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}
}
Vagnozzi, Roberto; Signoretti, Stefano; Cristofori, Luciano; Alessandrini, Franco; Floris, Roberto; Isgrò, Eugenio; Ria, Antonio; Marziali, Simone; Zoccatelli, Giada; Tavazzi, Barbara; Del Bolgia, Franco; Sorge, Roberto; Broglio, Steven P; McIntosh, Tracy K; Lazzarino, Giuseppe
Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients: Corrigendum Journal Article
In: Brain: A Journal of Neurology, vol. 136, no. 11, pp. e262–e262, 2013, ISBN: 0006-8950 1460-2156.
Abstract | BibTeX | Tags: 2013, Athletes, brain concussion, BRAIN damage, Concussion, Magnetic Resonance Spectroscopy, metabolic brain damage, mild traumatic brain injury, NEUROCHEMISTRY, Recovery, Recovery (Disorders), Spectroscopy, traumatic brain injury
@article{Vagnozzi2013a,
title = {Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients: Corrigendum},
author = {Vagnozzi, Roberto and Signoretti, Stefano and Cristofori, Luciano and Alessandrini, Franco and Floris, Roberto and Isgr\`{o}, Eugenio and Ria, Antonio and Marziali, Simone and Zoccatelli, Giada and Tavazzi, Barbara and {Del Bolgia}, Franco and Sorge, Roberto and Broglio, Steven P and McIntosh, Tracy K and Lazzarino, Giuseppe},
isbn = {0006-8950
1460-2156},
year = {2013},
date = {2013-01-01},
journal = {Brain: A Journal of Neurology},
volume = {136},
number = {11},
pages = {e262--e262},
abstract = {Reports an error in 'Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients' by Roberto Vagnozzi, Stefano Signoretti, Luciano Cristofori, Franco Alessandrini, Roberto Floris, Eugenio Isgr\`{o}, Antonio Ria, Simone Marziale, Giada Zoccatelli, Barbara Tavazzi, Franco Del Bolgia, Roberto Sorge, Steven P. Broglio, Tracy K. McIntosh and Giuseppe Lazzarino (Brain: A Journal of Neurology, 2010[Nov], Vol 133[11], 3232-3242). In the original article, the eighth author’s surname was incorrectly given as ‘Marziale’. The corrected surname of the eighth author is present in the erratum. (The following abstract of the original article appeared in record [rid]2010-23062-009[/rid]). Concussive head injury opens a temporary window of brain vulnerability due to the impairment of cellular energetic metabolism. As experimentally demonstrated, a second mild injury occurring during this period can lead to severe brain damage, a condition clinically described as the second impact syndrome. To corroborate the validity of proton magnetic resonance spectroscopy in monitoring cerebral metabolic changes following mild traumatic brain injury, apart from the magnetic field strength (1.5 or 3.0 T) and mode of acquisition, we undertook a multicentre prospective study in which a cohort of 40 athletes suffering from concussion and a group of 30 control healthy subjects were admitted. Athletes (aged 16\textendash35 years) were recruited and examined at three different institutions between September 2007 and June 2009. They underwent assessment of brain metabolism at 3, 15, 22 and 30 days post-injury through proton magnetic resonance spectroscopy for the determination of N-acetylaspartate, creatine and choline-containing compounds. Values of these representative brain metabolites were compared with those observed in the group of non-injured controls. Comparison of spectroscopic data, obtained in controls using different field strength and/or mode of acquisition, did not show any difference in the brain metabolite ratios. Athletes with concussion exhibited the most significant alteration of metabolite ratios at Day 3 post-injury (N-acetylaspartate/creatine: −17.6%, N-acetylaspartate/choline: −21.4%; P \< 0.001 with respect to controls). On average, metabolic disturbance gradually recovered, initially in a slow fashion and, following Day 15, more rapidly. At 30 days post-injury, all athletes showed complete recovery, having metabolite ratios returned to values detected in controls. Athletes self-declared symptom clearance between 3 and 15 days after concussion. Results indicate that N-acetylaspartate determination by proton magnetic resonance spectroscopy represents a non-invasive tool to accurately measure changes in cerebral energy metabolism occurring in mild traumatic brain injury. In particular, this metabolic evaluation may significantly improve, along with other clinical assessments, the management of athletes suffering from concussion. Further studies to verify the effects of a second concussive event occurring at different time points of the recovery curve of brain metabolism are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},
keywords = {2013, Athletes, brain concussion, BRAIN damage, Concussion, Magnetic Resonance Spectroscopy, metabolic brain damage, mild traumatic brain injury, NEUROCHEMISTRY, Recovery, Recovery (Disorders), Spectroscopy, 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 = {},
pubstate = {published},
tppubtype = {article}
}
Vagnozzi, Roberto; Signoretti, Stefano; Cristofori, Luciano; Alessandrini, Franco; Floris, Roberto; Isgrò, Eugenio; Ria, Antonio; Marziali, Simone; Zoccatelli, Giada; Tavazzi, Barbara; Del Bolgia, Franco; Sorge, Roberto; Broglio, Steven P; McIntosh, Tracy K; Lazzarino, Giuseppe
Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients: Corrigendum Journal Article
In: Brain: A Journal of Neurology, vol. 136, no. 11, pp. e262–e262, 2013, ISBN: 0006-8950 1460-2156.
@article{Vagnozzi2013a,
title = {Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients: Corrigendum},
author = {Vagnozzi, Roberto and Signoretti, Stefano and Cristofori, Luciano and Alessandrini, Franco and Floris, Roberto and Isgr\`{o}, Eugenio and Ria, Antonio and Marziali, Simone and Zoccatelli, Giada and Tavazzi, Barbara and {Del Bolgia}, Franco and Sorge, Roberto and Broglio, Steven P and McIntosh, Tracy K and Lazzarino, Giuseppe},
isbn = {0006-8950
1460-2156},
year = {2013},
date = {2013-01-01},
journal = {Brain: A Journal of Neurology},
volume = {136},
number = {11},
pages = {e262--e262},
abstract = {Reports an error in 'Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients' by Roberto Vagnozzi, Stefano Signoretti, Luciano Cristofori, Franco Alessandrini, Roberto Floris, Eugenio Isgr\`{o}, Antonio Ria, Simone Marziale, Giada Zoccatelli, Barbara Tavazzi, Franco Del Bolgia, Roberto Sorge, Steven P. Broglio, Tracy K. McIntosh and Giuseppe Lazzarino (Brain: A Journal of Neurology, 2010[Nov], Vol 133[11], 3232-3242). In the original article, the eighth author’s surname was incorrectly given as ‘Marziale’. The corrected surname of the eighth author is present in the erratum. (The following abstract of the original article appeared in record [rid]2010-23062-009[/rid]). Concussive head injury opens a temporary window of brain vulnerability due to the impairment of cellular energetic metabolism. As experimentally demonstrated, a second mild injury occurring during this period can lead to severe brain damage, a condition clinically described as the second impact syndrome. To corroborate the validity of proton magnetic resonance spectroscopy in monitoring cerebral metabolic changes following mild traumatic brain injury, apart from the magnetic field strength (1.5 or 3.0 T) and mode of acquisition, we undertook a multicentre prospective study in which a cohort of 40 athletes suffering from concussion and a group of 30 control healthy subjects were admitted. Athletes (aged 16\textendash35 years) were recruited and examined at three different institutions between September 2007 and June 2009. They underwent assessment of brain metabolism at 3, 15, 22 and 30 days post-injury through proton magnetic resonance spectroscopy for the determination of N-acetylaspartate, creatine and choline-containing compounds. Values of these representative brain metabolites were compared with those observed in the group of non-injured controls. Comparison of spectroscopic data, obtained in controls using different field strength and/or mode of acquisition, did not show any difference in the brain metabolite ratios. Athletes with concussion exhibited the most significant alteration of metabolite ratios at Day 3 post-injury (N-acetylaspartate/creatine: −17.6%, N-acetylaspartate/choline: −21.4%; P \< 0.001 with respect to controls). On average, metabolic disturbance gradually recovered, initially in a slow fashion and, following Day 15, more rapidly. At 30 days post-injury, all athletes showed complete recovery, having metabolite ratios returned to values detected in controls. Athletes self-declared symptom clearance between 3 and 15 days after concussion. Results indicate that N-acetylaspartate determination by proton magnetic resonance spectroscopy represents a non-invasive tool to accurately measure changes in cerebral energy metabolism occurring in mild traumatic brain injury. In particular, this metabolic evaluation may significantly improve, along with other clinical assessments, the management of athletes suffering from concussion. Further studies to verify the effects of a second concussive event occurring at different time points of the recovery curve of brain metabolism are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},
keywords = {},
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}
}
Vagnozzi, Roberto; Signoretti, Stefano; Cristofori, Luciano; Alessandrini, Franco; Floris, Roberto; Isgrò, Eugenio; Ria, Antonio; Marziali, Simone; Zoccatelli, Giada; Tavazzi, Barbara; Del Bolgia, Franco; Sorge, Roberto; Broglio, Steven P; McIntosh, Tracy K; Lazzarino, Giuseppe
Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients: Corrigendum Journal Article
In: Brain: A Journal of Neurology, vol. 136, no. 11, pp. e262–e262, 2013, ISBN: 0006-8950 1460-2156.
Abstract | BibTeX | Tags: 2013, Athletes, brain concussion, BRAIN damage, Concussion, Magnetic Resonance Spectroscopy, metabolic brain damage, mild traumatic brain injury, NEUROCHEMISTRY, Recovery, Recovery (Disorders), Spectroscopy, traumatic brain injury
@article{Vagnozzi2013a,
title = {Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients: Corrigendum},
author = {Vagnozzi, Roberto and Signoretti, Stefano and Cristofori, Luciano and Alessandrini, Franco and Floris, Roberto and Isgr\`{o}, Eugenio and Ria, Antonio and Marziali, Simone and Zoccatelli, Giada and Tavazzi, Barbara and {Del Bolgia}, Franco and Sorge, Roberto and Broglio, Steven P and McIntosh, Tracy K and Lazzarino, Giuseppe},
isbn = {0006-8950
1460-2156},
year = {2013},
date = {2013-01-01},
journal = {Brain: A Journal of Neurology},
volume = {136},
number = {11},
pages = {e262--e262},
abstract = {Reports an error in 'Assessment of metabolic brain damage and recovery following mild traumatic brain injury: A multicentre, proton magnetic resonance spectroscopic study in concussed patients' by Roberto Vagnozzi, Stefano Signoretti, Luciano Cristofori, Franco Alessandrini, Roberto Floris, Eugenio Isgr\`{o}, Antonio Ria, Simone Marziale, Giada Zoccatelli, Barbara Tavazzi, Franco Del Bolgia, Roberto Sorge, Steven P. Broglio, Tracy K. McIntosh and Giuseppe Lazzarino (Brain: A Journal of Neurology, 2010[Nov], Vol 133[11], 3232-3242). In the original article, the eighth author’s surname was incorrectly given as ‘Marziale’. The corrected surname of the eighth author is present in the erratum. (The following abstract of the original article appeared in record [rid]2010-23062-009[/rid]). Concussive head injury opens a temporary window of brain vulnerability due to the impairment of cellular energetic metabolism. As experimentally demonstrated, a second mild injury occurring during this period can lead to severe brain damage, a condition clinically described as the second impact syndrome. To corroborate the validity of proton magnetic resonance spectroscopy in monitoring cerebral metabolic changes following mild traumatic brain injury, apart from the magnetic field strength (1.5 or 3.0 T) and mode of acquisition, we undertook a multicentre prospective study in which a cohort of 40 athletes suffering from concussion and a group of 30 control healthy subjects were admitted. Athletes (aged 16\textendash35 years) were recruited and examined at three different institutions between September 2007 and June 2009. They underwent assessment of brain metabolism at 3, 15, 22 and 30 days post-injury through proton magnetic resonance spectroscopy for the determination of N-acetylaspartate, creatine and choline-containing compounds. Values of these representative brain metabolites were compared with those observed in the group of non-injured controls. Comparison of spectroscopic data, obtained in controls using different field strength and/or mode of acquisition, did not show any difference in the brain metabolite ratios. Athletes with concussion exhibited the most significant alteration of metabolite ratios at Day 3 post-injury (N-acetylaspartate/creatine: −17.6%, N-acetylaspartate/choline: −21.4%; P \< 0.001 with respect to controls). On average, metabolic disturbance gradually recovered, initially in a slow fashion and, following Day 15, more rapidly. At 30 days post-injury, all athletes showed complete recovery, having metabolite ratios returned to values detected in controls. Athletes self-declared symptom clearance between 3 and 15 days after concussion. Results indicate that N-acetylaspartate determination by proton magnetic resonance spectroscopy represents a non-invasive tool to accurately measure changes in cerebral energy metabolism occurring in mild traumatic brain injury. In particular, this metabolic evaluation may significantly improve, along with other clinical assessments, the management of athletes suffering from concussion. Further studies to verify the effects of a second concussive event occurring at different time points of the recovery curve of brain metabolism are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},
keywords = {2013, Athletes, brain concussion, BRAIN damage, Concussion, Magnetic Resonance Spectroscopy, metabolic brain damage, mild traumatic brain injury, NEUROCHEMISTRY, Recovery, Recovery (Disorders), Spectroscopy, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}