Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
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}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
Abstract | Links | BibTeX | Tags: adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Chun, I Y; Mao, X; Breedlove, E L; Leverenz, L J; Nauman, E A; Talavage, T M
DTI Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts Journal Article
In: Developmental Neuropsychology, vol. 40, no. 2, pp. 92–97, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/pa [Pathology], *Craniocerebral Trauma/pp [Physiopathology], *Diffusion Magnetic Resonance Imaging/mt [Methods], *Football/in [Injuries], *White Matter/ab [Abnormalities], *White Matter/pp [Physiopathology], Adolescent, Athletes, Brain Concussion/di [Diagnosis], Brain Concussion/pp [Physiopathology], Brain/pp [Physiopathology], Brain/ra [Radiography], Craniocerebral Trauma/di [Diagnosis], Head, Humans, Schools, Time Factors, White Matter/pa [Pathology]
@article{Chun2015,
title = {DTI Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts},
author = {Chun, I Y and Mao, X and Breedlove, E L and Leverenz, L J and Nauman, E A and Talavage, T M},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {2},
pages = {92--97},
abstract = {Longitudinal evaluation using diffusion-weighted imaging and collision event monitoring was performed on high school athletes who participate in American football. Observed changes in white matter health were suggestive of injury and found to be correlated with accumulation of head collision events during practices and games.},
keywords = {*Athletic Injuries/pa [Pathology], *Craniocerebral Trauma/pp [Physiopathology], *Diffusion Magnetic Resonance Imaging/mt [Methods], *Football/in [Injuries], *White Matter/ab [Abnormalities], *White Matter/pp [Physiopathology], Adolescent, Athletes, Brain Concussion/di [Diagnosis], Brain Concussion/pp [Physiopathology], Brain/pp [Physiopathology], Brain/ra [Radiography], Craniocerebral Trauma/di [Diagnosis], Head, Humans, Schools, Time Factors, White Matter/pa [Pathology]},
pubstate = {published},
tppubtype = {article}
}
Beckwith, J G; Greenwald, R M; Chu, J J; Crisco, J J; Rowson, S; Duma, S M; Broglio, S P; McAllister, T W; Guskiewicz, K M; Mihalik, J P; Anderson, S; Schnebel, B; Brolinson, P G; Collins, M W
Timing of concussion diagnosis is related to head impact exposure prior to injury Journal Article
In: Medicine & Science in Sports & Exercise, vol. 45, no. 4, pp. 747–754, 2013.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult
@article{Beckwith2013a,
title = {Timing of concussion diagnosis is related to head impact exposure prior to injury},
author = {Beckwith, J G and Greenwald, R M and Chu, J J and Crisco, J J and Rowson, S and Duma, S M and Broglio, S P and McAllister, T W and Guskiewicz, K M and Mihalik, J P and Anderson, S and Schnebel, B and Brolinson, P G and Collins, M W},
year = {2013},
date = {2013-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {45},
number = {4},
pages = {747--754},
abstract = {PURPOSE: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. METHODS: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (DELTAv). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). RESULTS: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P \< 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P \< 0.001) and within 7 d of injury (69.7 +/- 43.3},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Chiu, W T; Huang, S J; Tsai, S H; Lin, J W; Tsai, M D; Lin, T J; Huang, W C
The impact of time, legislation, and geography on the epidemiology of traumatic brain injury Journal Article
In: Journal of Clinical Neuroscience, vol. 14, no. 10, pp. 930–935, 2007.
Abstract | BibTeX | Tags: *Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics & Numerical D, *Rural Population/sn [Statistics & Numerical Data], *Urban Population/sn [Statistics & Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics & Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation & Jurisprudence], Motorcycles/sn [Statistics & Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation & Jurisprudence, Traffic/pc [Prevention & Control], Traffic/sn [Statistics & Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]
@article{Chiu2007,
title = {The impact of time, legislation, and geography on the epidemiology of traumatic brain injury},
author = {Chiu, W T and Huang, S J and Tsai, S H and Lin, J W and Tsai, M D and Lin, T J and Huang, W C},
year = {2007},
date = {2007-01-01},
journal = {Journal of Clinical Neuroscience},
volume = {14},
number = {10},
pages = {930--935},
abstract = {In 1991, a population-based epidemiologic traumatic brain injury (TBI) study was done in urban and rural areas of Taiwan; this was 5 years before the helmet use law was passed and 8 years before the drink driving law was passed. In order to evaluate the impact of three major determinants (time, geography, and legislation) on the epidemiology of TBI, we conducted a prospective study in 2001 and used the 1991 data to examine the differences in TBI distribution in urban and rural Taiwan a decade after these laws were passed. In 2001, 5754 TBI cases were collected from the urban area of Taipei City, and 1474 TBI cases were collected from the rural area of Hualien County. The TBI incidence rate in Taipei City in 2001 was estimated to be 218/100,000 population (285/100,000 for males and 152/100,000 for females). When compared to the 1991 data, the incidence rate in 2001 had increased by 20%. The TBI incidence rate in Hualien County in 2001 was estimated to be 417/100,000 population (516/100,000 for males and 306/100,000 for females); this was a 37% increase over the 1991 data. Our study found that the distribution of causes and age distribution had shifted significantly over the 10-year period. In 2001, the age group with the highest incidence was 20-29 years, while in 1991 it had been the over 70 years age group. While traffic-related TBI had decreased, falls and assaults had increased in 2001. We also found that legislation, such as the helmet law, affects TBI distribution by decreasing the traffic-related TBI rate, decreasing the admission severity of TBI, and reducing TBI-related mortality. Finally, geography plays a crucial role in the outcome of TBI; over the 10 year period, Taipei had an increase in moderately severe outcomes, while Hualien had an increase in more severe outcomes. Comparative studies of TBI in urban and rural areas have shown that time, legislation, and geography are crucial determinants of TBI epidemiology. Although time and legal interventions seem to have more of an impact, geography does affect TBI outcomes.},
keywords = {*Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics \& Numerical D, *Rural Population/sn [Statistics \& Numerical Data], *Urban Population/sn [Statistics \& Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics \& Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation \& Jurisprudence], Motorcycles/sn [Statistics \& Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation \& Jurisprudence, Traffic/pc [Prevention \& Control], Traffic/sn [Statistics \& Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Chetelat, G; Eustache, F; Viader, F; De La Sayette, V; Pelerin, A; Mezenge, F; Hannequin, D; Dupuy, B; Baron, J C; Desgranges, B
FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment Journal Article
In: Neurocase, vol. 11, no. 1, pp. 14–25, 2005.
Abstract | BibTeX | Tags: *Cognition Disorders/dg [Diagnostic Imaging], *Fluorodeoxyglucose F18, *Neuropsychological Tests, *Positron-Emission Tomography, 0Z5B2CJX4D (Fluorodeoxyglucose F18), 80 and over, aged, ANALYSIS of variance, Brain Concussion/dg [Diagnostic Imaging], Brain Concussion/pa [Pathology], BRAIN mapping, Cognition Disorders/di [Diagnosis], Dementia/dg [Diagnostic Imaging], Dementia/di [Diagnosis], Dementia/pp [Physiopathology], Female, Follow-Up Studies, Humans, Male, Memory/ph [Physiology], Mental Status Schedule, middle aged, Predictive Value of Tests, Regression (Psychology), Reproducibility of Results, Time Factors
@article{Chetelat2005,
title = {FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment},
author = {Chetelat, G and Eustache, F and Viader, F and {De La Sayette}, V and Pelerin, A and Mezenge, F and Hannequin, D and Dupuy, B and Baron, J C and Desgranges, B},
year = {2005},
date = {2005-01-01},
journal = {Neurocase},
volume = {11},
number = {1},
pages = {14--25},
abstract = {The accurate prediction, at a pre-dementia stage of Alzheimer's disease (AD), of the subsequent clinical evolution of patients would be a major breakthrough from both therapeutic and research standpoints. Amnestic mild cognitive impairment (MCI) is presently the most common reference to address the pre-dementia stage of AD. However, previous longitudinal studies on patients with MCI assessing neuropsychological and PET markers of future conversion to AD are sparse and yield discrepant findings, while a comprehensive comparison of the relative accuracy of these two categories of measure is still lacking. In the present study, we assessed the global cognitive decline as measured by the Mattis scale in 18 patients with amnestic MCI over an 18-month follow-up period, studying which subtest of this scale showed significant deterioration over time. Using baseline measurements from neuropsychological evaluation of memory and PET, we then assessed significant markers of global cognitive change, that is, percent annual change in the Mattis scale total score, and searched for the best predictor of this global cognitive decline. Altogether, our results revealed significant decline over the 18-month follow-up period in the total score and the verbal initiation and memory-recall subscores of the Mattis scale. The percent annual change in the total Mattis score significantly correlated with age and baseline performances in delayed episodic memory recall as well as semantic autobiographical and category word fluencies. Regarding functional imaging, significant correlations were also found with baseline PET values in the right temporo-parietal and medial frontal areas. Age and right temporo-parietal PET values were the most significant predictors of subsequent global cognitive decline, and the only ones to survive stepwise regression analyses. Our findings are consistent with previous works showing predominant delayed recall and semantic memory impairment at a pre-dementia stage of AD, as well as early metabolic defects in the temporo-parietal associative cortex. However, they suggest that only the latter predictor is specifically and accurately associated with subsequent cognitive decline in patients with MCI within 18 months of first assessment.},
keywords = {*Cognition Disorders/dg [Diagnostic Imaging], *Fluorodeoxyglucose F18, *Neuropsychological Tests, *Positron-Emission Tomography, 0Z5B2CJX4D (Fluorodeoxyglucose F18), 80 and over, aged, ANALYSIS of variance, Brain Concussion/dg [Diagnostic Imaging], Brain Concussion/pa [Pathology], BRAIN mapping, Cognition Disorders/di [Diagnosis], Dementia/dg [Diagnostic Imaging], Dementia/di [Diagnosis], Dementia/pp [Physiopathology], Female, Follow-Up Studies, Humans, Male, Memory/ph [Physiology], Mental Status Schedule, middle aged, Predictive Value of Tests, Regression (Psychology), Reproducibility of Results, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Corzatt, R D; Groppel, J L; Pfautsch, E; Boscardin, J
The biomechanics of head-first versus feet-first sliding Journal Article
In: American Journal of Sports Medicine, vol. 12, no. 3, pp. 229–232, 1984.
Abstract | BibTeX | Tags: *Baseball, *Biomechanical Phenomena, *SPORTS, Evaluation Studies as Topic, Foot/ph [Physiology], Head/ph [Physiology], Humans, Motion Pictures as Topic, Rotation, Time Factors
@article{Corzatt1984,
title = {The biomechanics of head-first versus feet-first sliding},
author = {Corzatt, R D and Groppel, J L and Pfautsch, E and Boscardin, J},
year = {1984},
date = {1984-01-01},
journal = {American Journal of Sports Medicine},
volume = {12},
number = {3},
pages = {229--232},
abstract = {The two basic sliding techniques, head-first and feet-first, were analyzed kinematically with high speed cinematography. Four phases were identified with each technique: sprint, attainment of sliding position, airborne, and landing. The velocity and displacement of the center of gravity were measured with each technique. The study was primarily descriptive but demonstrated potential for injury with each technique. Further studies are needed to determine which technique is safer and faster.},
keywords = {*Baseball, *Biomechanical Phenomena, *SPORTS, Evaluation Studies as Topic, Foot/ph [Physiology], Head/ph [Physiology], Humans, Motion Pictures as Topic, Rotation, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {},
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.
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chun, I Y; Mao, X; Breedlove, E L; Leverenz, L J; Nauman, E A; Talavage, T M
DTI Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts Journal Article
In: Developmental Neuropsychology, vol. 40, no. 2, pp. 92–97, 2015.
@article{Chun2015,
title = {DTI Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts},
author = {Chun, I Y and Mao, X and Breedlove, E L and Leverenz, L J and Nauman, E A and Talavage, T M},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {2},
pages = {92--97},
abstract = {Longitudinal evaluation using diffusion-weighted imaging and collision event monitoring was performed on high school athletes who participate in American football. Observed changes in white matter health were suggestive of injury and found to be correlated with accumulation of head collision events during practices and games.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Beckwith, J G; Greenwald, R M; Chu, J J; Crisco, J J; Rowson, S; Duma, S M; Broglio, S P; McAllister, T W; Guskiewicz, K M; Mihalik, J P; Anderson, S; Schnebel, B; Brolinson, P G; Collins, M W
Timing of concussion diagnosis is related to head impact exposure prior to injury Journal Article
In: Medicine & Science in Sports & Exercise, vol. 45, no. 4, pp. 747–754, 2013.
@article{Beckwith2013a,
title = {Timing of concussion diagnosis is related to head impact exposure prior to injury},
author = {Beckwith, J G and Greenwald, R M and Chu, J J and Crisco, J J and Rowson, S and Duma, S M and Broglio, S P and McAllister, T W and Guskiewicz, K M and Mihalik, J P and Anderson, S and Schnebel, B and Brolinson, P G and Collins, M W},
year = {2013},
date = {2013-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {45},
number = {4},
pages = {747--754},
abstract = {PURPOSE: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. METHODS: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (DELTAv). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). RESULTS: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P \< 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P \< 0.001) and within 7 d of injury (69.7 +/- 43.3},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chiu, W T; Huang, S J; Tsai, S H; Lin, J W; Tsai, M D; Lin, T J; Huang, W C
The impact of time, legislation, and geography on the epidemiology of traumatic brain injury Journal Article
In: Journal of Clinical Neuroscience, vol. 14, no. 10, pp. 930–935, 2007.
@article{Chiu2007,
title = {The impact of time, legislation, and geography on the epidemiology of traumatic brain injury},
author = {Chiu, W T and Huang, S J and Tsai, S H and Lin, J W and Tsai, M D and Lin, T J and Huang, W C},
year = {2007},
date = {2007-01-01},
journal = {Journal of Clinical Neuroscience},
volume = {14},
number = {10},
pages = {930--935},
abstract = {In 1991, a population-based epidemiologic traumatic brain injury (TBI) study was done in urban and rural areas of Taiwan; this was 5 years before the helmet use law was passed and 8 years before the drink driving law was passed. In order to evaluate the impact of three major determinants (time, geography, and legislation) on the epidemiology of TBI, we conducted a prospective study in 2001 and used the 1991 data to examine the differences in TBI distribution in urban and rural Taiwan a decade after these laws were passed. In 2001, 5754 TBI cases were collected from the urban area of Taipei City, and 1474 TBI cases were collected from the rural area of Hualien County. The TBI incidence rate in Taipei City in 2001 was estimated to be 218/100,000 population (285/100,000 for males and 152/100,000 for females). When compared to the 1991 data, the incidence rate in 2001 had increased by 20%. The TBI incidence rate in Hualien County in 2001 was estimated to be 417/100,000 population (516/100,000 for males and 306/100,000 for females); this was a 37% increase over the 1991 data. Our study found that the distribution of causes and age distribution had shifted significantly over the 10-year period. In 2001, the age group with the highest incidence was 20-29 years, while in 1991 it had been the over 70 years age group. While traffic-related TBI had decreased, falls and assaults had increased in 2001. We also found that legislation, such as the helmet law, affects TBI distribution by decreasing the traffic-related TBI rate, decreasing the admission severity of TBI, and reducing TBI-related mortality. Finally, geography plays a crucial role in the outcome of TBI; over the 10 year period, Taipei had an increase in moderately severe outcomes, while Hualien had an increase in more severe outcomes. Comparative studies of TBI in urban and rural areas have shown that time, legislation, and geography are crucial determinants of TBI epidemiology. Although time and legal interventions seem to have more of an impact, geography does affect TBI outcomes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chetelat, G; Eustache, F; Viader, F; De La Sayette, V; Pelerin, A; Mezenge, F; Hannequin, D; Dupuy, B; Baron, J C; Desgranges, B
FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment Journal Article
In: Neurocase, vol. 11, no. 1, pp. 14–25, 2005.
@article{Chetelat2005,
title = {FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment},
author = {Chetelat, G and Eustache, F and Viader, F and {De La Sayette}, V and Pelerin, A and Mezenge, F and Hannequin, D and Dupuy, B and Baron, J C and Desgranges, B},
year = {2005},
date = {2005-01-01},
journal = {Neurocase},
volume = {11},
number = {1},
pages = {14--25},
abstract = {The accurate prediction, at a pre-dementia stage of Alzheimer's disease (AD), of the subsequent clinical evolution of patients would be a major breakthrough from both therapeutic and research standpoints. Amnestic mild cognitive impairment (MCI) is presently the most common reference to address the pre-dementia stage of AD. However, previous longitudinal studies on patients with MCI assessing neuropsychological and PET markers of future conversion to AD are sparse and yield discrepant findings, while a comprehensive comparison of the relative accuracy of these two categories of measure is still lacking. In the present study, we assessed the global cognitive decline as measured by the Mattis scale in 18 patients with amnestic MCI over an 18-month follow-up period, studying which subtest of this scale showed significant deterioration over time. Using baseline measurements from neuropsychological evaluation of memory and PET, we then assessed significant markers of global cognitive change, that is, percent annual change in the Mattis scale total score, and searched for the best predictor of this global cognitive decline. Altogether, our results revealed significant decline over the 18-month follow-up period in the total score and the verbal initiation and memory-recall subscores of the Mattis scale. The percent annual change in the total Mattis score significantly correlated with age and baseline performances in delayed episodic memory recall as well as semantic autobiographical and category word fluencies. Regarding functional imaging, significant correlations were also found with baseline PET values in the right temporo-parietal and medial frontal areas. Age and right temporo-parietal PET values were the most significant predictors of subsequent global cognitive decline, and the only ones to survive stepwise regression analyses. Our findings are consistent with previous works showing predominant delayed recall and semantic memory impairment at a pre-dementia stage of AD, as well as early metabolic defects in the temporo-parietal associative cortex. However, they suggest that only the latter predictor is specifically and accurately associated with subsequent cognitive decline in patients with MCI within 18 months of first assessment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Corzatt, R D; Groppel, J L; Pfautsch, E; Boscardin, J
The biomechanics of head-first versus feet-first sliding Journal Article
In: American Journal of Sports Medicine, vol. 12, no. 3, pp. 229–232, 1984.
@article{Corzatt1984,
title = {The biomechanics of head-first versus feet-first sliding},
author = {Corzatt, R D and Groppel, J L and Pfautsch, E and Boscardin, J},
year = {1984},
date = {1984-01-01},
journal = {American Journal of Sports Medicine},
volume = {12},
number = {3},
pages = {229--232},
abstract = {The two basic sliding techniques, head-first and feet-first, were analyzed kinematically with high speed cinematography. Four phases were identified with each technique: sprint, attainment of sliding position, airborne, and landing. The velocity and displacement of the center of gravity were measured with each technique. The study was primarily descriptive but demonstrated potential for injury with each technique. Further studies are needed to determine which technique is safer and faster.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
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}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
Abstract | Links | BibTeX | Tags: adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Chun, I Y; Mao, X; Breedlove, E L; Leverenz, L J; Nauman, E A; Talavage, T M
DTI Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts Journal Article
In: Developmental Neuropsychology, vol. 40, no. 2, pp. 92–97, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/pa [Pathology], *Craniocerebral Trauma/pp [Physiopathology], *Diffusion Magnetic Resonance Imaging/mt [Methods], *Football/in [Injuries], *White Matter/ab [Abnormalities], *White Matter/pp [Physiopathology], Adolescent, Athletes, Brain Concussion/di [Diagnosis], Brain Concussion/pp [Physiopathology], Brain/pp [Physiopathology], Brain/ra [Radiography], Craniocerebral Trauma/di [Diagnosis], Head, Humans, Schools, Time Factors, White Matter/pa [Pathology]
@article{Chun2015,
title = {DTI Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts},
author = {Chun, I Y and Mao, X and Breedlove, E L and Leverenz, L J and Nauman, E A and Talavage, T M},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {2},
pages = {92--97},
abstract = {Longitudinal evaluation using diffusion-weighted imaging and collision event monitoring was performed on high school athletes who participate in American football. Observed changes in white matter health were suggestive of injury and found to be correlated with accumulation of head collision events during practices and games.},
keywords = {*Athletic Injuries/pa [Pathology], *Craniocerebral Trauma/pp [Physiopathology], *Diffusion Magnetic Resonance Imaging/mt [Methods], *Football/in [Injuries], *White Matter/ab [Abnormalities], *White Matter/pp [Physiopathology], Adolescent, Athletes, Brain Concussion/di [Diagnosis], Brain Concussion/pp [Physiopathology], Brain/pp [Physiopathology], Brain/ra [Radiography], Craniocerebral Trauma/di [Diagnosis], Head, Humans, Schools, Time Factors, White Matter/pa [Pathology]},
pubstate = {published},
tppubtype = {article}
}
Beckwith, J G; Greenwald, R M; Chu, J J; Crisco, J J; Rowson, S; Duma, S M; Broglio, S P; McAllister, T W; Guskiewicz, K M; Mihalik, J P; Anderson, S; Schnebel, B; Brolinson, P G; Collins, M W
Timing of concussion diagnosis is related to head impact exposure prior to injury Journal Article
In: Medicine & Science in Sports & Exercise, vol. 45, no. 4, pp. 747–754, 2013.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult
@article{Beckwith2013a,
title = {Timing of concussion diagnosis is related to head impact exposure prior to injury},
author = {Beckwith, J G and Greenwald, R M and Chu, J J and Crisco, J J and Rowson, S and Duma, S M and Broglio, S P and McAllister, T W and Guskiewicz, K M and Mihalik, J P and Anderson, S and Schnebel, B and Brolinson, P G and Collins, M W},
year = {2013},
date = {2013-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {45},
number = {4},
pages = {747--754},
abstract = {PURPOSE: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. METHODS: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (DELTAv). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). RESULTS: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P \< 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P \< 0.001) and within 7 d of injury (69.7 +/- 43.3},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Chiu, W T; Huang, S J; Tsai, S H; Lin, J W; Tsai, M D; Lin, T J; Huang, W C
The impact of time, legislation, and geography on the epidemiology of traumatic brain injury Journal Article
In: Journal of Clinical Neuroscience, vol. 14, no. 10, pp. 930–935, 2007.
Abstract | BibTeX | Tags: *Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics & Numerical D, *Rural Population/sn [Statistics & Numerical Data], *Urban Population/sn [Statistics & Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics & Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation & Jurisprudence], Motorcycles/sn [Statistics & Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation & Jurisprudence, Traffic/pc [Prevention & Control], Traffic/sn [Statistics & Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]
@article{Chiu2007,
title = {The impact of time, legislation, and geography on the epidemiology of traumatic brain injury},
author = {Chiu, W T and Huang, S J and Tsai, S H and Lin, J W and Tsai, M D and Lin, T J and Huang, W C},
year = {2007},
date = {2007-01-01},
journal = {Journal of Clinical Neuroscience},
volume = {14},
number = {10},
pages = {930--935},
abstract = {In 1991, a population-based epidemiologic traumatic brain injury (TBI) study was done in urban and rural areas of Taiwan; this was 5 years before the helmet use law was passed and 8 years before the drink driving law was passed. In order to evaluate the impact of three major determinants (time, geography, and legislation) on the epidemiology of TBI, we conducted a prospective study in 2001 and used the 1991 data to examine the differences in TBI distribution in urban and rural Taiwan a decade after these laws were passed. In 2001, 5754 TBI cases were collected from the urban area of Taipei City, and 1474 TBI cases were collected from the rural area of Hualien County. The TBI incidence rate in Taipei City in 2001 was estimated to be 218/100,000 population (285/100,000 for males and 152/100,000 for females). When compared to the 1991 data, the incidence rate in 2001 had increased by 20%. The TBI incidence rate in Hualien County in 2001 was estimated to be 417/100,000 population (516/100,000 for males and 306/100,000 for females); this was a 37% increase over the 1991 data. Our study found that the distribution of causes and age distribution had shifted significantly over the 10-year period. In 2001, the age group with the highest incidence was 20-29 years, while in 1991 it had been the over 70 years age group. While traffic-related TBI had decreased, falls and assaults had increased in 2001. We also found that legislation, such as the helmet law, affects TBI distribution by decreasing the traffic-related TBI rate, decreasing the admission severity of TBI, and reducing TBI-related mortality. Finally, geography plays a crucial role in the outcome of TBI; over the 10 year period, Taipei had an increase in moderately severe outcomes, while Hualien had an increase in more severe outcomes. Comparative studies of TBI in urban and rural areas have shown that time, legislation, and geography are crucial determinants of TBI epidemiology. Although time and legal interventions seem to have more of an impact, geography does affect TBI outcomes.},
keywords = {*Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics \& Numerical D, *Rural Population/sn [Statistics \& Numerical Data], *Urban Population/sn [Statistics \& Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics \& Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation \& Jurisprudence], Motorcycles/sn [Statistics \& Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation \& Jurisprudence, Traffic/pc [Prevention \& Control], Traffic/sn [Statistics \& Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Chetelat, G; Eustache, F; Viader, F; De La Sayette, V; Pelerin, A; Mezenge, F; Hannequin, D; Dupuy, B; Baron, J C; Desgranges, B
FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment Journal Article
In: Neurocase, vol. 11, no. 1, pp. 14–25, 2005.
Abstract | BibTeX | Tags: *Cognition Disorders/dg [Diagnostic Imaging], *Fluorodeoxyglucose F18, *Neuropsychological Tests, *Positron-Emission Tomography, 0Z5B2CJX4D (Fluorodeoxyglucose F18), 80 and over, aged, ANALYSIS of variance, Brain Concussion/dg [Diagnostic Imaging], Brain Concussion/pa [Pathology], BRAIN mapping, Cognition Disorders/di [Diagnosis], Dementia/dg [Diagnostic Imaging], Dementia/di [Diagnosis], Dementia/pp [Physiopathology], Female, Follow-Up Studies, Humans, Male, Memory/ph [Physiology], Mental Status Schedule, middle aged, Predictive Value of Tests, Regression (Psychology), Reproducibility of Results, Time Factors
@article{Chetelat2005,
title = {FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment},
author = {Chetelat, G and Eustache, F and Viader, F and {De La Sayette}, V and Pelerin, A and Mezenge, F and Hannequin, D and Dupuy, B and Baron, J C and Desgranges, B},
year = {2005},
date = {2005-01-01},
journal = {Neurocase},
volume = {11},
number = {1},
pages = {14--25},
abstract = {The accurate prediction, at a pre-dementia stage of Alzheimer's disease (AD), of the subsequent clinical evolution of patients would be a major breakthrough from both therapeutic and research standpoints. Amnestic mild cognitive impairment (MCI) is presently the most common reference to address the pre-dementia stage of AD. However, previous longitudinal studies on patients with MCI assessing neuropsychological and PET markers of future conversion to AD are sparse and yield discrepant findings, while a comprehensive comparison of the relative accuracy of these two categories of measure is still lacking. In the present study, we assessed the global cognitive decline as measured by the Mattis scale in 18 patients with amnestic MCI over an 18-month follow-up period, studying which subtest of this scale showed significant deterioration over time. Using baseline measurements from neuropsychological evaluation of memory and PET, we then assessed significant markers of global cognitive change, that is, percent annual change in the Mattis scale total score, and searched for the best predictor of this global cognitive decline. Altogether, our results revealed significant decline over the 18-month follow-up period in the total score and the verbal initiation and memory-recall subscores of the Mattis scale. The percent annual change in the total Mattis score significantly correlated with age and baseline performances in delayed episodic memory recall as well as semantic autobiographical and category word fluencies. Regarding functional imaging, significant correlations were also found with baseline PET values in the right temporo-parietal and medial frontal areas. Age and right temporo-parietal PET values were the most significant predictors of subsequent global cognitive decline, and the only ones to survive stepwise regression analyses. Our findings are consistent with previous works showing predominant delayed recall and semantic memory impairment at a pre-dementia stage of AD, as well as early metabolic defects in the temporo-parietal associative cortex. However, they suggest that only the latter predictor is specifically and accurately associated with subsequent cognitive decline in patients with MCI within 18 months of first assessment.},
keywords = {*Cognition Disorders/dg [Diagnostic Imaging], *Fluorodeoxyglucose F18, *Neuropsychological Tests, *Positron-Emission Tomography, 0Z5B2CJX4D (Fluorodeoxyglucose F18), 80 and over, aged, ANALYSIS of variance, Brain Concussion/dg [Diagnostic Imaging], Brain Concussion/pa [Pathology], BRAIN mapping, Cognition Disorders/di [Diagnosis], Dementia/dg [Diagnostic Imaging], Dementia/di [Diagnosis], Dementia/pp [Physiopathology], Female, Follow-Up Studies, Humans, Male, Memory/ph [Physiology], Mental Status Schedule, middle aged, Predictive Value of Tests, Regression (Psychology), Reproducibility of Results, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Corzatt, R D; Groppel, J L; Pfautsch, E; Boscardin, J
The biomechanics of head-first versus feet-first sliding Journal Article
In: American Journal of Sports Medicine, vol. 12, no. 3, pp. 229–232, 1984.
Abstract | BibTeX | Tags: *Baseball, *Biomechanical Phenomena, *SPORTS, Evaluation Studies as Topic, Foot/ph [Physiology], Head/ph [Physiology], Humans, Motion Pictures as Topic, Rotation, Time Factors
@article{Corzatt1984,
title = {The biomechanics of head-first versus feet-first sliding},
author = {Corzatt, R D and Groppel, J L and Pfautsch, E and Boscardin, J},
year = {1984},
date = {1984-01-01},
journal = {American Journal of Sports Medicine},
volume = {12},
number = {3},
pages = {229--232},
abstract = {The two basic sliding techniques, head-first and feet-first, were analyzed kinematically with high speed cinematography. Four phases were identified with each technique: sprint, attainment of sliding position, airborne, and landing. The velocity and displacement of the center of gravity were measured with each technique. The study was primarily descriptive but demonstrated potential for injury with each technique. Further studies are needed to determine which technique is safer and faster.},
keywords = {*Baseball, *Biomechanical Phenomena, *SPORTS, Evaluation Studies as Topic, Foot/ph [Physiology], Head/ph [Physiology], Humans, Motion Pictures as Topic, Rotation, Time Factors},
pubstate = {published},
tppubtype = {article}
}