Broglio, S P; Rettmann, A; Greer, J; Brimacombe, S; Moore, B; Narisetty, N; He, X; Eckner, J
Clinicians managing sports-related concussions are left to their clinical judgment in making diagnoses and return-to-play decisions. This study was designed to evaluate the utility of a novel measure of functional brain networking for concussion management. 24 athletes with acutely diagnosed concussion and 21 control participants were evaluated in a research laboratory. At each of the 4 post-injury time points, participants completed the Axon assessment of neurocognitive function, a self-report symptom inventory, and the auditory oddball and go/no-go tasks while electroencephalogram (EEG) readings were recorded. Brain Network Activation (BNA) scores were calculated from EEG data related to the auditory oddball and go/no-go tasks. BNA scores were unable to differentiate between the concussed and control groups or by self-report symptom severity. These findings conflict with previous work implementing electrophysiological assessments in concussed athletes, suggesting that BNA requires additional investigation and refinement before clinical implementation. PMID:27286176
N G Voropay; Ol'ga Borisovna Doronina; N G Voropai; Olga Borisovna Doronina; B M Doronin
Nootropics are used to treat patients who have sustained concussion of the brain and complain of reductions in memory and working capacity, as well as emotional disorders. The efficacy of ceretone® (choline alfoscerate) was studied in 76 patients (45 men and 31 women whose age was 21-56 years) who had sustained brain concussion and had complaints of headache, easy fatigability, nocturnal sleep disorders, daytime sleepiness, anxiety, and bad mood. Thirty-nine patients received intravenous cere...
Davies, Susan C.
Traumatic brain injuries (TBIs), including concussions, can result in a constellation of physical, cognitive, emotional, and behavioral symptoms that affect students' well-being and performance at school. Despite these effects, school personnel remain underprepared identify, educate, and assist this population of students. This article describes a…
Toledo, Esteban; Lebel, Alyssa; Becerra, Lino; Minster, Anna; Linnman, Clas; Maleki, Nasim; Dodick, David W; Borsook, David
Concussion (mild traumatic brain injury (mTBI)) is a significant pediatric public health concern. Despite increased awareness, a comprehensive understanding of the acute and chronic effects of concussion on central nervous system structure and function remains incomplete. Here we review the definition, epidemiology, and sequelae of concussion within the developing brain, during childhood and adolescence, with current data derived from studies of pathophysiology and neuroimaging. These findings may contribute to a better understanding of the neurological consequences of traumatic brain injuries, which in turn, may lead to the development of brain biomarkers to improve identification, management and prognosis of pediatric patients suffering from concussion. PMID:22476089
N G Voropay
Full Text Available Nootropics are used to treat patients who have sustained concussion of the brain and complain of reductions in memory and working capacity, as well as emotional disorders. The efficacy of ceretone® (choline alfoscerate was studied in 76 patients (45 men and 31 women whose age was 21-56 years who had sustained brain concussion and had complaints of headache, easy fatigability, nocturnal sleep disorders, daytime sleepiness, anxiety, and bad mood. Thirty-nine patients received intravenous ceretone® in a dose of 1000 mg/day for 10 days; the other 37 patients formed a control group. A one-year follow-up indicated that ceretone® had a positive effect on health, autonomic, and emotional status and working capacity.
Toledo, E. (Estefanía); Lebel, A.; Becerra, L.; Minster, A.; Linnman, C; Maleki, N; Dodick, D.W.; Borsook, D.
Concussion (mild traumatic brain injury (mTBI)) is a significant pediatric public health concern. Despite increased awareness, a comprehensive understanding of the acute and chronic effects of concussion on central nervous system structure and function remains incomplete. Here we review the definition, epidemiology, and sequelae of concussion within the developing brain, during childhood and adolescence, with current data derived from studies of pathophysiology and neuroimaging. These finding...
... require concentration (for example, texting, watching television, playing video games, using a computer or smartphone, or reading) Drink ... called second impact syndrome. This is a rapid brain swelling that is usually fatal. Never return to ...
Slobounov, Semyon; Gay, Michael; Johnson, Brian; Zhang, Kai
Concussion, the most common form of traumatic brain injury, proves to be increasingly complex and not mild in nature as its synonymous term mild traumatic brain injury (mTBI) would imply. Despite the increasing occurrence and prevalence of mTBI there is no universally accepted definition and conventional brain imaging techniques lack the sensitivity to detect subtle changes it causes. Moreover, clinical management of sports induced mild traumatic brain injury has not changed much over the past decade. Advances in neuroimaging that include electroencephalography (EEG), functional magnetic resonance imaging (fMRI), resting-state functional connectivity, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) offer promise in aiding research into understanding the complexities and nuances of mTBI which may ultimately influence clinical management of the condition. In this paper the authors review the major findings from these advanced neuroimaging methods along with current controversy within this field of research. As mTBI is frequently associated with youth and sports injury this review focuses on sports-related mTBI in the younger population. PMID:22669496
Full Text Available ... concussion? A Not giving the brain enough recovery time after a concussion can be dangerous. A repeat ... especially if the first concussion has not had time to heal. B will never have another concussion. ...
Michael G Hutchison
Full Text Available Sport-related concussions are now recognized as a major public health concern: The number of participants in sport and recreation is growing, possibly playing their games faster, and there is heightened public awareness of injuries to some high-profile athletes. However, many clinicians still rely on subjective symptom reports for the clinical determination of recovery. Relying on subjective symptom reports can be dangerous, as it has been shown that some concussed athletes may downplay their symptoms. The use of neuropsychological (NP testing tools has enabled clinicians to measure the effects and extent of impairment following concussion more precisely, providing more objective metrics for determining recovery after concussion. Nevertheless, there is a remaining concern that brain abnormalities may exist beyond the point at which individuals achieve recovery in self-reported symptoms and cognition measured by NP testing. Our understanding of brain recovery after concussion is important not only from a neuroscience perspective, but also from the perspective of clinical decision making for safe return-to-play (RTP. A number of advanced neuroimaging tools, including blood oxygen level dependent (BOLD functional magnetic resonance imaging (fMRI, have independently yielded early information on these abnormal brain functions. In the two cases presented in this article, we report contrasting brain activation patterns and recovery profiles using fMRI. Importantly, fMRI was conducted using adapted versions of the most sensitive computerized NP tests administered in current clinical practice to determine impairments and recovery after sport-related concussion. One of the cases is consistent with the concept of lagging brain recovery.
Virji-Babul, Naznin; Hilderman, Courtney G E; Makan, Nadia; Liu, Aiping; Smith-Forrester, Jenna; Franks, Chris; Wang, Z J
Sports-related concussion is a major public health issue; however, little is known about the underlying changes in functional brain networks in adolescents following injury. Our aim was to use the tools from graph theory to evaluate the changes in brain network properties following concussion in adolescent athletes. We recorded resting state electroencephalography (EEG) in 33 healthy adolescent athletes and 9 adolescent athletes with a clinical diagnosis of subacute concussion. Graph theory analysis was applied to these data to evaluate changes in brain networks. Global and local metrics of the structural properties of the graph were calculated for each group and correlated with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores. Brain networks of both groups showed small-world topology with no statistically significant differences in the global metrics; however, significant differences were found in the local metrics. Specifically, in the concussed group, we noted: 1) increased values of betweenness and degree in frontal electrode sites corresponding to the (R) dorsolateral prefrontal cortex and the (R) inferior frontal gyrus and 2) decreased values of degree in the region corresponding to the (R) frontopolar prefrontal cortex. In addition, there was significant negative correlation between degree and hub value, with total symptom score at the electrode site corresponding to the (R) prefrontal cortex. This preliminary report in adolescent athletes shows for the first time that resting-state EEG combined with graph theoretical analysis may provide an objective method of evaluating changes in brain networks following concussion. This approach may be useful in identifying individuals at risk for future injury. PMID:24956041
Smits, Marion; Wielopolski, Piotr A.; Vernooij, Meike W.; Lugt, Aad van der [Erasmus MC-University Medical Centre Rotterdam, Department of Radiology (Hs-224), PO Box 2040, Rotterdam (Netherlands); Houston, Gavin C. [Applied Science Lab, GE Healthcare, Hertogenbosch (Netherlands); Dippel, Diederik W.J.; Koudstaal, Peter J. [Erasmus MC-University Medical Centre Rotterdam, Department of Neurology, Rotterdam (Netherlands); Hunink, M.G.M. [Erasmus MC-University Medical Centre Rotterdam, Department of Radiology (Hs-224), PO Box 2040, Rotterdam (Netherlands); Erasmus MC-University Medical Centre Rotterdam, Department of Epidemiology, Rotterdam (Netherlands); Harvard School of Public Health, Department of Health Policy and Management, Boston, MA (United States)
After minor head injury (MHI), post-concussive symptoms commonly occur. The purpose of this study was to correlate the severity of post-concussive symptoms in MHI patients with MRI measures of microstructural brain injury, namely mean diffusivity (MD) and fractional anisotropy (FA), as well as the presence of microhaemorrhages. Twenty MHI patients and 12 healthy controls were scanned at 3 T using diffusion tensor imaging (DTI) and high-resolution gradient recalled echo (HRGRE) T2*-weighted sequences. One patient was excluded from the analysis because of bilateral subdural haematomas. DTI data were preprocessed using Tract Based Spatial Statistics. The resulting MD and FA images were correlated with the severity of post-concussive symptoms evaluated with the Rivermead Postconcussion Symptoms Questionnaire. The number and location of microhaemorrhages were assessed on the HRGRE T2*-weighted images. Comparing patients with controls, there were no differences in MD. FA was decreased in the right temporal subcortical white matter. MD was increased in association with the severity of post-concussive symptoms in the inferior fronto-occipital fasciculus (IFO), the inferior longitudinal fasciculus and the superior longitudinal fasciculus. FA was reduced in association with the severity of post-concussive symptoms in the uncinate fasciculus, the IFO, the internal capsule and the corpus callosum, as well as in the parietal and frontal subcortical white matter. Microhaemorrhages were observed in one patient only. The severity of post-concussive symptoms after MHI was significantly correlated with a reduction of white matter integrity, providing evidence of microstructural brain injury as a neuropathological substrate of the post-concussion syndrome. (orig.)
After minor head injury (MHI), post-concussive symptoms commonly occur. The purpose of this study was to correlate the severity of post-concussive symptoms in MHI patients with MRI measures of microstructural brain injury, namely mean diffusivity (MD) and fractional anisotropy (FA), as well as the presence of microhaemorrhages. Twenty MHI patients and 12 healthy controls were scanned at 3 T using diffusion tensor imaging (DTI) and high-resolution gradient recalled echo (HRGRE) T2*-weighted sequences. One patient was excluded from the analysis because of bilateral subdural haematomas. DTI data were preprocessed using Tract Based Spatial Statistics. The resulting MD and FA images were correlated with the severity of post-concussive symptoms evaluated with the Rivermead Postconcussion Symptoms Questionnaire. The number and location of microhaemorrhages were assessed on the HRGRE T2*-weighted images. Comparing patients with controls, there were no differences in MD. FA was decreased in the right temporal subcortical white matter. MD was increased in association with the severity of post-concussive symptoms in the inferior fronto-occipital fasciculus (IFO), the inferior longitudinal fasciculus and the superior longitudinal fasciculus. FA was reduced in association with the severity of post-concussive symptoms in the uncinate fasciculus, the IFO, the internal capsule and the corpus callosum, as well as in the parietal and frontal subcortical white matter. Microhaemorrhages were observed in one patient only. The severity of post-concussive symptoms after MHI was significantly correlated with a reduction of white matter integrity, providing evidence of microstructural brain injury as a neuropathological substrate of the post-concussion syndrome. (orig.)
Full Text Available Concussion and mild traumatic brain injury (mTBI research has made minimal progress diagnosing who will suffer from lingering symptomology or generating effective treatment strategies. Research demonstrates that dietary intake affects many biological systems including brain and neurological health. This study determined if exposure to a high fat diet (HFD or caloric restriction (CR altered post-concussion susceptibility or resiliency using a rodent model of pediatric concussion. Rats were maintained on HFD, CR, or standard diet (STD throughout life (including the prenatal period and weaning. At postnatal day 30, male and female rats experienced a concussion or a sham injury which was followed by 17 days of testing. Prefrontal cortex and hippocampus tissue was collected for molecular profiling. Gene expression changes in BDNF, CREB, DNMT1, FGF-2, IGF1, LEP, PGC-1α, SIRT1, Tau, and TERT were analyzed with respect to injury and diet. Analysis of telomere length (TL using peripheral skin cells and brain tissue found that TL in skin significantly correlated with TL in brain tissue and TL was affected by dietary intake and injury status. With respect to mTBI outcomes, diet was correlated with recovery as animals on the HFD often displayed poorer performance than animals on the CR diet. Molecular analysis demonstrated that diet induced epigenetic changes that can be associated with differences in individual predisposition and resiliency to post-concussion syndrome.
... later leads to an even steeper drop in glucose use and memory problems that last longer. But when the brain has several days to recover, and the use of glucose returns to normal, a second mild brain injury ...
Kravtsov, Iu I; Seliverstova, G A; Kalashnikova, T P
80 children of preschool age were observed after concussion of the brain. In follow-up from 6 months 3 years clinical-anamnestic and neuropsychologic methods were used. The functions of autonomic nervous system were evaluated according to the results of estimation of initial autonomic tonus, autonomic reactivity, autonomic maintenance of the activity and the data of cardiointervalography. The state of nonspecific systems of the brain was studied with day time polygraphic research with a visual EEG evaluation, construction of histogramms by Fora method, estimation of speed and order of the fading of the components of a rough response. Psychovegetative stress was the ground for neurologic disorders in posttraumatic period. The disorders of adaptive regulation were manifested in exhausting of ergotropic systems with compensatory overstrain of trophotropic mechanisms, resulted in predominance of inhibiting influences with an inadequate response of synchronization on EEG during functional loads. Severity of clinical manifestations and disorders of adaptive regulation were more pronounced in children 1-3 year-old and with hypoxic-traumatic damages of the brain in anamnesis. Disintegration of cerebral activity correlated with the remote period. In the first 6-12 months after the concussion of the brain changes of vegetative reactivity prevailed, after 18 months the alterations in vegetative maintenance progressed. PMID:10205838
The most frequent type of head injury in children is closed head trauma with brain concussion or contusion, and headache is the dominant complaint of early and late postinjury period. Because of scant number of studies on the problem of occurrence, characteristics and persistence of posttraumatic headache this study was undertaken in a group of 100 children (29 girls and 71 boys), aged 3-14 years old, 90 after brain concussion and 10 after contusion. Children with a history of injuries, central nervous system infections, with headaches before injury and chronic diseases were excluded. In 9 cases linear skull fracture was present after injury. The material was examined within one week after trauma, and then after 3, 6, and 12 months. After 3 months EEG was performed and repeated after 6 and 12 months in children with persistent headache or those without headache but with abnormal EEG results in the first examination. According to the additional diagnostic examinations, I excluded other causes of headache, besides head injury. In my observation 83% of children had headache after brain concussion and contusion. The majority--56%--had acute posttraumatic headache, but 27% of children complained of chronic headache, mainly tension type headache. Only 3% had migraine. In 21% of all group of 100 children, I noticed the headache persisting during the whole year of my observation. The important risk factor for the occurrence of posttraumatic headache were the age of child at the moment injury and the period of unconsciousness. The electroencephalographic recording still remains the important additional examination of posttraumatic consequences. PMID:10719686
Wäljas, Minna; Iverson, Grant L; Lange, Rael T; Hakulinen, Ullamari; Dastidar, Prasun; Huhtala, Heini; Liimatainen, Suvi; Hartikainen, Kaisa; Öhman, Juha
This study examined multiple biopsychosocial factors relating to post-concussion symptom (PCS) reporting in patients with mild traumatic brain injuries (mTBI), including structural (computed tomography and magnetic resonance imaging [MRI]) and microstructural neuroimaging (diffusion tensor imaging [DTI]). Patients with mTBIs completed several questionnaires and cognitive testing at approximately one month (n=126) and one year (n=103) post-injury. At approximately three weeks post-injury, DTI was undertaken using a Siemens 3T scanner in a subgroup (n=71). Measures of fractional anisotropy were calculated for 16 regions of interest (ROIs) and measures of apparent diffusion coefficient were calculated for 10 ROIs. Patients were compared with healthy control subjects. Using International Classification of Diseases, Tenth Revision (ICD-10) PCS criteria and mild or greater symptom reporting, 59% of the mTBI sample met criteria at one month and 38% met criteria at one year. However, 31% of the healthy control sample also met criteria for the syndrome-illustrating a high false-positive rate. Significant predictors of ICD-10 PCS at one month were pre-injury mental health problems and the presence of extra-cranial bodily injuries. Being symptomatic at one month was a significant predictor of being symptomatic at one year, and depression was significantly related to PCS at both one month and one year. Intracranial abnormalities visible on MRI were present in 12.1% of this sample, and multifocal areas of unusual white matter as measured by DTI were present in 50.7% (compared with 12.4% of controls). Structural MRI abnormalities and microstructural white matter findings were not significantly associated with greater post-concussion symptom reporting. The personal experience and reporting of post-concussion symptoms is likely individualized, representing the cumulative effect of multiple variables, such as genetics, mental health history, current life stress, medical problems
Full Text Available ... concussion are at increased risk for another concussion. C Young children and teens are more likely to ... how the brain works and a serious issue. C While rare, permanent brain damage and death are ...
Wendy A Morley
Full Text Available The number of sports-related concussions has been steadily rising in recent years. Diminished brain resilience syndrome is a term coined by the lead author to describe a particular physiological state of nutrient functional deficiency and disrupted homeostatic mechanisms leading to increased susceptibility to previously considered innocuous concussion. We discuss how modern day environmental toxicant exposure, along with major changes in our food supply and lifestyle practices, profoundly reduce the bioavailability of neuro-critical nutrients such that the normal processes of homeostatic balance and resilience are no longer functional. Their diminished capacity triggers physiological and biochemical ′work around′ processes that result in undesirable downstream consequences. Exposure to certain environmental chemicals, particularly glyphosate, the active ingredient in the herbicide, Roundup; , may disrupt the body′s innate switching mechanism, which normally turns off the immune response to brain injury once danger has been removed. Deficiencies in serotonin, due to disruption of the shikimate pathway, may lead to impaired melatonin supply, which reduces the resiliency of the brain through reduced antioxidant capacity and alterations in the cerebrospinal fluid, reducing critical protective buffering mechanisms in impact trauma. Depletion of certain rare minerals, overuse of sunscreen and/or overprotection from sun exposure, as well as overindulgence in heavily processed, nutrient deficient foods, further compromise the brain′s resilience. Modifications to lifestyle practices, if widely implemented, could significantly reduce this trend of neurological damage.
Full Text Available Preetinder S Gill,1 Tejkaran S Gill,2 Ashwini Kamath,3 Billy Whisnant41College of Technology, Eastern Michigan University, Ypsilanti, MI; 2College of Engineering, University of Michigan, Ann Arbor, MI; 3School of Information, University of Texas, Austin, TX; 4College of Technology, Eastern Michigan University, Ypsilanti, MI, USAAbstract: Health literacy is associated with a person’s capacity to find, access, contextualize, and understand information needed for health care-related decisions. The level of health literacy thus has an influence on an individual’s health status. It can be argued that low health literacy is associated with poor health status. Health care literature (eg, pamphlets, brochures, postcards, posters, forms are published by public and private organizations worldwide to provide information to the general public. The ability to read, use, and understand is critical to the successful application of knowledge disseminated by this literature. This study assessed the readability, suitability, and usability of health care literature associated with concussion and traumatic brain injury published by the United States Centers for Disease Control and Prevention. The Flesch–Kincaid Grade Level, Flesch Reading Ease, Gunning Fog, Simple Measure of Gobbledygook, and Suitability Assessment of Materials indices were used to assess 40 documents obtained from the Centers for Disease Control and Prevention website. The documents analyzed were targeted towards the general public. It was found that in order to be read properly, on average, these documents needed more than an eleventh grade/high school level education. This was consistent with the findings of other similar studies. However, the qualitative Suitability Assessment of Materials index showed that, on average, usability and suitability of these documents was superior. Hence, it was concluded that formatting, illustrations, layout, and graphics play a pivotal role in improving
Fineblit, Samuel; Selci, Erin; Loewen, Hal; Ellis, Michael; Russell, Kelly
Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE(®), PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion. PMID:26916876
Full Text Available ... LESSON 4 QUIZ QUESTION 3 Concussions affect people differently. While most athletes with a concussion recover quickly ... for Health Care Providers Materials for School Professionals Learn More about the Brain and How it Works ...
Lavigne, Gilles; Khoury, Samar; Chauny, Jean-Marc; Desautels, Alex
Concussion after a force to the head is called mild traumatic brain injury (mTBI). Approximately 1 in 5 patients with mTBI will develop chronic pain (headache and widespread pain, possibly of central origin) and/or sleep problems (insomnia, disordered breathing, periodic limb movements). However, the predisposing mechanisms for chronic pain in patients with mTBI are unknown. Mild traumatic brain injury is a rare model to prospectively assess the risk factors and mechanisms for pain chronification from the injury onset in the absence of pretrauma comorbidity or medication. In the acute phase, headaches and sleep disturbances seem to predict the poorest long-term cognitive and mood outcomes. Although recent studies suggest that certain brain biomarkers and mood alterations (eg, anxiety, depression) contribute, the causality of chronic pain remains unclear. In mTBI patients with pain, poor sleep quality was correlated with fast beta and gamma electroencephalographic activity in frontal, central, and occipital electroencephalographic (EEG) derivations in all sleep stages. Sleep recuperative function seems to be disturbed by persistent wake EEG activity, corroborating patient complaints such as feeling awake when asleep. Pain and sleep management in mTBI is not yet evidence-based. Treatments include cognitive behavioral and light therapies, medications, and continuous positive airway pressure (CPAP) or oral appliances for disordered sleep breathing. Customized approaches are indicated for mTBI, pain, and sleep complaints. Further studies in pediatric, sport, and transportation populations are needed to prevent TBI chronification. Improvements are emerging in biomarker sensitivity and specificity and management strategies for TBI, pain, and sleep comorbidities. PMID:25789439
Maroon, Joseph C; Mathyssek, Christina; Bost, Jeffrey
No topic in sports has gathered more attention and publicity than the diagnosis, management, and long-term effects of cerebral concussion. The relevant history of concussion starts in 1905 when President Theodore Roosevelt drew attention to the football 'death harvest'. Soon after, rules started to change to reduce the amount and severity of head injuries in football. Up until 1980, the primary focus regarding concussions was to diagnose a potentially fatal intracranial hemorrhage. While aware of long-term consequences of concussions, the perception at the time was that virtually all concussions would 'clear' with time and rest. Concussion management guidelines gave way to objective neuropsychological testing in the early 1990s with the development of the ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing) neurocognitive test. Led by organized football, in 1994 the National Football League (NFL) formed the Mild Traumatic Brain Injury Committee which began to investigate the cause of concussions, evaluate equipment (particularly helmets), and recommend methods for prevention. In 2005, the first case of chronic traumatic encephalopathy was described in a deceased football player, raising concerns about the long-term consequences of head injuries and concussions. Major advancements in contact sports and the military are underway to reduce the incidence of concussions and subconcussive blows to the head. PMID:24923388
Davies, Susan C.
A concussion is a serious injury--a mild traumatic brain injury (TBI)--that induces physiological disruption of brain function. A concussion is caused by a bump, blow, or jolt to the head or body. The sudden movement causes stretching and tearing of brain cells; cells become damaged and chemical changes occur within the brain. Concussions can lead…
Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report
Harch, Paul G.; Fogarty, Edward F; Staab, Paul K; Van Meter, Keith
A 25-year-old male military veteran presented with diagnoses of post concussion syndrome and post traumatic stress disorder three years after loss of consciousness from an explosion in combat. The patient underwent single photon emission computed tomography brain blood flow imaging before and after a block of thirty-nine 1.5 atmospheres absolute hyperbaric oxygen treatments. The patient experienced a permanent marked improvement in his post-concussive symptoms, physical exam findings, and bra...
Choe, Meeryo C
Concussion is a significant issue in medicine and the media today. With growing interest on the long-term effects of sports participation, it is important to understand what occurs in the brain after an impact of any degree. While some of the basic pathophysiology has been elucidated, much is still unknown about what happens in the brain after traumatic brain injury, particularly with milder injuries where no damage can be seen at the structural level on standard neuroimaging. Understanding the chain of events from a cellular level using studies investigating more severe injuries can help to drive research efforts in understanding the symptomatology that is seen in the acute phase after concussion, as well as point to mechanisms that may underlie persistent post-concussive symptoms. This review discusses the basic neuropathology that occurs after traumatic brain injury at the cellular level. We also present the pathology of chronic traumatic encephalopathy and its similarities to other neurodegenerative diseases. We conclude with recent imaging and biomarker findings looking at changes that may occur after repeated subconcussive blows, which may help to guide efforts in understanding if cumulative subconcussive mechanical forces upon the brain are detrimental in the long term or if concussive symptoms mark the threshold for brain injury. PMID:27184060
Hehar, Harleen; Mychasiuk, Richelle
Telomeres were originally believed to be passive players in cellular replication, but recent research has highlighted their more active role in epigenetic patterning and promotion of cellular growth and survival. Furthermore, literature demonstrates that telomere length (TL) is responsive to environmental manipulations such as prenatal stress and dietary programming. As the search for a prognostic biomarker of concussion has had limited success, this study sought to examine whether or not telomere length (TL) could be an efficacious predictor of symptom severity in juvenile rats following concussion. Rats from four distinct experimental groups (caloric restriction (CR), high fat diet (HFD), exercise (EX), and standard controls (STD)) received a mild traumatic brain injury (mTBI)/concussion and were then subjected to a behavioural test battery. The test battery was scored and the animals were categorized as poor, average, or good, based on their performance on the 6 tests examined. Skin cells (from ear notch samples) were taken 17days post-injury and DNA was extracted for telomere length analysis. Ear notch skin cell TL was highly correlated with brain tissue TL for a given individual. Animals in the CR and EX cohorts had significantly longer telomeres, while animals in the HFD cohort had significantly shorter telomeres, when compared to controls. The mTBI/concussion reduced TL in all cohorts except the EX group. A significant linear relationship was found between TL and performance on the behavioural test battery, whereby shorter telomeres were associated with poorer performance and longer telomeres with better performance. As performance on the test battery is linked to symptom severity, this study found TL to be a reasonable tool for concussion prognosis. Future studies with human populations should examine the validity of TL in peripheral cells, as a predictor of concussion pathology. PMID:26709201
Tang, Y P; Noda, Y; Hasegawa, T; Nabeshima, T
A novel concussive-like brain injury (CLBI) model characterized by transient neurobehavioral depression, short duration of brain edema, and long-lasting memory deficits has been reported in our companion paper. This was achieved by dropping a 21-g weight from a height of 25 cm onto the head of a mouse. In the present study, we examined the histopathological changes in this model. Male ddY mice were subjected to either the trauma or sham injury. Gross pathological examination of the brain 1 h posttrauma did not demonstrate subdural, subarachnoid, intraventricular, periventricular, and intraparenchymatous hemorrhage, focal lesions or contusions. Microscopic examination 24 h posttrauma with Nissl staining (cresyl violet), however, revealed a selective bilateral neuronal cell loss in the cerebral cortex and hippocampus but not in the regions of the thalamus, cerebellum, and brain stem. The characteristics of neuronal cell loss in the cortex suggested that this pathology was related in part, to the head impact dynamics, since the cell loss was noted in the central portion of the supraventricular cerebral cortex (p < 0.001), the site of the weight impact, gradually decreasing peripheral to this site, and disappearing in the areas remote from this locus. In contrast, neuronal cell loss seen in the hippocampus did not suggest that this pathology was directly associated with the impact site. Neuronal cell loss was concentrated in the pyramidal cell layer of CA2 (p < 0.01) and CA3 (p < 0.01), and a lesser degree was noted in the subfields of CA3c (p < 0.05) and the hilar region (p < 0.05) but not in the subfields of CA1 and the dentate gyrus layers. The present study characterized the histopathological change seen in the CLBI model, demonstrating the selective neuronal cell loss following weight-drop concussion in mice. PMID:9421457
Full Text Available ... GET MORE INFORMATION ON CONCUSSION and TRAUMATIC BRAIN INJURY IN THE UNITED STATES Statistics Causes Outcomes Prevention ... School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma Foundation Center for ...
Full Text Available ... Associations) GET MORE INFORMATION ON CONCUSSION and TRAUMATIC BRAIN INJURY IN THE UNITED STATES Statistics Causes Outcomes Prevention ... American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma Foundation Center for ...
Full Text Available ... the brain recovers from the first concussion can slow recovery or increase the chances for long-term ... Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma ...
Ponomarev, V A; Gurskaia, O E; Kropotov, Iu D; Artiushkova, L V; Muller, A
The comparison of three different clustering methods of 19-channels EEG independent components in 518 healthy subjects and 87 patients with post concussion syndrome after traumatic brain injury was performed to define more exact the location of sources of pathologic brain activity. Following methods of grouping were used: clustering of independent components topographies, clustering of coordinates of equivalent dipole sources corresponding to independent components topographies and sorting of independent components using extremes of equivalent source current density computed by Standardized Low Resolution Electromagnetic Tomography (sLORETA).The comparison of power spectra of independent components revealed statically significant increase of EEG power located in frontal and temporal brain areas in delta, theta and alpha frequency bands in patients with post concussion syndrome after traumatic brain injury. The method of clustering of independent components topographies seems to be most sensitive in comparison with other two methods. PMID:20432686
Shaw, Nigel A
Cerebral concussion is both the most common and most puzzling type of traumatic brain injury (TBI). It is normally produced by acceleration (or deceleration) of the head and is characterized by a sudden brief impairment of consciousness, paralysis of reflex activity and loss of memory. It has long been acknowledged that one of the most worthwhile techniques for studying the acute pathophysiology of concussion is by the recording of neurophysiological activity such as the electroencephalogram (EEG) and sensory evoked potentials (EPs) from experimental animals. In the first parts of this review, the majority of such studies conducted during the past half century are critically reviewed. When potential methodological flaws and limitations such as anesthetic protocols, infliction of multiple blows and delay in onset of recordings were taken into account, two general principles could be adduced. First, the immediate post-concussive EEG was excitatory or epileptiform in nature. Second, the cortical EP waveform was totally lost during this period. In the second parts of this review, five theories of concussion which have been prominent during the past century are summarized and supportive evidence assessed. These are the vascular, reticular, centripetal, pontine cholinergic and convulsive hypotheses. It is concluded that only the convulsive theory is readily compatible with the neurophysiological data and can provide a totally viable explanation for concussion. The chief tenet of the convulsive theory is that since the symptoms of concussion bear a strong resemblance to those of a generalized epileptic seizure, then it is a reasonable assumption that similar pathobiological processes underlie them both. Further, it is demonstrated that EPs and EEGs recorded acutely following concussive trauma are indeed the same or similar to those obtained following the induction of a state of generalized seizure activity (GSA). According to the present incarnation of the convulsive
Mollayeva, T.; Pratt, B.; Shapiro, C.;
Introduction: Insomnia is a common complaint among persons with mild traumatic brain injury (mTBI). However, its impact on recovery after mTBI/concussion has not been characterized. Clarifying the association between insomnia and self-perceived disability may serve the vital role in understanding...... questionnaires, insurer records, and clinical assessment at the time of recruitment. The Insomnia Severity Index (ISI) measured the primary independent variable and the Sheehan Disability Scale measured perceived disability outcome. This variable was highly skewed and therefore classified as "mild/moderate" and...... (56%)were onwork disability. Compared with those reporting mild/moderate disability, individuals reporting marked/extreme disability had more severe insomnia (p = 0.002), depression (p <0.0001) and greater pain (p <0.0001). In the fully adjusted logistic model, a one-point ISI increase was associated...
Khurana, Vini G; Kaye, Andrew H
Concussion is a sudden-onset, transient alteration of consciousness due to a combination of functional and structural brain disturbances following a physical impact transmitted to the brain. It is a common, although likely underreported, condition encountered in a wide range of sports. In the Australian Football League, concussion is estimated to occur at a rate of approximately seven injuries per team per season. While many instances of concussion are clinically mild, there is emerging evidence that a player's full recovery from a concussive injury may be more delayed and the sequelae of repeated concussions more severe than previously thought. In this light, a more conservative and rigorous approach to managing players with concussive injuries may be warranted, with the guiding principle being the player's immediate and long-term welfare. The current paper reviews the sports concussion literature. The definition, epidemiology, aetiology, pathophysiology, structural pathology, clinical features, assessment and investigation, treatment principles, and short-term and potential long-term complications of concussion are discussed. Special considerations in paediatric sports concussion, and the return-to-play implications of immediate, evolving and repetitive brain injury are also considered, as are the emerging concept and possible implications of subconcussive injury. PMID:22153800
Full Text Available ... Materials for School Professionals Learn More about the Brain and How it Works Order Free Copies of ... Associations) GET MORE INFORMATION ON CONCUSSION and TRAUMATIC BRAIN INJURY IN THE UNITED STATES Statistics Causes Outcomes ...
Full Text Available ... Learn More about the Brain and How it Works Order Free Copies of CDC's “Heads Up” Educational ... GET MORE INFORMATION ON CONCUSSION and TRAUMATIC BRAIN INJURY IN THE UNITED STATES Statistics Causes Outcomes Prevention ...
Full Text Available ... disruption of how the brain works and a serious issue. C While rare, permanent brain damage and ... last for days, or even weeks. A more serious concussion can last for months or longer. A ...
Full Text Available ... High School Coaches: “Concussion in Sports: What You Need to Know,” [Exit Disclaimer] Free Online Training (Developed in partnership with the National Federation of State High School Associations) GET MORE INFORMATION ON CONCUSSION and TRAUMATIC BRAIN INJURY IN THE ...
Tkachov, A V
The comparative analysis of a complex examination of 108 persons aged from 16 till 60 years in acute period of closed craniocerebral injury (CCCT) has been done. Every participants have been divided into 2 groups depending on a nootrop medication they receive in a complex treatment. A control group consisted of 30 practically healthy people. Objective examination by means of tests was done on the 1-st, 10-th that 30-th day of treatment. Patients of 1-st (37 persons) group received piracetam in complex treatment and patients of the 2-nd group (71 persons) pramistar. Patients of the first group received a base treatment (analgetics, tranquilizers, vitamins of group B, magnesium sulfate, diuretic preparations) as well as piracetam at dosage 0.2, two tablets three times per day. The Patients of the 2-nd group received a base treatment as well as pramistar at dosage 0.6, one tablet 2 times per day. Specially developed multiaspects scales and questionnaires, MRT of the brain and EEG have been used for objectification of patient, complaints. During a complex clinico-neuropsychological examination it was found that all cases of concussion of the brain are accompanied by those or other asthenic disorders. PMID:19145827
... How Can I Help a Friend Who Cuts? Sports and Concussions KidsHealth > For Teens > Sports and Concussions ... between skiers or snowboarders continue Preventing Concussions in Sports Start With the Right Equipment Everyone should wear ...
Full Text Available ... issue. C While rare, permanent brain damage and death are two potential consequences of not identifying and ... of Pittsburgh Medical Center, Sports Medicine Concussion Program US Lacrosse US Soccer USA Baseball USA Football USA ...
Full Text Available ... concussion and require rushing an athlete to the emergency department immediately: A The athlete seems slightly off ... Medical Center Defense and Veterans Brain Injury Center Emergency Nurses Association Health Resources and Services Administration, EMS ...
Slobounov, Semyon; Sebastianelli, Wayne; Newell, Karl M
There is a growing concern that traditional neuropsychological (NP) testing tools are not sensitive to detecting residual brain dysfunctions in subjects suffering from mild traumatic brain injuries (MTBI). Moreover, most MTBI patients are asymptomatic based on anatomical brain imaging (CT, MRI), neurological examinations and patients' subjective reports within 10 days post-injury. Our ongoing research has documented that residual balance and visual-kinesthetic dysfunctions along with its underlying alterations of neural substrates may be detected in "asymptomatic subjects" by means of Virtual Reality (VR) graphics incorporated with brain imaging (EEG) techniques. PMID:22254575
Heitger, Marcus; Jones, R D; MacLeod, A D; Snell, D.L.; Frampton, C M; Anderson, T J
Post-concussion syndrome (PCS) can affect up to 20%-30% of patients with mild closed head injury (mCHI), comprising incomplete recovery and debilitating persistence of post-concussional symptoms. Eye movements relate closely to the functional integrity of the injured brain and eye movement function is impaired post-acutely in mCHI. Here, we examined whether PCS patients continue to show disparities in eye movement function at 3-5 months following mCHI compared with patients with good recovery...
Objective To evaluate changes of c-jun mRNA after brain concussion. Methods Fifty-five rats were randomly divided into brain concussion groups ( 0min, 15 min, 30min, 60min, 3 h, 6h, 12h, 24h, 48 h,96h) and control group. The expression of c-jun mRNA in cortex 、thalamus and brain stem was microscopically observed by In site hybridization method. Results There were weak positive expression of c-jun mRNA in some neutrons and neuroglia cells in control group. In brain concussion group, however,positive expression of c-jun mRNA in some neutrons was seen at 15min after brain concussion,and reach to the peak at 30min after brain concussion the level of expression of c-jun mRNA were as well as control group at 96h. Conclusion There findings suggest that detection of c-jun mRNA could be an index of diagnosis of brain concussion and a sensitive marker of timing of injury after brain concussion.%目的 观察实验性大鼠脑震荡后c-jun mRNA的表达变化规律.方法 55只实验大鼠随机分为脑震荡组(0min、15min、30min、60min、3h、6h、12h、24h、48h、96h)和对照组,用原位杂交法观察大鼠脑震荡后各时间点,大脑皮质、脑干和丘脑神经元c-jun mRNA表达的变化规律.结果 对照组大鼠神经元和胶质细胞均可见c-jun mRNA的弱阳性表达.脑震荡组大鼠损伤后15min神经细胞观察到c-jun mRNA阳性表达,随损伤后经过时间的延长阳性表达逐渐增强;30min时c-jun mRNA阳性反应达高峰,随后逐渐降低,至96h时回落至对照组水平.结论 c-jun mRNA表达水平可成为诊断脑震荡和推断伤后经过时间的一项敏感指标.
Borich, Michael R; Cheung, Katharine L; Jones, Paul; Khramova, Vera; Gavrailoff, Lauren; Boyd, Lara A; Virji-Babul, Naznin
Current understanding of the term "concussion" is fraught with misconceptions regarding the extent and nature of brain injury. Despite increasing attention in popular media and within the context of sports, considerable gaps exist in our knowledge of the diagnosis, underlying brain pathology, recovery of function, and optimal interventions for concussion. In this special interest article, we discuss the definition and risk factors associated with concussion, summarize and highlight some of the most widely used assessment tools, and critique the evidence for current principles of concussion management. Our evaluation has identified opportunities for novel neuroimaging techniques to improve the understanding of the pathophysiology of concussion and to evaluate the changes in the recovering brain in response to rehabilitation. In summary, a clear definition of the underlying brain pathology, the potential long-term consequences, and the risk factors of injury and recovery will help guide future research aiming to minimize the impact of injury and develop innovative and successful therapeutic approaches aimed at ameliorating the functional impairments associated with concussion. PMID:23872682
Sussman, Eric S; Ho, Allen L; Pendharkar, Arjun V; Ghajar, Jamshid
Sports-related concussion is a change in brain function following a direct or an indirect force to the head, identified in awake individuals and accounting for a considerable proportion of mild traumatic brain injury. Although the neurological signs and symptoms of concussion can be subtle and transient, there can be persistent sequelae, such as impaired attention and balance, that make affected patients particularly vulnerable to further injury. Currently, there is no accepted definition or diagnostic criteria for concussion, and there is no single assessment that is accepted as capable of identifying all patients with concussion. In this paper, the authors review the available screening tools for concussion, with particular emphasis on the role of visual function testing. In particular, they discuss the oculomotor assessment tools that are being investigated in the setting of concussion screening. PMID:27032924
Ventura, Rachel E; Balcer, Laura J; Galetta, Steven L
Concussion may lead to subtle changes in brain function, and tests involving the visual system probe higher cortical functioning and increase our sensitivity in detecting these changes. Concussions are acutely and sometimes more persistently associated with abnormalities in balance, cognition, and vision. The visual system involves roughly half of the brain's circuits, including many regions susceptible to head impacts. After a concussion, the neuro-ophthalmologic exam commonly detects abnormalities in convergence, accommodation, the vestibulo-ocular reflex, ocular muscle balance, saccades, and pursuit. The King-Devick (K-D) test is a visual performance measure that may increase the sensitivity of detecting concussions on the sideline when used in combination with tests of cognition and balance that are part of the Sports Concussion Assessment Tool (3rd ed.; SCAT3). Portable eye movement trackers and pupillometry may in the future improve our neuro-ophthalmic assessment after concussions. Combining visual tasks with neuroimaging and neurophysiology has allowed subtle changes to be detected, may refine our ability to make appropriate return-to-play decisions, and could potentially determine susceptibility to long-term sequelae of concussion. PMID:26444405
Vállez Garcia, David; Otte, Andreas; Glaudemans, Andor WJM; Dierckx, Rudi AJO; Gielen, Jan LMA; Zwerver, Johannes
Concussions in sports and during recreational activities are a major source of traumatic brain injury in our society. This is mainly relevant in adolescence and young adulthood, where the annual rate of diagnosed concussions is increasing from year to year. Contact sports (e.g., ice hockey, American
Glang, Ann E.; Koester, Michael C.; Chesnutt, James C.; Gioia, Gerard A.; McAvoy, Karen; Marshall, Sondra; Gau, Jeff M.
BACKGROUND Because many sports concussions happen during school-sponsored sports events, most state concussion laws specifically hold schools accountable for coach training and effective concussion management practices. Brain 101: The Concussion Playbook is a web-based intervention that includes training in sports concussion for each member of the school community, presents guidelines on creating a concussion management team, and includes strategies for supporting students in the classroom. METHODS The group randomized controlled trial examined the efficacy of Brain 101 in managing sports concussion. Participating high schools (N=25) were randomly assigned to the Brain 101 intervention or control. Fall athletes and their parents completed online training, and Brain 101 school administrators were directed to create concussion management policy and procedures. RESULTS Student athletes and parents at Brain 101 schools significantly outperformed those at control schools on sports concussion knowledge, knowledge application, and behavioral intention to implement effective concussion management practices. Students who had concussions in Brain 101 schools received more varied academic accommodations than students in control schools. CONCLUSIONS Brain 101 can help schools create a comprehensive school-wide concussion management program. It requires minimal expenditures and offers engaging and effective education for teachers, coaches, parents, and students. PMID:25438964
Full Text Available ... are more likely to get a concussion than adults and they take longer to recover than adults. D All of the above. Submit LESSON 1 ... Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma ...
... a concussion and crowd the brain against the skull. Contact your health care professional or emergency department ... or cannot be awakened. Have one pupil (the black part in the middle of the eye) larger ...
Full Text Available ... NCAA Sports Download Materials [Exit Disclaimer] Watch a Video or PSA on Concussion NFL PSA on Concussion ... Exit Disclaimer] Banner 3 [Exit Disclaimer] Watch a Video or PSA on Concussion> NFL PSA on Concussion ...
Gabriela Murguía Cánovas
Full Text Available Recently, there has been increased attention to concussions that occur during sports activities, both at school level or amateur and professional level. Concussion is defined as a sudden and transient alteration of consciousness induced by traumatic biomechanical forces transmitted directly or indirectly to the brain. Such injuries most commonly occur in contact sports such as boxing, football, soccer, wrestling, hockey, among others. Concussion should be suspected in any athlete who suffers a head injury, whether or not it is associated to loss of consciousness. These athletes should not return to their sports activities immediately, and a few days of mental and physical leave are recommended in order to ensure full recovery. Repeat head injuries should be avoided, since there is evidence that in some athletes they can lead to chronic traumatic encephalopathy. The present review focuses on the different definitions of concussion, management and long-term consequences. It also contains the Spanish version of the Sport Concussion Assessment Tool 2 (SCAT2.
Bridgette D Semple
Full Text Available Sports-related concussions are particularly common during adolescence, a time when even mild brain injuries may disrupt ongoing brain maturation and result in long-term complications. A recent focus on the consequences of repetitive concussions amongst professional athletes has prompted the development of several new experimental models in rodents, as well as the revision of guidelines for best management of sports concussions. Here, we consider the utility of rodent models to understand the functional consequences and pathobiology of concussions in the developing brain, identifying the unique behavioral and pathological signatures of concussive brain injuries. The impact of repetitive concussions on behavioral consequences and injury progression is also addressed. In particular, we focus on the epidemiological, clinical and experimental evidence underlying current recommendations for physical and cognitive rest after concussion, and highlight key areas in which further research is needed. Lastly, we consider how best to promote recovery after injury, recognizing that optimally-timed, activity-based rehabilitative strategies may hold promise for the adolescent athlete who has sustained single or repetitive concussions. The purpose of this review is to inform the clinical research community as it strives to develop and optimize evidence-based guidelines for the concussed adolescent, in terms of both acute and long-term management.
Kuhl, Heather N.; Ritchie, David; Taveira-Dick, Angela C.; Hoefling, Katie A.; Russo, Stephen A.
Background: Head injuries are responsible for the majority of serious equestrian sports injuries and deaths. Because of significant health risks to equestrians, education regarding the prevention of head and brain injuries is essential. Hypothesis: A significant number of riders have experienced a concussion, and few have knowledge of concussion. Study Design: Cross-sectional study. Level of Evidence: Level 2. Methods: Ninety-four riders competing, riding, or attending equestrian events at th...
... Hot Topics Meningitis Choosing Your Mood Prescription Drug Abuse Healthy School Lunch Planner How Can I Help a Friend Who ... Should I Tell My Teachers? Tips for Dealing With a Concussion at School ...
... concentrating, and may have mild headaches and less tolerance for noise. Consider asking for more breaks when ... PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Concussion Browse the Encyclopedia ...
Smith, David W.; Myer, Gregory D; Currie, Dustin W.; Comstock, R Dawn; Clark, Joseph F.; Bailes, Julian E.
Background: Recent research indicates that the volume and/or pressure of intracranial fluid, a physiology affected by one’s altitude (ie, elevation above sea level), may be associated with the likelihood and/or severity of a concussion. The objective was to employ an epidemiological field investigation to evaluate the relationship between altitude and concussion rate in high school sports. Hypothesis: Because of the physiologies that occur during acclimatization, including a decline in intrac...
This podcast discusses concussions and provides information to help people better understand concussion. Created: 3/17/2010 by National Center for Injury Prevention and Control (NCIPC). Date Released: 3/17/2010.
Full Text Available Clifford A Robbins,1 Daniel H Daneshvar,1,2 John D Picano,1,3 Brandon E Gavett,1,4 Christine M Baugh,1,2 David O Riley,1 Christopher J Nowinski,1,2,5 Ann C McKee,1,2,6–8 Robert C Cantu,1,5,9,10 Robert A Stern1,2,8,91Center for the Study of Traumatic Encephalopathy, 2Department of Neurology, Boston University School of Medicine, Boston, MA, USA; 3School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA; 4Department of Psychology, University of Colorado, Colorado Springs, CO, USA; 5Sports Legacy Institute, Waltham MA, USA; 6United States Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA; 7Department of Pathology, 8Alzheimer's Disease Center, 9Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA; 10Department of Neurosurgery, Emerson Hospital, Concord, MA, USABackground: In recent years, the understanding of concussion has evolved in the research and medical communities to include more subtle and transient symptoms. The accepted definition of concussion in these communities has reflected this change. However, it is unclear whether this shift is also reflected in the understanding of the athletic community.What is known about the subject: Self-reported concussion history is an inaccurate assessment of someone's lifetime exposure to concussive brain trauma. However, unfortunately, in many cases it is the only available tool.Hypothesis/purpose: We hypothesize that athletes' self-reported concussion histories will be significantly greater after reading them the current definition of concussion, relative to the reporting when no definition was provided. An increase from baseline to post-definition response will suggest that athletes are unaware of the currently accepted medical definition.Study design: Cross-sectional study of 472 current and former athletes.Methods: Investigators conducted structured telephone interviews with current and former athletes between January
Li, Yazhou; Yu, Qian-sheng; Barak, Shani; Tamargo, Ian A.; Rubovitch, Vardit; Holloway, Harold W.; Lehrmann, Elin; Wood, William H.; Zhang, Yongqing; Becker, Kevin G.; Perez, Evelyn; Van Praag, Henriette; Luo, Yu; Hoffer, Barry J.; Becker, Robert E.; Pick, Chaim G.; Greig, Nigel H.
Traumatic brain injury (TBI), often caused by a concussive impact to the head, affects an estimated 1.7 million Americans annually. With no approved drugs, its pharmacological treatment represents a significant and currently unmet medical need. In our prior development of the anti-cholinesterase compound phenserine for the treatment of neurodegenerative disorders, we recognized that it also possesses non-cholinergic actions with clinical potential. Here, we demonstrate neuroprotective actions of phenserine in neuronal cultures challenged with oxidative stress and glutamate excitotoxicity, two insults of relevance to TBI. These actions translated into amelioration of spatial and visual memory impairments in a mouse model of closed head mild TBI (mTBI) two days following cessation of clinically translatable dosing with phenserine (2.5 and 5.0 mg/kg BID x 5 days initiated post mTBI) in the absence of anti-cholinesterase activity. mTBI elevated levels of thiobarbituric acid reactive substances (TBARS), a marker of oxidative stress. Phenserine counteracted this by augmenting homeostatic mechanisms to mitigate oxidative stress, including superoxide dismutase [SOD] 1 and 2, and glutathione peroxidase [GPx], the activity and protein levels of which were measured by specific assays. Microarray analysis of hippocampal gene expression established that large numbers of genes were exclusively regulated by each individual treatment with a substantial number of them co-regulated between groups. Molecular pathways associated with lipid peroxidation were found to be regulated by mTBI, and treatment of mTBI animals with phenserine effectively reversed injury-induced regulations in the ‘Blalock Alzheimer’s Disease Up’ pathway. Together these data suggest that multiple phenserine-associated actions underpin this compound’s ability to ameliorate cognitive deficits caused by mTBI, and support the further evaluation of the compound as a therapeutic for TBI. PMID:27254111
Robert Lake Conder
Full Text Available The study of Heart Rate Variability (HRV has emerged as an essential component of cardiovascular health, as well as a physiological mechanism by which one can increase the interactive communication between the cardiac and the neurocognitive systems (i.e., the body and the brain. It is well-established that lack of heart rate variability implies cardiopathology, morbidity, reduced quality-of-life, and precipitous mortality. On the positive, optimal heart rate variability has been associated with good cardiovascular health, autonomic nervous system (ANS control, emotional regulation, and enhanced neurocognitive processing. In addition to health benefits, optimal HRV has been shown to improve neurocognitive performance by enhancing focus, visual acuity and readiness, and by promoting emotional regulation needed for peak performance. In concussed athletes and soldiers, concussions not only alter brain connectivity, but also alter cardiac functioning and impair cardiovascular performance upon exertion. Altered sympathetic and parasympathetic balance in the ANS has been postulated as a critical factor in refractory Post Concussive Syndrome (PCS. This article will review both the pathological aspects of reduced heart rate variability on athletic performance, as well as the cardiovascular and cerebrovascular components of concussion and PCS. Additionally, this article will review interventions with HRV biofeedback (HRV BFB training as a promising and underutilized treatment for sports and military-related concussion. Finally, this article will review research and promising case studies pertaining to use of HRV BFB for enhancement of cognition and performance, with applicability to concussion rehabilitation.
Ramasamy, Mouli; Harbaugh, Robert E.; Varadan, Vijay K.
Football players are more to violent impacts and injuries more than any athlete in any other sport. Concussion or mild traumatic brain injuries were one of the lesser known sports injuries until the last decade. With the advent of modern technologies in medical and engineering disciplines, people are now more aware of concussion detection and prevention. These concussions are often overlooked by football players themselves. The cumulative effect of these mild traumatic brain injuries can cause long-term residual brain dysfunctions. The principle of concussion is based the movement of the brain in the neurocranium and viscerocranium. The brain is encapsulated by the cerebrospinal fluid which acts as a protective layer for the brain. This fluid can protect the brain against minor movements, however, any rapid movements of the brain may mitigate the protective capability of the cerebrospinal fluid. In this paper, we propose a wireless health monitoring helmet that addresses the concerns of the current monitoring methods - it is non-invasive for a football player as helmet is not an additional gear, it is efficient in performance as it is equipped with EEG nanosensors and 3D accelerometer, it does not restrict the movement of the user as it wirelessly communicates to the remote monitoring station, requirement of individual monitoring stations are not required for each player as the ZigBee protocol can couple multiple transmitters with one receiver. A helmet was developed and validated according to the above mentioned parameters.
Full Text Available ... Concussion Responding To Concussions Getting Back In The Game Concussion Prevention Resource Center Menu Button Return To ... or position Forgets sports plays Is unsure of game, score, or opponent Moves clumsily Answers questions slowly ...
Full Text Available ... Concussions [PDF 348KB] DOWNLOAD SPORT-SPECIFIC CONCUSSION INFORMATION Baseball Field Hockey Football Ice Hockey Lacrosse Rugby Soccer ... Medicine Concussion Program US Lacrosse US Soccer USA Baseball USA Football USA Rugby USA Volleyball YMCA of ...
Thomas A. Buckley; Jessie R. Oldham; Jaclyn B. Caccese
Concussion, or mild traumatic brain injury, incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom. The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control. The current acute evaluation for concussion utilizes the subjective balance error scoring system (BESS) to assess postural control. While the sensitivity of the overall test battery is high, the sensitivity of the BESS is unacceptably low and, with repeat administration, is unable to accurately identify recovery. Sophisticated measures of postural control, utilizing traditional linear assessments, have identified impairments in postural control well beyond BESS recovery. Both assessments of quiet stance and gait have identified lingering impairments for at least 1 month post-concussion. Recently, the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy (ApEn). ApEn, most commonly in the medial-lateral plane, has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values;unfortunately these studies have not gone beyond the acute phase of recovery. One study has identified lingering deficits in postural control, utilizing Shannon and Renyi entropy metrics, which persist at least through clinical recovery and return to participation. Finally, limited evidence from two studies suggest that individuals with a previous history of a single concussion, even months or years prior, may display altered ApEn metrics. Overall, non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.
Sports-related concussion also referred to in the literature as mild traumatic brain injury remains a popular area of study for physicians, neurologists, neuropsychologists, neuroimaging, athletic trainers, and researchers across the other areas of brain sciences. Treatment for concussion is an emerging area of focus with investigators seeking to improve outcomes and protect patients from the deleterious short-term and long-term consequences which have been extensively studied and identified. Broadly, current treatment strategies for athletes recovering from concussion have remained largely unchanged since early 2000s. Knowledge of the complex pathophysiology surrounding injury should improve or advance our ability to identify processes which may serve as targets for therapeutic intervention. Clinicians working with athletes recovering from sports-related concussion should have an advanced understanding of the injury cascade and also be aware of the current efforts within the research to treat concussion. In addition, how clinicians use the word "treatment" should be carefully defined and promoted so the patient is aware of the level of intervention and what stage of recovery or healing is being affected by a specific intervention. The purpose of this review is to bring together efforts across disciplines of brain science into 1 platform where clinicians can assimilate this information before making best practices decisions regarding the treatment of patients and athletes under their care. PMID:27482780
Concussion in High School Sports: Overall Estimate of Occurrence Is Not Available, but Key State Laws and Nationwide Guidelines Address Injury Management. Testimony before the Committee on Education and Labor, House of Representatives. GAO-10-569T
Kohn, Linda T.
Participation in school sports can benefit children but also carries a risk of injury, including concussion. Concussion is a brain injury that can affect memory, speech, and muscle coordination and can cause permanent disability or death. Concussion can be especially serious for children, who are more likely than adults both to sustain a…
Sasaki, Takeshi; Pasternak, Ofer; Mayinger, Michael; Muehlmann, Marc; Savadjiev, Peter; Bouix, Sylvain; Kubicki, Marek; Fredman, Eli; Dahlben, Brian; Helmer, Karl; Johnson, Andrew M.; Holmes, Jeff D.; Forwell, Lori A.; Skopelja, Elaine; Shenton, Martha E.; Echlin, Paul; Koerte, Inga K.
Object The aim of this study was to examine the brain’s white matter microstructure using magnetic resonance diffusion tensor imaging (DTI) in ice hockey players with a history of clinically symptomatic concussion compared to those players without a history of concussion. Methods Sixteen players with a history of concussion (Concussed Group; mean age: 21.7 ± 1.5 years; 6 female) and eighteen players without a history of concussion (Non-Concussed Group; mean age: 21.3 ± 1.8 years, 10 female) underwent 3T DTI at the end of the Canadian Interuniversity Sports ice hockey season 2011–2012. Tract-based spatial statistics (TBSS) was used to test for group differences in fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and trace. Cognitive evaluation was performed using the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) and the Sport Concussion Assessment Tool-2 (SCAT2). Results TBSS revealed a significant increase in FA and AD, and a significant decrease in RD and trace in several brain regions in the Concussed group, compared with the Non-concussed group (p ImPACT nor SCAT2. Conclusion The results of the current study indicate that a history of concussion may result in alterations of the brain’s white matter microstructure in ice hockey players. Increased FA based on decreased RD may reflect neuroinflammatory or neuroplastic processes of the brain responding to brain trauma. Future studies are needed that include a longitudinal analysis of the brain’s structure and function following a concussion in order to elucidate further the complex time course of DTI changes and their clinical meaning. PMID:24471841
Williams, Vernon B; Danan, Ilan J
The approach to sports concussion diagnosis and management has been evolving at an unprecedented rate over the last several years. So much so, that committees at all level of sports have implemented concussion protocols and made adjustments to certain league rules in an effort to minimize the risk of head injury. With this newfound attention has come an even greater push by the scientific community to address the many questions that remain. The aim of this review article is to present the topic of sports concussion by means of discreet eras. It begins by introducing the very first mentions of concussion, dating back to ancient Greece, to present day, highlighting important periods along the way. It then goes on to review emerging scientific data, from biomarkers and serum studies, to imaging modalities, and brain networking. All of which will hopefully contribute to both the diagnostic and therapeutic approach to sports concussion. PMID:27188579
Editor’s note: While concussions have long been linked to brain and central nervous system issues, a new study suggests that repeated hits to the head—mild or otherwise—can lead to memory loss, depression, and dementia. This postmortem brain study, conducted at the Boston University Center for the Study of Traumatic Encephalopathy, provides new and troubling evidence about chronic traumatic encephalopathy (CTE), a long-term degenerative and incurable brain disease. Although military personnel...
Zachary Robert Patterson
Full Text Available Mild traumatic brain injuries (mTBI have been associated with long-term cognitive deficits relating to trauma-induced neurodegeneration. These long-term deficits include impaired memory and attention, changes in executive function, emotional instability and sensorimotor deficits. Furthermore, individuals with concussions show a high co-morbidity with a host of psychiatric illnesses (e.g. depression, anxiety, addiction and dementia. The neurological damage seen in mTBI patients is the result of the direct impact and mechanical injury, followed by a delayed neuroimmune response that can last hours, days and even months after the injury. As part of the neuroimmune response, a cascade of pro- and anti-inflammatory cytokines are released and can be detected at the site of injury as well as subcortical, and often contralateral, regions. It has been suggested that the delayed neuroinflammatory response to concussions is more damaging then the initial impact itself. However, evidence exists for favourable consequences of cytokine production following traumatic brain injuries as well. In some cases, treatments that reduce the inflammatory response will also hinder the brain's intrinsic repair mechanisms. At present, there is no evidence-based pharmacological treatment for concussions in humans. The ability to treat concussions with drug therapy requires an in-depth understanding of the pathophysiological and neuroinflammatory changes that accompany concussive injuries. The use of neurotrophic factors (e.g. nerve growth factor and anti-inflammatory agents as an adjunct for the management of post-concussion symptomology will be explored in this review.
Moser, Austin; Miller, John J.
In 2011, Adrian Arrington filed a class action lawsuit against the National Collegiate Athletic Association (NCAA) on behalf of himself and other athletes who had sustained concussions that resulted in long-term injuries. In the lawsuit, Arrington alleged that the NCAA employed a negligent approach to concussed student-athletes.
Tegner, Y; Lorentzon, R
OBJECTIVE: To evaluate the frequency of concussion in Swedish ice hockey and to establish a uniform grading and treatment model for concussions of different severity. METHODS: Frequency of concussion was investigated in two studies, one retrospective and one prospective. In the retrospective study, all Swedish elite ice hockey players (n = 265) were asked to answer a questionnaire on the number and treatment of previous concussions. Only concussions diagnosed by a doctor were recorded. The qu...
Gay, Michael; Ray, William; Johnson, Brian; Teel, Elizabeth; Geronimo, Andrew; Slobounov, Semyon
Current clinical assessment of sports-related concussion and the determination of "Return-to-Play" lacks assessment of the pathophysiological processes affecting the concussed brain. The objective of this study was to demonstrate the feasibility of electroencephalogram measures that detect neuronal damage and monitor the healing process, giving an improved approximation of pathophysiological recovery. PMID:26179490
Gay, Michael; Slobounov, Semyon; Ray, William J.; Johnson, Brian; Teel, Elizabeth; Geronimo, Andrew
Current clinical assessment of sports-related concussion and the determination of ‘Return-to-Play’ lacks assessment of the pathophysiological processes affecting the concussed brain. The objective of this study was to demonstrate the feasiblity of EEG measures which detect neuronal damage and monitor the healing process, giving an improved approximation of pathophysiological recovery.
Traumatic Brain Injury and Delayed Sequelae: A Review - Traumatic Brain Injury and Mild Traumatic Brain Injury (Concussion) are Precursors to Later-Onset Brain Disorders, Including Early-Onset Dementia
Michael A. Kiraly; Kiraly, Stephen J.
Brain injuries are too common. Most people are unaware of the incidence of and horrendous consequences of traumatic brain injury (TBI) and mild traumatic brain injury (MTBI). Research and the advent of sophisticated imaging have led to progression in the understanding of brain pathophysiology following TBI. Seminal evidence from animal and human experiments demonstrate links between TBI and the subsequent onset of premature, psychiatric syndromes and neurodegenerative diseases, including Alzh...
Michael John Ellis
Full Text Available Concussion is a form of traumatic brain injury (TBI that presents with a wide spectrum of subjective symptoms and few objective clinical findings. Emerging research suggests that one of the processes that may contribute to concussion pathophysiology is dysregulation of cerebral blood flow (CBF leading to a mismatch between CBF delivery and the metabolic needs of the injured brain. Cerebrovascular reactivity (CVR is defined as the change in CBF in response to a measured vasoactive stimulus. Several magnetic resonance imaging (MRI techniques can be used as a surrogate measure of CBF in clinical and laboratory studies. In order to provide an accurate assessment of CVR, these sequences must be combined with a reliable, reproducible vasoactive stimulus that can manipulate CBF. Although CVR imaging currently plays a crucial role in the diagnosis and management of many cerebrovascular diseases, only recently have studies begun to apply this assessment tool in patients with concussion. In order to evaluate the quality, reliability and relevance of CVR studies in concussion, it is important that clinicians and researchers have a strong foundational understanding of the role of cerebral blood flow regulation in health, concussion and more severe forms of TBI, and an awareness of the advantages and limitations of currently available CVR measurement techniques. Accordingly, in this review we 1 discuss the role of CVR in TBI and concussion; 2 examine methodological considerations for MRI-based measurement of CVR; and 3 provide an overview of published CVR studies in concussion patients.
Traumatic Brain Injury and Delayed Sequelae: A Review - Traumatic Brain Injury and Mild Traumatic Brain Injury (Concussion are Precursors to Later-Onset Brain Disorders, Including Early-Onset Dementia
Michael A. Kiraly
Full Text Available Brain injuries are too common. Most people are unaware of the incidence of and horrendous consequences of traumatic brain injury (TBI and mild traumatic brain injury (MTBI. Research and the advent of sophisticated imaging have led to progression in the understanding of brain pathophysiology following TBI. Seminal evidence from animal and human experiments demonstrate links between TBI and the subsequent onset of premature, psychiatric syndromes and neurodegenerative diseases, including Alzheimer's disease (AD and Parkinson's disease (PD. Objectives of this summary are, therefore, to instill appreciation regarding the importance of brain injury prevention, diagnosis, and treatment, and to increase awareness regarding the long-term delayed consequences following TBI.
Mild traumatic brain injury (TBI) is associated with damage to frontal, temporal and parietal lobes. Post-concussion syndrome has been used to describe a range of residual symptoms that persist 12 months or more after the injury, often despite a lack of evidence of brain abnormalities on MRI and CT scans. The core deficits of post-concussion syndrome are similar to those of ADHD and mood disorders, and sufferers often report memory, socialization problems and frequent headaches. While cognitive rehabilitation and psychological support are widely used, neither has been shown to be effective in redressing the core deficits of post-concussion syndrome. On the other hand, quantitative EEG has been shown to be highly sensitive (96%) in identifying post-concussion syndrome, and neurotherapy has been shown in a number of studies to be effective in significantly improving or redressing the symptoms of post-concussion syndrome, as well as improving similar symptoms in non-TBI patients. PMID:15493535
McNamee, Michael J; Partridge, Bradley; Anderson, Lynley
Despite considerable scientific dispute the science of concussion, there has been a proliferation of position statements and professional guidelines published on sports concussion management over the last 15 years. A number of ethical and clinical problems associated with concussion management protocols remain concerning, (i) diagnosis and management; (ii) conflicts of interest and coercion; (iii) same day return to play; and (iv) reporting, auditing and confidentiality. These issues are critically discussed in the light of recent Consensus Statements. It is argued that the use of independent match day doctors may ameliorate some of these concerns. PMID:26832975
Full Text Available Abstract Background Despite negative neuroimaging findings many athletes display neurophysiological alterations and post-concussion symptoms that may be attributable to neurometabolic alterations. Methods The present study investigated the effects of sports concussion on brain metabolism using 1H-MR Spectroscopy by comparing a group of 10 non-concussed athletes with a group of 10 concussed athletes of the same age (mean: 22.5 years and education (mean: 16 years within both the acute and chronic post-injury phases. All athletes were scanned 1-6 days post-concussion and again 6-months later in a 3T Siemens MRI. Results Concussed athletes demonstrated neurometabolic impairment in prefrontal and motor (M1 cortices in the acute phase where NAA:Cr levels remained depressed relative to controls. There was some recovery observed in the chronic phase where Glu:Cr levels returned to those of control athletes; however, there was a pathological increase of m-I:Cr levels in M1 that was only present in the chronic phase. Conclusions These results confirm cortical neurometabolic changes in the acute post-concussion phase as well as recovery and continued metabolic abnormalities in the chronic phase. The results indicate that complex pathophysiological processes differ depending on the post-injury phase and the neurometabolite in question.
Full Text Available ... or longer. A True B False Submit POST TEST QUESTION 1 A concussion is a: A type ... loud sound heard from far away. Submit POST TEST QUESTION 2 When can concussions occur? A Only ...
Full Text Available ... slowly 6 Loses consciousness (even briefly) 7 Shows mood, behavior, or personality changes 8 Cant recall ... sport. Submit LESSON 4 QUIZ QUESTION 3 Concussions affect people differently. While most athletes with a concussion ...
Full Text Available ... Safety ORDER FREE PRINT COPIES OF CDC'S CONCUSSION RESOURCES Order Free Copies of CDC's “Heads Up” Educational Materials Materials on Concussion in Sports Materials for ...
Full Text Available ... Sheet Download a Fact Sheet on Overall Sports Safety: Protect the Ones You Love For parents Order ... or PSA on Concussion NFL PSA on Concussion Safety [Exit Disclaimer] Keeping Quiet Can Keep You Out ...
Full Text Available ... foggy, or groggy 17 Concentration or memory problems 18 Confusion 19 Just not “feeling right” or is “ ... NCAA Sports Download Materials [Exit Disclaimer] Watch a Video or PSA on Concussion NFL PSA on Concussion ...
Full Text Available ... Up! Prevent Concussions Prevent Head Injuries Sports Safety Students Play Safe Youth Sports Safety PROMOTIONAL MATERIALS "Heads ... Up! Prevent Concussions Prevent Head Injuries Sports Safety Students Play Safe Youth Sports Safety ORDER FREE PRINT ...
Full Text Available ... true? A Most concussions occur without loss of consciousness. B Athletes who have ever had a concussion ... or opponent Moves clumsily Answers questions slowly Loses consciousness (even briefly) Shows behavior or personality changes Can' ...
Full Text Available ... to move rapidly back and forth. A True B False Submit LESSON 1 QUIZ QUESTION 2 Which ... A Most concussions occur without loss of consciousness. B Athletes who have ever had a concussion are ...
Full Text Available ... risk for another concussion. C Young children and teens are more likely to get a concussion than ... seconds] Mom and Daughter [Audio: 0:30 seconds] Teens [Audio: 0:30 seconds] Announcers [Audio: 0:30 ...
Buckley, Thomas A.; Munkasy, Barry A.; Tapia-Lovler, Tiffen G.; Wikstrom, Erik A.
The purpose was to determine if planned gait termination can identify acute and lingering motor control strategy alterations in post-concussion individuals. Controls completed 2 standard gait and 5 planned gait termination trials once while concussed individuals were tested on Day-1 and Day-10 post-concussion. Dependent variables included gait velocity and normalized, relative to standard gait, peak propulsive and braking forces. Control and only Day-1 post-concussion gait velocity differed. ...
Scopaz, Kristen A.; Hatzenbuehler, John R.
Context: Currently, no consensus exists for grading the severity of concussions. Identification of risk factors that may affect concussion risk and the likelihood of prolonged recovery can be of value to providers who manage concussion. Evidence Acquisition: Relevant studies were identified through MEDLINE (1996-2011) using the keywords concussion, postconcussive syndrome, and risk or risk factor. Targeted searches for specific risk factors were conducted with additional keywords, such as gen...
Full Text Available ... TOOLS — CONCUSSION INFORMATION View CDC's “Heads Up” Concussion Educational Materials “Heads Up” for youth sports coaches, administrators, ... parents Order Free Copies of CDC's “Heads Up” Educational Materials Materials on Concussion in Sports Materials for ...
Full Text Available ... CONCUSSION INFORMATION View CDC's “Heads Up” Concussion Educational Materials “Heads Up” for youth sports coaches, administrators, and ... Order Free Copies of CDC's “Heads Up” Educational Materials Materials on Concussion in Sports Materials for Health ...
Full Text Available ... session will not be saved. DOWNLOADABLE TOOLS — CONCUSSION INFORMATION View CDC's “Heads Up” Concussion Educational Materials “Heads ... in Sports”) VIDEOS FROM EXPERTS AND FOR MORE INFORMATION Watch a Video or PSA on Concussion NFL ...
Moore, Davis R; Pindus, Dominika M; Raine, Lauren B; Drollette, Eric S; Scudder, Mark R; Ellemberg, Dave; Hillman, Charles H
The aim of this investigation was to examine the influence of pediatric sport-related concussion on brain and cognitive function. To do so, we used a between-participants design, measures of executive control, and event-related potentials (ERPs). The findings demonstrate that children with a history of concussion exhibit behavioral deficits in attention, working memory and impulse control, as well as neuroelectric alterations in ERP indices of visual attention (N1), conflict resolution (N2) and attentional resource allocation (P3). Furthermore, the age at injury related to the magnitude of several concussion-related deficits. Accordingly, a single sports-related concussive incident during childhood (m=2.1years prior to testing) may lead to subtle, yet pervasive alterations in the behavioral and neural indices of attention and executive control, and age at injury may moderate injury outcomes. PMID:26608697
Full Text Available Tracey Covassin, Robert J ElbinMichigan State University, Department of Kinesiology, East Lansing, MI, USAAbstract: Sports-related concussion is an injury that continues to receive attention from both the popular media and sports medicine community. The many different symptom presentations and cognitive decrements that follow concussions, have made this injury difficult to detect and manage. Furthermore, concussed athletes should not always be entrusted to appropriately self-report their concussion symptoms; therefore the burden falls on the clinician and coach. Recent management recommendations call for using a multi-faceted approach to managing concussion, which consists of neurocognitive testing before (ie, baseline/preseason and after injury. In addition age, sex, and previous history of concussion have been found to influence the risk and recovery from this injury.Keywords: cognitive function, neurocognitive testing, concussion
Full Text Available Sports concussions are an increasingly recognized common type of mild traumatic brain injury (TBI that affect athletes of all ages. The need for an increased involvement of trained physicians in the diagnosis and treatment of concussion has become more obvious as the pathophysiology and long-term sequelae of sports concussion are better understood. To date, there has been great variability in the athletic community about the recognition of symptoms, diagnosis, management, and physician role in concussion care. An awareness assessment survey administered to 96 high school coaches in a large metropolitan city demonstrated that 37.5% of responders refer their concussed players to an emergency department after the incident, only 39.5% of responders have a physician available to evaluate their players after a concussion, 71.6% of those who had a physician available sent their players to a sports medicine physician, and none of the responders had their player’s concussion evaluated by a neurologist. Interestingly, 71.8% of responders stated that their players returned to the team with “return to play” guidelines from their physician. This survey has highlighted two important areas where the medical community can better serve the athletic community. Because a concussion is a sport-inflicted injury to the nervous system, it is optimally evaluated and managed by a clinician with relevant training in both clinical neuroscience and sports medicine. Furthermore, all physicians who see patients suffering concussion should be educated in the current recommendations from the Consensus Statement on Concussion and provide return to play instructions that outline a graduated return to play, allowing the athlete to return to the field safely.
Orr, Catherine A; Albaugh, Matthew D; Watts, Richard; Garavan, Hugh; Andrews, Trevor; Nickerson, Joshua P; Gonyea, Jay; Hipko, Scott; Zweber, Cole; Logan, Katherine; Hudziak, James J
Participation in contact sports places athletes at elevated risk for repeated head injuries and is associated with negative mental health outcomes later in life. The current study identified changes observable on neuroimaging that persisted beyond the apparent resolution of acute symptoms of concussion. Sixteen young adult ice hockey players with a remote history of concussion but no subjective complaints were compared against 13 of their teammates with no history of concussion. Participants completed a detailed phenotypic assessment and a neuroimaging battery including diffusion kurtosis imaging and resting-state functional magnetic resonance imaging. Athletes with a history of concussion performed no differently from those without on phenotypic assessment, but showed significantly elevated fractional anisotropy (FA) in the left genu and anterior corona radiata relative to those without. Post hoc analyses revealed that elevated FA was associated with increased microstructural complexity perpendicular to the primary axon (radial kurtosis). Athletes with concussion history also showed significant differences in the organization of the default mode network (DMN) characterized by stronger temporal coherence in posterior DMN, decreased temporal coherence in anterior DMN, and increased functional connectivity outside the DMN. In the absence of deficits on detailed phenotypic assessment, athletes with a history of concussion displayed changes to the microstructural architecture of the cerebral white matter and to the functional connectivity of the brain at rest. Some of these changes are consistent with those previously associated with persisting deficits and complaints, but we also report novel, complementary changes that possibly represent compensatory mechanisms. PMID:26413910
Kelty-Stephen, Damian G; Qureshi Ahmad, Mona; Stirling, Leia
The likelihood of suffering a concussion while playing a contact sport ranges from 15-45% per year of play. These rates are highly variable as athletes seldom report concussive symptoms, or do not recognize their symptoms. We performed a prospective cohort study (n = 206, aged 10-17) to examine visuomotor tracing to determine the sensitivity for detecting neuromotor components of concussion. Tracing variability measures were investigated for a mean shift with presentation of concussion-related symptoms and a linear return toward baseline over subsequent return visits. Furthermore, previous research relating brain injury to the dissociation of smooth movements into "submovements" led to the expectation that cumulative micropause duration, a measure of motion continuity, might detect likelihood of injury. Separate linear mixed effects regressions of tracing measures indicated that 4 of the 5 tracing measures captured both short-term effects of injury and longer-term effects of recovery with subsequent visits. Cumulative micropause duration has a positive relationship with likelihood of participants having had a concussion. The present results suggest that future research should evaluate how well the coefficients for the tracing parameter in the logistic regression help to detect concussion in novel cases. PMID:25894704
This podcast describes how to take care of yourself after a concussion, including proper recognition and response recommendations. Created: 3/17/2010 by National Center for Injury Prevention and Control (NCIPC). Date Released: 3/17/2010.
Kathleen A. Linzmeier
Full Text Available Investigators from the University of Pittsburg, University of Arkansas, Lake Erie College of Osteopathic Medicine, and Boston Children’s Hospital/Harvard Medical College researched the incidence of concussions in youth hockey in relation to age and activity setting.
Balkan, Ozgur; Virji-Babul, Naznin; Miyakoshi, Makoto; Makeig, Scott; Garudadri, Harinath
Here, we investigated EEG-based source-level spectral differences between adolescents with sports-related concussions and healthy age matched controls. We transformed resting state EEG collected in both groups to the source domain using Independent Component Analysis (ICA) and computed the component process power spectra. For group-level analysis in the source domain, we used a probabilistic framework, Measure Projection Analysis (MPA), that has advantages over parametric k-means clustering of brain sources. MPA revealed that some frontal brain sources in the concussed group had significantly more power in the beta band (pconcussion from healthy controls. PMID:26737184
Covassin, Tracey; Elbin, Robert J
Sports-related concussion is an injury that continues to receive attention from both the popular media and sports medicine community. The many different symptom presentations and cognitive decrements that follow concussions, have made this injury difficult to detect and manage. Furthermore, concussed athletes should not always be entrusted to appropriately self-report their concussion symptoms; therefore the burden falls on the clinician and coach. Recent management recommendations call for using a multi-faceted approach to managing concussion, which consists of neurocognitive testing before (ie, baseline/preseason) and after injury. In addition age, sex, and previous history of concussion have been found to influence the risk and recovery from this injury. PMID:24198543
Iverson, Grant L.; Echemendia, Ruben J.; LaMarre, Amanda K.; Brooks, Brian L.; Gaetz, Michael B.
Background. The literature on lingering or “cumulative” effects of multiple concussions is mixed. The purpose of this study was to examine whether athletes with a history of three or more concussions perform more poorly on neuropsychological testing or report more subjective symptoms during a baseline, preseason evaluation. Hypothesis. Athletes reporting three or more past concussions would perform more poorly on preseason neurocognitive testing. Study Design. Case-control study. Methods. An ...
Full Text Available ... Foundation Society of State Directors of Health, Physical Education & Recreation Sports Legacy Institute University of Pittsburgh Medical Center, Sports Medicine Concussion Program ...
Lynall, Robert C; Kerr, Zachary Y; Parr, Matthew S; Hackney, Anthony C; Mihalik, Jason P
Study Design Retrospective cohort. Background Participating in sports at high altitude may have a protective effect on the brain, according to research studies. Research using validated data-collection methods in a previously unexplored cohort may better estimate the association between concussion injury risk and altitude. Objectives To determine the association between concussion rates and altitude during college football games. Methods Athletic trainers from 21 Division I football programs provided exposure and injury data to the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) from the 2009-2010 to 2013-2014 academic years. The elevation of each stadium was determined. Concussion rates per 1000 athlete-exposures (AEs) were compared in 2 ways, based on the sample of stadium elevations: (1) median split (elevation higher than 178 m or lower than 178 m), and (2) quartile split. Rate ratios (RRs), rate differences, and 95% confidence intervals (CIs) were computed. Results One hundred sixty-nine concussions were reported over 49 040 AEs (3.45/1000 AEs). Using the median split, the concussion rate above 178 m (RR = 4.18/1000 AEs) was 1.47 times the concussion rate below 178 m (RR = 2.84/1000 AEs; 95% CI: 1.09, 2.00; P = .01). The concussion rate at the highest altitude quartile (higher than 284 m; RR = 5.01/1000 AEs) was 1.67 times greater than the concussion rate at the lowest altitude quartile (lower than 43 m; RR = 3.00/1000 AEs; 95% CI: 1.13, 2.48; P = .01). Conclusion College football game concussion rates appear to increase at higher altitudes. The clinical significance of this relatively small increase is unknown. Future research should explore potential physiologic underpinnings associated with concussion risk at relatively higher and lower altitudes. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2016;46(2):96-103. Epub 11 Jan 2016. doi:10.2519/jospt.2016.6315. PMID:26755407
Jason P. Mihalik
Full Text Available Brain injuries in sports drew more and more public attentions in recent years. Brain injuries vary by name, type, and severity in the athletic setting. It should be noted, however, that these injuries are not isolated to only the athletic arena, as non-athletic mechanisms (e.g., motor vehicle accidents are more common causes of traumatic brain injuries (TBI among teenagers. Notwithstanding, as many as 1.6 to 3.8 million TBI result from sports and recreation each year in the United States alone. These injuries are extremely costly to the global health care system, and make TBI among the most expensive conditions to treat in children. This article serves to define common brain injuries in sport; describe their prevalence, what happens to the brain following injury, how to recognize and manage these injuries, and what you can expect as the athlete recovers. Some return-to-activity considerations for the brain-injured athlete will also be discussed.
Manasse-Cohick, Nancy J.; Shapley, Kathy L.
This survey study compared high school football players' knowledge and attitudes about concussion before and after receiving concussion education. There were no significant changes in the Concussion Attitude Index. Results revealed a statistically significant difference in the athletes' scores for the Concussion Knowledge Index,…
Full Text Available Background: Chronic traumatic encephalopathy (CTE is the term coined for the neurodegenerative disease often suspected in athletes with histories of repeated concussion and progressive dementia. Histologically, CTE is defined as a tauopathy with a distribution of tau-positive neurofibrillary tangles that is distinct from other tauopathies, and usually shows an absence of beta-amyloid deposits, in contrast to Alzheimer’s disease. Although the connection between repeated concussions and CTE-type neurodegeneration has been recently proposed, this causal relationship has not yet been firmly established. Also, the prevalence of CTE among athletes with multiple concussions is unknown. Methods: We performed a consecutive case series brain autopsy study on six retired professional football players from the Canadian Football League with histories of multiple concussions and significant neurological decline. Results: All participants had progressive neurocognitive decline prior to death; however, only 3 cases had post-mortem neuropathological findings consistent with CTE. The other 3 participants had pathological diagnoses of Alzheimer’s disease, amyotrophic lateral sclerosis and Parkinson’s disease. Moreover, the CTE cases showed co-morbid pathology of cancer, vascular disease and Alzheimer’s disease. Discussion: Our case studies highlight that not all athletes with history of repeated concussions and neurological symptomalogy present neuropathological changes of CTE. These preliminary findings support the need for further research into the link between concussion and CTE as well as the need to expand the research to other possible causes of taupathy in athletes. They point to a critical need for prospective studies with good sampling methods to allow us to understand the relationship between multiple concussions and the development of CTE.
Full Text Available ... After sustaining a concussion, you speak with a health care professional regarding your athletes condition and it was ... After sustaining a concussion, you speak with a health care professional regarding your athletes condition and it was ...
Full Text Available ... Health eCard Heads Up! Prevent Concussions Prevent Head Injuries Sports Safety Students Play Safe Youth Sports Safety PROMOTIONAL ... Health eCard Heads Up! Prevent Concussions Prevent Head Injuries Sports Safety Students Play Safe Youth Sports Safety ORDER ...
Full Text Available ... 10 When should you talk to the athletes parents about the possible concussion he/she may have ... go home. You should provide information to the parents regarding the signs and symptoms of concussion, encourage ...
This podcast provides the essential facts about concussions and describes symptoms, danger signs, and ways to recover and heal after a concussion. Created: 3/17/2010 by National Center for Injury Prevention and Control (NCIPC). Date Released: 3/17/2010.
Full Text Available ... in Spanish [Podcast: 1:27 minutes] Send a Health eCard Heads Up! Prevent Concussions Prevent Head Injuries ... in Spanish [Podcast: 1:27 minutes] Send a Health eCard Heads Up! Prevent Concussions Prevent Head Injuries ...
Full Text Available ... sustaining a concussion, you speak with a health care professional regarding your athletes condition and it was ... sustaining a concussion, you speak with a health care professional regarding your athletes condition and it was ...
Full Text Available ... 59 seconds]; in Spanish [Podcast: 1:27 minutes] Send a Health eCard Heads Up! Prevent Concussions Prevent ... 59 seconds]; in Spanish [Podcast: 1:27 minutes] Send a Health eCard Heads Up! Prevent Concussions Prevent ...
Full Text Available ... NCAA Sports Download Materials [Exit Disclaimer] Watch a Video or PSA on Concussion NFL PSA on Concussion Safety [Exit Disclaimer] Keeping Quiet Can Keep You Out of the Game [Exit Disclaimer] [Movie: 2:00 minutes] Read more ...
Full Text Available ... of concussion, encourage them to see a health care professional, and follow up regarding the status of the athlete. C Before the next game/match/event so as to make sure the child is cleared for play. Submit POST TEST QUESTION 11 How can you help prevent concussions? ...
Sport participation is a common occupation for many children and youth and can lead to improved physical and psychosocial health. Despite these benefits, it exposes children and youth to the increased risk of injury. Concussion, also referred to as mild traumatic brain injury (mTBI), is one of the most common sports injuries reported in the…
Ko, Jina; Hemphill, Matthew A.; Gabrieli, David; Wu, Leon; Yelleswarapu, Venkata; Lawrence, Gladys; Pennycooke, Wesley; Singh, Anup; Meaney, Dave F.; Issadore, David
A major impediment to improving the treatment of concussion is our current inability to identify patients that will experience persistent problems after the injury. Recently, brain-derived exosomes, which cross the blood-brain barrier and circulate following injury, have shown great potential as a noninvasive biomarker of brain recovery. However, clinical use of exosomes has been constrained by their small size (30–100 nm) and the extensive sample preparation (>24 hr) needed for traditional exosome measurements. To address these challenges, we developed a smartphone-enabled optofluidic platform to measure brain-derived exosomes. Sample-to-answer on our chip is 1 hour, 10x faster than conventional techniques. The key innovation is an optofluidic device that can detect enzyme amplified exosome biomarkers, and is read out using a smartphone camera. Using this approach, we detected and profiled GluR2+ exosomes in the post-injury state using both in vitro and murine models of concussion.
彭瑞云; 高亚兵; 王德文; 肖兴义; 杨瑞; 陈浩宇; 吴小红; 刘杰; 胡文华; 马俊杰
BACKGROUND: Cerebral concussion is a mild brain injury. In basic researches, the expression and significance of enkaphalin and dopamine in cerebral concussion remain poorly understood.OBJECTIVE: To observe the expression of neuronal nitric oxide synthase (nNOS) gene in rat models of cerebral concussion and to explore its significance.DESIGN: A randomized controlled trialled study.SETTING and PARTICIPANTS: This study was conducted in the Institute of Radiation Medicine, Academy of Military Medical Sciences. Rat models of cerebral concussion was established in 80 healthy male Wistar rats of clean grade purchased from the Experimental Animal Center of Academy of Military Medical Sciences with free access to food and water. The rats were randomly divided into 4 groups according to the different levels of cerebral impact for model establishment, namely the control group, 50, 100 and 200 g counterweight groups.MAIN OUTCOME MEASURES: Brain tissue samples were taken 1, 3, 7,14 and 30 days after injury respectively, from each group, to examine the changes in the expression of nNOS gene in the course of cerebral concussion by means of immunohistochemistry and in situ hybridization.RESULTS: Rats in 100 g group exhibited typical manifestations of cerebral concussion as seen in the clinical setting. The pathological changes included cerebral vascular dilatation, congestion, edema of the cerebral tissues, neuronal degeneration, necrosis, and decrease or even disappearance of the Nissl bodies. The protein and mRNA of nNOS were increased 3 days after the injury, peaked on the 7th day, and decreased till the 14th days but still remained positive on the 30th day. The positive expression was detected in the plasma of neurons in the cerebral cortex, hippocampus, thalamus and cerebellum.CONCLUSION: Cerebral concussion is pathologically characterized by blood circulation disorder and neural cell degeneration and necrosis. The expression of nNOS gene participates in brain tissue damage
Meier, Timothy B; Bellgowan, Patrick S F; Bergamino, Maurizio; Ling, Josef M; Mayer, Andrew R
Emerging evidence suggests that a history of sports-related concussions can lead to long-term neuroanatomical changes. The extent to which similar changes are present in young athletes is undetermined at this time. Here, we tested the hypothesis that collegiate football athletes with (n = 25) and without (n = 24) a self-reported history of concussion would have cortical thickness differences and altered white matter integrity relative to healthy controls (n = 27) in fronto-temporal regions that appear particularly susceptible to traumatic brain injury. Freesurfer software was used to estimate cortical thickness, fractional anisotropy was calculated in a priori white matter tracts, and behavior was assessed using a concussion behavioral battery. Groups did not differ in self-reported symptoms (p > 0.10) or cognitive performance (p > 0.10). Healthy controls reported significantly higher happiness levels than both football groups (all p 0.10). However, football athletes with a history of concussion had significantly thinner cortex in the left anterior cingulate cortex, orbital frontal cortex, and medial superior frontal cortex relative to healthy controls (p = 0.02, d = -0.69). Further, football athletes with a history of concussion had significantly thinner cortex in the right central sulcus and precentral gyrus relative to football athletes without a history of concussion (p = 0.03, d = -0.71). No differences were observed between football athletes without a history of concussion and healthy controls. These results suggest that previous concussions, but not necessarily football exposure, may be associated with cortical thickness differences in collegiate football athletes. PMID:26061068
Cao, Cheng; Tutwiler, Richard Laurence; Slobounov, Semyon
There is a growing body of knowledge indicating long-lasting residual electroencephalography (EEG) abnormalities in concussed athletes that may persist up to 10-year postinjury. Most often, these abnormalities are initially overlooked using traditional concussion assessment tools. Accordingly, premature return to sport participation may lead to recurrent episodes of concussion, increasing the risk of recurrent concussions with more severe consequences. Sixty-one athletes at high risk for concussion (i.e., collegiate rugby and football players) were recruited and underwent EEG baseline assessment. Thirty of these athletes suffered from concussion and were retested at day 30 postinjury. A number of task-related EEG recordings were conducted. A novel classification algorithm, the support vector machine (SVM), was applied as a classifier to identify residual functional abnormalities in athletes suffering from concussion using a multichannel EEG data set. The total accuracy of the classifier using the 10 features was 77.1%. The classifier has a high sensitivity of 96.7% (linear SVM), 80.0% (nonlinear SVM), and a relatively lower but acceptable selectivity of 69.1% (linear SVM) and 75.0% (nonlinear SVM). The major findings of this report are as follows: 1) discriminative features were observed at theta, alpha, and beta frequency bands, 2) the minimal redundancy relevance method was identified as being superior to the univariate t -test method in selecting features for the model calculation, 3) the EEG features selected for the classification model are linked to temporal and occipital areas, and 4) postural parameters influence EEG data set and can be used as discriminative features for the classification model. Overall, this report provides sufficient evidence that 10 EEG features selected for final analysis and SVM may be potentially used in clinical practice for automatic classification of athletes with residual brain functional abnormalities following a concussion
Full Text Available ... of safety. B By working with parents, athletes, school and club administrators to spread awareness about concussions all year: pre-season, during the season, and post-season. C ...
Full Text Available ... fully, some will have symptoms that last for days, or even weeks. A more serious concussion can ... level is slowly increased over a period of days, weeks, or months depending on the athletes response ...
Full Text Available ... Fact Sheet Download a Fact Sheet on Overall Sports Safety: Protect the Ones You Love For parents ... Exit Disclaimer] Concussion Educational Materials for all NCAA Sports Download Materials [Exit Disclaimer] Watch a Video or ...
Full Text Available ... recovery or increase the chances for long-term problems. B You cant see a concussion like ... or "pressure" in head Nausea or vomiting Balance problems or dizziness Double or blurry vision Sensitivity to ...
Full Text Available ... QUESTION 1 To help recognize a concussion, you should watch for and ask others to report which ... QUESTION 7 What is the first thing you should do as a coach when one of your ...
Full Text Available ... fingers. B The athlete feels weak, tired, and has stopped sweating. C The athlete states the lights ... Submit POST TEST QUESTION 6 If an athlete has had a previous concussion he or she: A ...
Full Text Available ... at increased risk for another concussion. C Young children and teens are more likely to get a ... following the game or practice-before allowing the child to go home. You should provide information to ...
Full Text Available ... originally aired on January 26th, 2000. For High School Coaches: “Concussion in Sports: What You Need to ... partnership with the National Federation of State High School Associations) Listen to a Radio PSA Coach and ...
Full Text Available ... Matthew Alan Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill May Clinic ... of Health, Physical Education & Recreation Sports Legacy Institute University of Pittsburgh Medical Center, Sports Medicine Concussion Program ...
Full Text Available ... devices. For the best experience use a desktop computer. Touch anywhere to close. Concussion Basics Recognizing A ... vomiting Balance problems or dizziness Double or blurry vision Sensitivity to light Sensitivity to noise Feeling sluggish, ...
Full Text Available ... Communicating Effectively Sports-Specific Information LESSON 1 QUIZ QUESTION 1 A concussion is a type of traumatic ... A True B False Submit LESSON 1 QUIZ QUESTION 2 Which of the following is true? A ...
Full Text Available ... you should watch for and ask others to report which of the following two things among your ... danger signs, of a severe concussion requiring immediate medical attention: 1 One pupil larger than the other ...
Full Text Available ... danger signs, of a severe concussion requiring immediate medical attention: 1 One pupil larger than the other ... etc. and then take the athlete for a medical examination. C Remove the athlete from play and ...
Full Text Available ... not go away 4 Weakness, numbness, or decreased coordination 5 Repeated vomiting or nausea 6 Slurred speech ... DOWNLOAD SPORT-SPECIFIC CONCUSSION INFORMATION Baseball Field Hockey Football Ice Hockey Lacrosse Rugby Soccer Softball Volleyball Play ...
Full Text Available ... Testing FAQs on Baseline Testing Fact Sheet Download a Fact Sheet on Overall Sports Safety: Protect the ... all NCAA Sports Download Materials [Exit Disclaimer] Watch a Video or PSA on Concussion NFL PSA on ...
Full Text Available ... move rapidly back and forth. A True B False Submit LESSON 1 QUIZ QUESTION 2 Which of ... last for months or longer. A True B False Submit POST TEST QUESTION 1 A concussion is ...
Full Text Available ... devices. For the best experience use a desktop computer. Touch anywhere to close. Concussion Basics Recognizing A ... National Education Association National Education Association Health Information Network National Federation of State High School Associations National ...
Concussions are frequent in contact sports. Clinical symptoms, cognitive impairment, neurobehavioral features can be present. Loss of consciousness is rare. If suspicion, the player must be removed from the game. Return to play is gradual; it may be possible only if the sportsman is asymptomatic. Strict application of the rules of the game, fair play can decrease the incidence of concussion. SCAT (pocket, SCAT 3, SCAT Child) should be used as a help to diagnosis and follow up. PMID:25141566
Stein, Cynthia J; Kinney, Susan A; McCrystal, Tara; Carew, Elizabeth A; Bottino, Nicole M; Meehan Iii, William P; Micheli, Lyle J
Sport-related concussion is a topic of increasing public and media attention; the medical literature on this topic is growing rapidly. However, to our knowledge no published papers have described concussion specifically in the dancer. This case series involved a retrospective chart review at a large teaching hospital over a 5.5-year period. Eleven dancers (10 female, 1 male) were identified who experienced concussions while in dance class, rehearsal, or performance: 2 in classical ballet, 2 in modern dance, 2 in acro dance, 1 in hip hop, 1 in musical theater, and 3 were unspecified. Dancers were between 12 and 20 years old at the time of presentation. Three concussions occurred during stunting, diving, or flipping. Three resulted from unintentional drops while partnering. Two followed slips and falls. Two were due to direct blows to the head, and one dancer developed symptoms after repeatedly whipping her head and neck in a choreographed movement. Time to presentation in the sports medicine clinic ranged from the day of injury to 3 months. Duration of symptoms ranged from less than 3 weeks to greater than 2 years at last documented follow-up appointment. It is concluded that dancers do suffer dance-related concussions that can result in severe symptoms, limitations in dance participation, and difficulty with activities of daily living. Future studies are needed to evaluate dancers' recognition of concussion symptoms and care-seeking behaviors. Additional work is also necessary to tailor existing guidelines for gradual, progressive, safe return to dance. PMID:24844421
Grant L. Iverson
Full Text Available Background. The literature on lingering or “cumulative” effects of multiple concussions is mixed. The purpose of this study was to examine whether athletes with a history of three or more concussions perform more poorly on neuropsychological testing or report more subjective symptoms during a baseline, preseason evaluation. Hypothesis. Athletes reporting three or more past concussions would perform more poorly on preseason neurocognitive testing. Study Design. Case-control study. Methods. An archival database including 786 male athletes who underwent preseason testing with a computerized battery (ImPACT was used to select the participants. Twenty-six athletes, between the ages of 17 and 22 with a history of three or more concussions, were identified. Athletes with no history of concussion were matched, in a case-control fashion, on age, education, self-reported ADHD, school, sport, and, when possible, playing position and self-reported academic problems. Results. The two groups were compared on the four neuropsychological composite scores from ImPACT using multivariate analysis of variance followed by univariate ANOVAs. MANOVA revealed no overall significant effect. Exploratory ANOVAs were conducted using Verbal Memory, Visual Memory, Reaction Time, Processing Speed, and Postconcussion Scale composite scores as dependent variables. There was a significant effect for only the Verbal Memory composite. Conclusions. Although inconclusive, the results suggest that some athletes with multiple concussions could have lingering memory deficits.
Covassin, Tracey; Swanik, C Buz; Sachs, Michael L
The purpose of this study was to examine epidemiological trends of concussions among 15 different intercollegiate sports during the 1997-1998, 1998-1999, and 1999-2000 seasons. Data were collected using the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS). For the 15 sports studied during the 3 academic years, the NCAA ISS documented 3,535 team-seasons, 40,547 reportable injuries, 5,566,924 practice athlete exposures (AEs), and 1,090,298 game AEs. Concussions accounted for 6.2% of all reported injuries during this 3-year study. Of all the reported injuries, women lacrosse players (13.9%) reported the highest percentage of suffering a concussion during a game followed by women's soccer (11.4%), men's ice hockey (10.3%), men's lacrosse (10.1%), football (8.8%), women's basketball, (8.5%), field hockey (7.2%), men's soccer (7.0%), wrestling (6.6%), men's basketball (5.0%), baseball (4.2%), and women's volleyball (4.1%). Female athletes from all 7 sports were found to be at a lower risk for suffering concussions during practice sessions than the 8 male sports. However, female athletes were found to be at a greater risk for suffering concussions during games compared to male athletes. Injury trends over the 3- year period indicate concussions continue to be on the rise for athletes participating in collegiate football, men's soccer, and women's and men's basketball. PMID:12734071
... or federal policy. More Health News on: Concussion Sports Injuries Recent Health News Related MedlinePlus Health Topics Concussion Sports Injuries About MedlinePlus Site Map FAQs Contact Us Get ...
... Concussion Tied to More School Problems Than Other Sports Injuries Study suggests need for 'return-to-learn' guidelines ... more school difficulties than their peers with other sports-related injuries, a new study suggests. Researchers found that concussed ...
... other experts agreed that family doctors have a role to play in concussion care. "This study demonstrates the importance of incorporating the primary physician in the treatment team as our youth work through concussion," said Dr. ...
... 159802.html Concussion Rates Have Doubled Among U.S. Kids Report can't determine whether trend signals more ... News) -- Concussion rates are rising sharply among U.S. kids and teens, researchers report. The study, which looked ...
Keightley, Michelle L; Saluja, Rajeet Singh; Chen, Jen-Kai; Gagnon, Isabelle; Leonard, Gabriel; Petrides, Michael; Ptito, Alain
Abstract In children, the importance of detecting deficits after mild traumatic brain injury (mTBI) or concussion has grown with the increasing popularity of leisure physical activities and contact sports. Whereas most postconcussive symptoms (PCS) are similar for children and adults, the breadth of consequences to children remains largely unknown. To investigate the effect of mTBI on brain function, we compared working memory performance and related brain activity using blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) in 15 concussed youths and 15 healthy age-matched control subjects. Neuropsychological tests, self-perceived PCS, and levels of anxiety and depression were also assessed. Our results showed that, behaviorally, concussed youths had significantly worse performances on the working memory tasks, as well as on the Rey figure delayed recall and verbal fluency. fMRI results revealed that, compared to healthy children, concussed youths had significantly reduced task-related activity in bilateral dorsolateral prefrontal cortex, left premotor cortex, supplementary motor area, and left superior parietal lobule during performance of verbal and nonverbal working memory tasks. Additionally, concussed youths also showed less activation than healthy controls in the dorsal anterior cingulate cortex, left thalamus, and left caudate nucleus during the nonverbal task. Regression analysis indicated that BOLD signal changes in bilateral dorsolateral prefrontal cortex were significantly correlated with performance such that greater activities in these regions, relative to the control condition, were associated with greater accuracy. Our findings confirmed functional alterations in brain activity after concussion in youths, a result similar to that observed in adults. However, significant differences were noted. In particular, the observation of reduced working memory accuracy suggests that youths may be unable to engage compensatory
Objectives: To examine the association between concussion duration and two calcium channel, voltage-dependent, R type, alpha 1E subunit (CACNA1E) single nucleotide polymorphisms (i.e., rs35737760 and rs704326). A secondary purpose was to examine the association between CACNA1E single nucleotide polymorphisms (SNPs) and three acute concussion severity scores (i.e., vestibule-ocular reflex test, balance error scoring scale, and Immediate Post-Concussion Assessment and Cognitive Testing). Methods: Forty athletes with a diagnosed concussion from a hospital concussion program completed a standardized initial evaluation. Concussion injury characteristics, acute signs and symptoms followed by an objective screening (i.e., vestibular ocular assessments, balance error scoring system test, and Immediate Post-Concussion Assessment and Cognitive Testing exam) were assessed. Enrolled participants provided salivary samples for isolation of DNA. Two exon SNPs rs35737760 and rs704326 within CACNA1E were genotyped. Results: There was a significant difference found between acute balance deficits and prolonged recovery group (X2 = 5.66, p = 0.017). There was an association found between the dominant model GG genotype (X2 = 5.41, p = 0.027) within the rs704326 SNP and prolonged recovery group. Significant differences were identified for the rs704326 SNP within the dominant model GG genotype (p = 0.030) for VOR scores by recovery. A significant difference was found between the rs704326 SNP codominant model AA (p = 0.042) and visual memory. There was an association between acute balance deficits and prolonged recovery (X2 = 5.66, p = 0.017) for the rs35737760 SNP. No significant associations between concussion severity and genotype for rs35737760 SNP. Conclusion: Athletes carrying the CACNA1E rs704326 homozygous genotype GG are at a greater risk of a prolonged recovery. Athletes that reported balance deficits at the time of injury were more likely to have prolonged recovery. These
Kroshus, Emily; Garnett, Bernice R.; Baugh, Christine M.; Calzo, Jerel P.
Concussion underreporting contributes to the substantial public health burden of concussions from sport. Teammates may be able to play an important role in encouraging injury identification and help seeking. This study assessed whether there was an association between beliefs about the consequences of continued play with a concussion and…
Ashley; Littleton; Kevin; Guskiewicz
Sport-related concussion is a common neurological injury that occurs in all levels of athletic participation.Concussions may actually go undiagnosed,as they do not always display outward signs and athletes may fail to report symptoms of concussion,either because they do not know the symptoms,or for fear of removal from play.Inappropriate management of concussion can lead to increased risk of subsequent injury.This article outlines various aspects of sport-related concussion management,including preparation/planning,education,evaluation,management,return to play decisions,and long term effects of concussion.Preparation and education are the first steps that must be taken to minimize the potentially negative consequences of concussion.If a concussion is suspected,it must be stressed that the evaluation should include a multifaceted approach,with a physical examination and assessment of signs and symptoms,neurocognition and balance.The management of concussion should include both physical and cognitive rest and factors such as transportation,sleep,work,and academics should be taken into consideration.Return to play following concussion should follow a graduated return to play protocol,with careful monitoring of symptoms.Sports medicine clinicians should stay up to date with information regarding concussion management and take a conservative approach,because there are recent reports of various cumulative effects of multiple concussions.
Keightley, Michelle L.; Singh Saluja, Rajeet; Chen, Jen-Kai; Gagnon, Isabelle; Leonard, Gabriel; Petrides, Michael; Ptito, Alain
In children, the importance of detecting deficits after mild traumatic brain injury (mTBI) or concussion has grown with the increasing popularity of leisure physical activities and contact sports. Whereas most postconcussive symptoms (PCS) are similar for children and adults, the breadth of consequences to children remains largely unknown. To investigate the effect of mTBI on brain function, we compared working memory performance and related brain activity using blood-oxygen-level–dependent (...
Full Text Available Sarah L StrandDepartment of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, USAAbstract: The objective of this case study was to identify the signs and symptoms of concussion and post-concussive syndrome in a collegiate, female basketball player, as well as her progress to becoming symptom free. The patient, a previously healthy, 21-year-old with no previous head injuries, experienced a concussion and continued to participate in her sport. Even though the athlete knew the risks of playing while symptomatic, she did not report her symptoms, and continued playing until the season ended. This case highlights that even when patients know the risks, they may be willing to overlook them to continue playing and it emphasizes the importance of further education. In addition, it shows that even when following recommended guidelines, and with normal neurocognitive testing, symptoms may come back upon return to play.Keywords: concussion, basketball, mild traumatic brain injury, female athletes
Namjoshi, Dhananjay R; Cheng, Wai Hang; Carr, Michael; Martens, Kris M; Zareyan, Shahab; Wilkinson, Anna; McInnes, Kurt A; Cripton, Peter A; Wellington, Cheryl L
Concussion is a serious health concern. Concussion in athletes is of particular interest with respect to the relationship of concussion exposure to risk of chronic traumatic encephalopathy (CTE), a neurodegenerative condition associated with altered cognitive and psychiatric functions and profound tauopathy. However, much remains to be learned about factors other than cumulative exposure that could influence concussion pathogenesis. Approximately 20% of CTE cases report a history of substance use including androgenic-anabolic steroids (AAS). How acute, chronic, or historical AAS use may affect the vulnerability of the brain to concussion is unknown. We therefore tested whether antecedent AAS exposure in young, male C57Bl/6 mice affects acute behavioral and neuropathological responses to mild traumatic brain injury (TBI) induced with the CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration) platform. Male C57Bl/6 mice received either vehicle or a cocktail of three AAS (testosterone, nandrolone and 17α-methyltestosterone) from 8-16 weeks of age. At the end of the 7th week of treatment, mice underwent two closed-head TBI or sham procedures spaced 24 h apart using CHIMERA. Post-repetitive TBI (rTBI) behavior was assessed for 7 d followed by tissue collection. AAS treatment induced the expected physiological changes including increased body weight, testicular atrophy, aggression and downregulation of brain 5-HT1B receptor expression. rTBI induced behavioral deficits, widespread axonal injury and white matter microgliosis. While AAS treatment did not worsen post-rTBI behavioral changes, AAS-treated mice exhibited significantly exacerbated axonal injury and microgliosis, indicating that AAS exposure can alter neuronal and innate immune responses to concussive TBI. PMID:26784694
... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 41. Kerr HA. Closed head ... Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 710. Liebig CW, Congeni JA. Sports- ...
Brown, Jeffrey A.; Dalecki, Marc; Hughes, Cindy; MacPherson, Alison K.; Sergio, Lauren E.
Background The ability to perform visually-guided motor tasks requires the transformation of visual information into programmed motor outputs. When the guiding visual information does not align spatially with the motor output, the brain processes rules to integrate the information for an appropriate motor response. Here, we look at how performance on such tasks is affected in young adult athletes with concussion history. Methods Participants displaced a cursor from a central to peripheral tar...
Kriel, Martha Getruida
Rugby is a popular sport in South Africa, and has been played by young boys from as early as seven years old (South African Rugby Union [SARU], 2011). Despite various physical health benefits, it carries a high risk for injury, especially head injury, and consequently has a high incidence of concussion (Alexander, 2009; Laubscher, 2006; Shuttleworth-Edwards, Smith & Radloff, 2008). It is common for 12 to 13 per cent of adolescent rugby players to report mild traumatic brain injury or concussi...
Kontos, Anthony P; Sufrinko, Alicia; Womble, Melissa; Kegel, Nathan
Neuropsychological evaluation is one component of a comprehensive and multifaceted assessment following concussion. Although some neuropsychologists use a "hybrid" assessment approach integrating computerized neurocognitive testing batteries with traditional paper and pencil tests, computerized neurocognitive test batteries are the predominant testing modality for assessment of athletes from the youth to professional level. This review summarizes the most recent research supporting the utility of neuropsychological evaluation and highlights the strengths and weaknesses of both computerized and traditional neuropsychological testing approaches. The most up to date research and guidelines on baseline neurocognitive testing is also discussed. This paper addresses concerns regarding reliability of neuropsychological testing while providing an overview of factors that influence test performance, both transient situational factors (e.g., pain level, anxiety) and characteristics of particular subgroups (e.g., age, preexisting learning disabilities), warranting the expertise of an experienced neuropsychologist for interpretation. Currently, research is moving forward by integrating neuropsychological evaluation with emerging assessment approaches for other domains of brain function (e.g., vestibular function) vulnerable to concussion. PMID:27099226
Pleacher, M D; Dexter, W W
Objective To assess current concussion management practices of primary care providers. Methods An 11 item questionnaire was mailed to primary care providers in the state of Maine, with serial mailings to non‐respondents. Results Over 50% of the questionnaires were completed, with nearly 70% of primary care providers indicating that they routinely use published guidelines as a tool in managing patients with concussion. Nearly two thirds of providers were aware that neuropsychological tests could be used, but only 16% had access to such tests within a week of injury. Conclusions Primary care providers are using published concussion management guidelines with high frequency, but many are unable to access neuropsychological testing when it is required. PMID:16371479
Steven P. Broglio
Full Text Available The purpose of the study was to investigate concussion history, knowledge, injury identification, and management strategies among athletes, coaches, and medical staff in Italian club level football (soccer clubs. Surveys (N=727 were distributed among Italian football clubs. Athletes' surveys were designed to evaluate athlete knowledge of concussive signs and symptoms and injury reporting. Coaches' surveys explored the understanding of concussive signs and symptoms and management practices. Medical staff surveys explored the standard of care regarding concussions. A total of 342 surveys were returned, for a 47% response rate. Descriptive analyses indicated 10% of athletes sustaining a concussion in the past year and 62% of these injuries were not reported, primarily due to the athletes not thinking the injury was serious enough. Coaches consistently identified non-concussion related symptoms (98.7%, but were unable to identify symptoms associated with concussion (38.9%. Most understood that loss of consciousness is not the sole indicator of injury (82.6%. Medical staff reported a heavy reliance on the clinical exam (92% and athlete symptom reports (92% to make the concussion diagnosis and return to play decision, with little use of neurocognitive (16.7% or balance (0.0% testing. Italian football athletes appear to report concussions at a rate similar to American football players, with a slightly higher rate of unreported injuries. Most of these athletes were aware they were concussed, but did not feel the injury was serious enough to report. Although coaches served as the primary person to whom concussions were reported, the majority of coaches were unable to accurately identify concussion related symptoms. With little use for neurocognitive and postural control assessments, the medical personnel may be missing injuries or returning athletes to play too soon. Collectively, these findings suggest that athletes, coaches, and medical personnel would
Full Text Available ... 2:00 minutes] Read more about Tracy's Story [PDF 187KB] Keeping Quiet Can Keep You Out of ... MATERIALS "Heads Up: Concussion in Youth Sports" flyer [PDF 104KB] Web Button Web Banner Slideshow [PDF 775KB] ...
Full Text Available ... and parents “Heads Up” for school nurses, parents, teachers, counselors, and other school professionals “Heads Up” for ... Up! Prevent Concussions Prevent Head Injuries Sports Safety Students Play Safe Youth Sports Safety PROMOTIONAL MATERIALS "Heads ...
Full Text Available ... How do you identify a concussion? A By looking at CT or MRI scans of an individuals ... or practice-before allowing the child to go home. You should provide information to the parents regarding ...
Full Text Available ... 9 Increasing confusion, restlessness, or agitation 10 Unusual behavior 11 Loss of consciousness Submit LESSON 4 QUIZ QUESTION 1 After sustaining a concussion, you speak with a health care professional regarding your athletes condition and it ...
Full Text Available ... from the first concussion can slow recovery or increase the chances for long-term problems. B You ... B Start light aerobic exercise, but only to increase an athletes heart rate–meaning 5-10 minutes ...
Hehar, Harleen; Yu, Katrina; Ma, Irene; Mychasiuk, Richelle
In an attempt to improve current understanding of risk factors that influence individual susceptibility to poor outcomes following mild traumatic brain injury (mTBI) or concussion, this project investigated whether modifications to paternal experiences (Advanced Age (AA) or High-Fat Diet (HFD)) affected offspring susceptibility to behavioral symptomology and changes in gene expression following pediatric concussion in a rodent model. The study demonstrated that paternal treatment prior to conception altered behavioral outcomes and molecular characterization of offspring. Offspring of AA fathers demonstrated abnormal behavioral performance when compared to offspring of control fathers. Similarly, paternal HFD altered pathophysiological outcomes for offspring, contributing to the heterogeneity in post-concussion syndrome. Additionally, this study provided insight into the mechanisms that mediate non-genetic paternal inheritance. Paternal treatment and the mTBI significantly influenced expression of a majority of the genes under examination in the prefrontal cortex, hippocampus, and nucleus accumbens, with changes being dependent upon sex and the brain region examined. These epigenetic changes may have contributed to the differences in offspring susceptibility to concussion. PMID:27365176
Joshua M. Williams; Jody L. Langdon; James L. McMillan; Thomas A. Buckley
Background: Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods: Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0–25) and attitude (15–75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results: The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11–22) and the attitude score was 59.6 ± 8.5 (range 41–71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion: The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers.
Ashbaugh, Andrew; McGrew, Christopher
There has been considerable research conducted in regard to the prevention and treatment of concussions. Numerous supplements and vitamins are being used throughout the country to help patients recover from concussions; however, to date, there are no completed human-based studies specifically examining supplement and vitamin use for the treatment or prevention of concussions. This article examines the most current evidence regarding supplements and vitamins for the treatment and prevention of concussions. The supplements and vitamins reviewed include omega-3 fatty acids, curcumin, resveratrol, melatonin, creatine, and Scutellaria baicalensis. PMID:26745164
Goswami, R; Dufort, P; Tartaglia, M C; Green, R E; Crawley, A; Tator, C H; Wennberg, R; Mikulis, D J; Keightley, M; Davis, Karen D
The frontotemporal cortical network is associated with behaviours such as impulsivity and aggression. The health of the uncinate fasciculus (UF) that connects the orbitofrontal cortex (OFC) with the anterior temporal lobe (ATL) may be a crucial determinant of behavioural regulation. Behavioural changes can emerge after repeated concussion and thus we used MRI to examine the UF and connected gray matter as it relates to impulsivity and aggression in retired professional football players who had sustained multiple concussions. Behaviourally, athletes had faster reaction times and an increased error rate on a go/no-go task, and increased aggression and mania compared to controls. MRI revealed that the athletes had (1) cortical thinning of the ATL, (2) negative correlations of OFC thickness with aggression and task errors, indicative of impulsivity, (3) negative correlations of UF axial diffusivity with error rates and aggression, and (4) elevated resting-state functional connectivity between the ATL and OFC. Using machine learning, we found that UF diffusion imaging differentiates athletes from healthy controls with significant classifiers based on UF mean and radial diffusivity showing 79-84 % sensitivity and specificity, and 0.8 areas under the ROC curves. The spatial pattern of classifier weights revealed hot spots at the orbitofrontal and temporal ends of the UF. These data implicate the UF system in the pathological outcomes of repeated concussion as they relate to impulsive behaviour. Furthermore, a support vector machine has potential utility in the general assessment and diagnosis of brain abnormalities following concussion. PMID:25721800
Conclusions: The feasibility of SCT use in Guam high school football was established and our pilot study identified areas for improvement. Established definitions of concussion and RTP guidelines were lacking. Therefore, an opportunity exists through public health efforts that involve the entire community to increase concussion awareness and reduce injuries in high school sports on Guam.
Faure, Caroline; Pemberton, Cynthia Lee A.
One in six high school football players in the United States will sustain a concussion at some point during their playing career. The consequences of concussion can be catastrophic, especially since the symptoms are rarely visible and often overlooked. To ensure the safety of athletes in youth and interscholastic sports programs, having Certified…
Diaz, Anne L.; Wyckoff, Leah J.
It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as school nurse) is an essential member of the team addressing concussions. As the school-based clinical professional on the team, the school nurse has the knowledge and skills to provide concussion prevention…
Kroshus, Emily; Garnett, Bernice R; Baugh, Christine M; Calzo, Jerel P
Concussion underreporting contributes to the substantial public health burden of concussions from sport. Teammates may be able to play an important role in encouraging injury identification and help seeking. This study assessed whether there was an association between beliefs about the consequences of continued play with a concussion and intentions to engage as a proactive bystander in facilitating or encouraging teammate help seeking for a possible concussion. Participants were 328 (male and female) members of 19 U.S. collegiate contact or collision sports teams. Athletes who believed that there were negative health or performance consequences of continued play with a concussion were significantly more likely than their peers to intend to encourage teammate help seeking, but not more likely to alert a coach or medical personnel. Additionally, athletes who believed that their teammates were more supportive of concussion safety were more likely to intend to engage as proactive bystanders in encouraging teammate help seeking. Exploring how to encourage bystander promotion of concussion safety is an important direction for future programming and evaluation research and may provide an opportunity to improve the effectiveness of concussion education. PMID:27405801
Ferullo, Shawn M; Green, Alysia
Don't allow an athlete who has symptoms at rest or with exertion to return to play. Consider neuropsychological testing in conjunction with continued clinical assessment for objective measurements to assist in managing concussion. Recommend up-to-date protective equipment for athletes. Recent improvements, especially in football, have been shown to help decrease the incidence of concussion. PMID:20714451
Covassin, Tracey; Elbin, R. J.; Sarmiento, Kelly
Background: Concussions remain a serious public health concern. It is important that persons involved in youth sports, particularly coaches, be made aware and educated on the signs and symptoms of concussion. This study assessed the perceptions of youth sport coaches who have received the Centers for Disease Control and Prevention's…
The most common head injury in sports is concussion and experiencing multiple concussions in a short period of time sometimes can cause severe brain damage. In this paper, we investigate severe brain damage due to repeated head injury in sports and discuss the pathophysiology of repeated sports injury. The majority of these severe cases are usually male adolescents or young adults that suffer a second head injury before they have recovered from the first head injury. All cases that could be confirmed by brain CT scan after the second injury revealed brain swelling associated with a thin subdural hematoma. We suggested that the existence of subdural hematoma is one of the major causes of brain swelling after repeated head injury in sports. Since repeated concussions occurring within a short period may have a risk for severe brain damage, the diagnosis for initial cerebral concussion should be done appropriately. To prevent catastrophic brain damage, the player who suffered from concussion should not engage in any sports before recovery. The american Academy of Neurology and Colorado Medical Society set a guideline to return to play after cerebral concussion. An international conference on concussion in sports was held at Prague in 2004. The summary and agreement of this meeting was published and the Sports Concussion Assessment Tool (SCAT) was introduced to treat sports-related concussion. In addition, a number of computerized cognitive assessment tests and test batteries have been developed to allow athletes to return to play. It is important that coaches, as well as players and trainers, understand the medical issues involved in concussion. (author)
... inflicted traumatic brain injury (ITBI), is a leading cause of child maltreatment deaths in the United States. Meeting the ... Awareness Additional Prevention Resources Childhood Injuries Concussion in Children and Teens Injuries from Violence Injuries from Motor Vehicle Crashes Teen Driver Safety ...
Jarrett, Michael; Tam, Roger; Hernández-Torres, Enedino; Martin, Nancy; Perera, Warren; Zhao, Yinshan; Shahinfard, Elham; Dadachanji, Shiroy; Taunton, Jack; Li, David K.B.; Rauscher, Alexander
Traumatic brain injury (TBI) is among the most common neurological disorders. Hemorrhagic lesions and white matter hyperintensities (WMH) are radiological features associated with moderate and severe TBI. Brain volume reductions have also been observed during the months following injury. In concussion, no signs of injury are observed on conventional magnetic resonance imaging (MRI), which may be a true feature of concussion or merely due to the limited sensitivity of imaging techniques used s...
McIntyre, Lauren; Liederbach, Marijeanne
Despite recent improvements in their concussion knowledge, athletes still demonstrate risky concussion behaviors (e.g., playing while concussed or not reporting a concussion). Little has been published about dancers' concussion knowledge and behaviors, but research in dance contending with questions about injury in general has found that dancers often avoid physician consults and ignore the signs of injury. In the present study, an IRB approved anonymous online survey, it was hypothesized that dancers would demonstrate concussion knowledge deficits, fail to report concussions, and have difficulty adhering to management guidelines. In addition, it was hypothesized that dancers in companies or schools with an onsite health care practitioner present would demonstrate improved concussion knowledge and safer concussion behaviors compared with those that do not have onsite health care. Concussion knowledge and behavior questions were modified for a dance sample based on validated sports-specific tools developed by other investigators. One hundred fifty-three subjects were recruited to complete the survey from an urban orthopaedic clinic specializing in dance medicine and via Facebook, email, and newsletter announcements. Dancers in this sample had good foundational knowledge of concussion; however, this knowledge did not correlate with safe, self-reported concussion care behaviors. Future research should focus on determination of dance-specific barriers to practicing safe behaviors and seeking care for concussive injury, as well as further identifying dance concussion epidemiology and outcomes. PMID:27245947
As many as 3.8 million sports- and recreation-related concussions are estimated to occur in the United States each year. This podcast is a radio interview with CDC's Dr. Julie Gilchrist on the newly available âHeads Up: Concussion in Youth Sports" tool kit, which was developed to provide information to coaches, parents, and athletes involved in youth sports on preventing, recognizing, and responding to a concussion. Created: 5/21/2007 by National Center for Injury Prevention and Control, Division of Injury Response. Date Released: 10/31/2007.
Broglio, Steven P.; Ferrara, Michael S.; Macciocchi, Stephen N.; Baumgartner, Ted A; Elliott, Ronald
Context: Computer-based neurocognitive assessment programs commonly are used to assist in concussion diagnosis and management. These tests have been adopted readily by many clinicians based on existing test-retest reliability data provided by test developers.
... Concussion Tied to More School Problems Than Other Sports Injuries Study suggests need for 'return-to-learn' ... more school difficulties than their peers with other sports-related injuries, a new study suggests. Researchers found ...
... gov/medlineplus/news/fullstory_158603.html High School Football Players Suffer More Symptoms After Concussion: Study Meanwhile, ... MONDAY, May 2, 2016 (HealthDay News) -- High school football players are more likely to suffer more symptoms ...
McCrea, Michael; Guskiewicz, Kevin
Concussion is not only one of the most common injuries encountered by athletes participating in contact and collision sports, but also among the most complex injuries to manage in a sports medicine setting. Over the past two decades, we have made great progress in advancing the basic and clinical science of concussion. These advances have had enormous clinical translational value for developing evidence-based guidelines for management of concussion in sports. Applied clinical research has clarified the defining characteristics of sport-related concussion (SRC) that support new diagnostic criteria. At the same time, major advancements have been realized in the development and validation of clinical tools that allow a more objective and accurate assessment of concussion and performance-based measures of recovery. These tools provide clinicians with a more informed basis for determining an athlete's cognitive and physical fitness to return to competition after concussion. Standardized injury management protocols that systematically prescribe rest, graded activity, and return to play have been adopted in nearly all clinical settings. Herein, we briefly summarize the findings and recommendations from several national and international consensus guidelines and position statements on best practice in the evaluation and management of SRC. PMID:24923397
Shapcott, Erin J B; Bloom, Gordon A; Johnston, Karen M; Loughead, Todd M; Delaney, J Scott
Individuals with an optimistic explanatory style have generally been linked with improved mental and physical health across a variety of chronic and serious conditions. The purpose of the current study was to examine the effects of explanatory style on recovery time and number of sport-related concussions suffered in the last 12 months. University varsity athletes (n=170) suffering from at least one concussion over the last 12 months from six contact or collision team sports completed both the Attributional Style Questionnaire and the Sport History Questionnaire. The results indicated that athletes with an optimistic explanatory style took longer to recover than athletes with a pessimistic or average explanatory style. More specifically, optimistic athletes who suffered a complex concussion (requiring more than 7 days to recover) took significantly longer to return to play. However, the results showed that explanatory style did not influence whether an athlete suffered subsequent concussions. Overall, the current results can be used to better understand the psychology of concussions, as well as concussion prevention efforts and management strategies. PMID:17917166
Notebaert, Andrew J; Guskiewicz, Kevin M
Context: Athletic trainers surveyed in 1999 demonstrated little consensus on the use of concussion grading scales and return-to-play criteria. Most relied on clinical examination or symptom checklists to evaluate athletes with concussion.
R.J.Elbin; Tracey Covassin
@@ Sport-related concussion remains a hot topic in the field of sport medicine as recent estimates indicate approximately 1.6 to 3 million concussions occur in sport and recreation every year in the United States.
Menger, Richard; Menger, Austin; Nanda, Anil
OBJECTIVE Multiple studies have illustrated that rugby headgear offers no statistically significant protection against concussions. However, there remains concern that many players believe rugby headgear in fact does prevent concussions. Further investigation was undertaken to illustrate that misconceptions about concussion prevention and rugby headgear may lead to an increase in aggressive play. METHODS Data were constructed by Internet survey solicitation among United States collegiate rugby players across 19 teams. Initial information given was related to club, age, experience, use of headgear, playing time, whether the rugger played football or wrestling in high school, and whether the player believed headgear prevented concussion. Data were then constructed as to whether wearing headgear would increase aggressive playing style secondary to a false sense of protection. RESULTS A total of 122 players responded. All players were male. The average player was 19.5 years old and had 2.7 years of experience. Twenty-three of 122 players (18.9%) wore protective headgear; 55.4% of players listed forward as their primary position. Overall, 45.8% (55/120) of players played 70-80 minutes per game, 44.6% (54/121) played football or wrestled in high school, 38.1% (45/118) believed headgear prevented concussions, and 42.2% (51/121) stated that if they were using headgear they would be more aggressive with their play in terms of running or tackling. Regression analysis illustrated that those who believed headgear prevented concussions were or would be more likely to engage in aggressive play (p = 0.001). CONCLUSIONS Nearly 40% of collegiate rugby players surveyed believed headgear helped to prevent concussions despite no scientific evidence that it does. This misconception about rugby headgear could increase aggressive play. Those who believed headgear prevented concussion were, on average, 4 times more likely to play with increased aggressive form than those who believed
Chinn, Nancy Resendes; Porter, Paul
The seriousness of concussions in athletics is only recently becoming fully understood and appreciated. There are significant implications for the concussed student-athlete both in returning to the playing field and the classroom. Although practices are now in place to improve identification and management of concussions in professional sports,…
Shultz, Sandy R; MacFabe, Derrick F; Foley, Kelly A; Taylor, Roy; Cain, Donald P
Brain concussion is a serious public health concern and is associated with short-term cognitive impairments and behavioral disturbances that typically occur in the absence of significant brain damage. The current study addresses the need to better understand the effects of a mild lateral fluid percussion injury on rat behavior and neuropathology in an animal model of concussion. Male Long-Evans rats received either a single mild fluid percussion injury or a sham-injury, and either a short (24h) or long (4 weeks) post-injury recovery period. After recovery, rats underwent a detailed behavioral analysis consisting of tests for rodent anxiety, cognition, social behavior, sensorimotor function, and depression-like behavior. After testing all rats were sacrificed and brains were examined immunohistochemically with markers for microglia/macrophage activation, reactive astrocytosis, and axonal injury. Injured rats (mean injury force: 1.20 ±.03 atm) displayed significant short-term cognitive impairments in the water maze and significantly more anxiolytic-like behavior in the elevated-plus maze compared to sham controls. Neuropathological analysis of the brains of injured rats showed an acute increase in reactive astrogliosis and activated microglia in cortex and evidence of axonal injury in the corpus callosum. There were no significant long-term effects on any behavioral or neuropathological measure 4 weeks after injury. These short-term behavioral and neuropathological changes are consistent with findings in human patients suffering a brain concussion, and provide further evidence for the use of a single mild lateral fluid percussion injury to study concussion in the rat. PMID:21704658
Full Text Available ... Program Brain Injury Association of America Brain Trauma Foundation Center for Injury Research and Policy, the Research ... Kids Worldwide Safe States Alliance Sarah Jane Brain Foundation Society of State Directors of Health, Physical Education & ...
Maerlender, Arthur; Nelson, Jennifer Mize; Honaker, Julie A
In sports concussion research, obtaining quality data from a sufficient number of participants to reach statistical power has been a particular problem. In addition, the necessary requirements of accessibility, informed consent, and confidentiality must be met. There is need to develop more efficient and controlled methods for collecting data to answer research questions in this realm, but the ability to collect and store these data in an efficient manner at the local level is limited. By virtue of their training, neuropsychologists can play a key role in improving data collection quality. The purpose of this paper is to describe a data repository that has been developed in the context of a university sports medicine concussion management program that includes baseline and postinjury data from student athletes. Diagnostic information, basic health information, current symptoms, neuropsychological test data, balance and vestibular data, and visual processing data are currently included in the standard of care for athletes; however, the process described need not be limited to these types of data. While a national traumatic brain injury (TBI) data repository has been developed by the National Institute of Health (NIH), local repositories have not yet become common. Thus, the description of this project is of value at the local level in the United States and internationally. PMID:27396292
Popoli, David Michael; Burns, Thomas G; Meehan, William P; Reisner, Andrew
Concussion research generally centers on physical challenges, though aspects such as social functioning and returning to school also warrant attention in pediatric populations. Restoring academic performance postconcussion remains a challenge. Here we provide recommendations addressing a uniform policy for pediatric concussion patients in academic institutions. Tools that may minimize difficulty with academic re-entry include independent educational evaluations, individualized educational programs (IEPs), student support teams (SSTs), letters of academic accommodation, time off, and 504 Plans. Recognition and treatment is crucial for symptom relief and prevention of functional disruption, as is specialist referral during the acute window. We recommend early intervention with a letter of academic accommodation and SST and suggest that 504 Plans and IEPs be reserved for protracted or medically complicated cases. Students with concussion should be observed for anxiety and depression because these symptoms can lead to prolonged recovery, decreased quality of life, and other social challenges. PMID:23960266
... will return after updating. Resources Archived Modules Updates Brain Cerebrum The cerebrum is the part of the ... the outside of the brain and spinal cord. Brain Stem The brain stem is the part of ...
Full Text Available ... Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma Foundation Center for Injury Research and Policy, the Research Institute at Nationwide Children's ...
Full Text Available ... and then take the athlete for a medical examination. C Remove the athlete from play and look ... Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma ...
Full Text Available ... Research and Policy, the Research Institute at Nationwide Children's Hospital Children's National Medical Center Defense and Veterans Brain Injury ... Association Health Resources and Services Administration, EMS for Children Health Resources Services Administration, Traumatic Brain Injury Program ...
Full Text Available ... Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma ... School Principals National Council for Youth Sports National Education Association National Education Association Health Information Network National ...
Full Text Available ... American Academy of Physical Medicine and Rehabilitation American College of Sports Medicine American Medical Society for Sports Medicine American School Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma ...
Full Text Available ... You will need a score of 80% or higher to pass. Please review the lessons and then ... Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma ...
Brooks, Brian L; McKay, Carly D; Mrazik, Martin; Barlow, Karen M; Meeuwisse, Willem H; Emery, Carolyn A
The existing literature on lingering effects from concussions in children and adolescents is limited and mixed, and there are no clear answers for patients, clinicians, researchers, or policy makers. The purpose of this study was to examine whether there are lingering effects of past concussions in adolescent athletes. Participants in this study included 643 competitive Bantam and Midget hockey players (most elite 20% by division of play) between 13 and 17 years of age (mean age=15.5, SD=1.2). Concussion history at baseline assessment was retrospectively documented using a pre-season questionnaire (PSQ), which was completed at home by parents and players in advance of baseline testing. Players with English as a second language, self-reported attention or learning disorders, a concussion within 6 months of baseline, or suspected invalid test profiles were excluded from these analyses. Demographically adjusted standard scores for the five composites/domains and raw symptom ratings from the brief Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computerized battery were analyzed. Adolescent athletes with one or two or more prior concussions did not have significantly worse neurocognitive functioning on ImPACT than did those with no previous concussions. There were significantly more symptoms reported in those with two or more prior concussions than in those with no or one prior concussion. Adolescents with multiple previous concussions had higher levels of baseline symptoms, but there were not group differences in neurocognitive functioning using this brief computerized battery. PMID:23560947
Gordon, Kevin E
The literature surrounding minor traumatic brain injury is complex, methodologically challenging, and controversial. Although we lack a consistent standardized definition, the annual rate is likely in excess of 200 per 100,000 children. The proportion of children with minor traumatic brain injury who will require neurosurgery is certainly return to play is currently recommended. The recurrence risk for subsequent concussions is elevated, but there is limited documentation of the effectiveness of preventative efforts. Much remains to be learned. PMID:17178354
Moore, Robert D; Pindus, Dominika M; Drolette, Eric S; Scudder, Mark R; Raine, Lauren B; Hillman, Charles H
This study investigated the influence of concussion history on children's neurocognitive processing. Thirty-two children ages 8-10 years (16 with a concussion history, 16 controls) completed compatible and incompatible conditions of a flanker task while behavioral and neuroelectric data were collected. Relative to controls, children with a concussion history exhibited alterations in the sequential congruency effect, committed more omission errors, and exhibited decreased post-error accuracy. Children with a concussion history exhibited longer N2 latency across task conditions, increased N2 amplitude during the incompatible condition of the task, and decreased P3b amplitude across task conditions. Children with a history of concussion also exhibited decreased ERN and Pe amplitudes, with group difference increasing for the incompatible condition of the task. The current results indicate that pediatric concussion may lead to subtle, but pervasive deficits in attention and cognitive control. These results serve to inform a poorly understood but significant public health concern. PMID:25951782
Thompson, James; Sebastianelli, Wayne; Slobounov, Semyon
Mild traumatic brain injury (MTBI), or concussion, is one of the least understood injuries facing the neuroscience and sports medicine community today. The notion of transient dysfunction and rapid symptom resolution is misleading since symptom resolution is not indicative of injury resolution. Our working hypothesis is that there are residual postural and EEG abnormalities in concussed individuals that could be reliably assessed using appropriate research methodology. This paper presents combined postural and electroencephalographic (EEG) findings suggesting the persistent functional deficits in athletes suffering from MTBI. Twelve concussed athletes and twelve normal controls participated in the study. There was a decrease in EEG power in all bandwidths studied in concussed subjects, especially in standing postures. This was accompanied by sustained postural instability especially under the no vision testing condition. Overall, this study demonstrated the presence of long-term functional abnormalities in individuals suffering from mild traumatic brain injury. PMID:15755518
De Beaumont, Louis; Tremblay, Sébastien; Henry, Luke C; Poirier, Judes; Lassonde, Maryse; Théoret, Hugo
Background Retired athletes with a history of sports concussions experience cognitive and motor declines with aging, and the risk of severe neurodegenerative conditions is magnified in this population. The present study investigated the effects of aging on motor system metabolism and function in former university-level athletes who sustained their last concussion several decades prior to testing. Methods To test the hypothesis that age and remote concussions induce functional as well as metab...
Ketcham, Caroline J; Hall, Eric; Bixby, Walter R; Vallabhajosula, Srikant; Folger, Stephen E; Kostek, Matthew C; Miller, Paul C; Barnes, Kenneth P; Patel, Kirtida
Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 million concussions occur in sports and recreational activities annually. Concussion as defined by the 2013 Concussion Consensus Statement "may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an 'impulsive' force transmitted to the head." Concussions leave the individual with both short- and long-term effects. The short-term effects of sport related concussions may include changes in playing ability, confusion, memory disturbance, the loss of consciousness, slowing of reaction time, loss of coordination, headaches, dizziness, vomiting, changes in sleep patterns and mood changes. These symptoms typically resolve in a matter of days. However, while some individuals recover from a single concussion rather quickly, many experience lingering effects that can last for weeks or months. The factors related to concussion susceptibility and the subsequent recovery times are not well known or understood at this time. Several factors have been suggested and they include the individual's concussion history, the severity of the initial injury, history of migraines, history of learning disabilities, history of psychiatric comorbidities, and possibly, genetic factors. Many studies have individually investigated certain factors both the short-term and long-term effects of concussions, recovery time course, susceptibility and recovery. What has not been clearly established is an effective multifaceted approach to concussion evaluation that would yield valuable information related to the etiology, functional changes, and recovery. The purpose of this manuscript is to show one such multifaceted approached which examines concussions using computerized neurocognitive testing, event related potentials, somatosensory perceptual responses, balance assessment, gait assessment and genetic testing. PMID
Full Text Available ... Injury Center Emergency Nurses Association Health Resources and Services Administration, EMS for Children Health Resources Services Administration, Traumatic Brain Injury Program Massachusetts Department of ...
Smith, Laurel B.; Radomski, Mary Vining; Davidson, Leslie Freeman; Finkelstein, Marsha; Weightman, Margaret M.; McCulloch, Karen L.; Scherer, Matthew R.
Researchers found encouraging preliminary interrater reliability data for the Charge of Quarters Duty Task, a multitask assessment designed to assess executive functioning in servicemembers after concussion.
Byrnes, Kimberly R.; Colin Wilson; Fiona Brabazon; Jennifer Jurgens; Oakes, Terrence R.
Traumatic brain injury (TBI) affects an estimated 1.7 million people in the United States and is a contributing factor to one third of all injury related deaths annually. According to the CDC, approximately 75% of all reported TBIs are concussions or considered mild in form, although the number of unreported mild TBIs and patients not seeking medical attention is unknown. Currently, classification of mild TBI (mTBI) or concussion is a clinical assessment since diagnostic imaging is typically ...
Lin, Alexander P.; Ramadan, Saadallah; Stern, Robert A.; Box, Hayden C; Nowinski, Christopher J.; Ross, Brian D.; Mountford, Carolyn E.
Introduction: The goal was to identify which neurochemicals differ in professional athletes with repetitive brain trauma (RBT) when compared to healthy controls using a relatively new technology, in vivo Localized COrrelated SpectroscopY (L-COSY). Methods: To achieve this, L-COSY was used to examine five former professional male athletes with 11 to 28 years of exposure to contact sports. Each athlete who had had multiple symptomatic concussions and repetitive sub concussive trauma during thei...
Full Text Available ... Health Association American School Health Association American Sports Education Program Brain Injury Association of America Brain Trauma Foundation Center for Injury Research and Policy, the Research Institute at Nationwide Children's Hospital Children's National Medical Center Defense and Veterans ...
Heyworth, Benton E.; Carroll, Kaitlin M.; Rizza, Andrew J.; McInnis, Kelly C.; Gill, Thomas J.
Objectives: Growing evidence suggests that there may be significant long term sequellae of cumulative concussions, which may include prolonged cognitive deficits and physical symptoms. There are a growing number of concussions each year in high school athletes that occur during sports. The objective of this study is to investigate the impact of cerebral concussions on athletes to gain a deeper understanding of sports related cerebral concussions that will ultimately lead to development of bet...
Research into concussion or mild traumatic brain injury (mTBI) has increased significantly within the past decade. In the literature some researchers are reporting 1.6 to 3.8 million concussions occurring in sports (Langlois, 2006), mTBI accounts for 80% of all reported traumatic brain injuries (Ruff, 2011). With these alarming statistics and an increasing number of athletes suffering a concussion there has been an increased emphasis for sports medicine practitioners to properly diagnose and treat those recovering from brain injury so that they may return safely to school, sports or work. Current clinical tools available to practitioners give them the ability to assess functional recovery in clinical measures of personality change; patient self reported symptom scales; functional cognitive domains (computer based neuropsychological batteries) and clinical balance measures. These current methods of clinical measurement, diagnosis and return to play protocols have remained largely unchanged for the past 20 years. In addition, there is some controversy into the application of these clinical measures within repeated measure testing as improvement does not necessarily reflect post-traumatic recovery but may instead reflect practice or "ceiling effects" of measurement. Therefore, diagnostic platforms that measure structural physiologic recovery must be implemented to assist the clinician in the 'Return to Play' process for athletic participation. In this study quantitative EEG (qEEG) analysis using a 128-lead dense array system during the first aerobic challenge in a 'Return to Play' protocol was performed. Subjects recovering from concussion and normal volunteers with no history of concussion were included and their neuroelectric activity recorded before, during, after and 24 hours post light aerobic exercise on a stationary bike. Subjects recovering from concussion demonstrated altered spectral absolute power across relevant regions of interest in the frontal, central
Full Text Available ... right? A Immediately rush an athlete to the hospital–even if none of the Danger Signs are ... and Policy, the Research Institute at Nationwide Children's Hospital Children's National Medical Center Defense and Veterans Brain ...
Full Text Available ... Administrators Association National Program for Playground Safety National Recreation and Park Association North American Brain Injury Society ... Society of State Directors of Health, Physical Education & Recreation Sports Legacy Institute University of Pittsburgh Medical Center, ...
Full Text Available ... Learn More about the Brain and How it Works Order Free Copies of CDC's “Heads Up” Educational ... Associations) Listen to a Radio PSA Coach and Team [Audio: 0:30 seconds] Mom and Daughter [Audio: ...
... said Asken, a graduate student in the clinical psychology program at the University of Florida. Putting off medical attention potentially exposes an athlete's already injured brain to additional stress that can compound damage to the nervous system, ...
Full Text Available ... Professionals Learn More about the Brain and How it Works Order Free Copies of CDC's “Heads Up” ... Enter your full name as you'd like it to appear on your completion certificate. Name: Submit
Full Text Available ... Softball American Academy of Neurology American Academy of Pediatrics American Academy of Physical Medicine and Rehabilitation American ... Association Health Resources and Services Administration, EMS for Children Health Resources Services Administration, Traumatic Brain Injury Program Massachusetts ...
Shroyer, Josh; Stewart, Craig
The purpose of this study was to determine the knowledge and opinions on concussions of high school coaches from a geographically large yet rural state in the northern Rocky Mountains of the United States. Few medical issues in sport are more important, or have had as much publicity recently, as concussions. The exposure gleaned from tragic health…
Andrew J. MacGregor, PhD, MPH
Full Text Available Concussions are a predominant injury of the conflicts in Iraq and Afghanistan. The aims of this study were to describe repeated concussive events among U.S. military personnel injured in Operation Iraqi Freedom and examine subsequent healthcare utilization. We reviewed clinical records from the Expeditionary Medical Encounter Database to identify servicemembers with repeat concussions. We abstracted demographic and injury-specific variables, calculated time between events, and identified healthcare utilization from electronic medical databases. Overall, 113 personnel experienced more than one concussion between 2004 and 2008. A majority of these incidents were blast related. The median time between events was 40 days, with 20% experiencing a second event within 2 weeks of the first and 87% within 3 months. Time between events was not associated with severity of the second event. Greater severity of the second concussive event was associated with higher postinjury utilization of mental health and neurology services. This study is one of the first to describe repeated concussions in a combat setting. We found that repeated concussions occur within a short interval among deployed personnel, although the effects of the first event are unclear. Further research is needed to define the effect of repeated concussions on the health of combat veterans.
Kolodziej, Andrea; Ploeg, Adam
The number of high school students who participate in athletics has increased over the past decade. There has also been an increased emphasis placed on athletic involvement and physical strength and ability. This has led to increased awareness of athletic injuries such as concussions. While concussions are not a new injury, the medical community…
Johnson, L. Syd M.
Background: High school football players are the single largest cohort of athletes playing tackle football, and account for the majority of sport-related concussions. Return to play guidelines (RTPs) have emerged as the preferred approach for addressing the problem of sport-related concussion in youth athletes. Methods: This article reviews…
Harrison, Emily A
In the early 21st century, sports concussion has become a prominent public health problem, popularly labeled "The Concussion Crisis." Football-related concussion contributes much of the epidemiological burden and inspires much of the public awareness. Though often cast as a recent phenomenon, the crisis in fact began more than a century ago, as concussions were identified among footballers in the game's first decades. This early concussion crisis subsided-allowing the problem to proliferate-because work was done by football's supporters to reshape public acceptance of risk. They appealed to an American culture that permitted violence, shifted attention to reforms addressing more visible injuries, and legitimized football within morally reputable institutions. Meanwhile, changing demands on the medical profession made practitioners reluctant to take a definitive stance. Drawing on scientific journals, public newspapers, and personal letters of players and coaches, this history of the early crisis raises critical questions about solutions being negotiated at present. PMID:24625171
Armistead-Jehle, Patrick; Cooper, Douglas B; Vanderploeg, Rodney D
The current investigation is a replication and extension of a previously published study by Cooper, Vanderploeg, Armistead-Jehle, Lewis, and Bowles (2014) demonstrating that performance validity test scores accounted for more variance in cognitive testing among service members with a history of concussion than did demographic variables, etiology of and time since injury, and symptom severity. The present study included a sample of 142 active-duty service members evaluated following a suspected or confirmed history of mild traumatic brain injury. Participants completed a battery of neuropsychological measures that included scales of performance and symptom validity (specifically the Medical Symptom Validity Test, Nonverbal Medical Symptom Validity Test, and Personality Assessment Inventory). Among the factors considered in the current study, performance validity test results accounted for the most variance in cognitive test scores, above demographic, concussion history, symptom validity, and psychological distress variables. Performance validity test results were modestly related to symptom validity as measured by the Personality Assessment Inventory Negative Impression Management scale. In sum, the current results replicated the original Cooper et al. study and highlight the importance of including performance validity tests as part of neurocognitive evaluation, even in clinical contexts, within this population. PMID:26569384
Brook, Emily M; Luo, Xuan; Curry, Emily J; Matzkin, Elizabeth G
Head injuries are a major concern for physicians in athletes of all ages. Specifically, sports-related concussions are becoming an all-too-common injury among female athletes. The incidence of concussions among female athletes has likely increased over the past few decades because of an increase in sports participation afforded by Title IX. It would be useful for physicians to have general knowledge of concussions and their potential sex-related differences. This review article summarizes the current body of research concerning sex-related differences in concussion epidemiology and outcomes. A literature search was performed using PubMed and included all articles published from 1993 to present, with a predominant focus on research conducted over the past fifteen years. Additional articles were found using the bibliography from articles found through the PubMed search. Several articles have compared incidence, severity of neurological deficit, constellation of symptoms, and length of recovery post-concussion in males and females. However, the literature does not unanimously support a significant sex-related difference in concussions. Lack of consensus in the literature can be attributed to differences between patient populations, different tools used to study concussions, including subjective or objective measures, and differences in mechanisms of injury. We conclude that concussions are a serious injury in both male and female athletes, and physicians should have a very high index of suspicion regardless of sex, because there currently is not sufficient consensus in the literature to institute sex-related changes to concussion management. Current research may suggest a sex-related difference pertaining to sports-related concussions, but further evaluation is needed on this topic. PMID:26781686
Full Text Available ... parents “Heads Up” for high school coaches, athletic directors, athletic trainers, and parents “Heads Up” for school ... Alliance Sarah Jane Brain Foundation Society of State Directors of Health, Physical Education & Recreation Sports Legacy Institute ...
The early and late outcome was evaluated in head injury patients who presented brain contusion(s) on the cranial CT scan and in patients hospitalized for concussion. There was a high degree of concurrence between mortality and CT findings. Late complaints were common among cases of concussion of the brain. However, the frequency of impaired memory and concentration, speech problems, paresis and epileptic seizures was increased in cases where the CT scan showed brain contusion. Adaptive and social functioning was most impaired in cases with multifocal contusions in both hemispheres. 16 refs., 5 tabs
Reed, N; Taha, T; Monette, G; Keightley, M
The objective of this study was to describe the effect of concussion on upper and lower body strength in children and youth athletes. The participant group was made up of 178 unique male and female ice hockey players (ages 8-14 years). Using a 3-year prospective longitudinal research design, baseline and post-concussion data on hand grip strength, jump tests, and leg maximal voluntary contraction were collected. Using a linear mixed-effects model, no significant differences were found when comparing the baseline strength performance of individuals who went on to experience a concussion and those who did not. When accounting for sex, multiple concussions, and ongoing changes in strength associated with age, weaker hand grip scores were found following concussion while participants were still symptomatic. Lower squat jump heights were achieved while participants were symptomatic as well as when they were no longer self-reporting symptoms associated with concussion. This study represents an initial step towards better understanding strength performance following concussion that may limit the on and off ice performance of youth ice hockey players, as well as predispose youth to subsequent injuries. PMID:27191209
Simon, Lauren M; Mitchell, Cory N
There are an estimated 1.6 to 3.8 million sports and recreation-related concussions annually in the United States, with an average annual increase in incidence of 15.5% from 1998 to 2007. From 2009 to 2014, all 50 states enacted youth concussion legislation. This study clarifies core elements common to state concussion legislation and State Interscholastic Athletic Association (SIAA) implementation. A concussion literature, legislative, and SIAA concussion bylaw review was performed for all 50 U.S. states. Mandated concussion education varies in the frequency of certification and method of education. Student athletes and their parents/guardians in a majority of states are required to sign annual educational information sheets. Forty-nine states specifically mandate removal from play. Return-to-play protocols vary with regard to the timeline, content, and health care professional that can provide written clearance. In conclusion, it is important for sports medicine clinicians to stay abreast of current and revised concussion legislation in the jurisdictions in which they provide care. PMID:27172079
Koehler, Steven A; Shakir, Abdulrezak; Ladham, Shaun; Rozin, Leon; Omalu, Bennet; Dominick, Joe; Wecht, Cyril H
A cardiac concussion is caused by a sudden, nonpenetrating, localized impact to the chest that is theorized to result in almost simultaneous sudden death from a disruption to the conductive system. The detailed external/internal forensic examination of the body reveals no evidence of structural, pathologic, or histologic signs of trauma to the heart. A cardiac concussion is a rare and often overlooked cause of sudden death. This type of sudden death is typically seen among younger individuals participating in sports involving projectiles and, to a lesser degree, where collisions occur. Cardiac concussions are clinically, pathologically, and chemically different from a cardiac contusion. The objective of this paper will be to define cardiac concussion, differentiate between cardiac concussion and cardiac contusion, and describe the clinical and pathologic features of a 32-year-old white male who died of a cardiac concussion following a collision with a catcher during a softball game. The civil ramification of incorrectly diagnosing the manner of death in cases of death involving a cardiac concussion will also be addressed. PMID:15322461
Howell, David; Osternig, Louis; Chou, Li-Shan
Despite medical best-practice recommendations, no consistent standard exists to systematically monitor recovery from concussion. Studies utilizing camera-based systems have reported center-of-mass (COM) motion control deficits persisting in individuals with concussion up to two months post-injury. The use of an accelerometer may provide an efficient and sensitive method to monitor COM alterations following concussion that can be employed in clinical settings. This study examined: (1) frontal/sagittal plane acceleration characteristics during dual-task walking for individuals with concussion and healthy controls; and (2) the effectiveness of utilizing acceleration characteristics to classify concussed and healthy individuals via receiver operating characteristic (ROC) curve analyses. Individuals with concussion completed testing within 72 h as well as 1 week, 2 weeks, 1 month, and 2 months post-injury. Control subjects completed the same protocol in similar time increments. Participants walked and simultaneously completed a cognitive task while wearing an accelerometer attached to L5. Participants with concussion walked with significantly less peak medial-lateral acceleration during 55-75% gait cycle (p=0.04) throughout the testing period compared with controls. Moderate levels of sensitivity and specificity were found at the 72 h and 1 week testing times (sensitivity=0.70, specificity=0.71). ROC analysis revealed significant AUC values at the 72 h (AUC=0.889) and two week (AUC=0.810) time points. Accelerometer-derived measurements may assist in detecting frontal plane control deficits during dual-task walking post-concussion, consistent with camera-based studies. These initial findings demonstrate potential for using accelerometry as a tool for clinicians to monitor gait balance control following concussion. PMID:26152463
Elgmark Andersson, Elisabeth; Bedics, Beate Kärrdahl; Falkmer, Torbjörn
Objective and design: Long-term consequences of mild traumatic brain injuries were investigated based on a 10-year follow-up of patients from a previously published randomized controlled study of mild traumatic brain injuries. One aim was to describe changes over time after mild traumatic brain injuries in terms of the extent of persisting post-concussion symptoms, life satisfaction, perceived health, activities of daily living, changes in life roles and sick leave. Another aim was to identif...
Engberg, Aase Worså; Teasdale, T W
hospitalised under diagnoses ICD 800, 801, 803, 850-854 decreased 41% from 265 to 157 per 100,000 of the population per year. Decreases were 42% for ICD 850, brain concussion, 56% for ICD 800, 801, 803, cranial fractures, and 16% for ICD 851 854, structural brain injury. The percentage of cases with ICD 851...
Hermann, Nuno Vibe; Lauridsen, Eva; Ahrensburg, Søren Steno; Gerds, Thomas Alexander; Andreasen, Jens Ove
Purpose The purpose of the study was to analyze the risk of periodontal ligament (PDL) healing complications following concussion and subluxation injuries in the permanent dentition. Material and method A total 469 permanent teeth (358 patients) with concussion and 404 permanent teeth with......-related resorption (ankylosis), marginal bone loss, and tooth loss were analyzed with the Kaplan–Meier method. Results Concussion: In teeth with immature root development, no healing complications were observed. For teeth with mature root development, the risk of repair related resorption after 3 years was 3.2% (95...... among teeth with concussion. Subluxation: In teeth with immature root development, the risk of infection-related resorption after 3 years was 1.7% [95% confidence interval (CI): 0–3.8%]. Infection-related resorption occurred significantly more often in teeth with concomitant crown fracture (P = 0...
McClure, D. Jake; Scott L. Zuckerman; Kutscher, Scott J.; Gregory, Andrew; Solomon, Gary S.
Objectives: When managing sport-related concussions (SRC), sports medicine physicians utilize serial neurocognitive assessments and self-reported symptom inventories when evaluating athlete recovery and safety for returning to play (RTP). Since post-concussive RTP goals include symptom resolution and return to neurocognitive baseline, clinical decisions rest on an understanding of modifiers of baseline performance. Several studies have reported the influence of age, gender and sport on baseli...
Brooks, Brian L.; McKay, Carly D.; Mrazik, Martin; Barlow, Karen M; Meeuwisse, Willem H.; Emery, Carolyn A
The existing literature on lingering effects from concussions in children and adolescents is limited and mixed, and there are no clear answers for patients, clinicians, researchers, or policy makers. The purpose of this study was to examine whether there are lingering effects of past concussions in adolescent athletes. Participants in this study included 643 competitive Bantam and Midget hockey players (most elite 20% by division of play) between 13 and 17 years of age (mean age=15.5, SD=1.2)...
Forty cases diagnosed as diffuse brain injury (DBI) were studied by magnetic resonance imaging (MRI) performed within 3 days after injury. These cases were divided into two groups, which were the concussion group and diffuse axonal injury (DAI) group established by Gennarelli. There were no findings on computerized tomography (CT) in the concussion group except for two cases which had a brain edema or subarachnoid hemorrhage. But on MRI, high intensity areas on T2 weighted imaging were demonstrated in the cerebral white matter in this group. Many lesions in this group were thought to be edemas of the cerebral white matter, because of the fact that on serial MRI, they were isointense. In mild types of DAI, the lesions on MRI were located only in the cerebral white matter, whereas, in the severe types of DAI, lesions were located in the basal ganglia, the corpus callosum, the dorsal part of the brain stem as well as in the cerebral white matter. As for CT findings, parenchymal lesions were not visualized especially in mild DAI. Our results suggested that the lesions in cerebral concussion were edemas in cerebral white matter. In mild DAI they were non-hemorrhagic contusion; and in severe DAI they were hemorrhagic contusions in the cerebral white matter, the basal ganglia, the corpus callosum or the dorsal part of the brain stem. (author)
Yokota, Hiroyuki; Yasuda, Kazuhiro; Mashiko, Kunihiro; Henmi, Hiroshi; Otsuka, Toshibumi; Kobayashi, Shiro; Nakazawa, Shozo (Nippon Medical School, Tokyo (Japan))
Forty cases diagnosed as diffuse brain injury (DBI) were studied by magnetic resonance imaging (MRI) performed within 3 days after injury. These cases were divided into two groups, which were the concussion group and diffuse axonal injury (DAI) group established by Gennarelli. There were no findings on computerized tomography (CT) in the concussion group except for two cases which had a brain edema or subarachnoid hemorrhage. But on MRI, high intensity areas on T2 weighted imaging were demonstrated in the cerebral white matter in this group. Many lesions in this group were thought to be edemas of the cerebral white matter, because of the fact that on serial MRI, they were isointense. In mild types of DAI, the lesions on MRI were located only in the cerebral white matter, whereas, in the severe types of DAI, lesions were located in the basal ganglia, the corpus callosum, the dorsal part of the brain stem as well as in the cerebral white matter. As for CT findings, parenchymal lesions were not visualized especially in mild DAI. Our results suggested that the lesions in cerebral concussion were edemas in cerebral white matter. In mild DAI they were non-hemorrhagic contusion; and in severe DAI they were hemorrhagic contusions in the cerebral white matter, the basal ganglia, the corpus callosum or the dorsal part of the brain stem. (author).
Marchi, Nicola; Bazarian, Jeffrey J; Puvenna, Vikram; Janigro, Mattia; Ghosh, Chaitali; Zhong, Jianhui; Zhu, Tong; Blackman, Eric; Stewart, Desiree; Ellis, Jasmina; Butler, Robert; Janigro, Damir
The acknowledgement of risks for traumatic brain injury in American football players has prompted studies for sideline concussion diagnosis and testing for neurological deficits. While concussions are recognized etiological factors for a spectrum of neurological sequelae, the consequences of sub-concussive events are unclear. We tested the hypothesis that blood-brain barrier disruption (BBBD) and the accompanying surge of the astrocytic protein S100B in blood may cause an immune response associated with production of auto-antibodies. We also wished to determine whether these events result in disrupted white matter on diffusion tensor imaging (DT) scans. Players from three college football teams were enrolled (total of 67 volunteers). None of the players experienced a concussion. Blood samples were collected before and after games (n = 57); the number of head hits in all players was monitored by movie review and post-game interviews. S100B serum levels and auto-antibodies against S100B were measured and correlated by direct and reverse immunoassays (n = 15 players; 5 games). A subset of players underwent DTI scans pre- and post-season and after a 6-month interval (n = 10). Cognitive and functional assessments were also performed. After a game, transient BBB damage measured by serum S100B was detected only in players experiencing the greatest number of sub-concussive head hits. Elevated levels of auto-antibodies against S100B were elevated only after repeated sub-concussive events characterized by BBBD. Serum levels of S100B auto-antibodies also predicted persistence of MRI-DTI abnormalities which in turn correlated with cognitive changes. Even in the absence of concussion, football players may experience repeated BBBD and serum surges of the potential auto-antigen S100B. The correlation of serum S100B, auto-antibodies and DTI changes support a link between repeated BBBD and future risk for cognitive changes. PMID:23483891