Giza, C C; Kline, A E

Found in translation: Understanding the biology and behavior of experimental traumatic brain injury Journal Article

In: Neuroscience and Biobehavioral Reviews, vol. 58, pp. 123–146, 2015.

Abstract | Links | BibTeX | Tags: 8 hydroxy 2 propylaminotetralin, Aggression, Attentional set-shifting test (AST), buspirone, Closed head injury, cognition, cognitive defect, cognitive function test, Concussion, conditioning, Controlled cortical impact (CCI), environmental enrichment, Environmental enrichment (EE), executive function, experimental disease, fear, Fluid percussion (FP), human, interpersonal communication, Memory, motor function test, nerve degeneration, neuropsychological test, Neurorehabilitation, nonhuman, outcome assessment, Pathophysiology, pediatrics, priority journal, rehabilitation care, Review, rodent, rotarod test, sensorimotor function, Social behavior, social disability, social interaction, spatial learning, TASK performance, traumatic brain injury

@article{Bondi2015,

title = {Found in translation: Understanding the biology and behavior of experimental traumatic brain injury},

author = {Bondi, C O and Semple, B D and Noble-Haeusslein, L J and Osier, N D and Carlson, S W and Dixon, C E and Giza, C C and Kline, A E},

doi = {10.1016/j.neubiorev.2014.12.004},

year  = {2015},

date = {2015-01-01},

journal = {Neuroscience and Biobehavioral Reviews},

volume = {58},

pages = {123--146},

abstract = {The aim of this review is to discuss in greater detail the topics covered in the recent symposium entitled "Traumatic brain injury: laboratory and clinical perspectives," presented at the 2014 International Behavioral Neuroscience Society annual meeting. Herein, we review contemporary laboratory models of traumatic brain injury (TBI) including common assays for sensorimotor and cognitive behavior. New modalities to evaluate social behavior after injury to the developing brain, as well as the attentional set-shifting test (AST) as a measure of executive function in TBI, will be highlighted. Environmental enrichment (EE) will be discussed as a preclinical model of neurorehabilitation, and finally, an evidence-based approach to sports-related concussion will be considered. The review consists predominantly of published data, but some discussion of ongoing or future directions is provided. © 2014 Elsevier Ltd.},

keywords = {8 hydroxy 2 propylaminotetralin, Aggression, Attentional set-shifting test (AST), buspirone, Closed head injury, cognition, cognitive defect, cognitive function test, Concussion, conditioning, Controlled cortical impact (CCI), environmental enrichment, Environmental enrichment (EE), executive function, experimental disease, fear, Fluid percussion (FP), human, interpersonal communication, Memory, motor function test, nerve degeneration, neuropsychological test, Neurorehabilitation, nonhuman, outcome assessment, Pathophysiology, pediatrics, priority journal, rehabilitation care, Review, rodent, rotarod test, sensorimotor function, Social behavior, social disability, social interaction, spatial learning, TASK performance, traumatic brain injury},

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}

}

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.

Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L

No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers Journal Article

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}

}

Zottoli, T M; Hoover, S; Barr, W B

Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases Journal Article

In: Clinical Neuropsychologist, vol. 29, no. 5, pp. 678–688, 2015.

Abstract | Links | BibTeX | Tags: brain concussion, Civil Litigation, Female, human, Humans, IME, Insufficient effort, legislation and jurisprudence, Male, malingering, Malpractice, middle aged, neuropsychological test, Neuropsychological Tests, neuropsychology, Physical Examination, questionnaire, Standardized assessment of concussion (SAC), statistics and numerical data, Surveys and Questionnaires

@article{Zottoli2015,

title = {Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases},

author = {Zottoli, T M and Hoover, S and Barr, W B},

doi = {10.1080/13854046.2015.1062562},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Neuropsychologist},

volume = {29},

number = {5},

pages = {678--688},

abstract = {Objective: The Standardized Assessment of Concussion (SAC) is a standardized mental status screening instrument initially developed for assessment and tracking of concussion symptoms in athletes. The purpose of the current study was to validate the utility of the SAC as an embedded screening measure for insufficient effort in independent medical examinations (IME) and personal injury cases. Method: A known-groups design was used to examine the SACs utility for the detection of insufficient effort in 75 de-identified private IME and civil litigation evaluations. Initial classifications of insufficient effort were made independently of SAC scores, on the basis of having two or more scores falling below established cut-offs on previously validated neuropsychological measures. Results: Results suggest that the total score on the SAC significantly distinguishes effortful respondents from those exhibiting insufficient effort. Empirically derived cut-off scores yielded adequate sensitivity (.62-.95) and negative predictive power (.93-.97). Conclusions: While optimal cut-off scores depend upon intended use, our data suggest that the SAC is useful as a potential screener for insufficient effort, after which one can employ additional measures to rule out false-positives. Further research is required before cut-off scores can be recommended for clinical use. © 2015 Taylor and Francis.},

keywords = {brain concussion, Civil Litigation, Female, human, Humans, IME, Insufficient effort, legislation and jurisprudence, Male, malingering, Malpractice, middle aged, neuropsychological test, Neuropsychological Tests, neuropsychology, Physical Examination, questionnaire, Standardized assessment of concussion (SAC), statistics and numerical data, Surveys and Questionnaires},

pubstate = {published},

tppubtype = {article}

}

Merritt, V C; Meyer, J E; Arnett, P A

A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale Journal Article

In: Journal of Clinical and Experimental Neuropsychology, vol. 37, no. 7, pp. 764–775, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult

@article{Merritt2015b,

title = {A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale},

author = {Merritt, V C and Meyer, J E and Arnett, P A},

doi = {10.1080/13803395.2015.1060950},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Clinical and Experimental Neuropsychology},

volume = {37},

number = {7},

pages = {764--775},

abstract = {Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor \& Francis.},

keywords = {Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor & Francis.

Lucas, S

Posttraumatic Headache: Clinical Characterization and Management Journal Article

In: Current Pain & Headache Reports, vol. 19, no. 10, 2015.

Abstract | Links | BibTeX | Tags: amitriptyline, botulinum toxin A, Brain Injuries, chiropractic, clinical feature, complication, Concussion, diagnostic approach route, disease association, disease classification, disease predisposition, drug efficacy, drug induced headache, evidence based medicine, human, Humans, migraine, neuropsychological test, Neuropsychological Tests, nonsteroid antiinflammatory agent, paracetamol, physiotherapy, Post-traumatic headache, postconcussion syndrome, posttraumatic headache, practice guideline, Prevalence, primary headache, Review, risk factor, Risk Factors, SEVERITY of illness index, sports concussion, symptomatology, tension headache, Tension-type headache, topiramate, traumatic brain injury, treatment response, UNITED States, valproate semisodium

@article{Lucas2015,

title = {Posttraumatic Headache: Clinical Characterization and Management},

author = {Lucas, S},

doi = {10.1007/s11916-015-0520-1},

year  = {2015},

date = {2015-01-01},

journal = {Current Pain \& Headache Reports},

volume = {19},

number = {10},

abstract = {Headache is the most common symptom after traumatic brain injury (TBI). TBI has become a global health concern with an estimated 2.5 million reported TBIs per year in the USA alone. Recent longitudinal studies of posttraumatic headache (PTH) show a high cumulative incidence of 71 % after moderate or severe TBI and an even higher cumulative incidence of 91 % after mild TBI (mTBI) at 1 year after injury. Prevalence remains high at over 44 % throughout the year after moderate or severe TBI and over 54 % after mTBI. A prior history of headache is associated with a higher risk for PTH, whereas older age appears to be protective. Gender does not appear to be a risk factor for PTH. Most PTH has clinical diagnostic criteria meeting that of migraine or probable migraine when primary headache disorder classification criteria are used, followed by tension-type headache. There are no evidence-based treatment guidelines for PTH management; however, expert opinion has suggested treating the PTH using primary headache disorder treatment recommendations according to its type. © 2015, Springer Science+Business Media New York.},

keywords = {amitriptyline, botulinum toxin A, Brain Injuries, chiropractic, clinical feature, complication, Concussion, diagnostic approach route, disease association, disease classification, disease predisposition, drug efficacy, drug induced headache, evidence based medicine, human, Humans, migraine, neuropsychological test, Neuropsychological Tests, nonsteroid antiinflammatory agent, paracetamol, physiotherapy, Post-traumatic headache, postconcussion syndrome, posttraumatic headache, practice guideline, Prevalence, primary headache, Review, risk factor, Risk Factors, SEVERITY of illness index, sports concussion, symptomatology, tension headache, Tension-type headache, topiramate, traumatic brain injury, treatment response, UNITED States, valproate semisodium},

pubstate = {published},

tppubtype = {article}

}

Andre, J B

Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials Journal Article

In: Topics in Magnetic Resonance Imaging, vol. 24, no. 5, pp. 275–287, 2015.

Abstract | BibTeX | Tags: Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter

@article{Andre2015,

title = {Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials},

author = {Andre, J B},

year  = {2015},

date = {2015-01-01},

journal = {Topics in Magnetic Resonance Imaging},

volume = {24},

number = {5},

pages = {275--287},

abstract = {Traumatic brain injury (TBI), including concussion, is a public health concern, as it affects over 1.7 million persons in the United States per year. Yet, the diagnosis of TBI, particularly mild TBI (mTBI), can be controversial, as neuroimaging findings can be sparse on conventional magnetic resonance and computed tomography examinations, and when present, often poorly correlate with clinical signs and symptoms. Furthermore, the discussion of TBI, concussion, and head impact exposure is immediately complicated by the many differing opinions of what constitutes each, their respective severities, and how the underlying biomechanics of the inciting head impact might alter the distribution, severity, and prognosis of the underlying brain injury. Advanced imaging methodologies hold promise in improving the sensitivity and detectability of associated imaging biomarkers that might better correlate with patient outcome and prognostication, allowing for improved triage and therapeutic guidance in the setting of TBI, particularly in mTBI. This work will examine the defining symptom complex associated with mTBI and explore changes in cerebral blood flow measured by arterial spin labeling, as a potential imaging biomarker for TBI, and briefly correlate these observations with findings identified by single photon emission computed tomography and positron emission tomography imaging.. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter},

pubstate = {published},

tppubtype = {article}

}

Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E

Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article

In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.

Abstract | Links | BibTeX | Tags: alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption

@article{Moran2015,

title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},

author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},

doi = {10.14423/SMJ.0000000000000340},

year  = {2015},

date = {2015-01-01},

journal = {Southern Medical Journal},

volume = {108},

number = {9},

pages = {553--558},

abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},

keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},

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}

}

Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M

Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article

In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.

Abstract | Links | BibTeX | Tags: academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome

@article{Alexander2015,

title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},

author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},

doi = {10.3109/02699052.2015.1031699},

year  = {2015},

date = {2015-01-01},

journal = {Brain Injury},

volume = {29},

number = {9},

pages = {1113--1125},

abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},

keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},

pubstate = {published},

tppubtype = {article}

}

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},

pubstate = {published},

tppubtype = {article}

}

Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.

2014

Jordan, B D

Chronic traumatic encephalopathy and other long-term sequelae Journal Article

In: CONTINUUM Lifelong Learning in Neurology, vol. 20, pp. 1588–1604, 2014.

Abstract | Links | BibTeX | Tags: Chronic Traumatic Encephalopathy chronic disease, cognitive defect, diagnostic procedure, human, Incidence, injury severity, laboratory test, medical history, neuroimaging, neurologic examination, neurologist, neuropsychological test, Pathophysiology, postconcussion syndrome, Review, sport injury, symptomatology, traumatic brain injury

@article{Jordan2014,

title = {Chronic traumatic encephalopathy and other long-term sequelae},

author = {Jordan, B D},

url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84927562326\&partnerID=40\&md5=da8cab7e63cee5fa58ae148fa7de9dec},

year  = {2014},

date = {2014-01-01},

journal = {CONTINUUM Lifelong Learning in Neurology},

volume = {20},

pages = {1588--1604},

abstract = {Purpose of Review: Growing public health concern exists over the incidence of chronic traumatic brain injury (TBI) in athletes participating in contact sports. Chronic TBI represents a spectrum of disorders associated with long-term consequences of single or repetitive TBI and includes chronic traumatic encephalopathy (CTE), chronic postconcussion syndrome, and chronic neurocognitive impairment. Neurologists should be familiar with the different types of chronic TBI and their diagnostic criteria. Recent Findings: CTE is the most severe chronic TBI and represents the neurologic consequences of repetitive mild TBI. It is particularly noted among boxers and football players. CTE presents with behavioral, cognitive, and motor symptoms, and can only be definitively diagnosed postmortem. Chronic postconcussion syndrome is defined as postconcussion symptoms that last longer than 1 year and do not appear to resolve; it may develop after a single concussive event. Chronic neurocognitive impairment is an all-encompassing clinical term denoting long-term neurologic sequelae secondary to sports-related trauma and can present either within the postconcussion syndrome or years after a symptom-free interval. Summary: This article discusses the diagnostic evaluation of chronic TBI, including clinical history, neurologic examination, neuropsychological testing, neuroimaging, and laboratory testing, as well as the distinctions between CTE, chronic postconcussion syndrome, and chronic neurocognitive impairment. Neurologic impairment among athletes exposed to repetitive brain injury appears to be a real phenomenon. Because CTE has no established treatment, prevention is of paramount importance for athletes participating in contact sports. © 2014, American Academy of Neurology.},

keywords = {Chronic Traumatic Encephalopathy chronic disease, cognitive defect, diagnostic procedure, human, Incidence, injury severity, laboratory test, medical history, neuroimaging, neurologic examination, neurologist, neuropsychological test, Pathophysiology, postconcussion syndrome, Review, sport injury, symptomatology, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

2013

Anonymous,

SCAT3 Journal Article

In: British Journal of Sports Medicine, vol. 47, no. 5, pp. 259, 2013, ISBN: 1473-0480.

BibTeX | Tags: Assessment/Testing article, ataxia, body equilibrium, brain concussion, cognitive defect, emergency treatment, human, injury scale, memory disorder, METHODOLOGY, neurologic examination, neuropsychological test, Physical Examination, questionnaire, sport injury, unconsciousness

Reference Search

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

@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 = {},

pubstate = {published},

tppubtype = {article}

}

Laker, S R; Meron, A; Greher, M R; Wilson, J

Retirement and Activity Restrictions Following Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.

Links | BibTeX

Kontos, A P; Sufrinko, A; Womble, M; Kegel, N

Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion Journal Article

In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.

Abstract | Links | BibTeX

Hyden, J; Petty, B

Sideline Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 395–409, 2016.

Links | BibTeX

Connery, A K; Peterson, R L; Baker, D A; Randolph, C; Kirkwood, M W

The Role of Neuropsychological Evaluation in the Clinical Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 475–486, 2016.

Links | BibTeX

Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K

Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article

In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.

Abstract | Links | BibTeX

@article{Vassilyadi2015,

title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},

author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},

doi = {10.1159/000431232},

year  = {2015},

date = {2015-01-01},

journal = {Pediatric Neurosurgery},

volume = {50},

number = {4},

pages = {196--203},

abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Bondi, C O; Semple, B D; Noble-Haeusslein, L J; Osier, N D; Carlson, S W; Dixon, C E; Giza, C C; Kline, A E

Found in translation: Understanding the biology and behavior of experimental traumatic brain injury Journal Article

In: Neuroscience and Biobehavioral Reviews, vol. 58, pp. 123–146, 2015.

Abstract | Links | BibTeX

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

@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 = {},

pubstate = {published},

tppubtype = {article}

}

Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L

No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers Journal Article

In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.

Abstract | Links | BibTeX

@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 = {},

pubstate = {published},

tppubtype = {article}

}

10.

Zottoli, T M; Hoover, S; Barr, W B

Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases Journal Article

In: Clinical Neuropsychologist, vol. 29, no. 5, pp. 678–688, 2015.

Abstract | Links | BibTeX

11.

Merritt, V C; Meyer, J E; Arnett, P A

A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale Journal Article

In: Journal of Clinical and Experimental Neuropsychology, vol. 37, no. 7, pp. 764–775, 2015.

Abstract | Links | BibTeX

@article{Merritt2015b,

title = {A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale},

author = {Merritt, V C and Meyer, J E and Arnett, P A},

doi = {10.1080/13803395.2015.1060950},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Clinical and Experimental Neuropsychology},

volume = {37},

number = {7},

pages = {764--775},

abstract = {Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor \& Francis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

12.

Lucas, S

Posttraumatic Headache: Clinical Characterization and Management Journal Article

In: Current Pain & Headache Reports, vol. 19, no. 10, 2015.

Abstract | Links | BibTeX

13.

Andre, J B

Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials Journal Article

In: Topics in Magnetic Resonance Imaging, vol. 24, no. 5, pp. 275–287, 2015.

Abstract | BibTeX

14.

Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E

Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article

In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.

Abstract | Links | BibTeX

15.

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

@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 = {},

pubstate = {published},

tppubtype = {article}

}

16.

Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M

Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article

In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.

Abstract | Links | BibTeX

17.

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

Abstract | Links | BibTeX

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

18.

Jordan, B D

Chronic traumatic encephalopathy and other long-term sequelae Journal Article

In: CONTINUUM Lifelong Learning in Neurology, vol. 20, pp. 1588–1604, 2014.

Abstract | Links | BibTeX

@article{Jordan2014,

title = {Chronic traumatic encephalopathy and other long-term sequelae},

author = {Jordan, B D},

url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84927562326\&partnerID=40\&md5=da8cab7e63cee5fa58ae148fa7de9dec},

year  = {2014},

date = {2014-01-01},

journal = {CONTINUUM Lifelong Learning in Neurology},

volume = {20},

pages = {1588--1604},

abstract = {Purpose of Review: Growing public health concern exists over the incidence of chronic traumatic brain injury (TBI) in athletes participating in contact sports. Chronic TBI represents a spectrum of disorders associated with long-term consequences of single or repetitive TBI and includes chronic traumatic encephalopathy (CTE), chronic postconcussion syndrome, and chronic neurocognitive impairment. Neurologists should be familiar with the different types of chronic TBI and their diagnostic criteria. Recent Findings: CTE is the most severe chronic TBI and represents the neurologic consequences of repetitive mild TBI. It is particularly noted among boxers and football players. CTE presents with behavioral, cognitive, and motor symptoms, and can only be definitively diagnosed postmortem. Chronic postconcussion syndrome is defined as postconcussion symptoms that last longer than 1 year and do not appear to resolve; it may develop after a single concussive event. Chronic neurocognitive impairment is an all-encompassing clinical term denoting long-term neurologic sequelae secondary to sports-related trauma and can present either within the postconcussion syndrome or years after a symptom-free interval. Summary: This article discusses the diagnostic evaluation of chronic TBI, including clinical history, neurologic examination, neuropsychological testing, neuroimaging, and laboratory testing, as well as the distinctions between CTE, chronic postconcussion syndrome, and chronic neurocognitive impairment. Neurologic impairment among athletes exposed to repetitive brain injury appears to be a real phenomenon. Because CTE has no established treatment, prevention is of paramount importance for athletes participating in contact sports. © 2014, American Academy of Neurology.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

19.

Anonymous,

SCAT3 Journal Article

In: British Journal of Sports Medicine, vol. 47, no. 5, pp. 259, 2013, ISBN: 1473-0480.

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2016

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.

@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},

pubstate = {published},

tppubtype = {article}

}

Laker, S R; Meron, A; Greher, M R; Wilson, J

Retirement and Activity Restrictions Following Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.

Kontos, A P; Sufrinko, A; Womble, M; Kegel, N

Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion Journal Article

In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.

@article{Kontos2016b,

title = {Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion},

author = {Kontos, A P and Sufrinko, A and Womble, M and Kegel, N},

doi = {10.1007/s11916-016-0571-y},

year  = {2016},

date = {2016-01-01},

journal = {Current Pain \& Headache Reports},

volume = {20},

number = {6},

abstract = {Neuropsychological evaluation is one component of a comprehensive and multifaceted assessment following concussion. Although some neuropsychologists use a “hybrid” assessment approach integrating computerized neurocognitive testing batteries with traditional paper and pencil tests, computerized neurocognitive test batteries are the predominant testing modality for assessment of athletes from the youth to professional level. This review summarizes the most recent research supporting the utility of neuropsychological evaluation and highlights the strengths and weaknesses of both computerized and traditional neuropsychological testing approaches. The most up to date research and guidelines on baseline neurocognitive testing is also discussed. This paper addresses concerns regarding reliability of neuropsychological testing while providing an overview of factors that influence test performance, both transient situational factors (e.g., pain level, anxiety) and characteristics of particular subgroups (e.g., age, preexisting learning disabilities), warranting the expertise of an experienced neuropsychologist for interpretation. Currently, research is moving forward by integrating neuropsychological evaluation with emerging assessment approaches for other domains of brain function (e.g., vestibular function) vulnerable to concussion. © 2016, Springer Science+Business Media New York.},

keywords = {Baseline, brain function, Computerized assessment battery, computerized neuropsychological test, Concussion, evidence based practice, human, MEDICAL research, Neurocognitive tests, Neuropsychological evaluation, neuropsychological test, paper and pencil neuropsychological test, psychologic assessment, reliability, Review, Sport, TASK performance},

pubstate = {published},

tppubtype = {article}

}

Hyden, J; Petty, B

Sideline Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 395–409, 2016.

Connery, A K; Peterson, R L; Baker, D A; Randolph, C; Kirkwood, M W

The Role of Neuropsychological Evaluation in the Clinical Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 475–486, 2016.

2015

Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K

Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article

In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.

@article{Vassilyadi2015,

title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},

author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},

doi = {10.1159/000431232},

year  = {2015},

date = {2015-01-01},

journal = {Pediatric Neurosurgery},

volume = {50},

number = {4},

pages = {196--203},

abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},

keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},

pubstate = {published},

tppubtype = {article}

}

Bondi, C O; Semple, B D; Noble-Haeusslein, L J; Osier, N D; Carlson, S W; Dixon, C E; Giza, C C; Kline, A E

Found in translation: Understanding the biology and behavior of experimental traumatic brain injury Journal Article

In: Neuroscience and Biobehavioral Reviews, vol. 58, pp. 123–146, 2015.

@article{Bondi2015,

title = {Found in translation: Understanding the biology and behavior of experimental traumatic brain injury},

author = {Bondi, C O and Semple, B D and Noble-Haeusslein, L J and Osier, N D and Carlson, S W and Dixon, C E and Giza, C C and Kline, A E},

doi = {10.1016/j.neubiorev.2014.12.004},

year  = {2015},

date = {2015-01-01},

journal = {Neuroscience and Biobehavioral Reviews},

volume = {58},

pages = {123--146},

abstract = {The aim of this review is to discuss in greater detail the topics covered in the recent symposium entitled "Traumatic brain injury: laboratory and clinical perspectives," presented at the 2014 International Behavioral Neuroscience Society annual meeting. Herein, we review contemporary laboratory models of traumatic brain injury (TBI) including common assays for sensorimotor and cognitive behavior. New modalities to evaluate social behavior after injury to the developing brain, as well as the attentional set-shifting test (AST) as a measure of executive function in TBI, will be highlighted. Environmental enrichment (EE) will be discussed as a preclinical model of neurorehabilitation, and finally, an evidence-based approach to sports-related concussion will be considered. The review consists predominantly of published data, but some discussion of ongoing or future directions is provided. © 2014 Elsevier Ltd.},

keywords = {8 hydroxy 2 propylaminotetralin, Aggression, Attentional set-shifting test (AST), buspirone, Closed head injury, cognition, cognitive defect, cognitive function test, Concussion, conditioning, Controlled cortical impact (CCI), environmental enrichment, Environmental enrichment (EE), executive function, experimental disease, fear, Fluid percussion (FP), human, interpersonal communication, Memory, motor function test, nerve degeneration, neuropsychological test, Neurorehabilitation, nonhuman, outcome assessment, Pathophysiology, pediatrics, priority journal, rehabilitation care, Review, rodent, rotarod test, sensorimotor function, Social behavior, social disability, social interaction, spatial learning, TASK performance, traumatic brain injury},

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.

@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}

}

Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L

No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers Journal Article

In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.

@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}

}

Zottoli, T M; Hoover, S; Barr, W B

Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases Journal Article

In: Clinical Neuropsychologist, vol. 29, no. 5, pp. 678–688, 2015.

@article{Zottoli2015,

title = {Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases},

author = {Zottoli, T M and Hoover, S and Barr, W B},

doi = {10.1080/13854046.2015.1062562},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Neuropsychologist},

volume = {29},

number = {5},

pages = {678--688},

abstract = {Objective: The Standardized Assessment of Concussion (SAC) is a standardized mental status screening instrument initially developed for assessment and tracking of concussion symptoms in athletes. The purpose of the current study was to validate the utility of the SAC as an embedded screening measure for insufficient effort in independent medical examinations (IME) and personal injury cases. Method: A known-groups design was used to examine the SACs utility for the detection of insufficient effort in 75 de-identified private IME and civil litigation evaluations. Initial classifications of insufficient effort were made independently of SAC scores, on the basis of having two or more scores falling below established cut-offs on previously validated neuropsychological measures. Results: Results suggest that the total score on the SAC significantly distinguishes effortful respondents from those exhibiting insufficient effort. Empirically derived cut-off scores yielded adequate sensitivity (.62-.95) and negative predictive power (.93-.97). Conclusions: While optimal cut-off scores depend upon intended use, our data suggest that the SAC is useful as a potential screener for insufficient effort, after which one can employ additional measures to rule out false-positives. Further research is required before cut-off scores can be recommended for clinical use. © 2015 Taylor and Francis.},

keywords = {brain concussion, Civil Litigation, Female, human, Humans, IME, Insufficient effort, legislation and jurisprudence, Male, malingering, Malpractice, middle aged, neuropsychological test, Neuropsychological Tests, neuropsychology, Physical Examination, questionnaire, Standardized assessment of concussion (SAC), statistics and numerical data, Surveys and Questionnaires},

pubstate = {published},

tppubtype = {article}

}

Merritt, V C; Meyer, J E; Arnett, P A

A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale Journal Article

In: Journal of Clinical and Experimental Neuropsychology, vol. 37, no. 7, pp. 764–775, 2015.

@article{Merritt2015b,

title = {A novel approach to classifying postconcussion symptoms: The application of a new framework to the Post-Concussion Symptom Scale},

author = {Merritt, V C and Meyer, J E and Arnett, P A},

doi = {10.1080/13803395.2015.1060950},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Clinical and Experimental Neuropsychology},

volume = {37},

number = {7},

pages = {764--775},

abstract = {Introduction: Self-report measures such as the Post-Concussion Symptom Scale (PCSS) are frequently used during baseline and postconcussion testing to evaluate athletes symptom profiles. However, the common approach of evaluating the total symptom score and/or symptom clusters may not allow for a complete understanding of the nature of athletes symptom reporting patterns. The primary objective of this study was to apply three "global indices of distress" variables, derived from the Symptom Checklist-90-Revised (SCL-90-R) framework, to the PCSS at baseline and postconcussion. We aimed to evaluate the utility of these symptom indices in relation to four PCSS symptom clusters and the total PCSS symptom score. Method: Participants included college athletes evaluated at baseline (N = 846) and postconcussion (N = 86). Athletes underwent neuropsychological testing at both time points, including completion of the PCSS and a paper/pencil and computerized test battery. Eight symptom indices were derived from the PCSS, and a postconcussion neurocognitive composite score was calculated. Results: Results showed that there were significant mean increases from baseline to postconcussion on four of the eight symptom indices evaluated. Furthermore, a significant proportion of athletes showed no change from baseline to postconcussion when evaluating the total symptom score, but showed at least a one standard deviation increase in symptom reporting from baseline to postconcussion when evaluating at least one other symptom index (i.e., a global index of distress or symptom cluster). Finally, the three global indices of distress variables, two of the four symptom clusters, and the total symptom score significantly predicted a postconcussion neurocognitive composite score, such that greater postconcussion symptoms were associated with lower postconcussion neurocognitive performance. Conclusions: These findings suggest that, in addition to evaluating the postconcussion total symptom score, there may be value in examining more specific symptom indices such as the global indices of distress variables and symptom clusters. © 2015 Taylor \& Francis.},

keywords = {Adolescent, Athletic Injuries, brain concussion, CLASSIFICATION, collegiate athletes, Female, human, Humans, Male, neuropsychological test, Neuropsychological Tests, Post-Concussion Syndrome, postconcussion symptoms, self report, SEVERITY of illness index, Sports-related concussion, symptom assessment, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Lucas, S

Posttraumatic Headache: Clinical Characterization and Management Journal Article

In: Current Pain & Headache Reports, vol. 19, no. 10, 2015.

@article{Lucas2015,

title = {Posttraumatic Headache: Clinical Characterization and Management},

author = {Lucas, S},

doi = {10.1007/s11916-015-0520-1},

year  = {2015},

date = {2015-01-01},

journal = {Current Pain \& Headache Reports},

volume = {19},

number = {10},

abstract = {Headache is the most common symptom after traumatic brain injury (TBI). TBI has become a global health concern with an estimated 2.5 million reported TBIs per year in the USA alone. Recent longitudinal studies of posttraumatic headache (PTH) show a high cumulative incidence of 71 % after moderate or severe TBI and an even higher cumulative incidence of 91 % after mild TBI (mTBI) at 1 year after injury. Prevalence remains high at over 44 % throughout the year after moderate or severe TBI and over 54 % after mTBI. A prior history of headache is associated with a higher risk for PTH, whereas older age appears to be protective. Gender does not appear to be a risk factor for PTH. Most PTH has clinical diagnostic criteria meeting that of migraine or probable migraine when primary headache disorder classification criteria are used, followed by tension-type headache. There are no evidence-based treatment guidelines for PTH management; however, expert opinion has suggested treating the PTH using primary headache disorder treatment recommendations according to its type. © 2015, Springer Science+Business Media New York.},

keywords = {amitriptyline, botulinum toxin A, Brain Injuries, chiropractic, clinical feature, complication, Concussion, diagnostic approach route, disease association, disease classification, disease predisposition, drug efficacy, drug induced headache, evidence based medicine, human, Humans, migraine, neuropsychological test, Neuropsychological Tests, nonsteroid antiinflammatory agent, paracetamol, physiotherapy, Post-traumatic headache, postconcussion syndrome, posttraumatic headache, practice guideline, Prevalence, primary headache, Review, risk factor, Risk Factors, SEVERITY of illness index, sports concussion, symptomatology, tension headache, Tension-type headache, topiramate, traumatic brain injury, treatment response, UNITED States, valproate semisodium},

pubstate = {published},

tppubtype = {article}

}

Andre, J B

Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials Journal Article

In: Topics in Magnetic Resonance Imaging, vol. 24, no. 5, pp. 275–287, 2015.

@article{Andre2015,

title = {Arterial spin labeling magnetic resonance perfusion for traumatic brain injury: Technical challenges and potentials},

author = {Andre, J B},

year  = {2015},

date = {2015-01-01},

journal = {Topics in Magnetic Resonance Imaging},

volume = {24},

number = {5},

pages = {275--287},

abstract = {Traumatic brain injury (TBI), including concussion, is a public health concern, as it affects over 1.7 million persons in the United States per year. Yet, the diagnosis of TBI, particularly mild TBI (mTBI), can be controversial, as neuroimaging findings can be sparse on conventional magnetic resonance and computed tomography examinations, and when present, often poorly correlate with clinical signs and symptoms. Furthermore, the discussion of TBI, concussion, and head impact exposure is immediately complicated by the many differing opinions of what constitutes each, their respective severities, and how the underlying biomechanics of the inciting head impact might alter the distribution, severity, and prognosis of the underlying brain injury. Advanced imaging methodologies hold promise in improving the sensitivity and detectability of associated imaging biomarkers that might better correlate with patient outcome and prognostication, allowing for improved triage and therapeutic guidance in the setting of TBI, particularly in mTBI. This work will examine the defining symptom complex associated with mTBI and explore changes in cerebral blood flow measured by arterial spin labeling, as a potential imaging biomarker for TBI, and briefly correlate these observations with findings identified by single photon emission computed tomography and positron emission tomography imaging.. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {Arterial spin labeling, artery blood flow, artifact, brain, brain blood flow, brain circulation, Brain Injuries, Brain Injury, brain perfusion, Cerebrovascular Circulation, clinical classification, Concussion, echo planar imaging, gray matter, human, Humans, Magnetic Resonance Imaging, mild traumatic brain injury, neuroimaging, neuropsychological test, nuclear magnetic resonance imaging, pathology, positron emission tomography, priority journal, procedures, Review, single photon emission computer tomography, spin labeling, Spin Labels, Sport, Sports-related concussion, symptom, traumatic brain injury, white matter},

pubstate = {published},

tppubtype = {article}

}

Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E

Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article

In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.

@article{Moran2015,

title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},

author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},

doi = {10.14423/SMJ.0000000000000340},

year  = {2015},

date = {2015-01-01},

journal = {Southern Medical Journal},

volume = {108},

number = {9},

pages = {553--558},

abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},

keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},

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.

@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}

}

Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M

Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article

In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.

@article{Alexander2015,

title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},

author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},

doi = {10.3109/02699052.2015.1031699},

year  = {2015},

date = {2015-01-01},

journal = {Brain Injury},

volume = {29},

number = {9},

pages = {1113--1125},

abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},

keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},

pubstate = {published},

tppubtype = {article}

}

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},

pubstate = {published},

tppubtype = {article}

}

2014

Jordan, B D

Chronic traumatic encephalopathy and other long-term sequelae Journal Article

In: CONTINUUM Lifelong Learning in Neurology, vol. 20, pp. 1588–1604, 2014.

@article{Jordan2014,

title = {Chronic traumatic encephalopathy and other long-term sequelae},

author = {Jordan, B D},

url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84927562326\&partnerID=40\&md5=da8cab7e63cee5fa58ae148fa7de9dec},

year  = {2014},

date = {2014-01-01},

journal = {CONTINUUM Lifelong Learning in Neurology},

volume = {20},

pages = {1588--1604},

abstract = {Purpose of Review: Growing public health concern exists over the incidence of chronic traumatic brain injury (TBI) in athletes participating in contact sports. Chronic TBI represents a spectrum of disorders associated with long-term consequences of single or repetitive TBI and includes chronic traumatic encephalopathy (CTE), chronic postconcussion syndrome, and chronic neurocognitive impairment. Neurologists should be familiar with the different types of chronic TBI and their diagnostic criteria. Recent Findings: CTE is the most severe chronic TBI and represents the neurologic consequences of repetitive mild TBI. It is particularly noted among boxers and football players. CTE presents with behavioral, cognitive, and motor symptoms, and can only be definitively diagnosed postmortem. Chronic postconcussion syndrome is defined as postconcussion symptoms that last longer than 1 year and do not appear to resolve; it may develop after a single concussive event. Chronic neurocognitive impairment is an all-encompassing clinical term denoting long-term neurologic sequelae secondary to sports-related trauma and can present either within the postconcussion syndrome or years after a symptom-free interval. Summary: This article discusses the diagnostic evaluation of chronic TBI, including clinical history, neurologic examination, neuropsychological testing, neuroimaging, and laboratory testing, as well as the distinctions between CTE, chronic postconcussion syndrome, and chronic neurocognitive impairment. Neurologic impairment among athletes exposed to repetitive brain injury appears to be a real phenomenon. Because CTE has no established treatment, prevention is of paramount importance for athletes participating in contact sports. © 2014, American Academy of Neurology.},

keywords = {Chronic Traumatic Encephalopathy chronic disease, cognitive defect, diagnostic procedure, human, Incidence, injury severity, laboratory test, medical history, neuroimaging, neurologic examination, neurologist, neuropsychological test, Pathophysiology, postconcussion syndrome, Review, sport injury, symptomatology, traumatic brain injury},

pubstate = {published},

tppubtype = {article}

}

2013

Anonymous,

SCAT3 Journal Article

In: British Journal of Sports Medicine, vol. 47, no. 5, pp. 259, 2013, ISBN: 1473-0480.