Blennow, K; Brody, D L; Kochanek, P M; Levin, H; McKee, A; Ribbers, G M; Yaffe, K; Zetterberg, H
Traumatic brain injuries Journal Article
In: Nature Reviews Disease Primers, vol. 2, 2016.
Abstract | Links | BibTeX | Tags: amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury
@article{Blennow2016,
title = {Traumatic brain injuries},
author = {Blennow, K and Brody, D L and Kochanek, P M and Levin, H and McKee, A and Ribbers, G M and Yaffe, K and Zetterberg, H},
doi = {10.1038/nrdp.2016.84},
year = {2016},
date = {2016-01-01},
journal = {Nature Reviews Disease Primers},
volume = {2},
abstract = {Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury-the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available. Most patients with mild TBI will recover quickly, but others report persistent symptoms, called post-concussive syndrome, the underlying pathophysiology of which is largely unknown. Repeated concussive and subconcussive head injuries have been linked to the neurodegenerative condition chronic traumatic encephalopathy (CTE), which has been reported post-mortem in contact sports athletes and soldiers exposed to blasts. Insights from severe injuries and CTE plausibly shed light on the underlying cellular and molecular processes involved in mild TBI. MRI techniques and blood tests for axonal proteins to identify and grade axonal injury, in addition to PET for tau pathology, show promise as tools to explore CTE pathophysiology in longitudinal clinical studies, and might be developed into diagnostic tools for CTE. Given that CTE is attributed to repeated head trauma, prevention might be possible through rule changes by sports organizations and legislators. © 2016 Macmillan Publishers Limited, part of Springer Nature.},
keywords = {amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Gregory, A; Kerr, Z; Parsons, J
Selected issues in injury and illness prevention and the team physician: A consensus statement Journal Article
In: Current Sports Medicine Reports, vol. 15, no. 1, pp. 48–59, 2016.
Abstract | Links | BibTeX | Tags: Accident prevention, Article, athlete, cervical spine injury, commotio cordis, Concussion, consultation, coronary artery anomaly, documentation, elbow injury, head and neck injury, heart right ventricle dysplasia, heat injury, human, hypertrophic cardiomyopathy, knowledge, patellofemoral pain syndrome, physician, risk factor, shoulder injury, skin infection, sport injury, SPORTS medicine, total quality management
@article{Gregory2016,
title = {Selected issues in injury and illness prevention and the team physician: A consensus statement},
author = {Gregory, A and Kerr, Z and Parsons, J},
doi = {10.1249/JSR.0000000000000231},
year = {2016},
date = {2016-01-01},
journal = {Current Sports Medicine Reports},
volume = {15},
number = {1},
pages = {48--59},
abstract = {This document provides an overview of selected medical issues that are important to team physicians who are responsible for the care and treatment of athletes. It is not intended as a standard of care, and should not be interpreted as such. This document is only a guide, and as such, is of a general nature, consistent with the reasonable, objective practice of the health care profession. Adequate insurance should be in place to help protect the physician, the athlete, and the sponsoring organization. This statement was developed by a collaboration of sixmajor professional associations concerned about clinical sports medicine issues. They have committed to forming an ongoing project-based alliance to bring together sports medicine organizations to best serve active people and athletes. The organizations are the American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine. Copyright © 2016 by the American College of Sports Medicine.},
keywords = {Accident prevention, Article, athlete, cervical spine injury, commotio cordis, Concussion, consultation, coronary artery anomaly, documentation, elbow injury, head and neck injury, heart right ventricle dysplasia, heat injury, human, hypertrophic cardiomyopathy, knowledge, patellofemoral pain syndrome, physician, risk factor, shoulder injury, skin infection, sport injury, SPORTS medicine, total quality management},
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}
}
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}
}
Bressan, S; Babl, F E
Diagnosis and management of paediatric concussion Journal Article
In: Journal of Paediatrics & Child Health, vol. 52, no. 2, pp. 151–157, 2016.
Abstract | Links | BibTeX | Tags: Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury
@article{Bressan2016,
title = {Diagnosis and management of paediatric concussion},
author = {Bressan, S and Babl, F E},
doi = {10.1111/jpc.12967},
year = {2016},
date = {2016-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {52},
number = {2},
pages = {151--157},
abstract = {Heightened recognition of concussions and concerns about their sequelae in children has become an increasing community and public health concern. Biomarkers and clinical tests are being explored, but the diagnosis of concussion in the emergency department continues to be based on clinical signs and symptoms. While the majority of children go on to recover from post-concussive symptoms within 2 weeks, it is unclear which patients with concussion will go on to develop short- or long-term sequelae. A number of more or less evidence-based guidelines have become available which seek to guide clinicians on how to manage children post-concussion. In general, care after the emergency department is focused on reducing the risk of re-injury and rest until cerebral recovery with a graduated return to school and then play. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).},
keywords = {Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury},
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}
}
Keener, A B
Tackling the brain: Clues emerge about the pathology of sports-related brain trauma Journal Article
In: Nature Medicine, vol. 22, no. 4, pp. 326–329, 2016.
Links | BibTeX | Tags: amnesia, Article, astrocyte, athlete, Athletic Injuries, behavior change, blood vessel injury, brain, Brain Injuries, Brain Injury, cognitive defect, Concussion, confusion, degenerative disease, Epilepsy, head injury, headache, hearing impairment, human, Humans, Neck pain, nerve cell, nervous system inflammation, neurofibrillary tangle, nonhuman, Pathophysiology, postconcussion syndrome, priority journal, sport injury, traumatic brain injury, unsteadiness, Vision, wrestling
@article{Keener2016,
title = {Tackling the brain: Clues emerge about the pathology of sports-related brain trauma},
author = {Keener, A B},
doi = {10.1038/nm0416-326},
year = {2016},
date = {2016-01-01},
journal = {Nature Medicine},
volume = {22},
number = {4},
pages = {326--329},
keywords = {amnesia, Article, astrocyte, athlete, Athletic Injuries, behavior change, blood vessel injury, brain, Brain Injuries, Brain Injury, cognitive defect, Concussion, confusion, degenerative disease, Epilepsy, head injury, headache, hearing impairment, human, Humans, Neck pain, nerve cell, nervous system inflammation, neurofibrillary tangle, nonhuman, Pathophysiology, postconcussion syndrome, priority journal, sport injury, traumatic brain injury, unsteadiness, Vision, wrestling},
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}
}
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}
}
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}
}
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}
}
Talavage, T M; Nauman, E A; Leverenz, L J
The role of medical imaging in the recharacterization of mild traumatic brain injury using youth sports as a laboratory Journal Article
In: Frontiers in Neurology, vol. 6, no. JAN, 2016.
Abstract | Links | BibTeX | Tags: Article, cognition assessment, Concussion, DIAGNOSTIC imaging, functional magnetic resonance imaging, Functional MRI, human, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Neuroanatomy, neuroimaging, neuromonitoring, nonhuman, NUCLEAR magnetic resonance spectroscopy, Patient monitoring, population risk, prediction, protective equipment, sport injury, Subconcussive, traumatic brain injury, validation process
@article{Talavage2016,
title = {The role of medical imaging in the recharacterization of mild traumatic brain injury using youth sports as a laboratory},
author = {Talavage, T M and Nauman, E A and Leverenz, L J},
doi = {10.3389/fneur.2015.00273},
year = {2016},
date = {2016-01-01},
journal = {Frontiers in Neurology},
volume = {6},
number = {JAN},
abstract = {The short- and long-term impact of mild traumatic brain injury (TBI) is an increasingly vital concern for both military and civilian personnel. Such injuries produce significant social and financial burdens and necessitate improved diagnostic and treatment methods. Recent integration of neuroimaging and biomechanical studies in youth collision-sport athletes has revealed that significant alterations in brain structure and function occur even in the absence of traditional clinical markers of "concussion." While task performance is maintained, athletes exposed to repetitive head accelerations exhibit structural changes to the underlying white matter, altered glial cell metabolism, aberrant vascular response, and marked changes in functional network behavior. Moreover, these changes accumulate with accrued years of exposure, suggesting a cumulative trauma mechanism that may culminate in categorization as "concussion" and long-term neurological deficits. The goal of this review is to elucidate the role of medical imaging in recharacterizing TBI, as a whole, to better identify at-risk individuals and improve the development of preventative and interventional approaches. © 2016 Talavage, Nauman and Leverenz.},
keywords = {Article, cognition assessment, Concussion, DIAGNOSTIC imaging, functional magnetic resonance imaging, Functional MRI, human, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Neuroanatomy, neuroimaging, neuromonitoring, nonhuman, NUCLEAR magnetic resonance spectroscopy, Patient monitoring, population risk, prediction, protective equipment, sport injury, Subconcussive, traumatic brain injury, validation process},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
Abstract | Links | BibTeX | Tags: Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident},
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}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Moon, K; Theodore, N
Football and Chronic Traumatic Encephalopathy: How Much Evidence Actually Exists? Journal Article
In: World Neurosurgery, vol. 89, pp. 720–721, 2016.
Links | BibTeX | Tags: Alzheimer disease, amyloid beta protein, amyloid plaque, anxiety disorder, apolipoprotein E, Article, behavior disorder, Boxing, brain atrophy, brain concussion, brain degeneration, chronic disease, Chronic traumatic encephalopathy, cognitive defect, degenerative disease, depression, environmental factor, football, frontotemporal dementia, genetic predisposition, genetic risk, genetic susceptibility, human, motor control, Neuroanatomy, opiate addiction, Parkinson disease, protein phosphorylation, scar formation, septum pellucidum, sport injury, substantia nigra, suicide, TAR DNA binding protein, tau protein, tauopathy, traumatic brain injury
@article{Moon2016,
title = {Football and Chronic Traumatic Encephalopathy: How Much Evidence Actually Exists?},
author = {Moon, K and Theodore, N},
doi = {10.1016/j.wneu.2016.03.073},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {89},
pages = {720--721},
keywords = {Alzheimer disease, amyloid beta protein, amyloid plaque, anxiety disorder, apolipoprotein E, Article, behavior disorder, Boxing, brain atrophy, brain concussion, brain degeneration, chronic disease, Chronic traumatic encephalopathy, cognitive defect, degenerative disease, depression, environmental factor, football, frontotemporal dementia, genetic predisposition, genetic risk, genetic susceptibility, human, motor control, Neuroanatomy, opiate addiction, Parkinson disease, protein phosphorylation, scar formation, septum pellucidum, sport injury, substantia nigra, suicide, TAR DNA binding protein, tau protein, tauopathy, traumatic brain injury},
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}
}
Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A
English professional football players concussion knowledge and attitude Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.
Abstract | Links | BibTeX | Tags: accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult
@article{Williams2016,
title = {English professional football players concussion knowledge and attitude},
author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},
doi = {10.1016/j.jshs.2015.01.009},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {197--204},
abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},
keywords = {accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}
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}
}
Sharma, V K; Rango, J; Connaughton, A J; Lombardo, D J; Sabesan, V J
The current state of head and neck injuries in extreme sports Journal Article
In: Orthopaedic Journal of Sports Medicine, vol. 3, no. 1, pp. 1–6, 2015.
Abstract | Links | BibTeX | Tags: Article, AWARENESS, Concussion, Concussions, EPIDEMIOLOGY, extreme sport, Extreme sports, fracture, Head and neck injuries, head and neck injury, head injury, human, Incidence, laceration, major clinical study, neck injury, physician, Prevalence, priority journal, quality of life, skateboarding, skiing, telephone interview
@article{Sharma2015,
title = {The current state of head and neck injuries in extreme sports},
author = {Sharma, V K and Rango, J and Connaughton, A J and Lombardo, D J and Sabesan, V J},
doi = {10.1177/2325967114564358},
year = {2015},
date = {2015-01-01},
journal = {Orthopaedic Journal of Sports Medicine},
volume = {3},
number = {1},
pages = {1--6},
abstract = {Background: Since their conception during the mid-1970s, international participation in extreme sports has grown rapidly. The recent death of extreme snowmobiler Caleb Moore at the 2013 Winter X Games has demonstrated the serious risks associated with these sports. Purpose: To examine the incidence and prevalence of head and neck injuries (HNIs) in extreme sports. Study Design: Descriptive epidemiological study. Methods: The National Electronic Injury Surveillance System (NEISS) was used to acquire data from 7 sports (2000-2011) that were included in the Winter and Summer X Games. Data from the NEISS database were collected for each individual sport per year and type of HNI. Cumulative data for overall incidence and injuries over the entire 11-year period were calculated. National estimates were determined using NEISS-weighted calculations. Incidence rates were calculated for extreme sports using data from Outdoor Foundation Participation Reports. Results: Over 4 million injuries were reported between 2000 and 2011, of which 11.3% were HNIs. Of all HNIs, 83% were head injuries and 17% neck injuries. The 4 sports with the highest total incidence of HNI were skateboarding (129,600), snowboarding (97,527), skiing (83,313), and motocross (78,236). Severe HNI (cervical or skull fracture) accounted for 2.5% of extreme sports HNIs. Of these, skateboarding had the highest percentage of severe HNIs. Conclusion: The number of serious injuries suffered in extreme sports has increased as participation in the sports continues to grow. A greater awareness of the dangers associated with these sports offers an opportunity for sports medicine and orthopaedic physicians to advocate for safer equipment, improved on-site medical care, and further research regarding extreme sports injuries. © 2015 The Author(s).},
keywords = {Article, AWARENESS, Concussion, Concussions, EPIDEMIOLOGY, extreme sport, Extreme sports, fracture, Head and neck injuries, head and neck injury, head injury, human, Incidence, laceration, major clinical study, neck injury, physician, Prevalence, priority journal, quality of life, skateboarding, skiing, telephone interview},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K
Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport
@article{Ellis2015,
title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},
author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},
doi = {10.3171/2015.1.PEDS14524},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {16},
number = {3},
pages = {248--255},
abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},
keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},
pubstate = {published},
tppubtype = {article}
}
Wang, H; Wang, B; Jackson, K; Miller, C M; Hasadsri, L; Llano, D; Rubin, R; Zimmerman, J; Johnson, C; Sutton, B
A novel head-neck cooling device for concussion injury in contact sports Journal Article
In: Translational Neuroscience, vol. 6, pp. 20–31, 2015.
Abstract | Links | BibTeX | Tags: Acceleration, Article, brain concussion, Brain hypothermia, brain perfusion, brain temperature, brain tissue, clinical study, cognition, contact sport, cooling, diving, exercise, exercise induced hyperthermia, experimental study, government, head neck cooling device, Head-neck cooling, human, hyperthermia, induced hypothermia, mild traumatic brain injury, nonhuman, priority journal, randomized controlled trial (topic), sport injury, Sports, surface property, thermal regulating system, thermal stimulation, thermoregulation, traumatic brain injury
@article{Wang2015a,
title = {A novel head-neck cooling device for concussion injury in contact sports},
author = {Wang, H and Wang, B and Jackson, K and Miller, C M and Hasadsri, L and Llano, D and Rubin, R and Zimmerman, J and Johnson, C and Sutton, B},
doi = {10.1515/tnsci-2015-0004},
year = {2015},
date = {2015-01-01},
journal = {Translational Neuroscience},
volume = {6},
pages = {20--31},
abstract = {Emerging research on the long-term impact of concussions on athletes has allowed public recognition of the potentially devastating effects of these and other mild head injuries. Mild traumatic brain injury (mTBI) is a multifaceted disease for which management remains a clinical challenge. Recent pre-clinical and clinical data strongly suggest a destructive synergism between brain temperature elevation and mTBI; conversely, brain hypothermia, with its broader, pleiotropic effects, represents the most potent neuro-protectant in laboratory studies to date. Although well-established in selected clinical conditions, a systemic approach to accomplish regional hypothermia has failed to yield an effective treatment strategy in traumatic brain injury (TBI). Furthermore, although systemic hypothermia remains a potentially valid treatment strategy for moderate to severe TBIs, it is neither practical nor safe for mTBIs. Therefore, selective head-neck cooling may represent an ideal strategy to provide therapeutic benefits to the brain. Optimizing brain temperature management using a National Aeronautics and Space Administration (NASA) spacesuit spinoff head-neck cooling technology before and/or after mTBI in contact sports may represent a sensible, practical, and effective method to potentially enhance recover and minimize post-injury deficits. In this paper, we discuss and summarize the anatomical, physiological, preclinical, and clinical data concerning NASA spinoff head-neck cooling technology as a potential treatment for mTBIs, particularly in the context of contact sports. © 2015 Huan Wang et al., licensee De Gruyter Open.},
keywords = {Acceleration, Article, brain concussion, Brain hypothermia, brain perfusion, brain temperature, brain tissue, clinical study, cognition, contact sport, cooling, diving, exercise, exercise induced hyperthermia, experimental study, government, head neck cooling device, Head-neck cooling, human, hyperthermia, induced hypothermia, mild traumatic brain injury, nonhuman, priority journal, randomized controlled trial (topic), sport injury, Sports, surface property, thermal regulating system, thermal stimulation, thermoregulation, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Gardner, A J; Iverson, G L; Quinn, T N; Makdissi, M; Levi, C R; Shultz, S R; Wright, D K; Stanwell, P
A preliminary video analysis of concussion in the National Rugby League Journal Article
In: Brain Injury, vol. 29, no. 10, pp. 1182–1185, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Athletes, brain concussion, case study, clinical article, Concussion, descriptive research, EPIDEMIOLOGY, human, Incidence, Injury surveillance, observational study, rugby, sport injury, unconsciousness, videorecording
@article{Gardner2015b,
title = {A preliminary video analysis of concussion in the National Rugby League},
author = {Gardner, A J and Iverson, G L and Quinn, T N and Makdissi, M and Levi, C R and Shultz, S R and Wright, D K and Stanwell, P},
doi = {10.3109/02699052.2015.1034179},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {10},
pages = {1182--1185},
abstract = {Primary objective: To conduct the first video analysis of concussion in the Australian National Rugby League (NRL) and describe player and injury characteristics, situational factors and time to return to play.Research design: Descriptive, observational case series.Methods and procedures: Video analysis of 20 medically diagnosed concussions for three consenting clubs during the 2013 NRL season.Main outcome and results: Most concussions (83%) occurred during a high tackle, and all injured ball carriers were hit high. Loss of consciousness was observed in 30% of cases. Common observable signs of injury included clutching of the head, balance problems or wobbly legs and a blank or vacant state. There were no post-concussive seizures. All players with loss of consciousness were removed from play. However, only half of the total sample was removed from play and one athlete who was removed returned to play in the same match. Of the players who were removed from play, the large majority returned the following week. Illegal play accounted for 25% of all concussions.Conclusions: Video analysis may be a useful method to study the incidence, mechanism and management of concussion in sports such as Rugby League. Future studies may include larger numbers to validate this preliminary data and may also investigate other levels of play and age ranges. © 2015 Taylor and Francis Group, LLC.},
keywords = {Article, athlete, Athletes, brain concussion, case study, clinical article, Concussion, descriptive research, EPIDEMIOLOGY, human, Incidence, Injury surveillance, observational study, rugby, sport injury, unconsciousness, videorecording},
pubstate = {published},
tppubtype = {article}
}
Rapp, P E; Keyser, D O; Albano, A; Hernandez, R; Gibson, D B; Zambon, R A; David Hairston, W; Hughes, J D; Krystal, A; Nichols, A S
Traumatic brain injury detection using electrophysiological methods Journal Article
In: Frontiers in Human Neuroscience, vol. 9, no. FEB, 2015.
Abstract | Links | BibTeX | Tags: Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury
@article{Rapp2015,
title = {Traumatic brain injury detection using electrophysiological methods},
author = {Rapp, P E and Keyser, D O and Albano, A and Hernandez, R and Gibson, D B and Zambon, R A and {David Hairston}, W and Hughes, J D and Krystal, A and Nichols, A S},
doi = {10.3389/fnhum.2015.00011},
year = {2015},
date = {2015-01-01},
journal = {Frontiers in Human Neuroscience},
volume = {9},
number = {FEB},
abstract = {Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI).This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3)The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5)The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system. © 2015 Rapp, Keyser , Albano, Hernandez, Gibson, Zambon, Hairston, Hughes, Krystal and Nichols.},
keywords = {Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Marinides, Z; Galetta, K M; Andrews, C N; Wilson, J A; Herman, D C; Robinson, C D; Smith, M S; Bentley, B C; Galetta, S L; Balcer, L J; Clugston, J R
Vision testing is additive to the sideline assessment of sports-related concussion Journal Article
In: Neurology: Clinical Practice, vol. 5, no. 1, pp. 25–34, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test
@article{Marinides2015,
title = {Vision testing is additive to the sideline assessment of sports-related concussion},
author = {Marinides, Z and Galetta, K M and Andrews, C N and Wilson, J A and Herman, D C and Robinson, C D and Smith, M S and Bentley, B C and Galetta, S L and Balcer, L J and Clugston, J R},
doi = {10.1212/CPJ.0000000000000060},
year = {2015},
date = {2015-01-01},
journal = {Neurology: Clinical Practice},
volume = {5},
number = {1},
pages = {25--34},
abstract = {We examined the King-Devick (K-D) test, a vision-based test of rapid number naming, as a complement to components of the Sport Concussion Assessment Tool, 3rd edition (SCAT3) for diagnosis of concussion. Baseline and postconcussion data for the University of Florida men's football, women's soccer, and women's lacrosse teams were collected, including the K-D test, Standardized Assessment of Concussion (SAC), and Balance Error Scoring System (BESS). Among 30 athletes with first concussion during their athletic season (n 5 217 total), differences from baseline to postinjury showed worsening of K-D time scores in 79%, while SAC showed a ≥2- point worsening in 52%. Combining K-D and SAC captured abnormalities in 89%; adding the BESS identified 100% of concussions. Adding a vision-based test may enhance the detection of athletes with concussion. © 2015 American Academy of Neurology.},
keywords = {Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test},
pubstate = {published},
tppubtype = {article}
}
Dessy, A M; Rasouli, J; Choudhri, T F
Second Impact Syndrome: A Rare, Devastating Consequence of Repetitive Head Injuries Journal Article
In: Neurosurgery Quarterly, vol. 25, no. 3, pp. 423–426, 2015.
Abstract | Links | BibTeX | Tags: Article, brain concussion, clinical feature, Concussion, Dizziness, fatigue, headache, human, hyperemia, intracranial hypertension, memory disorder, Neck pain, neuropathology, neurosurgeon, neurosurgery, Pathophysiology, postconcussion syndrome, priority journal, respiratory failure, Second impact syndrome, sport injury, traumatic brain injury
@article{Dessy2015,
title = {Second Impact Syndrome: A Rare, Devastating Consequence of Repetitive Head Injuries},
author = {Dessy, A M and Rasouli, J and Choudhri, T F},
doi = {10.1097/WNQ.0000000000000085},
year = {2015},
date = {2015-01-01},
journal = {Neurosurgery Quarterly},
volume = {25},
number = {3},
pages = {423--426},
abstract = {Sports-related concussion has been viewed as a developing public health crisis in recent years. Underrecognition of concussions can lead to premature clearance for athletic participation. Second impact syndrome (SIS) represents a rare, yet devastating, potential outcome of premature return to play. SIS is a condition in which rapid brain swelling occurs as a result of a repeat head injury sustained before symptoms of a previous head injury have resolved. Within minutes of the second impact, diffuse cerebral swelling, brain herniation, and death can occur. There are \<20 documented cases of SIS in the world literature to date, and the general understanding of the syndrome is based largely on interpretation of anecdotal cases. This article reviews current understanding of the epidemiology and pathology of SIS. Given neurosurgeons' role in management of head trauma, it is essential that neurosurgeons acquire and maintain thorough knowledge of concussion diagnosis, treatment, and management. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Article, brain concussion, clinical feature, Concussion, Dizziness, fatigue, headache, human, hyperemia, intracranial hypertension, memory disorder, Neck pain, neuropathology, neurosurgeon, neurosurgery, Pathophysiology, postconcussion syndrome, priority journal, respiratory failure, Second impact syndrome, sport injury, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L
In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.
Abstract | Links | BibTeX | Tags: 2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult
@article{Dretsch2015a,
title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},
author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},
doi = {10.1089/neu.2014.3637},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {16},
pages = {1217--1222},
abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},
keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Mayer, A R; Ling, J M; Dodd, A B; Gasparovic, C; Klimaj, S D; Meier, T B
A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters Journal Article
In: Journal of Neurotrauma, vol. 32, no. 22, pp. 1759–1767, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult
@article{Mayer2015b,
title = {A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters},
author = {Mayer, A R and Ling, J M and Dodd, A B and Gasparovic, C and Klimaj, S D and Meier, T B},
doi = {10.1089/neu.2014.3833},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {22},
pages = {1759--1767},
abstract = {Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p \> 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples. © Mary Ann Liebert, Inc. 2015.},
keywords = {Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
DiFazio, M; Silverberg, N D; Kirkwood, M W; Bernier, R; Iverson, G L
Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes? Journal Article
In: Clinical Pediatrics, vol. 55, no. 5, pp. 443–451, 2015.
Abstract | Links | BibTeX | Tags: activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling
@article{DiFazio2015,
title = {Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes?},
author = {DiFazio, M and Silverberg, N D and Kirkwood, M W and Bernier, R and Iverson, G L},
doi = {10.1177/0009922815589914},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {5},
pages = {443--451},
abstract = {The current treatment of concussion or mild traumatic brain injury (mTBI) is primarily based on expert consensus. Most clinical practice guidelines advise cognitive and physical rest after injury including withdrawal from normal life activities such as school attendance, sports participation, and technology use until symptoms resolve. Some individuals who sustain an mTBI experience persistent physical, cognitive, and mental health problems. Activity restriction itself may contribute to protracted recovery and other complications. Williamson's Activity Restriction Model of Depression, formulated more than 20 years ago, is central to this hypothesis. We review research evidence for potential harms of prolonged activity restriction and report an mTBI case as an example of how an "activity restriction cascade" can unfold. According to this model, psychological consequences of removal from validating life activities, combined with physical deconditioning, contribute to the development and persistence of postconcussive symptoms after mTBI in some youth. A modification to mTBI guidelines that emphasizes prompt reengagement in life activities as tolerated is encouraged. © SAGE Publications.},
keywords = {activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lawrence, D W; Comper, P; Hutchison, M G; Sharma, B
The role of apolipoprotein E episilon ($epsilon$)-4 allele on outcome following traumatic brain injury: A systematic review Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1018–1031, 2015.
Abstract | Links | BibTeX | Tags: 80 and over, aged, allele, Alleles, Alzheimer disease, amyloid beta protein, APOE, apolipoprotein E, apolipoprotein E4, Article, athlete, brain concussion, Brain Injuries, clinical evaluation, cognition, cognitive defect, disease severity, Female, follow up, genetic association, genetic risk, genetics, GENOTYPE, Glasgow Outcome Scale, heterozygote, histopathology, homozygote, human, Humans, Incidence, injury severity, Male, Memory, nerve cell necrosis, neuropathology, Neuroprotection, outcome assessment, pediatrics, Prevalence, Prognosis, prognostic assessment, protein function, psychologic test, psychology, Recovery, scoring system, Systematic Review, tau protein, traumatic brain injury, treatment outcome, very elderly, Wechsler Intelligence Scale
@article{Lawrence2015,
title = {The role of apolipoprotein E episilon ($epsilon$)-4 allele on outcome following traumatic brain injury: A systematic review},
author = {Lawrence, D W and Comper, P and Hutchison, M G and Sharma, B},
doi = {10.3109/02699052.2015.1005131},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1018--1031},
abstract = {Background: The apolipoprotein E gene (APOE) has emerged as a candidate for prognosticating traumatic brain injury (TBI) recovery, with APOE$epsilon$4 identified as a susceptibility marker for poor outcome, despite large discrepancy in its reported influence post-TBI.Methods: A systematic review was conducted, including all primary articles investigating the role of APOE$epsilon$4 on TBI outcome. A total of 65 studies were included, including 24 predominantly investigating mild (mTBI), seven moderate (modTBI) and 33 severe (sTBI); severity was not reported in one study.Results: In mTBI studies, the association between APOE$epsilon$4 and post-TBI outcome was concluded as non-contributory in 14 studies (58.3%), hazardous in nine (37.5%) and protective in one (4.2%). In sTBI studies, the role of APOE$epsilon$4 was hazardous in 21 (63.6%), non-contributory in nine (27.3%) and protective in three (9.1%). Of the seven studies investigating dementia outcomes, four observed a hazardous association with APOE$epsilon$4, while three reported no association. Six studies examined Alzheimers dementia pathology, of which three reported a hazardous influence of APOE$epsilon$4.Conclusions: The influence of APOE$epsilon$4 on neuropsychological testing, functional outcome and in paediatric populations was incongruous. This review supports the majority of research indicating APOE$epsilon$4 adversely influences recovery following TBI, particularly with respect to dementia-related outcomes and outcomes following sTBI. © 2015 Taylor \& Francis Group, LLC.},
keywords = {80 and over, aged, allele, Alleles, Alzheimer disease, amyloid beta protein, APOE, apolipoprotein E, apolipoprotein E4, Article, athlete, brain concussion, Brain Injuries, clinical evaluation, cognition, cognitive defect, disease severity, Female, follow up, genetic association, genetic risk, genetics, GENOTYPE, Glasgow Outcome Scale, heterozygote, histopathology, homozygote, human, Humans, Incidence, injury severity, Male, Memory, nerve cell necrosis, neuropathology, Neuroprotection, outcome assessment, pediatrics, Prevalence, Prognosis, prognostic assessment, protein function, psychologic test, psychology, Recovery, scoring system, Systematic Review, tau protein, traumatic brain injury, treatment outcome, very elderly, Wechsler Intelligence Scale},
pubstate = {published},
tppubtype = {article}
}
Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D
In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.
Abstract | Links | BibTeX | Tags: accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult
@article{Oeur2015,
title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},
author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},
doi = {10.3171/2014.10.JNS14440},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery},
volume = {123},
number = {2},
pages = {415--422},
abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},
keywords = {accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
Abstract | Links | BibTeX | Tags: academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S
Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article
In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult
@article{Baker2015,
title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},
author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},
doi = {10.1177/0009922815588820},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {54},
number = {10},
pages = {961--968},
abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},
keywords = {Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}
McDevitt, J; Tierney, R T; Phillips, J; Gaughan, J P; Torg, J S; Krynetskiy, E
Association between GRIN2A promoter polymorphism and recovery from concussion Journal Article
In: Brain Injury, vol. 29, no. 13-14, pp. 1674–1681, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat
@article{McDevitt2015,
title = {Association between GRIN2A promoter polymorphism and recovery from concussion},
author = {McDevitt, J and Tierney, R T and Phillips, J and Gaughan, J P and Torg, J S and Krynetskiy, E},
doi = {10.3109/02699052.2015.1075252},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {13-14},
pages = {1674--1681},
abstract = {Objective: To determine genetic variability within the N-methyl-D-aspartate receptor 2A sub-unit (GRIN2A) gene promoter and its association with concussion recovery time. The hypothesis tested was that there would be a difference in allele and/or genotype distribution between two groups of athletes with normal and prolonged recovery.Methods: DNA was extracted from saliva collected from a total of 87 athletes with a physician-diagnosed concussion. The (GT) variable number tandem repeats (VNTR) within the promoter region of GRIN2A was genotyped. The long (L) allele was an allele with ≥25 repeats and the short (S) allele was an allele with \<25 repeats in the GT tract. Participants recovery time was followed prospectively and was categorized as normal (≤60 days) or prolonged (\>60 days).Results: LL carriers were 6-times more likely to recover longer than 60 days following the concussive event (p = 0.0433) when compared to SS carriers. Additionally, L allele carriers were found more frequently in the prolonged recovery group (p = 0.048).Conclusion: Determining genetic influence on concussion recovery will aid in future development of genetic counselling. The clinical relevance of genotyping athletes could improve management of athletes who experience concussion injuries. © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat},
pubstate = {published},
tppubtype = {article}
}
Lefebvre, G; Tremblay, S; Théoret, H
Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1032–1043, 2015.
Abstract | Links | BibTeX | Tags: 4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult
@article{Lefebvre2015,
title = {Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex},
author = {Lefebvre, G and Tremblay, S and Th\'{e}oret, H},
doi = {10.3109/02699052.2015.1028447},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1032--1043},
abstract = {Primary objective: The present paper systematically reviews studies using transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to assess cortical excitability, intra-cortical inhibition/facilitation and synaptic plasticity following mild traumatic brain injury (mTBI).Methods: Articles using TMS over M1 in patients with mTBI or sport-related concussion indexed in PubMed and published between 1998 and September 2014 were included in the present review.Main outcomes and results: From the 17 articles that matched search criteria, results from various TMS paradigms were summarized and divided in three main areas of interest: motor cortical excitability/facilitation, motor cortical inhibition and cortical plasticity. Although studies suggest a trend of abnormal intra-cortical inhibition following mTBI, no clear and specific pattern emerges from the surveyed data.Conclusions: At this time and with the possible exception of intra-cortical inhibitory measures, TMS cannot reliably detect changes in M1 excitability in individuals with mTBI or a concussion at both the acute and chronic stages of injury. This may be explained by the small number of studies and large variety of stimulation parameters. Additional longitudinal and multimodal studies are needed to better understand the nature of the excitability changes that may occur within M1 following mTBI. © 2015 Taylor \& Francis Group, LLC.},
keywords = {4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury},
pubstate = {published},
tppubtype = {article}
}
Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E
Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article
In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.
Abstract | Links | BibTeX | Tags: alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption
@article{Moran2015,
title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},
author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},
doi = {10.14423/SMJ.0000000000000340},
year = {2015},
date = {2015-01-01},
journal = {Southern Medical Journal},
volume = {108},
number = {9},
pages = {553--558},
abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},
keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},
pubstate = {published},
tppubtype = {article}
}
Wolanin, A; Gross, M; Hong, E
Depression in athletes: Prevalence and risk factors Journal Article
In: Current Sports Medicine Reports, vol. 14, no. 1, pp. 56–60, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Athletes, Athletic Injuries, athletic performance, career, Career Choice, Concussion, DECISION making, depression, distress syndrome, emotional disorder, emotional stress, human, Humans, Mental Health, overtraining syndrome, Prevalence, psychology, risk factor, Risk Factors, social adaptation, social support, sport injury, SPORTS medicine, SPORTS psychology, suicide, trends
@article{Wolanin2015,
title = {Depression in athletes: Prevalence and risk factors},
author = {Wolanin, A and Gross, M and Hong, E},
doi = {10.1249/JSR.0000000000000123},
year = {2015},
date = {2015-01-01},
journal = {Current Sports Medicine Reports},
volume = {14},
number = {1},
pages = {56--60},
abstract = {Depression affects an estimated 6.7% of today's adult population in a 12-month period. The prevalence rates for certain age groups, such as young adults and older adults, are higher. There are approximately 400,000 National Collegiate Athletic Association student athletes competing each year and 5 to 7 million high school student athletes involved in competitive interscholastic sports. Given such a high prevalence rate in certain age groups and a large denominator pool of athletes, past notions that athletes are devoid of mental health issues have come under scrutiny by sports medicine providers. Initial data suggest that athletes are far from immune to depression. The purpose of this article was to review the current research on athletes and depression; particularly this article will provide an overview of studies, which have investigated the rate of depression among athletes, and discuss relevant risk factors, which may contribute to depression among athletes. Copyright © 2015 by the American College of Sports Medicine.},
keywords = {Article, athlete, Athletes, Athletic Injuries, athletic performance, career, Career Choice, Concussion, DECISION making, depression, distress syndrome, emotional disorder, emotional stress, human, Humans, Mental Health, overtraining syndrome, Prevalence, psychology, risk factor, Risk Factors, social adaptation, social support, sport injury, SPORTS medicine, SPORTS psychology, suicide, trends},
pubstate = {published},
tppubtype = {article}
}
Bowman, T G; Breedlove, K M; Breedlove, E L; Dodge, T M; Nauman, E A
Impact attenuation properties of new and used lacrosse helmets Journal Article
In: Journal of Biomechanics, vol. 48, no. 14, pp. 3782–3787, 2015.
Abstract | Links | BibTeX | Tags: Accident prevention, Article, Athletic Injuries, attenuation, brain concussion, Cracks, Drop test, Drops, Equipment Design, Gadd Severity Index, head impact, Head Protective Devices, Helmet, Helmet evaluation, human, Humans, Injuries, lacrosse helmet, Materials testing, mechanical stress, priority journal, protective equipment, racquet sport, Racquet Sports, recertification, rigidity, Safety devices, Severity index, Sporting goods, Sports Equipment, standards, stress strain relationship, velocity
@article{Bowman2015,
title = {Impact attenuation properties of new and used lacrosse helmets},
author = {Bowman, T G and Breedlove, K M and Breedlove, E L and Dodge, T M and Nauman, E A},
doi = {10.1016/j.jbiomech.2015.08.026},
year = {2015},
date = {2015-01-01},
journal = {Journal of Biomechanics},
volume = {48},
number = {14},
pages = {3782--3787},
abstract = {The National Operating Committee on Standards for Athletic Equipment (NOCSAE) has developed impact attenuation thresholds that protective helmets worn in sport must meet to be commercially available in an attempt to prevent injury. It remains unknown how normal helmet use in athletic activity alters the force attenuation ability of lacrosse helmets. We tested 3 new and 3 randomly selected used helmets from 2 popular lacrosse models (Cascade Pro7, Cascade CPXR). All used helmets had been worn for 3 collegiate seasons prior to testing and had never been refurbished. Helmets were drop-tested using 3 prescribed impact velocities at 6 locations according to the NOCSAE lacrosse helmet standard, and we compared the Gadd Severity Index (GSI) scores between new and used helmets using a repeated measure ANOVA with location as the repeated variable and data separated by impact velocity. All 12 helmets passed the NOCSAE GSI threshold for all testing conditions; however 1 used helmet shell cracked resulting in a failed test. We found a significant main effect for helmet age at the low (F5},
keywords = {Accident prevention, Article, Athletic Injuries, attenuation, brain concussion, Cracks, Drop test, Drops, Equipment Design, Gadd Severity Index, head impact, Head Protective Devices, Helmet, Helmet evaluation, human, Humans, Injuries, lacrosse helmet, Materials testing, mechanical stress, priority journal, protective equipment, racquet sport, Racquet Sports, recertification, rigidity, Safety devices, Severity index, Sporting goods, Sports Equipment, standards, stress strain relationship, velocity},
pubstate = {published},
tppubtype = {article}
}
Jackson, K; Rubin, R; Van Hoeck, N; Hauert, T; Lana, V; Wang, H
The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers Journal Article
In: Translational Neuroscience, vol. 6, no. 1, pp. 131–138, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, Athletics, body temperature, body temperature measurement, brain, brain temperature, clinical assessment, clinical effectiveness, cognition, cold tolerance, cold treatment, Concussion, diastolic blood pressure, executive function, Feasibility, Female, head neck cooling, Heart Rate, human, human experiment, infrared thermometer, Intervention, Male, mouth temperature, normal human, physiological process, priority journal, pulse oximetry, room temperature, systolic blood pressure, TASK performance, temperature management device, thermoregulation, tympanic temperature, velocity, welkins emt temperature management system, working memory
@article{Jackson2015,
title = {The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers},
author = {Jackson, K and Rubin, R and {Van Hoeck}, N and Hauert, T and Lana, V and Wang, H},
doi = {10.1515/tnsci-2015-0012},
year = {2015},
date = {2015-01-01},
journal = {Translational Neuroscience},
volume = {6},
number = {1},
pages = {131--138},
abstract = {In general, brain temperatures are elevated during physical sporting activities; therefore, reducing brain temperature shortly after a sports-related concussion (SRC) could be a promising intervention technique. The main objective of this study was to examine the effects of head and neck cooling on physiological and cognitive function in normal healthy volunteers. Twelve healthy volunteers underwent two different sessions of combined head and neck cooling, one session with a cold pack and one session with a room temperature pack. Physiological measurements included: systolic/diastolic blood pressure, pulse oximetry, heart rate, and sublingual and tympanic temperature. Cognitive assessment included: processing speed, executive function, and working memory tasks. Physiological measurements were taken pre-, mid- and post-cooling, while cognitive assessments were done before and after cooling. The order of the sessions was randomized. There was a significant decrease in tympanic temperature across both sessions; however more cooling occurred when the cold pack was in the device. There was no significant decrease in sublingual temperature across either session. The observed heart rates, pulse oximetry, systolic and diastolic blood pressure during the sessions were all within range of a normal healthy adult. Cognitive assessment remained stable across each session for both pre- and post-cooling. We propose that optimizing brain temperature management after brain injury using head and neck cooling technology may represent a sensible, practical, and effective strategy to potentially enhance recovery and perhaps minimize the subsequent short and long term consequences from SRC. © 2015 Kevin Jackson et al.},
keywords = {adult, Article, Athletics, body temperature, body temperature measurement, brain, brain temperature, clinical assessment, clinical effectiveness, cognition, cold tolerance, cold treatment, Concussion, diastolic blood pressure, executive function, Feasibility, Female, head neck cooling, Heart Rate, human, human experiment, infrared thermometer, Intervention, Male, mouth temperature, normal human, physiological process, priority journal, pulse oximetry, room temperature, systolic blood pressure, TASK performance, temperature management device, thermoregulation, tympanic temperature, velocity, welkins emt temperature management system, working memory},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}
Mirabelli, M H; Devine, M J; Singh, J; Mendoza, M
The preparticipation sports evaluation Journal Article
In: American Family Physician, vol. 92, no. 5, pp. 371–376, 2015.
Abstract | BibTeX | Tags: Article, asthma, athlete, bleeding disorder, bronchospasm, cardiovascular disease, drug abuse, Eating disorder, ELECTROCARDIOGRAPHY, Epilepsy, heart murmur, hematologic disease, HISTORY, human, imaging, lung disease, Marfan syndrome, medical society, mental disease, Morbidity, MORTALITY, musculoskeletal injury, neurologic disease, Physical Examination, physical performance, social participation, Sport, sport injury, sudden death, urinalysis
@article{Mirabelli2015,
title = {The preparticipation sports evaluation},
author = {Mirabelli, M H and Devine, M J and Singh, J and Mendoza, M},
year = {2015},
date = {2015-01-01},
journal = {American Family Physician},
volume = {92},
number = {5},
pages = {371--376},
abstract = {The preparticipation physical evaluation is a commonly requested medical visit for amateur and professional athletes of all ages. The overarching goal is to maximize the health of athletes and their safe participation in sports. Although studies have not found that the preparticipation physical evaluation prevents morbidity and mortality associated with sports, it may detect conditions that predispose the athlete to injury or illness and can provide strategies to prevent injuries. Clearance depends on the outcome of the evaluation and the type of sport (and sometimes position or event) in which the athlete participates. All persons undergoing a preparticipation physical evaluation should be questioned about exertional symptoms, presence of a heart murmur, symptoms of Marfan syndrome, and family history of premature serious cardiac conditions or sudden death. The physical examination should focus on the cardiovascular and musculoskeletal systems. U.S. medical and athletic organizations discourage screening electrocardiography and blood and urine testing in asymptomatic patients. Further evaluation should be considered for persons with heart or lung disease, bleeding disorders, musculoskeletal problems, history of concussion, or other neurologic disorders. © 2015 American Academy of Family Physicians.},
keywords = {Article, asthma, athlete, bleeding disorder, bronchospasm, cardiovascular disease, drug abuse, Eating disorder, ELECTROCARDIOGRAPHY, Epilepsy, heart murmur, hematologic disease, HISTORY, human, imaging, lung disease, Marfan syndrome, medical society, mental disease, Morbidity, MORTALITY, musculoskeletal injury, neurologic disease, Physical Examination, physical performance, social participation, Sport, sport injury, sudden death, urinalysis},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
pubstate = {published},
tppubtype = {article}
}
Brown, J C; Viljoen, W; Lambert, M I; Readhead, C; Fuller, C; Van Mechelen, W; Verhagen, E
The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments Journal Article
In: Journal of Science & Medicine in Sport, vol. 18, no. 4, pp. 394–399, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries
@article{Brown2015b,
title = {The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments},
author = {Brown, J C and Viljoen, W and Lambert, M I and Readhead, C and Fuller, C and {Van Mechelen}, W and Verhagen, E},
doi = {10.1016/j.jsams.2014.06.015},
year = {2015},
date = {2015-01-01},
journal = {Journal of Science \& Medicine in Sport},
volume = {18},
number = {4},
pages = {394--399},
abstract = {Objectives: Rugby Union ("rugby") is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries. Design: This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs. Methods: Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities. Results: Of the 3652 players, 2% (n=71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425-US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486-US$1500) than those without (US$220, 95% CI: US$145-US$302). Conclusions: Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance. © 2014 Sports Medicine Australia.},
keywords = {Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries},
pubstate = {published},
tppubtype = {article}
}
Papa, L; Brophy, G M; Welch, R D; Lewis, L M; Braga, C F; Tan, C N; Ameli, N J; Lopez, M A; Haeussler, C A; Mendez Giordano, D I; Silvestri, S; Giordano, P; Weber, K D; Hill-Pryor, C; Hack, D C
In: JAMA Neurology, vol. 73, no. 5, pp. 551–560, 2016.
@article{Papa2016a,
title = {Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury},
author = {Papa, L and Brophy, G M and Welch, R D and Lewis, L M and Braga, C F and Tan, C N and Ameli, N J and Lopez, M A and Haeussler, C A and {Mendez Giordano}, D I and Silvestri, S and Giordano, P and Weber, K D and Hill-Pryor, C and Hack, D C},
doi = {10.1001/jamaneurol.2016.0039},
year = {2016},
date = {2016-01-01},
journal = {JAMA Neurology},
volume = {73},
number = {5},
pages = {551--560},
abstract = {Importance: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. Objectives: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. Design, Setting, and Participants: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. Main Outcomes and Measures: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. Results: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0%[362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95%CI, 0.69-0.77) to 0.94 (95%CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95%CI, 0.02-0.50) to 0.67 (95%CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95%CI, 0.67-0.92) to 0.97 (95%CI, 0.93-1.00)for GFAP and 0.31 (95%CI, 0-0.63) to 0.77 (95%CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95%CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95%CI, 0-1.00) to 0.92 (95%CI, 0.83-1.00). Conclusions and Relevance: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period. © Copyright 2016 American Medical Association. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {},
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.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A
English professional football players concussion knowledge and attitude Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.
@article{Williams2016,
title = {English professional football players concussion knowledge and attitude},
author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},
doi = {10.1016/j.jshs.2015.01.009},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {197--204},
abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},
keywords = {},
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.
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Moon, K; Theodore, N
Football and Chronic Traumatic Encephalopathy: How Much Evidence Actually Exists? Journal Article
In: World Neurosurgery, vol. 89, pp. 720–721, 2016.
@article{Moon2016,
title = {Football and Chronic Traumatic Encephalopathy: How Much Evidence Actually Exists?},
author = {Moon, K and Theodore, N},
doi = {10.1016/j.wneu.2016.03.073},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {89},
pages = {720--721},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Talavage, T M; Nauman, E A; Leverenz, L J
The role of medical imaging in the recharacterization of mild traumatic brain injury using youth sports as a laboratory Journal Article
In: Frontiers in Neurology, vol. 6, no. JAN, 2016.
@article{Talavage2016,
title = {The role of medical imaging in the recharacterization of mild traumatic brain injury using youth sports as a laboratory},
author = {Talavage, T M and Nauman, E A and Leverenz, L J},
doi = {10.3389/fneur.2015.00273},
year = {2016},
date = {2016-01-01},
journal = {Frontiers in Neurology},
volume = {6},
number = {JAN},
abstract = {The short- and long-term impact of mild traumatic brain injury (TBI) is an increasingly vital concern for both military and civilian personnel. Such injuries produce significant social and financial burdens and necessitate improved diagnostic and treatment methods. Recent integration of neuroimaging and biomechanical studies in youth collision-sport athletes has revealed that significant alterations in brain structure and function occur even in the absence of traditional clinical markers of "concussion." While task performance is maintained, athletes exposed to repetitive head accelerations exhibit structural changes to the underlying white matter, altered glial cell metabolism, aberrant vascular response, and marked changes in functional network behavior. Moreover, these changes accumulate with accrued years of exposure, suggesting a cumulative trauma mechanism that may culminate in categorization as "concussion" and long-term neurological deficits. The goal of this review is to elucidate the role of medical imaging in recharacterizing TBI, as a whole, to better identify at-risk individuals and improve the development of preventative and interventional approaches. © 2016 Talavage, Nauman and Leverenz.},
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}
}
Blennow, K; Brody, D L; Kochanek, P M; Levin, H; McKee, A; Ribbers, G M; Yaffe, K; Zetterberg, H
Traumatic brain injuries Journal Article
In: Nature Reviews Disease Primers, vol. 2, 2016.
@article{Blennow2016,
title = {Traumatic brain injuries},
author = {Blennow, K and Brody, D L and Kochanek, P M and Levin, H and McKee, A and Ribbers, G M and Yaffe, K and Zetterberg, H},
doi = {10.1038/nrdp.2016.84},
year = {2016},
date = {2016-01-01},
journal = {Nature Reviews Disease Primers},
volume = {2},
abstract = {Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury-the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available. Most patients with mild TBI will recover quickly, but others report persistent symptoms, called post-concussive syndrome, the underlying pathophysiology of which is largely unknown. Repeated concussive and subconcussive head injuries have been linked to the neurodegenerative condition chronic traumatic encephalopathy (CTE), which has been reported post-mortem in contact sports athletes and soldiers exposed to blasts. Insights from severe injuries and CTE plausibly shed light on the underlying cellular and molecular processes involved in mild TBI. MRI techniques and blood tests for axonal proteins to identify and grade axonal injury, in addition to PET for tau pathology, show promise as tools to explore CTE pathophysiology in longitudinal clinical studies, and might be developed into diagnostic tools for CTE. Given that CTE is attributed to repeated head trauma, prevention might be possible through rule changes by sports organizations and legislators. © 2016 Macmillan Publishers Limited, part of Springer Nature.},
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}
}
Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D
Association of football subconcussive head impacts with ocular near point of convergence Journal Article
In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.
@article{Kawata2016,
title = {Association of football subconcussive head impacts with ocular near point of convergence},
author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},
doi = {10.1001/jamaophthalmol.2016.1085},
year = {2016},
date = {2016-01-01},
journal = {JAMA Ophthalmology},
volume = {134},
number = {7},
pages = {763--769},
abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Keener, A B
Tackling the brain: Clues emerge about the pathology of sports-related brain trauma Journal Article
In: Nature Medicine, vol. 22, no. 4, pp. 326–329, 2016.
@article{Keener2016,
title = {Tackling the brain: Clues emerge about the pathology of sports-related brain trauma},
author = {Keener, A B},
doi = {10.1038/nm0416-326},
year = {2016},
date = {2016-01-01},
journal = {Nature Medicine},
volume = {22},
number = {4},
pages = {326--329},
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}
}
Bressan, S; Babl, F E
Diagnosis and management of paediatric concussion Journal Article
In: Journal of Paediatrics & Child Health, vol. 52, no. 2, pp. 151–157, 2016.
@article{Bressan2016,
title = {Diagnosis and management of paediatric concussion},
author = {Bressan, S and Babl, F E},
doi = {10.1111/jpc.12967},
year = {2016},
date = {2016-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {52},
number = {2},
pages = {151--157},
abstract = {Heightened recognition of concussions and concerns about their sequelae in children has become an increasing community and public health concern. Biomarkers and clinical tests are being explored, but the diagnosis of concussion in the emergency department continues to be based on clinical signs and symptoms. While the majority of children go on to recover from post-concussive symptoms within 2 weeks, it is unclear which patients with concussion will go on to develop short- or long-term sequelae. A number of more or less evidence-based guidelines have become available which seek to guide clinicians on how to manage children post-concussion. In general, care after the emergency department is focused on reducing the risk of re-injury and rest until cerebral recovery with a graduated return to school and then play. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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}
}
Gregory, A; Kerr, Z; Parsons, J
Selected issues in injury and illness prevention and the team physician: A consensus statement Journal Article
In: Current Sports Medicine Reports, vol. 15, no. 1, pp. 48–59, 2016.
@article{Gregory2016,
title = {Selected issues in injury and illness prevention and the team physician: A consensus statement},
author = {Gregory, A and Kerr, Z and Parsons, J},
doi = {10.1249/JSR.0000000000000231},
year = {2016},
date = {2016-01-01},
journal = {Current Sports Medicine Reports},
volume = {15},
number = {1},
pages = {48--59},
abstract = {This document provides an overview of selected medical issues that are important to team physicians who are responsible for the care and treatment of athletes. It is not intended as a standard of care, and should not be interpreted as such. This document is only a guide, and as such, is of a general nature, consistent with the reasonable, objective practice of the health care profession. Adequate insurance should be in place to help protect the physician, the athlete, and the sponsoring organization. This statement was developed by a collaboration of sixmajor professional associations concerned about clinical sports medicine issues. They have committed to forming an ongoing project-based alliance to bring together sports medicine organizations to best serve active people and athletes. The organizations are the American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine. Copyright © 2016 by the American College of Sports Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Blennow, K; Brody, D L; Kochanek, P M; Levin, H; McKee, A; Ribbers, G M; Yaffe, K; Zetterberg, H
Traumatic brain injuries Journal Article
In: Nature Reviews Disease Primers, vol. 2, 2016.
Abstract | Links | BibTeX | Tags: amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury
@article{Blennow2016,
title = {Traumatic brain injuries},
author = {Blennow, K and Brody, D L and Kochanek, P M and Levin, H and McKee, A and Ribbers, G M and Yaffe, K and Zetterberg, H},
doi = {10.1038/nrdp.2016.84},
year = {2016},
date = {2016-01-01},
journal = {Nature Reviews Disease Primers},
volume = {2},
abstract = {Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury-the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available. Most patients with mild TBI will recover quickly, but others report persistent symptoms, called post-concussive syndrome, the underlying pathophysiology of which is largely unknown. Repeated concussive and subconcussive head injuries have been linked to the neurodegenerative condition chronic traumatic encephalopathy (CTE), which has been reported post-mortem in contact sports athletes and soldiers exposed to blasts. Insights from severe injuries and CTE plausibly shed light on the underlying cellular and molecular processes involved in mild TBI. MRI techniques and blood tests for axonal proteins to identify and grade axonal injury, in addition to PET for tau pathology, show promise as tools to explore CTE pathophysiology in longitudinal clinical studies, and might be developed into diagnostic tools for CTE. Given that CTE is attributed to repeated head trauma, prevention might be possible through rule changes by sports organizations and legislators. © 2016 Macmillan Publishers Limited, part of Springer Nature.},
keywords = {amyloid beta protein, Article, axonal injury, biological marker, BIOPHYSICS, blood, brain, BRAIN damage, cerebrospinal fluid, Chronic traumatic encephalopathy, computer assisted tomography, disease severity, endocrine disease, heredity, human, molecular pathology, neuropathology, nonhuman, nuclear magnetic resonance imaging, Pathophysiology, positron emission tomography, postconcussion syndrome, priority journal, protein aggregation, quality of life, screening, tau protein, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Gregory, A; Kerr, Z; Parsons, J
Selected issues in injury and illness prevention and the team physician: A consensus statement Journal Article
In: Current Sports Medicine Reports, vol. 15, no. 1, pp. 48–59, 2016.
Abstract | Links | BibTeX | Tags: Accident prevention, Article, athlete, cervical spine injury, commotio cordis, Concussion, consultation, coronary artery anomaly, documentation, elbow injury, head and neck injury, heart right ventricle dysplasia, heat injury, human, hypertrophic cardiomyopathy, knowledge, patellofemoral pain syndrome, physician, risk factor, shoulder injury, skin infection, sport injury, SPORTS medicine, total quality management
@article{Gregory2016,
title = {Selected issues in injury and illness prevention and the team physician: A consensus statement},
author = {Gregory, A and Kerr, Z and Parsons, J},
doi = {10.1249/JSR.0000000000000231},
year = {2016},
date = {2016-01-01},
journal = {Current Sports Medicine Reports},
volume = {15},
number = {1},
pages = {48--59},
abstract = {This document provides an overview of selected medical issues that are important to team physicians who are responsible for the care and treatment of athletes. It is not intended as a standard of care, and should not be interpreted as such. This document is only a guide, and as such, is of a general nature, consistent with the reasonable, objective practice of the health care profession. Adequate insurance should be in place to help protect the physician, the athlete, and the sponsoring organization. This statement was developed by a collaboration of sixmajor professional associations concerned about clinical sports medicine issues. They have committed to forming an ongoing project-based alliance to bring together sports medicine organizations to best serve active people and athletes. The organizations are the American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine. Copyright © 2016 by the American College of Sports Medicine.},
keywords = {Accident prevention, Article, athlete, cervical spine injury, commotio cordis, Concussion, consultation, coronary artery anomaly, documentation, elbow injury, head and neck injury, heart right ventricle dysplasia, heat injury, human, hypertrophic cardiomyopathy, knowledge, patellofemoral pain syndrome, physician, risk factor, shoulder injury, skin infection, sport injury, SPORTS medicine, total quality management},
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}
}
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}
}
Bressan, S; Babl, F E
Diagnosis and management of paediatric concussion Journal Article
In: Journal of Paediatrics & Child Health, vol. 52, no. 2, pp. 151–157, 2016.
Abstract | Links | BibTeX | Tags: Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury
@article{Bressan2016,
title = {Diagnosis and management of paediatric concussion},
author = {Bressan, S and Babl, F E},
doi = {10.1111/jpc.12967},
year = {2016},
date = {2016-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {52},
number = {2},
pages = {151--157},
abstract = {Heightened recognition of concussions and concerns about their sequelae in children has become an increasing community and public health concern. Biomarkers and clinical tests are being explored, but the diagnosis of concussion in the emergency department continues to be based on clinical signs and symptoms. While the majority of children go on to recover from post-concussive symptoms within 2 weeks, it is unclear which patients with concussion will go on to develop short- or long-term sequelae. A number of more or less evidence-based guidelines have become available which seek to guide clinicians on how to manage children post-concussion. In general, care after the emergency department is focused on reducing the risk of re-injury and rest until cerebral recovery with a graduated return to school and then play. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).},
keywords = {Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury},
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}
}
Keener, A B
Tackling the brain: Clues emerge about the pathology of sports-related brain trauma Journal Article
In: Nature Medicine, vol. 22, no. 4, pp. 326–329, 2016.
Links | BibTeX | Tags: amnesia, Article, astrocyte, athlete, Athletic Injuries, behavior change, blood vessel injury, brain, Brain Injuries, Brain Injury, cognitive defect, Concussion, confusion, degenerative disease, Epilepsy, head injury, headache, hearing impairment, human, Humans, Neck pain, nerve cell, nervous system inflammation, neurofibrillary tangle, nonhuman, Pathophysiology, postconcussion syndrome, priority journal, sport injury, traumatic brain injury, unsteadiness, Vision, wrestling
@article{Keener2016,
title = {Tackling the brain: Clues emerge about the pathology of sports-related brain trauma},
author = {Keener, A B},
doi = {10.1038/nm0416-326},
year = {2016},
date = {2016-01-01},
journal = {Nature Medicine},
volume = {22},
number = {4},
pages = {326--329},
keywords = {amnesia, Article, astrocyte, athlete, Athletic Injuries, behavior change, blood vessel injury, brain, Brain Injuries, Brain Injury, cognitive defect, Concussion, confusion, degenerative disease, Epilepsy, head injury, headache, hearing impairment, human, Humans, Neck pain, nerve cell, nervous system inflammation, neurofibrillary tangle, nonhuman, Pathophysiology, postconcussion syndrome, priority journal, sport injury, traumatic brain injury, unsteadiness, Vision, wrestling},
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}
}
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}
}
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}
}
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}
}
Talavage, T M; Nauman, E A; Leverenz, L J
The role of medical imaging in the recharacterization of mild traumatic brain injury using youth sports as a laboratory Journal Article
In: Frontiers in Neurology, vol. 6, no. JAN, 2016.
Abstract | Links | BibTeX | Tags: Article, cognition assessment, Concussion, DIAGNOSTIC imaging, functional magnetic resonance imaging, Functional MRI, human, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Neuroanatomy, neuroimaging, neuromonitoring, nonhuman, NUCLEAR magnetic resonance spectroscopy, Patient monitoring, population risk, prediction, protective equipment, sport injury, Subconcussive, traumatic brain injury, validation process
@article{Talavage2016,
title = {The role of medical imaging in the recharacterization of mild traumatic brain injury using youth sports as a laboratory},
author = {Talavage, T M and Nauman, E A and Leverenz, L J},
doi = {10.3389/fneur.2015.00273},
year = {2016},
date = {2016-01-01},
journal = {Frontiers in Neurology},
volume = {6},
number = {JAN},
abstract = {The short- and long-term impact of mild traumatic brain injury (TBI) is an increasingly vital concern for both military and civilian personnel. Such injuries produce significant social and financial burdens and necessitate improved diagnostic and treatment methods. Recent integration of neuroimaging and biomechanical studies in youth collision-sport athletes has revealed that significant alterations in brain structure and function occur even in the absence of traditional clinical markers of "concussion." While task performance is maintained, athletes exposed to repetitive head accelerations exhibit structural changes to the underlying white matter, altered glial cell metabolism, aberrant vascular response, and marked changes in functional network behavior. Moreover, these changes accumulate with accrued years of exposure, suggesting a cumulative trauma mechanism that may culminate in categorization as "concussion" and long-term neurological deficits. The goal of this review is to elucidate the role of medical imaging in recharacterizing TBI, as a whole, to better identify at-risk individuals and improve the development of preventative and interventional approaches. © 2016 Talavage, Nauman and Leverenz.},
keywords = {Article, cognition assessment, Concussion, DIAGNOSTIC imaging, functional magnetic resonance imaging, Functional MRI, human, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Neuroanatomy, neuroimaging, neuromonitoring, nonhuman, NUCLEAR magnetic resonance spectroscopy, Patient monitoring, population risk, prediction, protective equipment, sport injury, Subconcussive, traumatic brain injury, validation process},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
Abstract | Links | BibTeX | Tags: Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident},
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}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Moon, K; Theodore, N
Football and Chronic Traumatic Encephalopathy: How Much Evidence Actually Exists? Journal Article
In: World Neurosurgery, vol. 89, pp. 720–721, 2016.
Links | BibTeX | Tags: Alzheimer disease, amyloid beta protein, amyloid plaque, anxiety disorder, apolipoprotein E, Article, behavior disorder, Boxing, brain atrophy, brain concussion, brain degeneration, chronic disease, Chronic traumatic encephalopathy, cognitive defect, degenerative disease, depression, environmental factor, football, frontotemporal dementia, genetic predisposition, genetic risk, genetic susceptibility, human, motor control, Neuroanatomy, opiate addiction, Parkinson disease, protein phosphorylation, scar formation, septum pellucidum, sport injury, substantia nigra, suicide, TAR DNA binding protein, tau protein, tauopathy, traumatic brain injury
@article{Moon2016,
title = {Football and Chronic Traumatic Encephalopathy: How Much Evidence Actually Exists?},
author = {Moon, K and Theodore, N},
doi = {10.1016/j.wneu.2016.03.073},
year = {2016},
date = {2016-01-01},
journal = {World Neurosurgery},
volume = {89},
pages = {720--721},
keywords = {Alzheimer disease, amyloid beta protein, amyloid plaque, anxiety disorder, apolipoprotein E, Article, behavior disorder, Boxing, brain atrophy, brain concussion, brain degeneration, chronic disease, Chronic traumatic encephalopathy, cognitive defect, degenerative disease, depression, environmental factor, football, frontotemporal dementia, genetic predisposition, genetic risk, genetic susceptibility, human, motor control, Neuroanatomy, opiate addiction, Parkinson disease, protein phosphorylation, scar formation, septum pellucidum, sport injury, substantia nigra, suicide, TAR DNA binding protein, tau protein, tauopathy, traumatic brain injury},
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}
}
Williams, J M; Langdon, J L; McMillan, J L; Buckley, T A
English professional football players concussion knowledge and attitude Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 2, pp. 197–204, 2016.
Abstract | Links | BibTeX | Tags: accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult
@article{Williams2016,
title = {English professional football players concussion knowledge and attitude},
author = {Williams, J M and Langdon, J L and McMillan, J L and Buckley, T A},
doi = {10.1016/j.jshs.2015.01.009},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {2},
pages = {197--204},
abstract = {Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers. © 2016.},
keywords = {accuracy, adult, Article, attitude, behavior, Concussion, Concussion recovery, Concussion reporting, controlled study, education program, follow up, football, human, human experiment, injury severity, knowledge, mild traumatic brain injury, normal human, priority journal, psychometry, questionnaire, RISK assessment, RoCKAS, Rosenbaum Concussion Knowledge and Attitudes Surve, scoring system, semi structured interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}
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}
}
Sharma, V K; Rango, J; Connaughton, A J; Lombardo, D J; Sabesan, V J
The current state of head and neck injuries in extreme sports Journal Article
In: Orthopaedic Journal of Sports Medicine, vol. 3, no. 1, pp. 1–6, 2015.
Abstract | Links | BibTeX | Tags: Article, AWARENESS, Concussion, Concussions, EPIDEMIOLOGY, extreme sport, Extreme sports, fracture, Head and neck injuries, head and neck injury, head injury, human, Incidence, laceration, major clinical study, neck injury, physician, Prevalence, priority journal, quality of life, skateboarding, skiing, telephone interview
@article{Sharma2015,
title = {The current state of head and neck injuries in extreme sports},
author = {Sharma, V K and Rango, J and Connaughton, A J and Lombardo, D J and Sabesan, V J},
doi = {10.1177/2325967114564358},
year = {2015},
date = {2015-01-01},
journal = {Orthopaedic Journal of Sports Medicine},
volume = {3},
number = {1},
pages = {1--6},
abstract = {Background: Since their conception during the mid-1970s, international participation in extreme sports has grown rapidly. The recent death of extreme snowmobiler Caleb Moore at the 2013 Winter X Games has demonstrated the serious risks associated with these sports. Purpose: To examine the incidence and prevalence of head and neck injuries (HNIs) in extreme sports. Study Design: Descriptive epidemiological study. Methods: The National Electronic Injury Surveillance System (NEISS) was used to acquire data from 7 sports (2000-2011) that were included in the Winter and Summer X Games. Data from the NEISS database were collected for each individual sport per year and type of HNI. Cumulative data for overall incidence and injuries over the entire 11-year period were calculated. National estimates were determined using NEISS-weighted calculations. Incidence rates were calculated for extreme sports using data from Outdoor Foundation Participation Reports. Results: Over 4 million injuries were reported between 2000 and 2011, of which 11.3% were HNIs. Of all HNIs, 83% were head injuries and 17% neck injuries. The 4 sports with the highest total incidence of HNI were skateboarding (129,600), snowboarding (97,527), skiing (83,313), and motocross (78,236). Severe HNI (cervical or skull fracture) accounted for 2.5% of extreme sports HNIs. Of these, skateboarding had the highest percentage of severe HNIs. Conclusion: The number of serious injuries suffered in extreme sports has increased as participation in the sports continues to grow. A greater awareness of the dangers associated with these sports offers an opportunity for sports medicine and orthopaedic physicians to advocate for safer equipment, improved on-site medical care, and further research regarding extreme sports injuries. © 2015 The Author(s).},
keywords = {Article, AWARENESS, Concussion, Concussions, EPIDEMIOLOGY, extreme sport, Extreme sports, fracture, Head and neck injuries, head and neck injury, head injury, human, Incidence, laceration, major clinical study, neck injury, physician, Prevalence, priority journal, quality of life, skateboarding, skiing, telephone interview},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K
Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport
@article{Ellis2015,
title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},
author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},
doi = {10.3171/2015.1.PEDS14524},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {16},
number = {3},
pages = {248--255},
abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},
keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},
pubstate = {published},
tppubtype = {article}
}
Wang, H; Wang, B; Jackson, K; Miller, C M; Hasadsri, L; Llano, D; Rubin, R; Zimmerman, J; Johnson, C; Sutton, B
A novel head-neck cooling device for concussion injury in contact sports Journal Article
In: Translational Neuroscience, vol. 6, pp. 20–31, 2015.
Abstract | Links | BibTeX | Tags: Acceleration, Article, brain concussion, Brain hypothermia, brain perfusion, brain temperature, brain tissue, clinical study, cognition, contact sport, cooling, diving, exercise, exercise induced hyperthermia, experimental study, government, head neck cooling device, Head-neck cooling, human, hyperthermia, induced hypothermia, mild traumatic brain injury, nonhuman, priority journal, randomized controlled trial (topic), sport injury, Sports, surface property, thermal regulating system, thermal stimulation, thermoregulation, traumatic brain injury
@article{Wang2015a,
title = {A novel head-neck cooling device for concussion injury in contact sports},
author = {Wang, H and Wang, B and Jackson, K and Miller, C M and Hasadsri, L and Llano, D and Rubin, R and Zimmerman, J and Johnson, C and Sutton, B},
doi = {10.1515/tnsci-2015-0004},
year = {2015},
date = {2015-01-01},
journal = {Translational Neuroscience},
volume = {6},
pages = {20--31},
abstract = {Emerging research on the long-term impact of concussions on athletes has allowed public recognition of the potentially devastating effects of these and other mild head injuries. Mild traumatic brain injury (mTBI) is a multifaceted disease for which management remains a clinical challenge. Recent pre-clinical and clinical data strongly suggest a destructive synergism between brain temperature elevation and mTBI; conversely, brain hypothermia, with its broader, pleiotropic effects, represents the most potent neuro-protectant in laboratory studies to date. Although well-established in selected clinical conditions, a systemic approach to accomplish regional hypothermia has failed to yield an effective treatment strategy in traumatic brain injury (TBI). Furthermore, although systemic hypothermia remains a potentially valid treatment strategy for moderate to severe TBIs, it is neither practical nor safe for mTBIs. Therefore, selective head-neck cooling may represent an ideal strategy to provide therapeutic benefits to the brain. Optimizing brain temperature management using a National Aeronautics and Space Administration (NASA) spacesuit spinoff head-neck cooling technology before and/or after mTBI in contact sports may represent a sensible, practical, and effective method to potentially enhance recover and minimize post-injury deficits. In this paper, we discuss and summarize the anatomical, physiological, preclinical, and clinical data concerning NASA spinoff head-neck cooling technology as a potential treatment for mTBIs, particularly in the context of contact sports. © 2015 Huan Wang et al., licensee De Gruyter Open.},
keywords = {Acceleration, Article, brain concussion, Brain hypothermia, brain perfusion, brain temperature, brain tissue, clinical study, cognition, contact sport, cooling, diving, exercise, exercise induced hyperthermia, experimental study, government, head neck cooling device, Head-neck cooling, human, hyperthermia, induced hypothermia, mild traumatic brain injury, nonhuman, priority journal, randomized controlled trial (topic), sport injury, Sports, surface property, thermal regulating system, thermal stimulation, thermoregulation, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Gardner, A J; Iverson, G L; Quinn, T N; Makdissi, M; Levi, C R; Shultz, S R; Wright, D K; Stanwell, P
A preliminary video analysis of concussion in the National Rugby League Journal Article
In: Brain Injury, vol. 29, no. 10, pp. 1182–1185, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Athletes, brain concussion, case study, clinical article, Concussion, descriptive research, EPIDEMIOLOGY, human, Incidence, Injury surveillance, observational study, rugby, sport injury, unconsciousness, videorecording
@article{Gardner2015b,
title = {A preliminary video analysis of concussion in the National Rugby League},
author = {Gardner, A J and Iverson, G L and Quinn, T N and Makdissi, M and Levi, C R and Shultz, S R and Wright, D K and Stanwell, P},
doi = {10.3109/02699052.2015.1034179},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {10},
pages = {1182--1185},
abstract = {Primary objective: To conduct the first video analysis of concussion in the Australian National Rugby League (NRL) and describe player and injury characteristics, situational factors and time to return to play.Research design: Descriptive, observational case series.Methods and procedures: Video analysis of 20 medically diagnosed concussions for three consenting clubs during the 2013 NRL season.Main outcome and results: Most concussions (83%) occurred during a high tackle, and all injured ball carriers were hit high. Loss of consciousness was observed in 30% of cases. Common observable signs of injury included clutching of the head, balance problems or wobbly legs and a blank or vacant state. There were no post-concussive seizures. All players with loss of consciousness were removed from play. However, only half of the total sample was removed from play and one athlete who was removed returned to play in the same match. Of the players who were removed from play, the large majority returned the following week. Illegal play accounted for 25% of all concussions.Conclusions: Video analysis may be a useful method to study the incidence, mechanism and management of concussion in sports such as Rugby League. Future studies may include larger numbers to validate this preliminary data and may also investigate other levels of play and age ranges. © 2015 Taylor and Francis Group, LLC.},
keywords = {Article, athlete, Athletes, brain concussion, case study, clinical article, Concussion, descriptive research, EPIDEMIOLOGY, human, Incidence, Injury surveillance, observational study, rugby, sport injury, unconsciousness, videorecording},
pubstate = {published},
tppubtype = {article}
}
Rapp, P E; Keyser, D O; Albano, A; Hernandez, R; Gibson, D B; Zambon, R A; David Hairston, W; Hughes, J D; Krystal, A; Nichols, A S
Traumatic brain injury detection using electrophysiological methods Journal Article
In: Frontiers in Human Neuroscience, vol. 9, no. FEB, 2015.
Abstract | Links | BibTeX | Tags: Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury
@article{Rapp2015,
title = {Traumatic brain injury detection using electrophysiological methods},
author = {Rapp, P E and Keyser, D O and Albano, A and Hernandez, R and Gibson, D B and Zambon, R A and {David Hairston}, W and Hughes, J D and Krystal, A and Nichols, A S},
doi = {10.3389/fnhum.2015.00011},
year = {2015},
date = {2015-01-01},
journal = {Frontiers in Human Neuroscience},
volume = {9},
number = {FEB},
abstract = {Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI).This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3)The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5)The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system. © 2015 Rapp, Keyser , Albano, Hernandez, Gibson, Zambon, Hairston, Hughes, Krystal and Nichols.},
keywords = {Article, brain electrophysiology, computer assisted tomography, Concussion, connectome, diagnostic accuracy, EEG, electroencephalogram, Electroencephalography, event related potential, Event-Related Potentials, evidence based medicine, executive function, human, intermethod comparison, latent period, neuroimaging, neuropathology, Non-linear dynamical analysis, nuclear magnetic resonance imaging, QEEG, Signal Processing, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Marinides, Z; Galetta, K M; Andrews, C N; Wilson, J A; Herman, D C; Robinson, C D; Smith, M S; Bentley, B C; Galetta, S L; Balcer, L J; Clugston, J R
Vision testing is additive to the sideline assessment of sports-related concussion Journal Article
In: Neurology: Clinical Practice, vol. 5, no. 1, pp. 25–34, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test
@article{Marinides2015,
title = {Vision testing is additive to the sideline assessment of sports-related concussion},
author = {Marinides, Z and Galetta, K M and Andrews, C N and Wilson, J A and Herman, D C and Robinson, C D and Smith, M S and Bentley, B C and Galetta, S L and Balcer, L J and Clugston, J R},
doi = {10.1212/CPJ.0000000000000060},
year = {2015},
date = {2015-01-01},
journal = {Neurology: Clinical Practice},
volume = {5},
number = {1},
pages = {25--34},
abstract = {We examined the King-Devick (K-D) test, a vision-based test of rapid number naming, as a complement to components of the Sport Concussion Assessment Tool, 3rd edition (SCAT3) for diagnosis of concussion. Baseline and postconcussion data for the University of Florida men's football, women's soccer, and women's lacrosse teams were collected, including the K-D test, Standardized Assessment of Concussion (SAC), and Balance Error Scoring System (BESS). Among 30 athletes with first concussion during their athletic season (n 5 217 total), differences from baseline to postinjury showed worsening of K-D time scores in 79%, while SAC showed a ≥2- point worsening in 52%. Combining K-D and SAC captured abnormalities in 89%; adding the BESS identified 100% of concussions. Adding a vision-based test may enhance the detection of athletes with concussion. © 2015 American Academy of Neurology.},
keywords = {Article, athlete, Balance Error Scoring System, brain concussion, clinical assessment, Female, football, human, King Devick Test, major clinical study, Male, priority journal, Soccer, sport injury, Standardized Assessment of Concussion, vision test},
pubstate = {published},
tppubtype = {article}
}
Dessy, A M; Rasouli, J; Choudhri, T F
Second Impact Syndrome: A Rare, Devastating Consequence of Repetitive Head Injuries Journal Article
In: Neurosurgery Quarterly, vol. 25, no. 3, pp. 423–426, 2015.
Abstract | Links | BibTeX | Tags: Article, brain concussion, clinical feature, Concussion, Dizziness, fatigue, headache, human, hyperemia, intracranial hypertension, memory disorder, Neck pain, neuropathology, neurosurgeon, neurosurgery, Pathophysiology, postconcussion syndrome, priority journal, respiratory failure, Second impact syndrome, sport injury, traumatic brain injury
@article{Dessy2015,
title = {Second Impact Syndrome: A Rare, Devastating Consequence of Repetitive Head Injuries},
author = {Dessy, A M and Rasouli, J and Choudhri, T F},
doi = {10.1097/WNQ.0000000000000085},
year = {2015},
date = {2015-01-01},
journal = {Neurosurgery Quarterly},
volume = {25},
number = {3},
pages = {423--426},
abstract = {Sports-related concussion has been viewed as a developing public health crisis in recent years. Underrecognition of concussions can lead to premature clearance for athletic participation. Second impact syndrome (SIS) represents a rare, yet devastating, potential outcome of premature return to play. SIS is a condition in which rapid brain swelling occurs as a result of a repeat head injury sustained before symptoms of a previous head injury have resolved. Within minutes of the second impact, diffuse cerebral swelling, brain herniation, and death can occur. There are \<20 documented cases of SIS in the world literature to date, and the general understanding of the syndrome is based largely on interpretation of anecdotal cases. This article reviews current understanding of the epidemiology and pathology of SIS. Given neurosurgeons' role in management of head trauma, it is essential that neurosurgeons acquire and maintain thorough knowledge of concussion diagnosis, treatment, and management. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Article, brain concussion, clinical feature, Concussion, Dizziness, fatigue, headache, human, hyperemia, intracranial hypertension, memory disorder, Neck pain, neuropathology, neurosurgeon, neurosurgery, Pathophysiology, postconcussion syndrome, priority journal, respiratory failure, Second impact syndrome, sport injury, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L
In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.
Abstract | Links | BibTeX | Tags: 2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult
@article{Dretsch2015a,
title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},
author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},
doi = {10.1089/neu.2014.3637},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {16},
pages = {1217--1222},
abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},
keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Mayer, A R; Ling, J M; Dodd, A B; Gasparovic, C; Klimaj, S D; Meier, T B
A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters Journal Article
In: Journal of Neurotrauma, vol. 32, no. 22, pp. 1759–1767, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult
@article{Mayer2015b,
title = {A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters},
author = {Mayer, A R and Ling, J M and Dodd, A B and Gasparovic, C and Klimaj, S D and Meier, T B},
doi = {10.1089/neu.2014.3833},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {22},
pages = {1759--1767},
abstract = {Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p \> 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples. © Mary Ann Liebert, Inc. 2015.},
keywords = {Adolescent, adult, Article, biological marker, Biomarkers, BRAIN chemistry, brain concussion, brain cortex, brain size, Cerebral Cortex, CHOLINE, clinical article, cognition, Concussion, controlled study, cortical thickness (brain), creatine, executive function, Female, follow up, Follow-Up Studies, frontal gyrus, glutamic acid, glutamine, human, Humans, Injuries, inositol, Longitudinal, Longitudinal studies, longitudinal study, Magnetic Resonance Imaging, Male, martial art, Martial Arts, Memory, middle aged, mixed martial art, n acetylaspartic acid, neuropsychological test, Neuropsychological Tests, nuclear magnetic resonance imaging, NUCLEAR magnetic resonance spectroscopy, occipital cortex, pathology, posterior cingulate, psychology, repetitive injury, Spectroscopy, volumetrics, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
DiFazio, M; Silverberg, N D; Kirkwood, M W; Bernier, R; Iverson, G L
Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes? Journal Article
In: Clinical Pediatrics, vol. 55, no. 5, pp. 443–451, 2015.
Abstract | Links | BibTeX | Tags: activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling
@article{DiFazio2015,
title = {Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes?},
author = {DiFazio, M and Silverberg, N D and Kirkwood, M W and Bernier, R and Iverson, G L},
doi = {10.1177/0009922815589914},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {5},
pages = {443--451},
abstract = {The current treatment of concussion or mild traumatic brain injury (mTBI) is primarily based on expert consensus. Most clinical practice guidelines advise cognitive and physical rest after injury including withdrawal from normal life activities such as school attendance, sports participation, and technology use until symptoms resolve. Some individuals who sustain an mTBI experience persistent physical, cognitive, and mental health problems. Activity restriction itself may contribute to protracted recovery and other complications. Williamson's Activity Restriction Model of Depression, formulated more than 20 years ago, is central to this hypothesis. We review research evidence for potential harms of prolonged activity restriction and report an mTBI case as an example of how an "activity restriction cascade" can unfold. According to this model, psychological consequences of removal from validating life activities, combined with physical deconditioning, contribute to the development and persistence of postconcussive symptoms after mTBI in some youth. A modification to mTBI guidelines that emphasizes prompt reengagement in life activities as tolerated is encouraged. © SAGE Publications.},
keywords = {activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lawrence, D W; Comper, P; Hutchison, M G; Sharma, B
The role of apolipoprotein E episilon ($epsilon$)-4 allele on outcome following traumatic brain injury: A systematic review Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1018–1031, 2015.
Abstract | Links | BibTeX | Tags: 80 and over, aged, allele, Alleles, Alzheimer disease, amyloid beta protein, APOE, apolipoprotein E, apolipoprotein E4, Article, athlete, brain concussion, Brain Injuries, clinical evaluation, cognition, cognitive defect, disease severity, Female, follow up, genetic association, genetic risk, genetics, GENOTYPE, Glasgow Outcome Scale, heterozygote, histopathology, homozygote, human, Humans, Incidence, injury severity, Male, Memory, nerve cell necrosis, neuropathology, Neuroprotection, outcome assessment, pediatrics, Prevalence, Prognosis, prognostic assessment, protein function, psychologic test, psychology, Recovery, scoring system, Systematic Review, tau protein, traumatic brain injury, treatment outcome, very elderly, Wechsler Intelligence Scale
@article{Lawrence2015,
title = {The role of apolipoprotein E episilon ($epsilon$)-4 allele on outcome following traumatic brain injury: A systematic review},
author = {Lawrence, D W and Comper, P and Hutchison, M G and Sharma, B},
doi = {10.3109/02699052.2015.1005131},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1018--1031},
abstract = {Background: The apolipoprotein E gene (APOE) has emerged as a candidate for prognosticating traumatic brain injury (TBI) recovery, with APOE$epsilon$4 identified as a susceptibility marker for poor outcome, despite large discrepancy in its reported influence post-TBI.Methods: A systematic review was conducted, including all primary articles investigating the role of APOE$epsilon$4 on TBI outcome. A total of 65 studies were included, including 24 predominantly investigating mild (mTBI), seven moderate (modTBI) and 33 severe (sTBI); severity was not reported in one study.Results: In mTBI studies, the association between APOE$epsilon$4 and post-TBI outcome was concluded as non-contributory in 14 studies (58.3%), hazardous in nine (37.5%) and protective in one (4.2%). In sTBI studies, the role of APOE$epsilon$4 was hazardous in 21 (63.6%), non-contributory in nine (27.3%) and protective in three (9.1%). Of the seven studies investigating dementia outcomes, four observed a hazardous association with APOE$epsilon$4, while three reported no association. Six studies examined Alzheimers dementia pathology, of which three reported a hazardous influence of APOE$epsilon$4.Conclusions: The influence of APOE$epsilon$4 on neuropsychological testing, functional outcome and in paediatric populations was incongruous. This review supports the majority of research indicating APOE$epsilon$4 adversely influences recovery following TBI, particularly with respect to dementia-related outcomes and outcomes following sTBI. © 2015 Taylor \& Francis Group, LLC.},
keywords = {80 and over, aged, allele, Alleles, Alzheimer disease, amyloid beta protein, APOE, apolipoprotein E, apolipoprotein E4, Article, athlete, brain concussion, Brain Injuries, clinical evaluation, cognition, cognitive defect, disease severity, Female, follow up, genetic association, genetic risk, genetics, GENOTYPE, Glasgow Outcome Scale, heterozygote, histopathology, homozygote, human, Humans, Incidence, injury severity, Male, Memory, nerve cell necrosis, neuropathology, Neuroprotection, outcome assessment, pediatrics, Prevalence, Prognosis, prognostic assessment, protein function, psychologic test, psychology, Recovery, scoring system, Systematic Review, tau protein, traumatic brain injury, treatment outcome, very elderly, Wechsler Intelligence Scale},
pubstate = {published},
tppubtype = {article}
}
Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D
In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.
Abstract | Links | BibTeX | Tags: accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult
@article{Oeur2015,
title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},
author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},
doi = {10.3171/2014.10.JNS14440},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery},
volume = {123},
number = {2},
pages = {415--422},
abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},
keywords = {accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
Abstract | Links | BibTeX | Tags: academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S
Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article
In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult
@article{Baker2015,
title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},
author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},
doi = {10.1177/0009922815588820},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {54},
number = {10},
pages = {961--968},
abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},
keywords = {Absenteeism, Adolescent, adolescent disease, adult, Article, athlete, Athletic Injuries, brain concussion, computer testing, Concussion, disease association, disease severity, Female, follow up, Follow-Up Studies, health service, human, Humans, interview, Interviews as Topic, Logistic Models, major clinical study, Male, Pathophysiology, receiver operating characteristic, recovery time, Recurrence, recurrent disease, return to learn, ROC Curve, school, school problems, sport injury, Sport-related concussion, statistical model, Symptoms, telephone interview, Young Adult},
pubstate = {published},
tppubtype = {article}
}
McDevitt, J; Tierney, R T; Phillips, J; Gaughan, J P; Torg, J S; Krynetskiy, E
Association between GRIN2A promoter polymorphism and recovery from concussion Journal Article
In: Brain Injury, vol. 29, no. 13-14, pp. 1674–1681, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat
@article{McDevitt2015,
title = {Association between GRIN2A promoter polymorphism and recovery from concussion},
author = {McDevitt, J and Tierney, R T and Phillips, J and Gaughan, J P and Torg, J S and Krynetskiy, E},
doi = {10.3109/02699052.2015.1075252},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {13-14},
pages = {1674--1681},
abstract = {Objective: To determine genetic variability within the N-methyl-D-aspartate receptor 2A sub-unit (GRIN2A) gene promoter and its association with concussion recovery time. The hypothesis tested was that there would be a difference in allele and/or genotype distribution between two groups of athletes with normal and prolonged recovery.Methods: DNA was extracted from saliva collected from a total of 87 athletes with a physician-diagnosed concussion. The (GT) variable number tandem repeats (VNTR) within the promoter region of GRIN2A was genotyped. The long (L) allele was an allele with ≥25 repeats and the short (S) allele was an allele with \<25 repeats in the GT tract. Participants recovery time was followed prospectively and was categorized as normal (≤60 days) or prolonged (\>60 days).Results: LL carriers were 6-times more likely to recover longer than 60 days following the concussive event (p = 0.0433) when compared to SS carriers. Additionally, L allele carriers were found more frequently in the prolonged recovery group (p = 0.048).Conclusion: Determining genetic influence on concussion recovery will aid in future development of genetic counselling. The clinical relevance of genotyping athletes could improve management of athletes who experience concussion injuries. © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, Article, athlete, brain concussion, Brain Injury, calcium, capillary electrophoresis, CONVALESCENCE, DNA, Female, gene frequency, genetic association, genetic polymorphism, genetic variability, GENOTYPE, heterozygote, human, inheritance, major clinical study, Male, n methyl dextro aspartic acid receptor 2A, NR2A sub-unit, pedigree analysis, promoter region, sport injury, variable number of tandem repeat},
pubstate = {published},
tppubtype = {article}
}
Lefebvre, G; Tremblay, S; Théoret, H
Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1032–1043, 2015.
Abstract | Links | BibTeX | Tags: 4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult
@article{Lefebvre2015,
title = {Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex},
author = {Lefebvre, G and Tremblay, S and Th\'{e}oret, H},
doi = {10.3109/02699052.2015.1028447},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1032--1043},
abstract = {Primary objective: The present paper systematically reviews studies using transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to assess cortical excitability, intra-cortical inhibition/facilitation and synaptic plasticity following mild traumatic brain injury (mTBI).Methods: Articles using TMS over M1 in patients with mTBI or sport-related concussion indexed in PubMed and published between 1998 and September 2014 were included in the present review.Main outcomes and results: From the 17 articles that matched search criteria, results from various TMS paradigms were summarized and divided in three main areas of interest: motor cortical excitability/facilitation, motor cortical inhibition and cortical plasticity. Although studies suggest a trend of abnormal intra-cortical inhibition following mTBI, no clear and specific pattern emerges from the surveyed data.Conclusions: At this time and with the possible exception of intra-cortical inhibitory measures, TMS cannot reliably detect changes in M1 excitability in individuals with mTBI or a concussion at both the acute and chronic stages of injury. This may be explained by the small number of studies and large variety of stimulation parameters. Additional longitudinal and multimodal studies are needed to better understand the nature of the excitability changes that may occur within M1 following mTBI. © 2015 Taylor \& Francis Group, LLC.},
keywords = {4 aminobutyric acid B receptor, adult, aged, Article, brain concussion, brain cortex, Brain Injuries, central motor conduction time, clinical assessment, Concussion, cortical excitability, electrostimulation, evoked muscle response, Evoked Potentials, Female, human, Humans, Inhibition, latent inhibition, latent period, long interval intracortical inhibition, magnetic stimulation, Male, Medline, middle aged, Motor, motor cortex, motor evoked potential, motor nerve conduction, muscle contraction, nerve cell excitability, nerve cell plasticity, neuromuscular facilitation, Neuronal Plasticity, outcome assessment, paired associative stimulation, Pathophysiology, PHYSIOLOGY, postsynaptic inhibition, primary motor cortex, procedures, short interval intracortical inhibition, short latency afferent inhibition, sport injury, stimulus response, Systematic Review, therapy effect, theta burst stimulation, TRANSCRANIAL magnetic stimulation, traumatic brain injury, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury},
pubstate = {published},
tppubtype = {article}
}
Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E
Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article
In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.
Abstract | Links | BibTeX | Tags: alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption
@article{Moran2015,
title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},
author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},
doi = {10.14423/SMJ.0000000000000340},
year = {2015},
date = {2015-01-01},
journal = {Southern Medical Journal},
volume = {108},
number = {9},
pages = {553--558},
abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},
keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},
pubstate = {published},
tppubtype = {article}
}
Wolanin, A; Gross, M; Hong, E
Depression in athletes: Prevalence and risk factors Journal Article
In: Current Sports Medicine Reports, vol. 14, no. 1, pp. 56–60, 2015.
Abstract | Links | BibTeX | Tags: Article, athlete, Athletes, Athletic Injuries, athletic performance, career, Career Choice, Concussion, DECISION making, depression, distress syndrome, emotional disorder, emotional stress, human, Humans, Mental Health, overtraining syndrome, Prevalence, psychology, risk factor, Risk Factors, social adaptation, social support, sport injury, SPORTS medicine, SPORTS psychology, suicide, trends
@article{Wolanin2015,
title = {Depression in athletes: Prevalence and risk factors},
author = {Wolanin, A and Gross, M and Hong, E},
doi = {10.1249/JSR.0000000000000123},
year = {2015},
date = {2015-01-01},
journal = {Current Sports Medicine Reports},
volume = {14},
number = {1},
pages = {56--60},
abstract = {Depression affects an estimated 6.7% of today's adult population in a 12-month period. The prevalence rates for certain age groups, such as young adults and older adults, are higher. There are approximately 400,000 National Collegiate Athletic Association student athletes competing each year and 5 to 7 million high school student athletes involved in competitive interscholastic sports. Given such a high prevalence rate in certain age groups and a large denominator pool of athletes, past notions that athletes are devoid of mental health issues have come under scrutiny by sports medicine providers. Initial data suggest that athletes are far from immune to depression. The purpose of this article was to review the current research on athletes and depression; particularly this article will provide an overview of studies, which have investigated the rate of depression among athletes, and discuss relevant risk factors, which may contribute to depression among athletes. Copyright © 2015 by the American College of Sports Medicine.},
keywords = {Article, athlete, Athletes, Athletic Injuries, athletic performance, career, Career Choice, Concussion, DECISION making, depression, distress syndrome, emotional disorder, emotional stress, human, Humans, Mental Health, overtraining syndrome, Prevalence, psychology, risk factor, Risk Factors, social adaptation, social support, sport injury, SPORTS medicine, SPORTS psychology, suicide, trends},
pubstate = {published},
tppubtype = {article}
}
Bowman, T G; Breedlove, K M; Breedlove, E L; Dodge, T M; Nauman, E A
Impact attenuation properties of new and used lacrosse helmets Journal Article
In: Journal of Biomechanics, vol. 48, no. 14, pp. 3782–3787, 2015.
Abstract | Links | BibTeX | Tags: Accident prevention, Article, Athletic Injuries, attenuation, brain concussion, Cracks, Drop test, Drops, Equipment Design, Gadd Severity Index, head impact, Head Protective Devices, Helmet, Helmet evaluation, human, Humans, Injuries, lacrosse helmet, Materials testing, mechanical stress, priority journal, protective equipment, racquet sport, Racquet Sports, recertification, rigidity, Safety devices, Severity index, Sporting goods, Sports Equipment, standards, stress strain relationship, velocity
@article{Bowman2015,
title = {Impact attenuation properties of new and used lacrosse helmets},
author = {Bowman, T G and Breedlove, K M and Breedlove, E L and Dodge, T M and Nauman, E A},
doi = {10.1016/j.jbiomech.2015.08.026},
year = {2015},
date = {2015-01-01},
journal = {Journal of Biomechanics},
volume = {48},
number = {14},
pages = {3782--3787},
abstract = {The National Operating Committee on Standards for Athletic Equipment (NOCSAE) has developed impact attenuation thresholds that protective helmets worn in sport must meet to be commercially available in an attempt to prevent injury. It remains unknown how normal helmet use in athletic activity alters the force attenuation ability of lacrosse helmets. We tested 3 new and 3 randomly selected used helmets from 2 popular lacrosse models (Cascade Pro7, Cascade CPXR). All used helmets had been worn for 3 collegiate seasons prior to testing and had never been refurbished. Helmets were drop-tested using 3 prescribed impact velocities at 6 locations according to the NOCSAE lacrosse helmet standard, and we compared the Gadd Severity Index (GSI) scores between new and used helmets using a repeated measure ANOVA with location as the repeated variable and data separated by impact velocity. All 12 helmets passed the NOCSAE GSI threshold for all testing conditions; however 1 used helmet shell cracked resulting in a failed test. We found a significant main effect for helmet age at the low (F5},
keywords = {Accident prevention, Article, Athletic Injuries, attenuation, brain concussion, Cracks, Drop test, Drops, Equipment Design, Gadd Severity Index, head impact, Head Protective Devices, Helmet, Helmet evaluation, human, Humans, Injuries, lacrosse helmet, Materials testing, mechanical stress, priority journal, protective equipment, racquet sport, Racquet Sports, recertification, rigidity, Safety devices, Severity index, Sporting goods, Sports Equipment, standards, stress strain relationship, velocity},
pubstate = {published},
tppubtype = {article}
}
Jackson, K; Rubin, R; Van Hoeck, N; Hauert, T; Lana, V; Wang, H
The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers Journal Article
In: Translational Neuroscience, vol. 6, no. 1, pp. 131–138, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, Athletics, body temperature, body temperature measurement, brain, brain temperature, clinical assessment, clinical effectiveness, cognition, cold tolerance, cold treatment, Concussion, diastolic blood pressure, executive function, Feasibility, Female, head neck cooling, Heart Rate, human, human experiment, infrared thermometer, Intervention, Male, mouth temperature, normal human, physiological process, priority journal, pulse oximetry, room temperature, systolic blood pressure, TASK performance, temperature management device, thermoregulation, tympanic temperature, velocity, welkins emt temperature management system, working memory
@article{Jackson2015,
title = {The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers},
author = {Jackson, K and Rubin, R and {Van Hoeck}, N and Hauert, T and Lana, V and Wang, H},
doi = {10.1515/tnsci-2015-0012},
year = {2015},
date = {2015-01-01},
journal = {Translational Neuroscience},
volume = {6},
number = {1},
pages = {131--138},
abstract = {In general, brain temperatures are elevated during physical sporting activities; therefore, reducing brain temperature shortly after a sports-related concussion (SRC) could be a promising intervention technique. The main objective of this study was to examine the effects of head and neck cooling on physiological and cognitive function in normal healthy volunteers. Twelve healthy volunteers underwent two different sessions of combined head and neck cooling, one session with a cold pack and one session with a room temperature pack. Physiological measurements included: systolic/diastolic blood pressure, pulse oximetry, heart rate, and sublingual and tympanic temperature. Cognitive assessment included: processing speed, executive function, and working memory tasks. Physiological measurements were taken pre-, mid- and post-cooling, while cognitive assessments were done before and after cooling. The order of the sessions was randomized. There was a significant decrease in tympanic temperature across both sessions; however more cooling occurred when the cold pack was in the device. There was no significant decrease in sublingual temperature across either session. The observed heart rates, pulse oximetry, systolic and diastolic blood pressure during the sessions were all within range of a normal healthy adult. Cognitive assessment remained stable across each session for both pre- and post-cooling. We propose that optimizing brain temperature management after brain injury using head and neck cooling technology may represent a sensible, practical, and effective strategy to potentially enhance recovery and perhaps minimize the subsequent short and long term consequences from SRC. © 2015 Kevin Jackson et al.},
keywords = {adult, Article, Athletics, body temperature, body temperature measurement, brain, brain temperature, clinical assessment, clinical effectiveness, cognition, cold tolerance, cold treatment, Concussion, diastolic blood pressure, executive function, Feasibility, Female, head neck cooling, Heart Rate, human, human experiment, infrared thermometer, Intervention, Male, mouth temperature, normal human, physiological process, priority journal, pulse oximetry, room temperature, systolic blood pressure, TASK performance, temperature management device, thermoregulation, tympanic temperature, velocity, welkins emt temperature management system, working memory},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}
Mirabelli, M H; Devine, M J; Singh, J; Mendoza, M
The preparticipation sports evaluation Journal Article
In: American Family Physician, vol. 92, no. 5, pp. 371–376, 2015.
Abstract | BibTeX | Tags: Article, asthma, athlete, bleeding disorder, bronchospasm, cardiovascular disease, drug abuse, Eating disorder, ELECTROCARDIOGRAPHY, Epilepsy, heart murmur, hematologic disease, HISTORY, human, imaging, lung disease, Marfan syndrome, medical society, mental disease, Morbidity, MORTALITY, musculoskeletal injury, neurologic disease, Physical Examination, physical performance, social participation, Sport, sport injury, sudden death, urinalysis
@article{Mirabelli2015,
title = {The preparticipation sports evaluation},
author = {Mirabelli, M H and Devine, M J and Singh, J and Mendoza, M},
year = {2015},
date = {2015-01-01},
journal = {American Family Physician},
volume = {92},
number = {5},
pages = {371--376},
abstract = {The preparticipation physical evaluation is a commonly requested medical visit for amateur and professional athletes of all ages. The overarching goal is to maximize the health of athletes and their safe participation in sports. Although studies have not found that the preparticipation physical evaluation prevents morbidity and mortality associated with sports, it may detect conditions that predispose the athlete to injury or illness and can provide strategies to prevent injuries. Clearance depends on the outcome of the evaluation and the type of sport (and sometimes position or event) in which the athlete participates. All persons undergoing a preparticipation physical evaluation should be questioned about exertional symptoms, presence of a heart murmur, symptoms of Marfan syndrome, and family history of premature serious cardiac conditions or sudden death. The physical examination should focus on the cardiovascular and musculoskeletal systems. U.S. medical and athletic organizations discourage screening electrocardiography and blood and urine testing in asymptomatic patients. Further evaluation should be considered for persons with heart or lung disease, bleeding disorders, musculoskeletal problems, history of concussion, or other neurologic disorders. © 2015 American Academy of Family Physicians.},
keywords = {Article, asthma, athlete, bleeding disorder, bronchospasm, cardiovascular disease, drug abuse, Eating disorder, ELECTROCARDIOGRAPHY, Epilepsy, heart murmur, hematologic disease, HISTORY, human, imaging, lung disease, Marfan syndrome, medical society, mental disease, Morbidity, MORTALITY, musculoskeletal injury, neurologic disease, Physical Examination, physical performance, social participation, Sport, sport injury, sudden death, urinalysis},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
pubstate = {published},
tppubtype = {article}
}
Brown, J C; Viljoen, W; Lambert, M I; Readhead, C; Fuller, C; Van Mechelen, W; Verhagen, E
The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments Journal Article
In: Journal of Science & Medicine in Sport, vol. 18, no. 4, pp. 394–399, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries
@article{Brown2015b,
title = {The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments},
author = {Brown, J C and Viljoen, W and Lambert, M I and Readhead, C and Fuller, C and {Van Mechelen}, W and Verhagen, E},
doi = {10.1016/j.jsams.2014.06.015},
year = {2015},
date = {2015-01-01},
journal = {Journal of Science \& Medicine in Sport},
volume = {18},
number = {4},
pages = {394--399},
abstract = {Objectives: Rugby Union ("rugby") is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries. Design: This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs. Methods: Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities. Results: Of the 3652 players, 2% (n=71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425-US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486-US$1500) than those without (US$220, 95% CI: US$145-US$302). Conclusions: Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance. © 2014 Sports Medicine Australia.},
keywords = {Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries},
pubstate = {published},
tppubtype = {article}
}