Richards, D; Ivarsson, B J; Scher, I; Hoover, R; Rodowicz, K; Cripton, P
Ice hockey shoulder pad design and the effect on head response during shoulder-to-head impacts Journal Article
In: Sports Biomechanics, vol. 15, no. 4, pp. 385–396, 2016.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/pc [Prevention & Control], *Head/ph [Physiology], *Hockey/ph [Physiology], *Protective Clothing, *Shoulder/ph [Physiology], Acceleration, Biomechanical Phenomena, Equipment Design, Humans, Male, Manikins, Materials testing, Reproducibility of Results, Risk Factors
@article{Richards2016,
title = {Ice hockey shoulder pad design and the effect on head response during shoulder-to-head impacts},
author = {Richards, D and Ivarsson, B J and Scher, I and Hoover, R and Rodowicz, K and Cripton, P},
year = {2016},
date = {2016-01-01},
journal = {Sports Biomechanics},
volume = {15},
number = {4},
pages = {385--396},
abstract = {Ice hockey body checks involving direct shoulder-to-head contact frequently result in head injury. In the current study, we examined the effect of shoulder pad style on the likelihood of head injury from a shoulder-to-head check. Shoulder-to-head body checks were simulated by swinging a modified Hybrid-III anthropomorphic test device (ATD) with and without shoulder pads into a stationary Hybrid-III ATD at 21 km/h. Tests were conducted with three different styles of shoulder pads (traditional, integrated and tethered) and without shoulder pads for the purpose of control. Head response kinematics for the stationary ATD were measured. Compared to the case of no shoulder pads, the three different pad styles significantly (p \< 0.05) reduced peak resultant linear head accelerations of the stationary ATD by 35-56%. The integrated shoulder pads reduced linear head accelerations by an additional 18-21% beyond the other two styles of shoulder pads. The data presented here suggest that shoulder pads can be designed to help protect the head of the struck player in a shoulder-to-head check.},
keywords = {*Craniocerebral Trauma/pc [Prevention \& Control], *Head/ph [Physiology], *Hockey/ph [Physiology], *Protective Clothing, *Shoulder/ph [Physiology], Acceleration, Biomechanical Phenomena, Equipment Design, Humans, Male, Manikins, Materials testing, Reproducibility of Results, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Stewart, W; McNamara, P H; Lawlor, B; Hutchinson, S; Farrell, M
Chronic traumatic encephalopathy: a potential late and under recognized consequence of rugby union? Journal Article
In: Qjm, vol. 109, no. 1, pp. 11–15, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Brain Injury, *Brain/pp [Physiopathology], *Football/in [Injuries], *Neurodegenerative Diseases/pp [Physiopathology], Chronic/pa [Pathology], Humans, Magnetic Resonance Imaging, Male, middle aged, neurologic examination
@article{Stewart2016,
title = {Chronic traumatic encephalopathy: a potential late and under recognized consequence of rugby union?},
author = {Stewart, W and McNamara, P H and Lawlor, B and Hutchinson, S and Farrell, M},
year = {2016},
date = {2016-01-01},
journal = {Qjm},
volume = {109},
number = {1},
pages = {11--15},
abstract = {The association between exposure to head injury and increased risk of neurodegenerative disease, specifically chronic traumatic encephalopathy (CTE), is widely recognized. Historically, this was largely considered a phenomenon restricted to boxers, with more recent case series identifying further 'high risk' individuals, such as former American footballers, or military personnel. However, in all cases thus far reported, it is clear that it is the exposure to head injury which is associated with increased dementia risk, and not the circumstances or environment of exposure. As such, there is considerable potential for under-recognition of CTE in patients presenting with neurodegenerative disease, particularly where head injury exposure might have been historical and through sport. This article reviews current understanding of CTE and, via an illustrative case in rugby union, highlights the value of a detailed history on head injury and also draws attention to imaging studies in assessing patients with neurodegenerative disease. Copyright © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.},
keywords = {*Brain Concussion/co [Complications], *Brain Injury, *Brain/pp [Physiopathology], *Football/in [Injuries], *Neurodegenerative Diseases/pp [Physiopathology], Chronic/pa [Pathology], Humans, Magnetic Resonance Imaging, Male, middle aged, neurologic examination},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Covassin, T; Moran, R; Elbin, R J
Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009 Journal Article
In: Journal of Athletic Training, vol. 51, no. 3, pp. 189–194, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities
@article{Covassin2016,
title = {Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009},
author = {Covassin, T and Moran, R and Elbin, R J},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {3},
pages = {189--194},
abstract = {CONTEXT: Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. OBJECTIVE: To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. DESIGN: Descriptive epidemiologic study. SETTING: National Collegiate Athletic Association athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. MAIN OUTCOME MEASURE(S): Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. RESULTS: During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. CONCLUSIONS: Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Cooper, D B; Vanderploeg, R D
The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension Journal Article
In: Applied Neuropsychology. Adult, vol. 23, no. 4, pp. 264–273, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult
@article{Armistead-Jehle2016,
title = {The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension},
author = {Armistead-Jehle, P and Cooper, D B and Vanderploeg, R D},
year = {2016},
date = {2016-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {23},
number = {4},
pages = {264--273},
abstract = {The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population.},
keywords = {*Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Calcagnile, O; Anell, A; Unden, J
The addition of S100B to guidelines for management of mild head injury is potentially cost saving Journal Article
In: BMC Neurology, vol. 16, no. 1, pp. 200, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult
@article{Calcagnile2016,
title = {The addition of S100B to guidelines for management of mild head injury is potentially cost saving},
author = {Calcagnile, O and Anell, A and Unden, J},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
number = {1},
pages = {200},
abstract = {BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study. Patients were followed up after 3 months with a standardized questionnaire. Theoretical and actual cost differences were calculated. RESULTS: Seven hundred twenty-six patients were included and 29 (4.7 %) showed traumatic abnormalities on CT. No further significant intracranial complications were discovered on follow-up. Two hundred twenty-nine patients (27 %) had normal S100B levels and 497 patients (73 %) showed elevated S100B levels. Over-triage occurred in 73 patients (32 %) and under-triage occurred in 39 patients (7 %). No significant intracranial complications were missed. The introduction of S100B could save 71 per patient if guidelines were strictly followed. As compliance to the guidelines was not perfect, the actual cost saving was 39 per patient. CONCLUSION: Adding S100B to existing guidelines for mild TBI seems to reduce CT usage and costs, especially if guideline compliance could be increased.},
keywords = {*Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lucke-Wold, B P; Turner, R C; Logsdon, A F; Nguyen, L; Bailes, J E; Lee, J M; Robson, M J; Omalu, B I; Huber, J D; Rosen, C L
Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy Journal Article
In: Journal of Neurosurgery, vol. 124, no. 3, pp. 687–702, 2016.
Abstract | BibTeX | Tags: *Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley
@article{Lucke-Wold2016,
title = {Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy},
author = {Lucke-Wold, B P and Turner, R C and Logsdon, A F and Nguyen, L and Bailes, J E and Lee, J M and Robson, M J and Omalu, B I and Huber, J D and Rosen, C L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery},
volume = {124},
number = {3},
pages = {687--702},
abstract = {OBJECTIVE: Chronic traumatic encephalopathy is a progressive neurodegenerative disease characterized by neurofibrillary tau tangles following repetitive neurotrauma. The underlying mechanism linking traumatic brain injury to chronic traumatic encephalopathy has not been elucidated. The authors investigate the role of endoplasmic reticulum stress as a link between acute neurotrauma and chronic neurodegeneration. METHODS: The authors used pharmacological, biochemical, and behavioral tools to assess the role of endoplasmic reticulum stress in linking acute repetitive traumatic brain injury to the development of chronic neurodegeneration. Data from the authors' clinically relevant and validated rodent blast model were compared with those obtained from postmortem human chronic traumatic encephalopathy specimens from a National Football League player and World Wrestling Entertainment wrestler. RESULTS: The results demonstrated strong correlation of endoplasmic reticulum stress activation with subsequent tau hyperphosphorylation. Various endoplasmic reticulum stress markers were increased in human chronic traumatic encephalopathy specimens, and the endoplasmic reticulum stress response was associated with an increase in the tau kinase, glycogen synthase kinase-3beta. Docosahexaenoic acid, an endoplasmic reticulum stress inhibitor, improved cognitive performance in the rat model 3 weeks after repetitive blast exposure. The data showed that docosahexaenoic acid administration substantially reduced tau hyperphosphorylation (t = 4.111, p \< 0.05), improved cognition (t = 6.532, p \< 0.001), and inhibited C/EBP homology protein activation (t = 5.631, p \< 0.01). Additionally the data showed, for the first time, that endoplasmic reticulum stress is involved in the pathophysiology of chronic traumatic encephalopathy. CONCLUSIONS: Docosahexaenoic acid therefore warrants further investigation as a potential therapeutic agent for the prevention of chronic traumatic encephalopathy.},
keywords = {*Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley},
pubstate = {published},
tppubtype = {article}
}
Custer, A; Sufrinko, A; Elbin, R J; Covassin, T; Collins, M; Kontos, A
High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 136–141, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students
@article{Custer2016,
title = {High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes},
author = {Custer, A and Sufrinko, A and Elbin, R J and Covassin, T and Collins, M and Kontos, A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {136--141},
abstract = {CONTEXT: Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined. OBJECTIVE: To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC. DESIGN: Cohort study. SETTING: High school and collegiate athletic programs. PATIENTS OR OTHER PARTICIPANTS: A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Dretsch, M N; Slaboda, J C; Johnson, D E; Adam, O R; Tsao, J W
Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 280–286, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values
@article{Haran2016b,
title = {Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment},
author = {Haran, F J and Dretsch, M N and Slaboda, J C and Johnson, D E and Adam, O R and Tsao, J W},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {280--286},
abstract = {PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p \< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p \> 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.},
keywords = {*Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
Abstract | BibTeX | Tags: *Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {*Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
Abstract | BibTeX | Tags: *Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {*Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization & Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
keywords = {*Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization \& Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
Abstract | Links | BibTeX | Tags: adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly},
pubstate = {published},
tppubtype = {article}
}
Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D
Association of football subconcussive head impacts with ocular near point of convergence Journal Article
In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.
Abstract | Links | BibTeX | Tags: Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult
@article{Kawata2016,
title = {Association of football subconcussive head impacts with ocular near point of convergence},
author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},
doi = {10.1001/jamaophthalmol.2016.1085},
year = {2016},
date = {2016-01-01},
journal = {JAMA Ophthalmology},
volume = {134},
number = {7},
pages = {763--769},
abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},
keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Mannix, R; Iverson, G L
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Silverberg2016b,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply},
author = {Silverberg, N D and Mannix, R and Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M; Bleiberg, J; Williams, K; Caban, J; Kelly, J; Grammer, G; DeGraba, T
Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 23–29, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare
@article{Dretsch2016,
title = {Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI},
author = {Dretsch, M and Bleiberg, J and Williams, K and Caban, J and Kelly, J and Grammer, G and DeGraba, T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {23--29},
abstract = {OBJECTIVE: To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. SETTING: A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. PARTICIPANTS: Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. DESIGN: Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. MAIN MEASURES: Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). RESULTS: All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. CONCLUSION: Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.},
keywords = {*Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
Abstract | BibTeX | Tags: *Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {*Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Suicide/sn [Statistics & Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {*Brain Concussion/co [Complications], *Suicide/sn [Statistics \& Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Stieg, P E; Perrine, K
Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article
In: World Neurosurgery, vol. 86, pp. 65–68, 2016.
Links | BibTeX | Tags: brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport
@article{Stieg2016,
title = {Helmet Use and Traumatic Brain Injury in Snowboarding},
author = {Stieg, P E and Perrine, K},
doi = {10.1016/j.wneu.2015.07.044},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {86},
pages = {65--68},
keywords = {brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {*Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {*Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Mez, J; Solomon, T M; Daneshvar, D H; Stein, T D; McKee, A C
Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player Journal Article
In: JAMA Neurology, vol. 73, no. 3, pp. 353–355, 2016.
BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections
@article{Mez2016,
title = {Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player},
author = {Mez, J and Solomon, T M and Daneshvar, D H and Stein, T D and McKee, A C},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {3},
pages = {353--355},
keywords = {*Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections},
pubstate = {published},
tppubtype = {article}
}
Babcock, L; Kurowski, B G
Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms Journal Article
In: JAMA, vol. 315, no. 10, pp. 987–988, 2016.
BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male
@article{Babcock2016,
title = {Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms},
author = {Babcock, L and Kurowski, B G},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {987--988},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Zonfrillo, M R; Kim, K H; Arbogast, K B
In Reply Journal Article
In: Academic Emergency Medicine, vol. 23, no. 1, pp. 109, 2016.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics & Nume, Humans, Male, X-Ray Computed/ut [Utilization]
@article{Zonfrillo2016a,
title = {In Reply},
author = {Zonfrillo, M R and Kim, K H and Arbogast, K B},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {1},
pages = {109},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics \& Nume, Humans, Male, X-Ray Computed/ut [Utilization]},
pubstate = {published},
tppubtype = {article}
}
Comrie, D
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 399–400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Comrie2016,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure},
author = {Comrie, D},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {399--400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Kazemi, Mohsen
Concussion assessment and management knowledge among chiropractic fourth year interns and residents Journal Article
In: Journal of the Canadian Chiropractic Association, vol. 60, no. 4, pp. 273–285, 2016, ISBN: 0008-3194.
BibTeX | Tags: Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis
@article{Kazemi2016,
title = {Concussion assessment and management knowledge among chiropractic fourth year interns and residents},
author = {Kazemi, Mohsen},
isbn = {0008-3194},
year = {2016},
date = {2016-01-01},
journal = {Journal of the Canadian Chiropractic Association},
volume = {60},
number = {4},
pages = {273--285},
publisher = {Canadian Chiropractic Association},
address = {Toronto, Ontario},
keywords = {Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis},
pubstate = {published},
tppubtype = {article}
}
Astafiev, S V; Zinn, K L; Shulman, G L; Corbetta, M
Exploring the physiological correlates of chronic mild traumatic brain injury symptoms Journal Article
In: NeuroImage Clinical, vol. 11, pp. 10–19, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests
@article{Astafiev2016,
title = {Exploring the physiological correlates of chronic mild traumatic brain injury symptoms},
author = {Astafiev, S V and Zinn, K L and Shulman, G L and Corbetta, M},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {10--19},
abstract = {We report on the results of a multimodal imaging study involving behavioral assessments, evoked and resting-state BOLD fMRI, and DTI in chronic mTBI subjects. We found that larger task-evoked BOLD activity in the MT+/LO region in extra-striate visual cortex correlated with mTBI and PTSD symptoms, especially light sensitivity. Moreover, higher FA values near the left optic radiation (OR) were associated with both light sensitivity and higher BOLD activity in the MT+/LO region. The MT+/LO region was localized as a region of abnormal functional connectivity with central white matter regions previously found to have abnormal physiological signals during visual eye movement tracking (Astafiev et al., 2015). We conclude that mTBI symptoms and light sensitivity may be related to excessive responsiveness of visual cortex to sensory stimuli. This abnormal sensitivity may be related to chronic remodeling of white matter visual pathways acutely injured.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests},
pubstate = {published},
tppubtype = {article}
}
O'Sullivan, D; Fife, G P; Pieter, W; Lim, T; Shin, I
Resultant linear acceleration of an instrumented head form does not differ between junior and collegiate taekwondo athletes' kicks Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 226–230, 2016.
Abstract | Links | BibTeX | Tags: accelerometer, Adolescent, age distribution, analytical parameters, Article, athlete, Biomechanics, body mass, Concussion, controlled study, head injury, high school student, human, injury, Male, Martial Arts, middle school student, priority journal, resultant linear acceleration, taekwondo, university student
@article{OSullivan2016,
title = {Resultant linear acceleration of an instrumented head form does not differ between junior and collegiate taekwondo athletes' kicks},
author = {O'Sullivan, D and Fife, G P and Pieter, W and Lim, T and Shin, I},
doi = {10.1016/j.jshs.2015.01.004},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {226--230},
abstract = {Objective: The purpose of this study was to compare the effects of various taekwondo kicks and age (school level) in absolute terms and relative body mass on the resultant linear acceleration (RLA) of an instrumented head form. Methods: Forty-eight male (middle school: 16; high school: 16; university: 16) taekwondo athletes were recruited for this study. Subjects performed 10 turning, 10 jump spinning hook, and 10 jump back kicks on a Hybrid II head mounted on a height-adjustable frame. Results: A 2-way (School × Kick) MANOVA was used to determine the differences in RLA between schools (age groups) by type of kick. There was no univariate School main effect for absolute RLA ($eta$2 = 0.06) and RLA relative to body mass ($eta$2 = 0.06). No univariate Kick main effects were found for absolute ($eta$2 = 0.06) and relative RLA ($eta$2 = 0.06). Conclusion: It is of concern that RLA did not significantly differ between school levels, implying that young taekwondo athletes generate similar forces to their adult counterparts, possibly exposing young athletes to an increased risk for head injuries. © 2016.},
keywords = {accelerometer, Adolescent, age distribution, analytical parameters, Article, athlete, Biomechanics, body mass, Concussion, controlled study, head injury, high school student, human, injury, Male, Martial Arts, middle school student, priority journal, resultant linear acceleration, taekwondo, university student},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {*Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
Abstract | Links | BibTeX | Tags: adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War},
pubstate = {published},
tppubtype = {article}
}
Beiske, K K; Kostov, K H; Kostov, H
Rhythmic midtemporal discharge in a youth during light sleep Journal Article
In: Neurodiagnostic Journal, vol. 56, no. 1, pp. 32–36, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness
@article{Beiske2016,
title = {Rhythmic midtemporal discharge in a youth during light sleep},
author = {Beiske, K K and Kostov, K H and Kostov, H},
doi = {10.1080/21646821.2015.1119579},
year = {2016},
date = {2016-01-01},
journal = {Neurodiagnostic Journal},
volume = {56},
number = {1},
pages = {32--36},
abstract = {Rhythmic midtemporal discharge (RMTD) is a rare, benign EEG pattern that may have epileptic morphology. Recognizing variations of RMTD is important in order to avoid over- or misinterpretation of EEG findings, which may lead to inappropriate treatment and negative consequences for the patient in question. We present a case report of RTMDs during light sleep where initial erroneous description necessitated repeat EEGs and additional diagnostic exams and led to the postponement of obtaining a drivers licence for this young patient. Copyright © ASET - The Neurodiagnostic Society.},
keywords = {Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {*Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
Abstract | BibTeX | Tags: *Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {*Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Geh, N; Selzer, B J; Bower, R; Himedan, M; Strahle, M; Wetjen, N M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with Chiari I malformation Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 403–409, 2016.
Abstract | BibTeX | Tags: *Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool
@article{Strahle2016,
title = {Sports participation with Chiari I malformation},
author = {Strahle, J and Geh, N and Selzer, B J and Bower, R and Himedan, M and Strahle, M and Wetjen, N M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {403--409},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with Chiari I malformation (CM-I). The authors' goal was to define the risk of sports participation for children with the imaging finding of CM-I. METHODS A prospective survey was administered to 503 CM-I patients at 2 sites over a 46-month period. Data were gathered on imaging characteristics, treatment, sports participation, and any sport-related injuries. Additionally, 81 patients completed at least 1 subsequent survey following their initial entry into the registry and were included in a prospective group, with a mean prospective follow-up period of 11 months. RESULTS Of the 503 CM-I patients, 328 participated in sports for a cumulative duration of 4641 seasons; 205 of these patients participated in contact sports. There were no serious or catastrophic neurological injuries. One patient had temporary extremity paresthesias that resolved within hours, and this was not definitely considered to be related to the CM-I. In the prospective cohort, there were no permanent neurological injuries. CONCLUSIONS No permanent or catastrophic neurological injuries were observed in CM-I patients participating in athletic activities. The authors believe that the risk of such injuries is low and that, in most cases, sports participation by children with CM-I is safe.},
keywords = {*Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T
Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult
@article{Bailie2016,
title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},
author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {2--12},
abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},
keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
Wu, L C; Nangia, V; Bui, K; Hammoor, B; Kurt, M; Hernandez, F; Kuo, C; Camarillo, D B
In Vivo Evaluation of Wearable Head Impact Sensors Journal Article
In: Annals of Biomedical Engineering, vol. 44, no. 4, pp. 1234–1245, 2016.
Abstract | BibTeX | Tags: *Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording
@article{Wu2016,
title = {In Vivo Evaluation of Wearable Head Impact Sensors},
author = {Wu, L C and Nangia, V and Bui, K and Hammoor, B and Kurt, M and Hernandez, F and Kuo, C and Camarillo, D B},
year = {2016},
date = {2016-01-01},
journal = {Annals of Biomedical Engineering},
volume = {44},
number = {4},
pages = {1234--1245},
abstract = {Inertial sensors are commonly used to measure human head motion. Some sensors have been tested with dummy or cadaver experiments with mixed results, and methods to evaluate sensors in vivo are lacking. Here we present an in vivo method using high speed video to test teeth-mounted (mouthguard), soft tissue-mounted (skin patch), and headgear-mounted (skull cap) sensors during 6-13 g sagittal soccer head impacts. Sensor coupling to the skull was quantified by displacement from an ear-canal reference. Mouthguard displacements were within video measurement error (\<1 mm), while the skin patch and skull cap displaced up to 4 and 13 mm from the ear-canal reference, respectively. We used the mouthguard, which had the least displacement from skull, as the reference to assess 6-degree-of-freedom skin patch and skull cap measurements. Linear and rotational acceleration magnitudes were over-predicted by both the skin patch (with 120% NRMS error for a(mag), 290% for alpha(mag)) and the skull cap (320% NRMS error for a(mag), 500% for alpha(mag)). Such over-predictions were largely due to out-of-plane motion. To model sensor error, we found that in-plane skin patch linear acceleration in the anterior-posterior direction could be modeled by an underdamped viscoelastic system. In summary, the mouthguard showed tighter skull coupling than the other sensor mounting approaches. Furthermore, the in vivo methods presented are valuable for investigating skull acceleration sensor technologies.},
keywords = {*Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording},
pubstate = {published},
tppubtype = {article}
}
Comrie, D
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 399–400, 2016.
@article{Comrie2016,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure},
author = {Comrie, D},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {399--400},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stieg, P E; Perrine, K
Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article
In: World Neurosurgery, vol. 86, pp. 65–68, 2016.
@article{Stieg2016,
title = {Helmet Use and Traumatic Brain Injury in Snowboarding},
author = {Stieg, P E and Perrine, K},
doi = {10.1016/j.wneu.2015.07.044},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {86},
pages = {65--68},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Mez, J; Solomon, T M; Daneshvar, D H; Stein, T D; McKee, A C
Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player Journal Article
In: JAMA Neurology, vol. 73, no. 3, pp. 353–355, 2016.
@article{Mez2016,
title = {Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player},
author = {Mez, J and Solomon, T M and Daneshvar, D H and Stein, T D and McKee, A C},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {3},
pages = {353--355},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Babcock, L; Kurowski, B G
Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms Journal Article
In: JAMA, vol. 315, no. 10, pp. 987–988, 2016.
@article{Babcock2016,
title = {Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms},
author = {Babcock, L and Kurowski, B G},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {987--988},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zonfrillo, M R; Kim, K H; Arbogast, K B
In Reply Journal Article
In: Academic Emergency Medicine, vol. 23, no. 1, pp. 109, 2016.
@article{Zonfrillo2016a,
title = {In Reply},
author = {Zonfrillo, M R and Kim, K H and Arbogast, K B},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {1},
pages = {109},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Beiske, K K; Kostov, K H; Kostov, H
Rhythmic midtemporal discharge in a youth during light sleep Journal Article
In: Neurodiagnostic Journal, vol. 56, no. 1, pp. 32–36, 2016.
@article{Beiske2016,
title = {Rhythmic midtemporal discharge in a youth during light sleep},
author = {Beiske, K K and Kostov, K H and Kostov, H},
doi = {10.1080/21646821.2015.1119579},
year = {2016},
date = {2016-01-01},
journal = {Neurodiagnostic Journal},
volume = {56},
number = {1},
pages = {32--36},
abstract = {Rhythmic midtemporal discharge (RMTD) is a rare, benign EEG pattern that may have epileptic morphology. Recognizing variations of RMTD is important in order to avoid over- or misinterpretation of EEG findings, which may lead to inappropriate treatment and negative consequences for the patient in question. We present a case report of RTMDs during light sleep where initial erroneous description necessitated repeat EEGs and additional diagnostic exams and led to the postponement of obtaining a drivers licence for this young patient. Copyright © ASET - The Neurodiagnostic Society.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
O'Sullivan, D; Fife, G P; Pieter, W; Lim, T; Shin, I
Resultant linear acceleration of an instrumented head form does not differ between junior and collegiate taekwondo athletes' kicks Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 226–230, 2016.
@article{OSullivan2016,
title = {Resultant linear acceleration of an instrumented head form does not differ between junior and collegiate taekwondo athletes' kicks},
author = {O'Sullivan, D and Fife, G P and Pieter, W and Lim, T and Shin, I},
doi = {10.1016/j.jshs.2015.01.004},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {226--230},
abstract = {Objective: The purpose of this study was to compare the effects of various taekwondo kicks and age (school level) in absolute terms and relative body mass on the resultant linear acceleration (RLA) of an instrumented head form. Methods: Forty-eight male (middle school: 16; high school: 16; university: 16) taekwondo athletes were recruited for this study. Subjects performed 10 turning, 10 jump spinning hook, and 10 jump back kicks on a Hybrid II head mounted on a height-adjustable frame. Results: A 2-way (School × Kick) MANOVA was used to determine the differences in RLA between schools (age groups) by type of kick. There was no univariate School main effect for absolute RLA ($eta$2 = 0.06) and RLA relative to body mass ($eta$2 = 0.06). No univariate Kick main effects were found for absolute ($eta$2 = 0.06) and relative RLA ($eta$2 = 0.06). Conclusion: It is of concern that RLA did not significantly differ between school levels, implying that young taekwondo athletes generate similar forces to their adult counterparts, possibly exposing young athletes to an increased risk for head injuries. © 2016.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kazemi, Mohsen
Concussion assessment and management knowledge among chiropractic fourth year interns and residents Journal Article
In: Journal of the Canadian Chiropractic Association, vol. 60, no. 4, pp. 273–285, 2016, ISBN: 0008-3194.
@article{Kazemi2016,
title = {Concussion assessment and management knowledge among chiropractic fourth year interns and residents},
author = {Kazemi, Mohsen},
isbn = {0008-3194},
year = {2016},
date = {2016-01-01},
journal = {Journal of the Canadian Chiropractic Association},
volume = {60},
number = {4},
pages = {273--285},
publisher = {Canadian Chiropractic Association},
address = {Toronto, Ontario},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Richards, D; Ivarsson, B J; Scher, I; Hoover, R; Rodowicz, K; Cripton, P
Ice hockey shoulder pad design and the effect on head response during shoulder-to-head impacts Journal Article
In: Sports Biomechanics, vol. 15, no. 4, pp. 385–396, 2016.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/pc [Prevention & Control], *Head/ph [Physiology], *Hockey/ph [Physiology], *Protective Clothing, *Shoulder/ph [Physiology], Acceleration, Biomechanical Phenomena, Equipment Design, Humans, Male, Manikins, Materials testing, Reproducibility of Results, Risk Factors
@article{Richards2016,
title = {Ice hockey shoulder pad design and the effect on head response during shoulder-to-head impacts},
author = {Richards, D and Ivarsson, B J and Scher, I and Hoover, R and Rodowicz, K and Cripton, P},
year = {2016},
date = {2016-01-01},
journal = {Sports Biomechanics},
volume = {15},
number = {4},
pages = {385--396},
abstract = {Ice hockey body checks involving direct shoulder-to-head contact frequently result in head injury. In the current study, we examined the effect of shoulder pad style on the likelihood of head injury from a shoulder-to-head check. Shoulder-to-head body checks were simulated by swinging a modified Hybrid-III anthropomorphic test device (ATD) with and without shoulder pads into a stationary Hybrid-III ATD at 21 km/h. Tests were conducted with three different styles of shoulder pads (traditional, integrated and tethered) and without shoulder pads for the purpose of control. Head response kinematics for the stationary ATD were measured. Compared to the case of no shoulder pads, the three different pad styles significantly (p \< 0.05) reduced peak resultant linear head accelerations of the stationary ATD by 35-56%. The integrated shoulder pads reduced linear head accelerations by an additional 18-21% beyond the other two styles of shoulder pads. The data presented here suggest that shoulder pads can be designed to help protect the head of the struck player in a shoulder-to-head check.},
keywords = {*Craniocerebral Trauma/pc [Prevention \& Control], *Head/ph [Physiology], *Hockey/ph [Physiology], *Protective Clothing, *Shoulder/ph [Physiology], Acceleration, Biomechanical Phenomena, Equipment Design, Humans, Male, Manikins, Materials testing, Reproducibility of Results, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Stewart, W; McNamara, P H; Lawlor, B; Hutchinson, S; Farrell, M
Chronic traumatic encephalopathy: a potential late and under recognized consequence of rugby union? Journal Article
In: Qjm, vol. 109, no. 1, pp. 11–15, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Brain Injury, *Brain/pp [Physiopathology], *Football/in [Injuries], *Neurodegenerative Diseases/pp [Physiopathology], Chronic/pa [Pathology], Humans, Magnetic Resonance Imaging, Male, middle aged, neurologic examination
@article{Stewart2016,
title = {Chronic traumatic encephalopathy: a potential late and under recognized consequence of rugby union?},
author = {Stewart, W and McNamara, P H and Lawlor, B and Hutchinson, S and Farrell, M},
year = {2016},
date = {2016-01-01},
journal = {Qjm},
volume = {109},
number = {1},
pages = {11--15},
abstract = {The association between exposure to head injury and increased risk of neurodegenerative disease, specifically chronic traumatic encephalopathy (CTE), is widely recognized. Historically, this was largely considered a phenomenon restricted to boxers, with more recent case series identifying further 'high risk' individuals, such as former American footballers, or military personnel. However, in all cases thus far reported, it is clear that it is the exposure to head injury which is associated with increased dementia risk, and not the circumstances or environment of exposure. As such, there is considerable potential for under-recognition of CTE in patients presenting with neurodegenerative disease, particularly where head injury exposure might have been historical and through sport. This article reviews current understanding of CTE and, via an illustrative case in rugby union, highlights the value of a detailed history on head injury and also draws attention to imaging studies in assessing patients with neurodegenerative disease. Copyright © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.},
keywords = {*Brain Concussion/co [Complications], *Brain Injury, *Brain/pp [Physiopathology], *Football/in [Injuries], *Neurodegenerative Diseases/pp [Physiopathology], Chronic/pa [Pathology], Humans, Magnetic Resonance Imaging, Male, middle aged, neurologic examination},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Covassin, T; Moran, R; Elbin, R J
Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009 Journal Article
In: Journal of Athletic Training, vol. 51, no. 3, pp. 189–194, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities
@article{Covassin2016,
title = {Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009},
author = {Covassin, T and Moran, R and Elbin, R J},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {3},
pages = {189--194},
abstract = {CONTEXT: Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. OBJECTIVE: To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. DESIGN: Descriptive epidemiologic study. SETTING: National Collegiate Athletic Association athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. MAIN OUTCOME MEASURE(S): Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. RESULTS: During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. CONCLUSIONS: Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Cooper, D B; Vanderploeg, R D
The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension Journal Article
In: Applied Neuropsychology. Adult, vol. 23, no. 4, pp. 264–273, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult
@article{Armistead-Jehle2016,
title = {The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension},
author = {Armistead-Jehle, P and Cooper, D B and Vanderploeg, R D},
year = {2016},
date = {2016-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {23},
number = {4},
pages = {264--273},
abstract = {The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population.},
keywords = {*Brain Concussion/di [Diagnosis], *Cognitive Dysfunction/di [Diagnosis], *Military Personnel/px [Psychology], *Neuropsychological Tests/st [Standards], adult, Brain Concussion/px [Psychology], Cognitive Dysfunction/px [Psychology], Female, Humans, Male, Malingering/di [Diagnosis], REGRESSION analysis, Reproducibility of Results, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Calcagnile, O; Anell, A; Unden, J
The addition of S100B to guidelines for management of mild head injury is potentially cost saving Journal Article
In: BMC Neurology, vol. 16, no. 1, pp. 200, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult
@article{Calcagnile2016,
title = {The addition of S100B to guidelines for management of mild head injury is potentially cost saving},
author = {Calcagnile, O and Anell, A and Unden, J},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
number = {1},
pages = {200},
abstract = {BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study. Patients were followed up after 3 months with a standardized questionnaire. Theoretical and actual cost differences were calculated. RESULTS: Seven hundred twenty-six patients were included and 29 (4.7 %) showed traumatic abnormalities on CT. No further significant intracranial complications were discovered on follow-up. Two hundred twenty-nine patients (27 %) had normal S100B levels and 497 patients (73 %) showed elevated S100B levels. Over-triage occurred in 73 patients (32 %) and under-triage occurred in 39 patients (7 %). No significant intracranial complications were missed. The introduction of S100B could save 71 per patient if guidelines were strictly followed. As compliance to the guidelines was not perfect, the actual cost saving was 39 per patient. CONCLUSION: Adding S100B to existing guidelines for mild TBI seems to reduce CT usage and costs, especially if guideline compliance could be increased.},
keywords = {*Brain Concussion/bl [Blood], *Brain Concussion/ec [Economics], *Cost Savings, *Practice Guidelines as Topic, *S100 Calcium Binding Protein beta Subunit/bl [Blo, 0 (Biomarkers), 0 (S100 Calcium Binding Protein beta Subunit), 80 and over, Adolescent, adult, aged, Biomarkers/bl [Blood], Female, Humans, Male, middle aged, SWEDEN, Young Adult},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lucke-Wold, B P; Turner, R C; Logsdon, A F; Nguyen, L; Bailes, J E; Lee, J M; Robson, M J; Omalu, B I; Huber, J D; Rosen, C L
Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy Journal Article
In: Journal of Neurosurgery, vol. 124, no. 3, pp. 687–702, 2016.
Abstract | BibTeX | Tags: *Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley
@article{Lucke-Wold2016,
title = {Endoplasmic reticulum stress implicated in chronic traumatic encephalopathy},
author = {Lucke-Wold, B P and Turner, R C and Logsdon, A F and Nguyen, L and Bailes, J E and Lee, J M and Robson, M J and Omalu, B I and Huber, J D and Rosen, C L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery},
volume = {124},
number = {3},
pages = {687--702},
abstract = {OBJECTIVE: Chronic traumatic encephalopathy is a progressive neurodegenerative disease characterized by neurofibrillary tau tangles following repetitive neurotrauma. The underlying mechanism linking traumatic brain injury to chronic traumatic encephalopathy has not been elucidated. The authors investigate the role of endoplasmic reticulum stress as a link between acute neurotrauma and chronic neurodegeneration. METHODS: The authors used pharmacological, biochemical, and behavioral tools to assess the role of endoplasmic reticulum stress in linking acute repetitive traumatic brain injury to the development of chronic neurodegeneration. Data from the authors' clinically relevant and validated rodent blast model were compared with those obtained from postmortem human chronic traumatic encephalopathy specimens from a National Football League player and World Wrestling Entertainment wrestler. RESULTS: The results demonstrated strong correlation of endoplasmic reticulum stress activation with subsequent tau hyperphosphorylation. Various endoplasmic reticulum stress markers were increased in human chronic traumatic encephalopathy specimens, and the endoplasmic reticulum stress response was associated with an increase in the tau kinase, glycogen synthase kinase-3beta. Docosahexaenoic acid, an endoplasmic reticulum stress inhibitor, improved cognitive performance in the rat model 3 weeks after repetitive blast exposure. The data showed that docosahexaenoic acid administration substantially reduced tau hyperphosphorylation (t = 4.111, p \< 0.05), improved cognition (t = 6.532, p \< 0.001), and inhibited C/EBP homology protein activation (t = 5.631, p \< 0.01). Additionally the data showed, for the first time, that endoplasmic reticulum stress is involved in the pathophysiology of chronic traumatic encephalopathy. CONCLUSIONS: Docosahexaenoic acid therefore warrants further investigation as a potential therapeutic agent for the prevention of chronic traumatic encephalopathy.},
keywords = {*Blast Injuries/px [Psychology], *Brain Injury, *Endoplasmic Reticulum Stress/ph [Physiology], *Football/in [Injuries], *Wrestling/in [Injuries], adult, animal, Animals, Blast Injuries/et [Etiology], Blast Injuries/pa [Pathology], Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/px [Psychology], Disease Models, Humans, Male, Rats, Sprague-Dawley},
pubstate = {published},
tppubtype = {article}
}
Custer, A; Sufrinko, A; Elbin, R J; Covassin, T; Collins, M; Kontos, A
High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 136–141, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students
@article{Custer2016,
title = {High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes},
author = {Custer, A and Sufrinko, A and Elbin, R J and Covassin, T and Collins, M and Kontos, A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {136--141},
abstract = {CONTEXT: Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined. OBJECTIVE: To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC. DESIGN: Cohort study. SETTING: High school and collegiate athletic programs. PATIENTS OR OTHER PARTICIPANTS: A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Post-Concussion Syndrome/di [Diagnosis], Adolescent, Athletes, Cohort Studies, Female, Humans, Male, Memory, Neuropsychological Tests, Prognosis, reaction time, Risk Factors, Students},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Dretsch, M N; Slaboda, J C; Johnson, D E; Adam, O R; Tsao, J W
Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 280–286, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values
@article{Haran2016b,
title = {Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment},
author = {Haran, F J and Dretsch, M N and Slaboda, J C and Johnson, D E and Adam, O R and Tsao, J W},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {280--286},
abstract = {PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p \< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p \> 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.},
keywords = {*Brain Concussion/di [Diagnosis], *Military Personnel/px [Psychology], adult, Brain Concussion/px [Psychology], Female, Humans, Male, Neuropsychological Tests, Reference Standards, Reference Values},
pubstate = {published},
tppubtype = {article}
}
Sung, C W; Chen, K Y; Chiang, Y H; Chiu, W T; Ou, J C; Lee, H C; Tsai, S H; Lin, J W; Yang, C M; Tsai, Y R; Liao, K H; Chen, G S; Li, W J; Wang, J Y
Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury Journal Article
In: Clinical Neurophysiology, vol. 127, no. 2, pp. 1629–1638, 2016.
Abstract | BibTeX | Tags: *Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult
@article{Sung2016,
title = {Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury},
author = {Sung, C W and Chen, K Y and Chiang, Y H and Chiu, W T and Ou, J C and Lee, H C and Tsai, S H and Lin, J W and Yang, C M and Tsai, Y R and Liao, K H and Chen, G S and Li, W J and Wang, J Y},
year = {2016},
date = {2016-01-01},
journal = {Clinical Neurophysiology},
volume = {127},
number = {2},
pages = {1629--1638},
abstract = {OBJECTIVE: Patients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. METHODS: We assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. RESULTS: mTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. CONCLUSIONS: We infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SIGNIFICANCE: The study is relevant for specific diagnostic markers in mTBI patients.Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
keywords = {*Anxiety/bl [Blood], *Brain Injuries/bl [Blood], *Depression/bl [Blood], *Heart Rate/ph [Physiology], *Insulin-Like Growth Factor I/me [Metabolism], 0 (Biomarkers), 67763-96-6 (Insulin-Like Growth Factor I), adult, Affective Symptoms/bl [Blood], Affective Symptoms/di [Diagnosis], Affective Symptoms/px [Psychology], Anxiety/di [Diagnosis], Anxiety/px [Psychology], Biomarkers/bl [Blood], Brain Injuries/di [Diagnosis], Brain Injuries/px [Psychology], Cohort Studies, Depression/di [Diagnosis], Depression/px [Psychology], Female, Follow-Up Studies, Humans, Male, middle aged, Mood Disorders/bl [Blood], Mood Disorders/di [Diagnosis], Mood Disorders/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
Abstract | BibTeX | Tags: *Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {*Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Subbian, V; Ratcliff, J J; Korfhagen, J J; Hart, K W; Meunier, J M; Shaw, G J; Lindsell, C J; Beyette Jr., F R
A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up? Journal Article
In: Academic Emergency Medicine, vol. 23, no. 4, pp. 382–392, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization & Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult
@article{Subbian2016,
title = {A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?},
author = {Subbian, V and Ratcliff, J J and Korfhagen, J J and Hart, K W and Meunier, J M and Shaw, G J and Lindsell, C J and {Beyette Jr.}, F R},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {4},
pages = {382--392},
abstract = {OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose of this study was to determine if PCS following mild TBI can be predicted during the initial presentation to an emergency department (ED) using a novel robotic-assisted assessment of neurologic function. METHODS: All patients presenting to an urban ED with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild TBI by the treating physician, and 4) blood alcohol level of \<100 mg/dL. Eligible mild TBI patients were enrolled and their neuromotor function was assessed in the ED using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post-Concussion Symptoms Questionnaire to assess the presence of significant PCS. RESULTS: A total of 66 mild TBI patients were enrolled in the study with 42 of them completing both the ED assessment and the follow-up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (AUC) for the entire test battery was 0.72 (95% confidence interval [CI] = 0.54 to 0.90). The AUC for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% CI = 0.65 to 0.95) and 0.71 (95% CI = 0.53 to 0.89), respectively. CONCLUSIONS: The robotic-assisted test battery has the ability to discriminate between subjects who developed PCS and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent PCS.Copyright © 2016 by the Society for Academic Emergency Medicine.},
keywords = {*Brain Injuries/co [Complications], *Emergency Service, *Post-Concussion Syndrome/di [Diagnosis], *Post-Concussion Syndrome/et [Etiology], *Robotics/mt [Methods], adult, Closed/co [Complications], Diagnostic Techniques, Female, Follow-Up Studies, Head Injuries, Hospital/og [Organization \& Ad, Humans, Male, middle aged, Neurological, Observer Variation, Sensitivity and Specificity, Urban Population, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
Abstract | Links | BibTeX | Tags: adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {adult, aged, American Indian, amnesia, area under the curve, Article, Asian, assault, bicycle, Black person, blood sampling, blunt trauma, brain concussion, Caucasian, cohort analysis, computer assisted tomography, controlled study, diagnostic accuracy, diagnostic test accuracy study, disorientation, emergency ward, falling, Female, Glasgow Coma Scale, glial fibrillary acidic protein, Hispanic, human, limit of detection, limit of quantitation, major clinical study, Male, mild to moderate traumatic brain injury, neurosurgery, pedestrian, priority journal, prospective study, sport injury, traffic accident, traumatic brain injury, traumatic intracranial lesion, ubiquitin, ubiquitin carboxy terminal hydrolase L1, unclassified drug, unconsciousness, very elderly},
pubstate = {published},
tppubtype = {article}
}
Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D
Association of football subconcussive head impacts with ocular near point of convergence Journal Article
In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.
Abstract | Links | BibTeX | Tags: Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult
@article{Kawata2016,
title = {Association of football subconcussive head impacts with ocular near point of convergence},
author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},
doi = {10.1001/jamaophthalmol.2016.1085},
year = {2016},
date = {2016-01-01},
journal = {JAMA Ophthalmology},
volume = {134},
number = {7},
pages = {763--769},
abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},
keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Mannix, R; Iverson, G L
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Silverberg2016b,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure--Reply},
author = {Silverberg, N D and Mannix, R and Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Odom, M J; Lee, Y M; Zuckerman, S L; Apple, R P; Germanos, T; Solomon, G S; Sills, A K
Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System Journal Article
In: J Surg Orthop Adv, vol. 25, no. 2, pp. 93–98, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult
@article{Odom2016,
title = {Balance Assessment in Sports-Related Concussion: Evaluating Test-Retest Reliability of the Equilibrate System},
author = {Odom, M J and Lee, Y M and Zuckerman, S L and Apple, R P and Germanos, T and Solomon, G S and Sills, A K},
year = {2016},
date = {2016-01-01},
journal = {J Surg Orthop Adv},
volume = {25},
number = {2},
pages = {93--98},
abstract = {This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Postural Balance, *Sensation Disorders/di [Diagnosis], adult, Athletic Injuries/co [Complications], Brain Concussion/co [Complications], Computer-Assisted, DIAGNOSIS, Female, Humans, Male, Reproducibility of Results, Sensation Disorders/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M; Bleiberg, J; Williams, K; Caban, J; Kelly, J; Grammer, G; DeGraba, T
Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 23–29, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare
@article{Dretsch2016,
title = {Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI},
author = {Dretsch, M and Bleiberg, J and Williams, K and Caban, J and Kelly, J and Grammer, G and DeGraba, T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {23--29},
abstract = {OBJECTIVE: To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. SETTING: A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. PARTICIPANTS: Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. DESIGN: Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. MAIN MEASURES: Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). RESULTS: All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. CONCLUSION: Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.},
keywords = {*Brain Injuries/px [Psychology], *Brain Injuries/rh [Rehabilitation], *Military Personnel, *Neuropsychological Tests, adult, ambulatory care, Female, Humans, Male, Retrospective Studies, UNITED States, Warfare},
pubstate = {published},
tppubtype = {article}
}
Hoffer, M E; Szczupak, M; Kiderman, A; Crawford, J; Murphy, S; Marshall, K; Pelusso, C; Balaban, C
Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury Journal Article
In: PLoS ONE, vol. 11, no. 1, pp. e0146039, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult
@article{Hoffer2016,
title = {Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury},
author = {Hoffer, M E and Szczupak, M and Kiderman, A and Crawford, J and Murphy, S and Marshall, K and Pelusso, C and Balaban, C},
year = {2016},
date = {2016-01-01},
journal = {PLoS ONE},
volume = {11},
number = {1},
pages = {e0146039},
abstract = {Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.},
keywords = {*Brain Injuries/co [Complications], *Vestibular Function Tests, acute disease, Adolescent, adult, Affective Symptoms/et [Etiology], Brain Injuries/di [Diagnosis], Cluster Analysis, Dizziness/et [Etiology], Emergency Service, Fatigue/et [Etiology], Female, Gait Disorders, Headache/et [Etiology], Hospital, Hospitals, Humans, Male, middle aged, Mild Cognitive Impairment/et [Etiology], Military, Nausea/et [Etiology], Neurologic/et [Etiology], Neuropsychological Tests, Principal Component Analysis, Prognosis, Sex Factors, Surveys and Questionnaires, symptom assessment, Trauma Severity Indices, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
Abstract | BibTeX | Tags: *Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {*Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Fralick, M; Thiruchelvam, D; Tien, H C; Redelmeier, D A
Risk of suicide after a concussion Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 188, no. 7, pp. 497–504, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Suicide/sn [Statistics & Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors
@article{Fralick2016,
title = {Risk of suicide after a concussion},
author = {Fralick, M and Thiruchelvam, D and Tien, H C and Redelmeier, D A},
year = {2016},
date = {2016-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {188},
number = {7},
pages = {497--504},
abstract = {BACKGROUND: Head injuries have been associated with subsequent suicide among military personnel, but outcomes after a concussion in the community are uncertain. We assessed the long-term risk of suicide after concussions occurring on weekends or weekdays in the community. METHODS: We performed a longitudinal cohort analysis of adults with diagnosis of a concussion in Ontario, Canada, from Apr. 1, 1992, to Mar. 31, 2012 (a 20-yr period), excluding severe cases that resulted in hospital admission. The primary outcome was the long-term risk of suicide after a weekend or weekday concussion. RESULTS: We identified 235,110 patients with a concussion. Their mean age was 41 years, 52% were men, and most (86%) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or 3 times the population norm. Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions (relative risk 1.36, 95% confidence interval 1.14-1.64). The increased risk applied regardless of patients' demographic characteristics, was independent of past psychiatric conditions, became accentuated with time and exceeded the risk among military personnel. Half of these patients had visited a physician in the last week of life. INTERPRETATION: Adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.Copyright © 2016 Canadian Medical Association or its licensors.},
keywords = {*Brain Concussion/co [Complications], *Suicide/sn [Statistics \& Numerical Data], adult, Canada/ep [Epidemiology], Cohort Studies, Female, Humans, Long-Term Care, Longitudinal studies, Male, ONTARIO, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Stieg, P E; Perrine, K
Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article
In: World Neurosurgery, vol. 86, pp. 65–68, 2016.
Links | BibTeX | Tags: brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport
@article{Stieg2016,
title = {Helmet Use and Traumatic Brain Injury in Snowboarding},
author = {Stieg, P E and Perrine, K},
doi = {10.1016/j.wneu.2015.07.044},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {86},
pages = {65--68},
keywords = {brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport},
pubstate = {published},
tppubtype = {article}
}
van der Horn, H J; Liemburg, E J; Scheenen, M E; de Koning, M E; Marsman, J B; Spikman, J M; van der Naalt, J
Brain network dysregulation, emotion, and complaints after mild traumatic brain injury Journal Article
In: Human Brain Mapping, vol. 37, no. 4, pp. 1645–1654, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult
@article{VanderHorn2016,
title = {Brain network dysregulation, emotion, and complaints after mild traumatic brain injury},
author = {van der Horn, H J and Liemburg, E J and Scheenen, M E and de Koning, M E and Marsman, J B and Spikman, J M and van der Naalt, J},
year = {2016},
date = {2016-01-01},
journal = {Human Brain Mapping},
volume = {37},
number = {4},
pages = {1645--1654},
abstract = {OBJECTIVES: To assess the role of brain networks in emotion regulation and post-traumatic complaints in the sub-acute phase after non-complicated mild traumatic brain injury (mTBI). EXPERIMENTAL DESIGN: Fifty-four patients with mTBI (34 with and 20 without complaints) and 20 healthy controls (group-matched for age, sex, education, and handedness) were included. Resting-state fMRI was performed at four weeks post-injury. Static and dynamic functional connectivity were studied within and between the default mode, executive (frontoparietal and bilateral frontal network), and salience network. The hospital anxiety and depression scale (HADS) was used to measure anxiety (HADS-A) and depression (HADS-D). PRINCIPAL OBSERVATIONS: Regarding within-network functional connectivity, none of the selected brain networks were different between groups. Regarding between-network interactions, patients with complaints exhibited lower functional connectivity between the bilateral frontal and salience network compared to patients without complaints. In the total patient group, higher HADS-D scores were related to lower functional connectivity between the bilateral frontal network and both the right frontoparietal and salience network, and to higher connectivity between the right frontoparietal and salience network. Furthermore, whereas higher HADS-D scores were associated with lower connectivity within the parietal midline areas of the bilateral frontal network, higher HADS-A scores were related to lower connectivity within medial prefrontal areas of the bilateral frontal network. CONCLUSIONS: Functional interactions of the executive and salience networks were related to emotion regulation and complaints after mTBI, with a key role for the bilateral frontal network. These findings may have implications for future studies on the effect of psychological interventions.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {*Brain Concussion/pp [Physiopathology], *Brain/pp [Physiopathology], *Emotions, *MAGNETIC resonance imaging, *Nerve Net/pp [Physiopathology], Adolescent, adult, Brain Concussion/px [Psychology], Emotions/ph [Physiology], Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Prospective Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal},
pubstate = {published},
tppubtype = {article}
}
Donders, J; Strong, C A
Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 1, pp. 29–36, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult
@article{Donders2016,
title = {Latent Structure of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) After Mild Traumatic Brain Injury},
author = {Donders, J and Strong, C A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {1},
pages = {29--36},
abstract = {One hundred persons with mild traumatic brain injury (TBI) and their informants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) within 1-12 months after injury. Exploratory maximum-likelihood factor analysis with oblique rotation revealed that although a traditional 2-factor model fit the informant-report data well, a 3-factor solution fit the self-report data relatively best. These factors were labeled Metacognition, Behavioral Regulation, and Emotional Regulation. The presence of a premorbid history of outpatient psychiatric treatment was strongly predictive of higher scores (reflecting more perceived problems) on each of these 3 factors. Lower educational attainment was associated with higher scores on the Behavioral Regulation factor, whereas absence of intracranial findings on neuroimaging was associated with higher scores on the Emotional Regulation factor. It is concluded that, after mild TBI, self-report data on the BRIEF-A can be interpreted along a 3-factorial model and that high elevations on this instrument are strongly affected by premorbid complications. Copyright © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.},
keywords = {*Brain Injuries/px [Psychology], *Cognition Disorders/px [Psychology], *Executive Function, Adolescent, adult, Brain Injuries/co [Complications], Brain Injuries/di [Diagnosis], Cognition Disorders/co [Complications], Cognition Disorders/di [Diagnosis], FACTOR analysis, Female, Humans, Male, Models, Neuropsychological Tests, Psychological, self report, Statistical, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Mez, J; Solomon, T M; Daneshvar, D H; Stein, T D; McKee, A C
Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player Journal Article
In: JAMA Neurology, vol. 73, no. 3, pp. 353–355, 2016.
BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections
@article{Mez2016,
title = {Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player},
author = {Mez, J and Solomon, T M and Daneshvar, D H and Stein, T D and McKee, A C},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {3},
pages = {353--355},
keywords = {*Athletic Injuries/co [Complications], *Brain Injury, *Football, adult, Bacterial, Brain Injury, Chronic/et [Etiology], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Endocarditis, Fatal Outcome, Heart Arrest, Humans, Male, Staphylococcal Infections},
pubstate = {published},
tppubtype = {article}
}
Babcock, L; Kurowski, B G
Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms Journal Article
In: JAMA, vol. 315, no. 10, pp. 987–988, 2016.
BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male
@article{Babcock2016,
title = {Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms},
author = {Babcock, L and Kurowski, B G},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {987--988},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Zonfrillo, M R; Kim, K H; Arbogast, K B
In Reply Journal Article
In: Academic Emergency Medicine, vol. 23, no. 1, pp. 109, 2016.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics & Nume, Humans, Male, X-Ray Computed/ut [Utilization]
@article{Zonfrillo2016a,
title = {In Reply},
author = {Zonfrillo, M R and Kim, K H and Arbogast, K B},
year = {2016},
date = {2016-01-01},
journal = {Academic Emergency Medicine},
volume = {23},
number = {1},
pages = {109},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/ra [Radiography], *Emergency Service, *Tomography, Female, Hospital/sn [Statistics \& Nume, Humans, Male, X-Ray Computed/ut [Utilization]},
pubstate = {published},
tppubtype = {article}
}
Comrie, D
Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure Journal Article
In: JAMA Pediatr, vol. 170, no. 4, pp. 399–400, 2016.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male
@article{Comrie2016,
title = {Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure},
author = {Comrie, D},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {4},
pages = {399--400},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], *Post-Concussion Syndrome/ep [Epidemiology], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Kazemi, Mohsen
Concussion assessment and management knowledge among chiropractic fourth year interns and residents Journal Article
In: Journal of the Canadian Chiropractic Association, vol. 60, no. 4, pp. 273–285, 2016, ISBN: 0008-3194.
BibTeX | Tags: Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis
@article{Kazemi2016,
title = {Concussion assessment and management knowledge among chiropractic fourth year interns and residents},
author = {Kazemi, Mohsen},
isbn = {0008-3194},
year = {2016},
date = {2016-01-01},
journal = {Journal of the Canadian Chiropractic Association},
volume = {60},
number = {4},
pages = {273--285},
publisher = {Canadian Chiropractic Association},
address = {Toronto, Ontario},
keywords = {Brain Concussion -- Diagnosis, CANADA, Chi Square Test, chiropractic, CONFIDENCE intervals, Data Analysis Software, DESCRIPTIVE statistics, disease management, Education, Female, Health Occupations -- Canada, human, Interns and Residents, Male, P-Value, Problem-Based Learning, Professional Knowledge -- Evaluation, Questionnaires, Schools, SURVEYS, Thematic analysis},
pubstate = {published},
tppubtype = {article}
}
Astafiev, S V; Zinn, K L; Shulman, G L; Corbetta, M
Exploring the physiological correlates of chronic mild traumatic brain injury symptoms Journal Article
In: NeuroImage Clinical, vol. 11, pp. 10–19, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests
@article{Astafiev2016,
title = {Exploring the physiological correlates of chronic mild traumatic brain injury symptoms},
author = {Astafiev, S V and Zinn, K L and Shulman, G L and Corbetta, M},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {10--19},
abstract = {We report on the results of a multimodal imaging study involving behavioral assessments, evoked and resting-state BOLD fMRI, and DTI in chronic mTBI subjects. We found that larger task-evoked BOLD activity in the MT+/LO region in extra-striate visual cortex correlated with mTBI and PTSD symptoms, especially light sensitivity. Moreover, higher FA values near the left optic radiation (OR) were associated with both light sensitivity and higher BOLD activity in the MT+/LO region. The MT+/LO region was localized as a region of abnormal functional connectivity with central white matter regions previously found to have abnormal physiological signals during visual eye movement tracking (Astafiev et al., 2015). We conclude that mTBI symptoms and light sensitivity may be related to excessive responsiveness of visual cortex to sensory stimuli. This abnormal sensitivity may be related to chronic remodeling of white matter visual pathways acutely injured.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pp [Physiopathology], *Post-Concussion Syndrome/pp [Physiopathology], *White Matter/pp [Physiopathology], anisotropy, chronic disease, Diffusion Tensor Imaging/mt [Methods], Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, Neuropsychological Tests},
pubstate = {published},
tppubtype = {article}
}
O'Sullivan, D; Fife, G P; Pieter, W; Lim, T; Shin, I
Resultant linear acceleration of an instrumented head form does not differ between junior and collegiate taekwondo athletes' kicks Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 226–230, 2016.
Abstract | Links | BibTeX | Tags: accelerometer, Adolescent, age distribution, analytical parameters, Article, athlete, Biomechanics, body mass, Concussion, controlled study, head injury, high school student, human, injury, Male, Martial Arts, middle school student, priority journal, resultant linear acceleration, taekwondo, university student
@article{OSullivan2016,
title = {Resultant linear acceleration of an instrumented head form does not differ between junior and collegiate taekwondo athletes' kicks},
author = {O'Sullivan, D and Fife, G P and Pieter, W and Lim, T and Shin, I},
doi = {10.1016/j.jshs.2015.01.004},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {226--230},
abstract = {Objective: The purpose of this study was to compare the effects of various taekwondo kicks and age (school level) in absolute terms and relative body mass on the resultant linear acceleration (RLA) of an instrumented head form. Methods: Forty-eight male (middle school: 16; high school: 16; university: 16) taekwondo athletes were recruited for this study. Subjects performed 10 turning, 10 jump spinning hook, and 10 jump back kicks on a Hybrid II head mounted on a height-adjustable frame. Results: A 2-way (School × Kick) MANOVA was used to determine the differences in RLA between schools (age groups) by type of kick. There was no univariate School main effect for absolute RLA ($eta$2 = 0.06) and RLA relative to body mass ($eta$2 = 0.06). No univariate Kick main effects were found for absolute ($eta$2 = 0.06) and relative RLA ($eta$2 = 0.06). Conclusion: It is of concern that RLA did not significantly differ between school levels, implying that young taekwondo athletes generate similar forces to their adult counterparts, possibly exposing young athletes to an increased risk for head injuries. © 2016.},
keywords = {accelerometer, Adolescent, age distribution, analytical parameters, Article, athlete, Biomechanics, body mass, Concussion, controlled study, head injury, high school student, human, injury, Male, Martial Arts, middle school student, priority journal, resultant linear acceleration, taekwondo, university student},
pubstate = {published},
tppubtype = {article}
}
Leung, A; Shukla, S; Fallah, A; Song, D; Lin, L; Golshan, S; Tsai, A; Jak, A; Polston, G; Lee, R
Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches Journal Article
In: Neuromodulation, vol. 19, no. 2, pp. 133–141, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome
@article{Leung2016,
title = {Repetitive Transcranial Magnetic Stimulation in Managing Mild Traumatic Brain Injury-Related Headaches},
author = {Leung, A and Shukla, S and Fallah, A and Song, D and Lin, L and Golshan, S and Tsai, A and Jak, A and Polston, G and Lee, R},
year = {2016},
date = {2016-01-01},
journal = {Neuromodulation},
volume = {19},
number = {2},
pages = {133--141},
abstract = {OBJECTIVE: Headache is one of the most common debilitating chronic pain conditions in either active or retired military personnel with mild traumatic brain injury (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related headache (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week headache and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 men and 3 women with average year-old +/- SD at 14.3 +/- 12.6) subjects' data were analyzed. A two-factor (visit x treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily headache decreasing from 5.7 +/- 1.9 to 2.2 +/- 2.7 and 4.6 +/- 1.3 to 3.5 +/- 2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent headache intensity than the SHAM group (56.3 +/- 48.2% vs.15.4 +/- 43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% headache intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating headache exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.Copyright © 2015 International Neuromodulation Society.},
keywords = {*Brain Concussion/co [Complications], *Headache/et [Etiology], *Headache/th [Therapy], *Transcranial Magnetic Stimulation/mt [Methods], adult, aged, Female, Humans, Male, middle aged, Neuronavigation, Neuropsychological Tests, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
Abstract | Links | BibTeX | Tags: adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War},
pubstate = {published},
tppubtype = {article}
}
Beiske, K K; Kostov, K H; Kostov, H
Rhythmic midtemporal discharge in a youth during light sleep Journal Article
In: Neurodiagnostic Journal, vol. 56, no. 1, pp. 32–36, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness
@article{Beiske2016,
title = {Rhythmic midtemporal discharge in a youth during light sleep},
author = {Beiske, K K and Kostov, K H and Kostov, H},
doi = {10.1080/21646821.2015.1119579},
year = {2016},
date = {2016-01-01},
journal = {Neurodiagnostic Journal},
volume = {56},
number = {1},
pages = {32--36},
abstract = {Rhythmic midtemporal discharge (RMTD) is a rare, benign EEG pattern that may have epileptic morphology. Recognizing variations of RMTD is important in order to avoid over- or misinterpretation of EEG findings, which may lead to inappropriate treatment and negative consequences for the patient in question. We present a case report of RTMDs during light sleep where initial erroneous description necessitated repeat EEGs and additional diagnostic exams and led to the postponement of obtaining a drivers licence for this young patient. Copyright © ASET - The Neurodiagnostic Society.},
keywords = {Adolescent, Article, Automobile Driving, Benign EEG pattern, car driving, case report, case reports, complication, computer assisted tomography, Concussion, Craniocerebral Trauma, drowsiness, EEG pattern, electroencephalogram, Electroencephalography, Epilepsy, epileptic discharge, febrile convulsion, football, Functional Laterality, head injury, hemispheric dominance, human, Humans, hyperventilation, Injuries, Light sleep, Male, neuroimaging, neurologic examination, nuclear magnetic resonance imaging, Pathophysiology, Patient treatment, Rhythmic midtemporal discharge, RMTD, SLEEP, Sleep research, spike wave, temporal lobe, temporal lobe epilepsy, theta rhythm, tonic clonic seizure, unconsciousness, wakefulness},
pubstate = {published},
tppubtype = {article}
}
Stergiou-Kita, M; Mansfield, E; Sokoloff, S; Colantonio, A
Gender Influences on Return to Work After Mild Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 97, no. 2 Suppl, pp. S40–5, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult
@article{Stergiou-Kita2016,
title = {Gender Influences on Return to Work After Mild Traumatic Brain Injury},
author = {Stergiou-Kita, M and Mansfield, E and Sokoloff, S and Colantonio, A},
year = {2016},
date = {2016-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {97},
number = {2 Suppl},
pages = {S40--5},
abstract = {OBJECTIVE: To examine the influence of gender on the return to work experience of workers who sustained a work-related mild traumatic brain injury (TBI). DESIGN: Qualitative study using in-depth telephone interviews. SETTING: Community. PARTICIPANTS: Purposive sampling was used to recruit participants. Participants were adults (N=12; males},
keywords = {*Brain Injuries/rh [Rehabilitation], *Return to Work/px [Psychology], *Sex Factors, adult, aged, Brain Injuries/px [Psychology], Female, Humans, Male, middle aged, Patient Acceptance of Health Care/px [Psychology], Qualitative Research, Rehabilitation, Social Environment, Vocational/px [Psychology], Workplace/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hilz, M J; Liu, M; Koehn, J; Wang, R; Ammon, F; Flanagan, S R; Hosl, K M
Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury Journal Article
In: BMC Neurology, vol. 16, pp. 61, 2016.
Abstract | BibTeX | Tags: *Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration
@article{Hilz2016,
title = {Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury},
author = {Hilz, M J and Liu, M and Koehn, J and Wang, R and Ammon, F and Flanagan, S R and Hosl, K M},
year = {2016},
date = {2016-01-01},
journal = {BMC Neurology},
volume = {16},
pages = {61},
abstract = {BACKGROUND: Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients. METHODS: In 29 healthy persons (31.3+/-12.2 years; 9 women) and 25 post-mTBI-patients (35.0+/-13.2 years, 7 women, 4-98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal. We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P\<0.05). RESULTS: At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P\<0.05). CONCLUSIONS: Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.},
keywords = {*Autonomic Nervous System Diseases/pp [Physiopatho, *Baroreflex, *Blood Pressure, *Brain Concussion/pp [Physiopathology], *Valsalva Maneuver, adult, Case-Control Studies, Female, Heart Rate/ph [Physiology], Humans, Male, Respiration},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Geh, N; Selzer, B J; Bower, R; Himedan, M; Strahle, M; Wetjen, N M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with Chiari I malformation Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 403–409, 2016.
Abstract | BibTeX | Tags: *Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool
@article{Strahle2016,
title = {Sports participation with Chiari I malformation},
author = {Strahle, J and Geh, N and Selzer, B J and Bower, R and Himedan, M and Strahle, M and Wetjen, N M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {403--409},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with Chiari I malformation (CM-I). The authors' goal was to define the risk of sports participation for children with the imaging finding of CM-I. METHODS A prospective survey was administered to 503 CM-I patients at 2 sites over a 46-month period. Data were gathered on imaging characteristics, treatment, sports participation, and any sport-related injuries. Additionally, 81 patients completed at least 1 subsequent survey following their initial entry into the registry and were included in a prospective group, with a mean prospective follow-up period of 11 months. RESULTS Of the 503 CM-I patients, 328 participated in sports for a cumulative duration of 4641 seasons; 205 of these patients participated in contact sports. There were no serious or catastrophic neurological injuries. One patient had temporary extremity paresthesias that resolved within hours, and this was not definitely considered to be related to the CM-I. In the prospective cohort, there were no permanent neurological injuries. CONCLUSIONS No permanent or catastrophic neurological injuries were observed in CM-I patients participating in athletic activities. The authors believe that the risk of such injuries is low and that, in most cases, sports participation by children with CM-I is safe.},
keywords = {*Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T
Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult
@article{Bailie2016,
title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},
author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {2--12},
abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},
keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
Wu, L C; Nangia, V; Bui, K; Hammoor, B; Kurt, M; Hernandez, F; Kuo, C; Camarillo, D B
In Vivo Evaluation of Wearable Head Impact Sensors Journal Article
In: Annals of Biomedical Engineering, vol. 44, no. 4, pp. 1234–1245, 2016.
Abstract | BibTeX | Tags: *Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording
@article{Wu2016,
title = {In Vivo Evaluation of Wearable Head Impact Sensors},
author = {Wu, L C and Nangia, V and Bui, K and Hammoor, B and Kurt, M and Hernandez, F and Kuo, C and Camarillo, D B},
year = {2016},
date = {2016-01-01},
journal = {Annals of Biomedical Engineering},
volume = {44},
number = {4},
pages = {1234--1245},
abstract = {Inertial sensors are commonly used to measure human head motion. Some sensors have been tested with dummy or cadaver experiments with mixed results, and methods to evaluate sensors in vivo are lacking. Here we present an in vivo method using high speed video to test teeth-mounted (mouthguard), soft tissue-mounted (skin patch), and headgear-mounted (skull cap) sensors during 6-13 g sagittal soccer head impacts. Sensor coupling to the skull was quantified by displacement from an ear-canal reference. Mouthguard displacements were within video measurement error (\<1 mm), while the skin patch and skull cap displaced up to 4 and 13 mm from the ear-canal reference, respectively. We used the mouthguard, which had the least displacement from skull, as the reference to assess 6-degree-of-freedom skin patch and skull cap measurements. Linear and rotational acceleration magnitudes were over-predicted by both the skin patch (with 120% NRMS error for a(mag), 290% for alpha(mag)) and the skull cap (320% NRMS error for a(mag), 500% for alpha(mag)). Such over-predictions were largely due to out-of-plane motion. To model sensor error, we found that in-plane skin patch linear acceleration in the anterior-posterior direction could be modeled by an underdamped viscoelastic system. In summary, the mouthguard showed tighter skull coupling than the other sensor mounting approaches. Furthermore, the in vivo methods presented are valuable for investigating skull acceleration sensor technologies.},
keywords = {*Head Movements/ph [Physiology], *Models, *Soccer/ph [Physiology], *Telemetry/is [Instrumentation], adult, Biological, Biomechanical Phenomena, Craniocerebral Trauma, Humans, Male, MOUTH protectors, Skin, Soccer/in [Injuries], VIDEO recording},
pubstate = {published},
tppubtype = {article}
}