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Sample records for brain concussion

  1. Concussion and Traumatic Brain Injury

    Science.gov (United States)

    ... turn JavaScript on. Feature: Concussion Concussion and Traumatic Brain Injury Past Issues / Summer 2015 Table of Contents Children ... body, may have a concussion or more serious brain injury. Concussion Signs Observed Can't recall events prior ...

  2. Concussion

    Science.gov (United States)

    ... Saunders; 2014:chap 41. Kerr HA. Closed head injury. Clin Sports Med . 2013;32:273-287. PMID: 23522509 www. ... Elsevier; 2016:chap 710. Liebig CW, Congeni JA. Sports-related traumatic brain injury (Concussion). In: Kliegman RM, Stanton BF, St Geme ...

  3. School-Based Traumatic Brain Injury and Concussion Management Program

    Science.gov (United States)

    Davies, Susan C.

    2016-01-01

    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…

  4. Concussion and Mild Traumatic Brain Injury: An Annotated Bibliography

    Science.gov (United States)

    2013-08-01

    induced mTBI has increased in recent years. Intracranial pressure monitoring is not always available in clinical care settings, and protocols need to... intracranial pressure , shear stress concentration, and relative motion between the brain and skull do indeed cause surface contusion, concussion, diffuse axonal injury, as well as acute subdural hematoma. ...civilian hospital for mild head injury. Follow-up 1-month post-injury, allowed for PCS evaluation. The analyses (odds ratios) suggest that elevated

  5. A history of sport-related concussion on event-related brain potential correlates of cognition.

    Science.gov (United States)

    Broglio, Steven P; Moore, Robert D; Hillman, Charles H

    2011-10-01

    Over the past decade, a growing body of research has detailed persistent changes to neuroelectric indices of cognition in amateur and professional athletes with a concussion history. Here, we review the relevant neuroelectric findings on this relationship while considering the duration from the last concussive event. Collectively, the findings support a negative relation of concussive injury to neuroelectric indices of brain health and cognition in the presence of normal clinical findings. The results suggest that event-related brain potentials are especially well-suited for identifying aspects of cognition that remain dysfunctional for an extended period of time, which are otherwise unidentified using standard neuropsychological tests. Such findings also suggest the need for additional research to fully elucidate the extent to which concussive injuries negatively impact brain health and cognition.

  6. Technical knockout: when is traumatic brain injury “just” a concussion?

    LENUS (Irish Health Repository)

    O’Halloran, P J

    2016-05-01

    While cricket is an unlikely source of concussion, the fierce contagion of media coverage surrounding Rugby and Gaelic Football has led to difficulties in deciphering real from perceived risk. The surge in public interest has forced this young science to mature quickly. The principles of managing head injury have not changed, but there is now a greater awareness that concussion is a traumatic brain injury (TBI).\\r\

  7. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration

    OpenAIRE

    Morley, Wendy A.; Stephanie Seneff

    2014-01-01

    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 red...

  8. Concussion in Motor Vehicle Accidents: The Concussion Identification Index

    Science.gov (United States)

    2016-08-03

    Motor Vehicle Accidents; TBI (Traumatic Brain Injury); Brain Contusion; Brain Injuries; Cortical Contusion; Concussion Mild; Cerebral Concussion; Brain Concussion; Accidents, Traffic; Traffic Accidents; Traumatic Brain Injury With Brief Loss of Consciousness; Traumatic Brain Injury With no Loss of Consciousness; Traumatic Brain Injury With Loss of Consciousness

  9. fMRI and brain activation after sport concussion: a tale of two cases

    Directory of Open Access Journals (Sweden)

    Michael G Hutchison

    2014-04-01

    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.

  10. Changes in functional brain networks following sports-related concussion in adolescents.

    Science.gov (United States)

    Virji-Babul, Naznin; Hilderman, Courtney G E; Makan, Nadia; Liu, Aiping; Smith-Forrester, Jenna; Franks, Chris; Wang, Z J

    2014-12-01

    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.

  11. Brain function decline in healthy retired athletes who sustained their last sports concussion in early adulthood.

    Science.gov (United States)

    De Beaumont, Louis; Théoret, Hugo; Mongeon, David; Messier, Julie; Leclerc, Suzanne; Tremblay, Sébastien; Ellemberg, Dave; Lassonde, Maryse

    2009-03-01

    Recent studies have shown that the detrimental effects of sports concussions on cognitive and motor function may persist up to a few years post-injury. The present study sought to investigate the effects of having sustained a sports concussion more than 30 years prior to testing on cognitive and motor functions. Nineteen healthy former athletes, in late adulthood (mean age = 60.79; SD = 5.16), who sustained their last sport-related concussion in early adulthood (mean age = 26.05; SD = 9.21) were compared with 21 healthy former athletes with no history of concussion (mean age = 58.89; SD = 9.07). Neuropsychological tests sensitive to age-related changes in cognition were administered. An auditory oddball paradigm was used to evoke P3a and P3b brain responses. Four TMS paradigms were employed to assess motor cortex excitability: (i) resting motor threshold; (ii) paired-pulse intracortical inhibition and intracortical facilitation; (iii) input/output curve and (iv) cortical silent period (CSP). A rapid alternating movement task was also used to characterize motor system dysfunctions. Relative to controls, former athletes with a history of concussion had: (i) lower performance on neuropsychological tests of episodic memory and response inhibition; (ii) significantly delayed and attenuated P3a/P3b components; (iii) significantly prolonged CSP and (iv) significantly reduced movement velocity (bradykinesia). The finding that the P3, the CSP as well as neuropsychological and motor indices were altered more than three decades post-concussion provides evidence for the chronicity of cognitive and motor system changes consecutive to sports concussion.

  12. FMRI and brain activation after sport concussion: a tale of two cases.

    Science.gov (United States)

    Hutchison, Michael G; Schweizer, Tom A; Tam, Fred; Graham, Simon J; Comper, Paul

    2014-01-01

    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 problematic, as it has been shown that some concussed athletes may downplay their symptoms. The use of neuropsychological (NP) testing has enabled clinicians to measure the effects and extent of impairment following concussion more precisely, providing more objective metrics for determining recovery. 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. A number of advanced neuroimaging tools, including blood oxygen level dependent functional magnetic resonance imaging (fMRI), have independently yielded early information on abnormal brain functioning. 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 our 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.

  13. Brain functions after sports-related concussion: insights from event-related potentials and functional MRI.

    Science.gov (United States)

    Gosselin, Nadia; Saluja, Rajeet Singh; Chen, Jen-Kai; Bottari, Carolina; Johnston, Karen; Ptito, Alain

    2010-10-01

    The high incidence of concussions in contact sports and their impact on brain functions are a major cause for concern. To improve our understanding of brain functioning after sports-related concussion, advanced functional assessment techniques, namely event-related potentials (ERPs) and functional magnetic resonance imaging (fMRI), have been recently used in research studies. Contrary to neuropsychological tests that measure verbal and/or motor responses, ERPs and fMRI assess the neural activities associated with cognitive/behavioral demands, and thus provide access to better comprehension of brain functioning. In fact, ERPs have excellent temporal resolution, and fMRI identifies the involved structures during a task. This article describes ERP and fMRI techniques and reviews the results obtained with these tools in sports-related concussion. Although these techniques are not yet readily available, they offer a unique clinical approach, particularly for complex cases (ie, athletes with multiple concussions, chronic symptoms) and objective measures that provide valuable information to guide management and return-to-play decision making.

  14. Sport-related concussions

    Directory of Open Access Journals (Sweden)

    Jéssica Natuline Ianof

    Full Text Available ABSTRACT Traumatic brain injury (TBI is a major cause of lifelong disability and death worldwide. Sport-related traumatic brain injury is an important public health concern. The purpose of this review was to highlight the importance of sport-related concussions. Concussion refers to a transient alteration in consciousness induced by external biomechanical forces transmitted directly or indirectly to the brain. It is a common, although most likely underreported, condition. Contact sports such as American football, rugby, soccer, boxing, basketball and hockey are associated with a relatively high prevalence of concussion. Various factors may be associated with a greater risk of sport-related concussion, such as age, sex, sport played, level of sport played and equipment used. Physical complaints (headache, fatigue, dizziness, behavioral changes (depression, anxiety, irritability and cognitive impairment are very common after a concussion. The risk of premature return to activities includes the prolongation of post-concussive symptoms and increased risk of concussion recurrence.

  15. Brain activation during neurocognitive testing using functional near-infrared spectroscopy in patients following concussion compared to healthy controls

    Science.gov (United States)

    Huppert, T. J.; Beluk, N. H.; Elbin, R. J.; Henry, L. C.; French, J.; Dakan, S. M.; Collins, M. W.

    2016-01-01

    There is no accepted clinical imaging modality for concussion, and current imaging modalities including fMRI, DTI, and PET are expensive and inaccessible to most clinics/ patients. Functional near-infrared spectroscopy (fNIRS) is a non-invasive, portable, and low-cost imaging modality that can measure brain activity. The purpose of this study was to compare brain activity as measured by fNIRS in concussed and age-matched controls during the performance of cognitive tasks from a computerized neurocognitive test battery. Participants included nine currently symptomatic patients aged 18–45 years with a recent (15–45 days) sport-related concussion and five age-matched healthy controls. The participants completed a computerized neurocognitive test battery while wearing the fNIRS unit. Our results demonstrated reduced brain activation in the concussed subject group during word memory, (spatial) design memory, digit-symbol substitution (symbol match), and working memory (X’s and O’s) tasks. Behavioral performance (percent-correct and reaction time respectively) was lower for concussed participants on the word memory, design memory, and symbol match tasks than controls. The results of this preliminary study suggest that fNIRS could be a useful, portable assessment tool to assess reduced brain activation and augment current approaches to assessment and management of patients following concussion. PMID:24477579

  16. Advances in sport concussion assessment: from behavioral to brain imaging measures.

    Science.gov (United States)

    Ellemberg, Dave; Henry, Luke C; Macciocchi, Steve N; Guskiewicz, Kevin M; Broglio, Steven P

    2009-12-01

    Given that the incidence of sports-related concussion is considered to have reached epidemic proportions, in the past 15 years we have witnessed an explosion of research in this field. The purpose of the current review is to compare the results provided by the different assessment tools used in the scientific literature in order to gain a better understanding of the sequelae and recovery following a concussion. Until recently, the bulk of the has literature focused on the immediate outcome in the hours and days post-injury as a means to plan the safest return-to-play strategy. This has led to the development of several assessment batteries that are relatively easy and rapid to administer and that allow for multiple testing sessions. The main conclusion derived from that literature is that cognitive symptoms tend to resolve within 1 week. However, accumulating evidence indicates that cognitive testing should be viewed as one of several complementary tools necessary for a comprehensive assessment of concussion. Including an objective measure of postural stability increases the sensitivity of the return-to-play decision-making process and minimizes the consequences of mitigating factors (e.g., practice effects and motivation) on neuropsychological test results. This is consistent with findings that symptom severity, neuropsychological function, and postural stability do not appear to be related or affected to the same degree after a concussion. Furthermore, recent evidence from brain imaging, including event-related potentials and functional and metabolic imaging, suggest abnormalities in the electrical responses, metabolic balance, and oxygen consumption of neurons that persist several months after the incident. We explain this apparent discrepancy in recovery by suggesting an initial and rapid phase of functional recovery driven by compensatory mechanisms and brain plasticity, which is followed by a prolonged neuronal recovery period during which subtle deficits in

  17. Brain MRI CO2 stress testing: a pilot study in patients with concussion.

    Directory of Open Access Journals (Sweden)

    W Alan C Mutch

    Full Text Available There is a real need for quantifiable neuro-imaging biomarkers in concussion. Here we outline a brain BOLD-MRI CO2 stress test to assess the condition.This study was approved by the REB at the University of Manitoba. A group of volunteers without prior concussion were compared to post-concussion syndrome (PCS patients--both symptomatic and recovered asymptomatic. Five 3-minute periods of BOLD imaging at 3.0 T were studied--baseline 1 (BL1--at basal CO2 tension, hypocapnia (CO2 decreased ∼5 mmHg, BL2, hypercapnia (CO2 increased ∼10 mmHg and BL3. Data were processed using statistical parametric mapping (SPM for 1st level analysis to compare each subject's response to the CO2 stress at the p = 0.001 level. A 2nd level analysis compared each PCS patient's response to the mean response of the control subjects at the p = 0.05 level.We report on 5 control subjects, 8 symptomatic and 4 asymptomatic PCS patients. Both increased and decreased response to CO2 was seen in all PCS patients in the 2nd level analysis. The responses were quantified as reactive voxel counts: whole brain voxel counts (2.0±1.6%, p = 0.012 for symptomatic patients for CO2 response controls: 0.49±0.31%, p = 0.053 for asymptomatic patients for CO2 response controls.Quantifiable alterations in regional cerebrovascular responsiveness are present in concussion patients during provocative CO2 challenge and BOLD MRI and not in healthy controls. Future longitudinal studies must aim to clarify the relationship between CO2 responsiveness and individual patient symptoms and outcomes.

  18. The Relationship between Concussion Knowledge and the High School Athlete's Intention to Report Traumatic Brain Injury Symptoms: A Systematic Review of the Literature

    Science.gov (United States)

    Taylor, Mary Ellen; Sanner, Jennifer E.

    2017-01-01

    Sports-related concussion or traumatic brain injury (TBI) is a frequent occurrence among high school athletes. Long-term and short-term effects of TBI on the athlete's developing brain can be minimized if the athlete reports and is effectively treated for TBI symptoms. Knowledge of concussion symptoms and a school culture of support are critical…

  19. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration.

    Science.gov (United States)

    Morley, Wendy A; Seneff, Stephanie

    2014-01-01

    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.

  20. The relationship between suboptimal effort and post-concussion symptoms in children and adolescents with mild traumatic brain injury.

    Science.gov (United States)

    Araujo, Gabriel C; Antonini, Tanya N; Monahan, Kerry; Gelfius, Carl; Klamar, Karl; Potts, Michelle; Yeates, Keith O; Bodin, Doug

    2014-01-01

    This retrospective chart review study explored the relationship between suboptimal effort and post-concussion symptoms in pediatric mild traumatic brain injury (mTBI). Participants were 382 clinically referred children and adolescents between 8 and 16 years of age who sustained an mTBI. Suboptimal effort was identified using reliable digit span and age-corrected scaled scores from the Numbers subtest of the Children's Memory Scale (CMS); 20% of the sample were classified as non-credible performers. Chi-square analyses and t-tests were used to examine differences in post-concussion symptoms and neuropsychological test performance between credible and non-credible performers. Linear regression was used to examine whether CMS Numbers performance predicted post-concussion symptoms after controlling for baseline symptoms and other relevant demographic- and injury-related factors. We found that non-credible performers presented with a greater number of post-concussion symptoms as compared with credible performers. Additionally, non-credible performers demonstrated comparatively poorer performance on neuropsychological tests of focused attention and processing speed. These results suggest that children and adolescents with mTBI who fail effort testing might have a greater tendency to exaggerate post-concussion symptoms and cognitive impairment. The clinical implications of these findings are discussed.

  1. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  2. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration

    Directory of Open Access Journals (Sweden)

    Wendy A Morley

    2014-01-01

    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.

  3. Sport-related concussions

    OpenAIRE

    2014-01-01

    ABSTRACT Traumatic brain injury (TBI) is a major cause of lifelong disability and death worldwide. Sport-related traumatic brain injury is an important public health concern. The purpose of this review was to highlight the importance of sport-related concussions. Concussion refers to a transient alteration in consciousness induced by external biomechanical forces transmitted directly or indirectly to the brain. It is a common, although most likely underreported, condition. Contact sports such...

  4. White matter damage and brain network alterations in concussed patients: a review of recent diffusion tensor imaging and resting-state functional connectivity data.

    Science.gov (United States)

    Chong, Catherine D; Schwedt, Todd J

    2015-05-01

    Over 2 million people are diagnosed with concussion each year in the USA, resulting in substantial individual and societal burdens. Although 'routine' clinical neuroimaging is useful for the diagnosis of more severe forms of traumatic brain injury, it is insensitive for detecting pathology associated with concussion. Diffusion tensor imaging (DTI) and blood-oxygenation-level-dependent (BOLD) resting-state functional connectivity magnetic resonance imaging (rs-fMRI) are techniques that allow for investigation of brain structural and functional connectivity patterns. DTI and rs-fMRI may be more sensitive than routine neuroimaging for detecting brain sequelae of concussion. This review summarizes recent DTI and rs-fMRI findings of altered structural and functional connectivity patterns in concussed patients.

  5. Persistent differences in patterns of brain activation after sports-related concussion: a longitudinal functional magnetic resonance imaging study.

    Science.gov (United States)

    Dettwiler, Annegret; Murugavel, Murali; Putukian, Margot; Cubon, Valerie; Furtado, John; Osherson, Daniel

    2014-01-15

    Avoiding recurrent injury in sports-related concussion (SRC) requires understanding the neural mechanisms involved during the time of recovery after injury. The decision for return-to-play is one of the most difficult responsibilities facing the physician, and so far this decision has been based primarily on neurological examination, symptom checklists, and neuropsychological (NP) testing. Functional magnetic resonance imaging (fMRI) may be an additional, more objective tool to assess the severity and recovery of function after concussion. The purpose of this study was to define neural correlates of SRC during the 2 months after injury in varsity contact sport athletes who suffered a SRC. All athletes were scanned as they performed an n-back task, for n=1, 2, 3. Subjects were scanned within 72 hours (session one), at 2 weeks (session two), and 2 months (session three) post-injury. Compared with age and sex matched normal controls, concussed subjects demonstrated persistent, significantly increased activation for the 2 minus 1 n-back contrast in bilateral dorsolateral prefrontal cortex (DLPFC) in all three sessions and in the inferior parietal lobe in session one and two (α≤0.01 corrected). Measures of task performance revealed no significant differences between concussed versus control groups at any of the three time points with respect to any of the three n-back tasks. These findings suggest that functional brain activation differences persist at 2 months after injury in concussed athletes, despite the fact that their performance on a standard working memory task is comparable to normal controls and normalization of clinical and NP test results. These results might indicate a delay between neural and behaviorally assessed recovery after SRC.

  6. Diagnostic terminology, athlete status, and history of concussion affect return to play expectations and anticipated symptoms following mild traumatic brain injury.

    Science.gov (United States)

    Kelly, Kiersten; Erdal, Kristi

    2016-11-13

    "Mild traumatic brain injury" (mTBI) and "concussion" are terms often used interchangeably. However, "mTBI" is frequently seen as representing a broader injury that encompasses the construct of "concussion," which often conveys transience or decreased severity. The present study examined the influence of varying diagnostic terminology on acute injury expectations in an undergraduate population (N = 105). Participants were presented with an mTBI vignette and were randomly assigned to one of two conditions in which the term "mTBI" or "concussion" was used to describe the injury. There were no significant differences between the two conditions on anxiety, symptomatology, timeline, or consequence scales. However, participants in the "mTBI" group allocated more days to return to play than participants in the "concussion" group, suggesting that terminology has an effect on perceptions of the severity of the injury. Varsity athletes allocated fewer days to return to play than nonathletes. Individuals with a history of concussion, both athletes and nonathletes, indicated fewer days to return to play, but greater symptomatology than individuals with no history of concussion. Clinicians should consider the influence of diagnostic terminology, athletic background, and history of concussion on perceptions of the severity of an injury because expectations can influence injury outcomes and compliance in a recovery process.

  7. fMRI and Brain Activation after Sport Concussion: A Tale of Two Cases

    OpenAIRE

    2014-01-01

    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 problematic, as it has been shown that some concussed athletes may downplay the...

  8. Systematic review of clinical studies examining biomarkers of brain injury in athletes after sports-related concussion.

    Science.gov (United States)

    Papa, Linda; Ramia, Michelle M; Edwards, Damyan; Johnson, Brian D; Slobounov, Semyon M

    2015-05-15

    The aim of this study was to systematically review clinical studies examining biofluid biomarkers of brain injury for concussion in athletes. Data sources included PubMed, MEDLINE, and the Cochrane Database from 1966 to October 2013. Studies were included if they recruited athletes participating in organized sports who experienced concussion or head injury during a sports-related activity and had brain injury biomarkers measured. Acceptable research designs included experimental, observational, and case-control studies. Review articles, opinion papers, and editorials were excluded. After title and abstract screening of potential articles, full texts were independently reviewed to identify articles that met inclusion criteria. A composite evidentiary table was then constructed and documented the study title, design, population, methods, sample size, outcome measures, and results. The search identified 52 publications, of which 13 were selected and critically reviewed. All of the included studies were prospective and were published either in or after the year 2000. Sports included boxing (six studies), soccer (five studies), running/jogging (two studies), hockey (one study), basketball (one study), cycling (one study), and swimming (one study). The majority of studies (92%) had fewer than 100 patients. Three studies (23%) evaluated biomarkers in cerebrospinal fluid (CSF), one in both serum and CSF, and 10 (77%) in serum exclusively. There were 11 different biomarkers assessed, including S100β, glial fibrillary acidic protein, neuron-specific enolase, tau, neurofilament light protein, amyloid beta, brain-derived neurotrophic factor, creatine kinase and heart-type fatty acid binding protein, prolactin, cortisol, and albumin. A handful of biomarkers showed a correlation with number of hits to the head (soccer), acceleration/deceleration forces (jumps, collisions, and falls), postconcussive symptoms, trauma to the body versus the head, and dynamics of different sports

  9. The independent influence of concussive and sub-concussive impacts on soccer players' neurophysiological and neuropsychological function.

    Science.gov (United States)

    Moore, R Davis; Lepine, Julien; Ellemberg, Dave

    2017-02-01

    Accumulating research demonstrates that repetitive sub-concussive impacts can alter the structure, function and connectivity of the brain. However, the functional significance of these alterations as well as the independent contribution of concussive and sub-concussive impacts to neurophysiological and neuropsychological health are unclear. Accordingly, we compared the neurophysiological and neuropsychological function of contact athletes with (concussion group) and without (sub-concussion group) a history of concussion, to non-contact athletes. We evaluated event-related brain potentials (ERPs) elicited during an oddball task and performance on a targeted battery of neuropsychological tasks. Athletes in the sub-concussion and concussion groups exhibited similar amplitude reductions in the ERP indices of attentional resource allocation (P3b) and attentional orienting (P3a) relative to non-contact athletes. However, only athletes in the concussion group exhibited reduced amplitude in the ERP index of perceptual attention (N1). Athletes in the sub-concussion and concussion groups also exhibited deficits in memory recall relative to non-contact athletes, but athletes in the concussion group also exhibited significantly more recall errors than athletes in the sub-concussion group. Additionally, only athletes in the concussion group exhibited response delays during the oddball task. The current findings suggest that sub-concussive impacts are associated with alterations in the neurophysiological and neuropsychological indices of essential cognitive functions, albeit to a lesser degree than the combination of sub-concussive and concussive impacts.

  10. Concussion in Winter Sports

    Science.gov (United States)

    ... Heads Up! Tool Kit Prevent Concussions Prevent Head Injuries Sports Safety Students Play Safe Youth Sports Safety Download ... — United States, 2001–2009 Nonfatal Traumatic Brain Injuries from Sports and Recreation Activities — United States, 2001–2005 ( ...

  11. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  12. Toward objective markers of concussion in sport: a review of white matter and neurometabolic changes in the brain after sports-related concussion.

    Science.gov (United States)

    Dimou, Stefan; Lagopoulos, Jim

    2014-03-01

    Abstract Sports-related concussion is an issue that has piqued the public's attention of late as concerns surrounding potential long-term sequelae as well as new methods of characterizing the effects of this form of injury continue to develop. For the most part, diagnosis of concussion is based on subjective clinical measures and thus is prone to under-reporting. In the current environment, where conventional imaging modalities, such as computed tomography and magnetic resonance imaging, are unable to elucidate the degree of white matter damage and neurometabolic change, a discussion of two advanced imaging techniques-diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS)-is undertaken with a view to highlighting their potential utility. Our aim is to outline a variety of the approaches to concussion research that have been employed, with special attention given to the clinical considerations and acute complications attributed to concussive injury. DTI and MRS have been at the forefront of research as a result of their noninvasiveness and ease of acquisition, and hence it is thought that the use of these neuroimaging modalities has the potential to aid clinical decision making and management, including guiding return-to-play protocols.

  13. Repeated mild lateral fluid percussion brain injury in the rat causes cumulative long-term behavioral impairments, neuroinflammation, and cortical loss in an animal model of repeated concussion.

    Science.gov (United States)

    Shultz, Sandy R; Bao, Feng; Omana, Vanessa; Chiu, Charlotte; Brown, Arthur; Cain, Donald Peter

    2012-01-20

    There is growing evidence that repeated brain concussion can result in cumulative and long-term behavioral symptoms, neuropathological changes, and neurodegeneration. Little is known about the factors and mechanisms that contribute to these effects. The current study addresses the need to investigate and better understand the effects of repeated concussion through the development of an animal model. Male Long-Evans rats received 1, 3, or 5 mild lateral fluid percussion injuries or sham injuries spaced 5 days apart. After the final injury, rats received either a short (24 h) or long (8 weeks) post-injury recovery period, followed by a detailed behavioral analysis consisting of tests for rodent anxiety-like behavior, cognition, social behavior, sensorimotor function, and depression-like behavior. Brains were examined immunohistochemically to assess neuroinflammation and cortical damage. Rats given 1, 3, or 5 mild percussion injuries displayed significant short-term cognitive impairments. Rats given repeated mild percussion injuries displayed significantly worse short- and long-term cognitive impairments. Rats given 5 mild percussion injuries also displayed increased anxiety- and depression-like behaviors. Neuropathological analysis revealed short-term neuroinflammation in 3-injury rats, and both short- and long-term neuroinflammation in 5-injury rats. There was also evidence that repeated injuries induced short- and long-term cortical damage. These cumulative and long-term changes are consistent with findings in human patients suffering repeated brain concussion, provide support for the use of repeated mild lateral fluid percussion injuries to study repeated concussion in the rat, and suggest that neuroinflammation may be important for understanding the cumulative and chronic effects of repeated concussion.

  14. Insomnia and self-perceived disability in workers with delayed recovery after mild traumatic brain injury/concussion

    DEFF Research Database (Denmark)

    Mollayeva, T.; Pratt, B.; Shapiro, C.

    2015-01-01

    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...... (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

  15. Concussion/mild traumatic brain injury-related chronic pain in males and females: A diagnostic modelling study

    Science.gov (United States)

    Mollayeva, Tatyana; Cassidy, J. David; Shapiro, Colin M.; Mollayeva, Shirin; Colantonio, Angela

    2017-01-01

    Abstract Pain is an unpleasant, complex, and perceived experience that places a significant burden on patients and clinicians. Its severity may be mediated by emotion, attitude, and environmental influences, and pain may be expressed differently in males and females. Traumatic brain injury (TBI) is frequently associated with chronic pain. This diagnostic modeling study examined sex differences in the construct of chronic pain in patients with delayed recovery from concussion/mild traumatic brain injury (mTBI). Data were collected from standardized questionnaires, neuroimaging records, and comprehensive clinical assessments. Bivariate associations were calculated using the Spearman correlation coefficient or analysis of variance. We established sex-specific stepwise multivariate linear regression models of factors associated with pain. Of the 94 participants diagnosed with mTBI (the mean age was 45.20 ± 9.94 years; 61.2% were males; the median time since injury was 197 days [interquartile range 139–416]), head/neck, and bodily pain were reported by 93% and 64%, respectively. No sex differences were identified in pain frequencies or severity. Pain was significantly associated with certain socio-demographic, injury-related, behavioral, and clinical variables. In the multivariable regression analysis, several determinants explained 60% of the pain variance in males and 46% in females. Pain is common in patients with delayed recovery from mTBI and is significantly associated with potentially modifiable clinical and nonclinical variables. Examining the multidimensional construct of pain in concussion/mTBI through a sex lens garners new directions for future longitudinal research on the pain mechanisms involved in postconcussion syndrome. PMID:28207508

  16. Sir Hugh Cairns and World War II British advances in head injury management, diffuse brain injury, and concussion: an Oxford tale.

    Science.gov (United States)

    Stone, James L; Patel, Vimal; Bailes, Julian E

    2016-11-01

    The authors trace the Oxford, England, roots of World War II (WWII)-related advances in head injury management, the biomechanics of concussion and brain injury, and postwar delineation of pathological findings in severe concussion and diffuse brain injury in man. The prominent figure in these developments was the charismatic and innovative Harvey Cushing-trained neurosurgeon Sir Hugh Cairns. Cairns, who was to closely emulate Cushing's surgical and scholarly approach, is credited with saving thousands of lives during WWII by introducing and implementing innovative programs such as helmets for motorcyclists, mobile neurosurgical units near battle zones, and the military usage of penicillin. In addition, he inspired and taught a generation of neurosurgeons, neurologists, and neurological nurses in the care of brain and spinal cord injuries at Oxford's Military Hospital for Head Injuries. During this time Cairns also trained the first full-time female neurosurgeon. Pivotal in supporting animal research demonstrating the critical role of acceleration in the causation of concussion, Cairns recruited the physicist Hylas Holbourn, whose research implicated rotary acceleration and shear strains as particularly damaging. Cairns' work in military medicine and head injury remain highly influential in efforts to mitigate and manage brain injury.

  17. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  18. Increased gray matter diffusion anisotropy in patients with persistent post-concussive symptoms following mild traumatic brain injury.

    Directory of Open Access Journals (Sweden)

    Sylvain Bouix

    Full Text Available A significant percentage of individuals diagnosed with mild traumatic brain injury (mTBI experience persistent post-concussive symptoms (PPCS. Little is known about the pathology of these symptoms and there is often no radiological evidence based on conventional clinical imaging. We aimed to utilize methods to evaluate microstructural tissue changes and to determine whether or not a link with PPCS was present. A novel analysis method was developed to identify abnormalities in high-resolution diffusion tensor imaging (DTI when the location of brain injury is heterogeneous across subjects. A normative atlas with 145 brain regions of interest (ROI was built from 47 normal controls. Comparing each subject's diffusion measures to the atlas generated subject-specific profiles of injury. Abnormal ROIs were defined by absolute z-score values above a given threshold. The method was applied to 11 PPCS patients following mTBI and 11 matched controls. Z-score information for each individual was summarized with two location-independent measures: "load" (number of abnormal regions and "severity" (largest absolute z-score. Group differences were then computed using Wilcoxon rank sum tests. Results showed statistically significantly higher load (p = 0.018 and severity (p = 0.006 for fractional anisotropy (FA in patients compared with controls. Subject-specific profiles of injury evinced abnormally high FA regions in gray matter (30 occurrences over 11 patients, and abnormally low FA in white matter (3 occurrences over 11 subjects. Subject-specific profiles provide important information regarding the pathology associated with PPCS. Increased gray matter (GM anisotropy is a novel in-vivo finding, which is consistent with an animal model of brain trauma that associates increased FA in GM with pathologies such as gliosis. In addition, the individualized analysis shows promise for enhancing the clinical care of PPCS patients as it could play a role in the

  19. [Asthenic syndrome in clinical course of acute period of brain concussion during complex treatment using nootropic agents].

    Science.gov (United States)

    Tkachov, A V

    2008-01-01

    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.

  20. A potential biomarker in sports-related concussion: brain functional connectivity alteration of the default-mode network measured with longitudinal resting-state fMRI over thirty days.

    Science.gov (United States)

    Zhu, David C; Covassin, Tracey; Nogle, Sally; Doyle, Scarlett; Russell, Doozie; Pearson, Randolph L; Monroe, Jeffrey; Liszewski, Christine M; DeMarco, J Kevin; Kaufman, David I

    2015-03-01

    Current diagnosis and monitoring of sports-related concussion rely on clinical signs and symptoms, and balance, vestibular, and neuropsychological examinations. Conventional brain imaging often does not reveal abnormalities. We sought to assess if the longitudinal change of functional and structural connectivity of the default-mode network (DMN) can serve as a potential biomarker. Eight concussed Division I collegiate football student-athletes in season (one participated twice) and 11 control subjects participated in this study. ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) was administered over the course of recovery. High-resolution three dimensional T1-weighted, T2*-weighted diffusion-tensor images and resting-state functional magnetic resonance imaging (rs-fMRI) scans were collected from each subject within 24 h, 7±1 d and 30±1 d after concussion. Both network based and whole-brain based functional correlation analyses on DMN were performed. ImPACT findings demonstrated significant cognitive impairment across multiple categories and a significant increase of symptom severity on Day 1 following a concussion but full recovery by 6.0±2.4 d. While the structural connectivity within DMN and gross anatomy appeared unchanged, a significantly reduced functional connectivity within DMN from Day 1 to Day 7 was found in the concussed group in this small pilot study. This reduction was seen in eight of our nine concussion cases. Compared with the control group, there appears a general trend of increased DMN functional connectivity on Day 1, a significant drop on Day 7, and partial recovery on Day 30. The results of this pilot study suggest that the functional connectivity of DMN measured with longitudinal rs-fMRI can serve as a potential biomarker to monitor the dynamically changing brain function after sports-related concussion, even in patients who have shown clinical improvement.

  1. Mild Concussion, but Not Moderate Traumatic Brain Injury, Is Associated with Long-Term Depression-Like Phenotype in Mice.

    Science.gov (United States)

    Bajwa, Nikita M; Halavi, Shina; Hamer, Mary; Semple, Bridgette D; Noble-Haeusslein, Linda J; Baghchechi, Mohsen; Hiroto, Alex; Hartman, Richard E; Obenaus, André

    2016-01-01

    Mild traumatic brain injuries can lead to long-lasting cognitive and motor deficits, increasing the risk of future behavioral, neurological, and affective disorders. Our study focused on long-term behavioral deficits after repeated injury in which mice received either a single mild CHI (mCHI), a repeated mild CHI (rmCHI) consisting of one impact to each hemisphere separated by 3 days, or a moderate controlled cortical impact injury (CCI). Shams received only anesthesia. Behavioral tests were administered at 1, 3, 5, 7, and 90 days post-injury (dpi). CCI animals showed significant motor and sensory deficits in the early (1-7 dpi) and long-term (90 dpi) stages of testing. Interestingly, sensory and subtle motor deficits in rmCHI animals were found at 90 dpi. Most importantly, depression-like behaviors and social passiveness were observed in rmCHI animals at 90 dpi. These data suggest that mild concussive injuries lead to motor and sensory deficits and affective disorders that are not observed after moderate TBI.

  2. Mild Concussion, but Not Moderate Traumatic Brain Injury, Is Associated with Long-Term Depression-Like Phenotype in Mice.

    Directory of Open Access Journals (Sweden)

    Nikita M Bajwa

    Full Text Available Mild traumatic brain injuries can lead to long-lasting cognitive and motor deficits, increasing the risk of future behavioral, neurological, and affective disorders. Our study focused on long-term behavioral deficits after repeated injury in which mice received either a single mild CHI (mCHI, a repeated mild CHI (rmCHI consisting of one impact to each hemisphere separated by 3 days, or a moderate controlled cortical impact injury (CCI. Shams received only anesthesia. Behavioral tests were administered at 1, 3, 5, 7, and 90 days post-injury (dpi. CCI animals showed significant motor and sensory deficits in the early (1-7 dpi and long-term (90 dpi stages of testing. Interestingly, sensory and subtle motor deficits in rmCHI animals were found at 90 dpi. Most importantly, depression-like behaviors and social passiveness were observed in rmCHI animals at 90 dpi. These data suggest that mild concussive injuries lead to motor and sensory deficits and affective disorders that are not observed after moderate TBI.

  3. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... 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 UNITED STATES Statistics Causes Outcomes Prevention COMMUNICATING EFFECTIVELY ABOUT ...

  4. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... Learn More about the Brain and How it Works Order Free Copies of CDC's “Heads Up” Educational ... Up! Prevent Concussions Prevent Head Injuries Sports Safety Students Play Safe Youth Sports Safety PROMOTIONAL MATERIALS "Heads ...

  5. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... to Know,” [Exit Disclaimer] Free Online Training (Developed in partnership with the National Federation of State High ... MORE INFORMATION ON CONCUSSION and TRAUMATIC BRAIN INJURY IN THE UNITED STATES Statistics Causes Outcomes Prevention COMMUNICATING ...

  6. Concussion and football: a review and editorial.

    Science.gov (United States)

    Abdullah, Kalil G; Grady, M Sean; Levine, Joshua M

    2015-04-01

    The issue of concussion in football is of substantial interest to players, coaches, fans, and physicians. In this article, we review specific cultural hindrances to diagnosis and treatment of concussion in football. We review current trends in management and identify areas for improvement. We also discuss the obligations that physicians, particularly neurosurgeons and neurologists, have toward brain-injured football players and the larger societal role they may play in helping to minimize football-associated brain injury.

  7. Coping Strategies as a Predictor of Post-concussive Symptoms in Children with Mild Traumatic Brain Injury versus Mild Orthopedic Injury

    OpenAIRE

    2011-01-01

    This study examined whether children’s coping strategies are related to post-concussive symptoms following mild traumatic brain injury (TBI) versus orthopedic injury (OI). Participants were 8- to 15-year-old children with mild TBI (n =167) or OI (n =84). They rated their current preferred coping strategies and post-injury symptoms at 2 weeks (baseline) and 1, 3, and 12 months post-injury. Children’s reported use of coping strategies did not vary significantly over time, so their baseline copi...

  8. [Application of nootropic agents in complex treatment of patients with concussion of the brain].

    Science.gov (United States)

    Tkachev, A V

    2007-01-01

    65 patients with a mild craniocereberal trauma have been observed. Medical examination included among general clinical methods the following methods: KT (MRT) of the brain, oculist examination including the observation of eye fundus. For objectification of a patient' complaints the authors used orientation and Galvestona's amnesia tests, feeling scale (psychological test), the table to determine the level of memory. Tests have been carried out on the first, tenth and thirty day of the treatment. Patients of the first group received in a complex treatment -pramistar, patients of the second group - piracetam. Patients of both groups noted considerable improvement during a complex treatment (disappearance of headache, dizziness and nausea) and at the same time patients receiving pramistar had better restoration of orientation and feeling. Pramistar was also more effective in patients with amnesia.

  9. Repetitive concussive traumatic brain injury interacts with post-injury foot shock stress to worsen social and depression-like behavior in mice.

    Science.gov (United States)

    Klemenhagen, Kristen C; O'Brien, Scott P; Brody, David L

    2013-01-01

    The debilitating effects of repetitive concussive traumatic brain injury (rcTBI) have been increasingly recognized in both military and civilian populations. rcTBI may result in significant neurological, cognitive, and affective sequelae, and is often followed by physical and/or psychological post-injury stressors that may exacerbate the effects of the injury and prolong the recovery period for injured patients. However, the consequences of post-injury stressors and their subsequent effects on social and emotional behavior in the context of rcTBI have been relatively little studied in animal models. Here, we use a mouse model of rcTBI with two closed-skull blunt impacts 24 hours apart and social and emotional behavior testing to examine the consequences of a stressor (foot shock fear conditioning) following brain injury (rcTBI). rcTBI alone did not affect cued or contextual fear conditioning or extinction compared to uninjured sham animals. In the sucrose preference test, rcTBI animals had decreased preference for sucrose, an anhedonia-like behavior, regardless of whether they experienced foot shock stress or were non-shocked controls. However, rcTBI and post-injury foot shock stress had synergistic effects in tests of social recognition and depression-like behavior. In the social recognition test, animals with both injury and shock were more impaired than either non-shocked injured mice or shocked but uninjured mice. In the tail suspension test, injured mice had increased depression-like behavior compared with uninjured mice, and shock stress worsened the depression-like behavior only in the injured mice with no effect in the uninjured mice. These results provide a model of subtle emotional behavioral deficits after combined concussive brain injury and stress, and may provide a platform for testing treatment and prevention strategies for social behavior deficits and mood disorders that are tailored to patients with traumatic brain injury.

  10. Repetitive concussive traumatic brain injury interacts with post-injury foot shock stress to worsen social and depression-like behavior in mice.

    Directory of Open Access Journals (Sweden)

    Kristen C Klemenhagen

    Full Text Available The debilitating effects of repetitive concussive traumatic brain injury (rcTBI have been increasingly recognized in both military and civilian populations. rcTBI may result in significant neurological, cognitive, and affective sequelae, and is often followed by physical and/or psychological post-injury stressors that may exacerbate the effects of the injury and prolong the recovery period for injured patients. However, the consequences of post-injury stressors and their subsequent effects on social and emotional behavior in the context of rcTBI have been relatively little studied in animal models. Here, we use a mouse model of rcTBI with two closed-skull blunt impacts 24 hours apart and social and emotional behavior testing to examine the consequences of a stressor (foot shock fear conditioning following brain injury (rcTBI. rcTBI alone did not affect cued or contextual fear conditioning or extinction compared to uninjured sham animals. In the sucrose preference test, rcTBI animals had decreased preference for sucrose, an anhedonia-like behavior, regardless of whether they experienced foot shock stress or were non-shocked controls. However, rcTBI and post-injury foot shock stress had synergistic effects in tests of social recognition and depression-like behavior. In the social recognition test, animals with both injury and shock were more impaired than either non-shocked injured mice or shocked but uninjured mice. In the tail suspension test, injured mice had increased depression-like behavior compared with uninjured mice, and shock stress worsened the depression-like behavior only in the injured mice with no effect in the uninjured mice. These results provide a model of subtle emotional behavioral deficits after combined concussive brain injury and stress, and may provide a platform for testing treatment and prevention strategies for social behavior deficits and mood disorders that are tailored to patients with traumatic brain injury.

  11. Parallel Human and Animal Models of Blast- and Concussion-Induced Tinnitus and Related Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2014-01-01

    associated with hemorrhage (Harris et al., 2006), attention deficit hyperactivity disorder (Li et al., 2010), developmental and adult-onset stuttering...Increased fractional anisotropy in white matter of the right frontal region in children with attention - deficit / hyperactivity disorder : a diffusion...Concussion may induce onset rather than chronic tinnitus and auditory detection deficits . In general, the induced effects are accompanied by moderate level

  12. The WRAIR projectile concussive impact model of mild traumatic brain injury: re-design, testing and preclinical validation.

    Science.gov (United States)

    Leung, Lai Yee; Larimore, Zachary; Holmes, Larry; Cartagena, Casandra; Mountney, Andrea; Deng-Bryant, Ying; Schmid, Kara; Shear, Deborah; Tortella, Frank

    2014-08-01

    The WRAIR projectile concussive impact (PCI) model was developed for preclinical study of concussion. It represents a truly non-invasive closed-head injury caused by a blunt impact. The original design, however, has several drawbacks that limit the manipulation of injury parameters. The present study describes engineering advancements made to the PCI injury model including helmet material testing, projectile impact energy/head kinematics and impact location. Material testing indicated that among the tested materials, 'fiber-glass/carbon' had the lowest elastic modulus and yield stress for providing an relative high percentage of load transfer from the projectile impact, resulting in significant hippocampal astrocyte activation. Impact energy testing of small projectiles, ranging in shape and size, showed the steel sphere produced the highest impact energy and the most consistent impact characteristics. Additional tests confirmed the steel sphere produced linear and rotational motions on the rat's head while remaining within a range that meets the criteria for mTBI. Finally, impact location testing results showed that PCI targeted at the temporoparietal surface of the rat head produced the most prominent gait abnormalities. Using the parameters defined above, pilot studies were conducted to provide initial validation of the PCI model demonstrating quantifiable and significant increases in righting reflex recovery time, axonal damage and astrocyte activation following single and multiple concussions.

  13. Psychological evaluation of patients with brain concussion%脑震荡患者心理状况评定(附186例报告)

    Institute of Scientific and Technical Information of China (English)

    赵鹏洲; 罗江兵; 杨本生; 欧英雄; 谭社练; 方胜; 赵伯端

    2008-01-01

    目的 探讨脑震荡患者的心理状况特征.方法 对186例脑震荡患者进行90项症状自评量表(SCL-90)评定,并与常模(正常人阳件症状均分)比较.结果 腩震荡患者SCL-90总分(137.71±39.48),总均分(1.53±0.44),阳性项目数(32.90±19.41),躯体化症状因子分(1.57±0.52)、强迫症状因子分(1.79±0.50)、焦虑症状因子分(1.50±0.49)、敌对症状因子分(1.63±0.57)、恐惧症状因子分(1.57±0.51)、偏执症状因子分(1.62±0.51)、精神病性因子分(1.49±0.43)明显高于常模(129.96±38.76、1.44±0.43、24.92±18.41、1.37±0.48、1.62±0.58、1.39±0.43、1.48±0.56、1.23±0.41、1.43±0.57、1.29±0.42),差异有统计学意义(P0.05).结论 脑震荡可导致患者心理障碍的产生,应早期就对患者进行心理治疗.%Objective To investigate the psychological status of patients with brain concussion. Methods A total of 186 patients with brain concussion were evaluated using Symptom Check-List 90 (SCL-90) and the scores were compared with the norms. Results The general scores (137.71±39.48), total mean scores (1.53±0.44) and positive object number (32.90±19.41) of SCL-90, as well as the factor scores ofsomatization(1.57±0.52), compulsion(1.79±0.50), anxiety disorder(1.50±0.49), hostility(1.63± 0.57), phobic anxiety(1.57±0.51), paranoid ideation(1.62±0.51) and psychoticism ( 1.49±0.43) in the patients with brain concussion were all higher than the normal ones (129.96±38.76, 1.44±0.43, 24.92± 18.41, 1.37±0.48, 1.62±0.58, 1.39±0.43, 1.48±0.56, 1.23±0.41, 1.43±0.57, 1.29±0.42, respectively)(P0.05). Conclusion Brain concussion may lead to psychological disturbance, for which early interventions should be administered.

  14. Nuclear Medicine Imaging in Concussive Head Injuries in Sports

    NARCIS (Netherlands)

    Vállez Garcia, David; Otte, Andreas; Glaudemans, Andor WJM; Dierckx, Rudi AJO; Gielen, Jan LMA; Zwerver, Johannes

    2015-01-01

    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

  15. Sport-Related Concussions

    Science.gov (United States)

    Brady, Don; Brady, Flo

    2011-01-01

    Sport-related concussions (SRC) are not limited to specific age ranges, professional athletes, or gender. The primary focus of much of SRC research pertains to the assessment, management, and return to play (RTP) of the concussed athlete. This article highlights some major issues of SRC along with some controversies that presently exist within the…

  16. Post-Concussion Syndrome

    Science.gov (United States)

    ... if you're having problems with memory or problem-solving. There is no specific treatment for post-concussion ... for post-concussion syndrome if you have cognitive problems, as most of them ... or other techniques to work around memory deficits and attention skills. ...

  17. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... and obey the rules of safety. B By working with parents, athletes, school and club administrators to spread awareness about concussions ... Sports Materials for Health Care Providers Materials for School ... about the Brain and How it Works Order Free Copies of CDC's “Heads Up” Educational ...

  18. Concussion associated with head trauma in athletes

    Directory of Open Access Journals (Sweden)

    Gabriela Murguía Cánovas

    2013-01-01

    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.

  19. Repetitive concussions in adolescent athletes – translating clinical and experimental research into perspectives on rehabilitation strategies

    Directory of Open Access Journals (Sweden)

    Bridgette D Semple

    2015-04-01

    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.

  20. Know the Facts: Understand Concussion

    Centers for Disease Control (CDC) Podcasts

    2010-03-17

    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.

  1. Concussions From Youth Football

    Science.gov (United States)

    Jacobson, Nathan A.; Buzas, David; Morawa, Lawrence G.

    2013-01-01

    Background: Youth football programs across the United States represent an at-risk population of approximately 3.5 million athletes for sports-related concussions. The frequency of concussions in this population is not known. Study Design: Descriptive epidemiology study. Methods: Over an 11-year span from January 2002 to December 2012, the authors reviewed the concussions sustained by athletes aged 5 to 13 years while playing football, as evaluated in emergency departments (EDs) in the United States and captured by the National Electronic Injury Surveillance System (NEISS) database of the US Consumer Product Safety Commission. Results: There were 2028 (national estimate, 49,185) young football players evaluated in NEISS EDs with concussion from 2002 to 2012. There were 1987 (97.9%) males and 41 (2.1%) females, with a mean age of 11.2 years. The total number of concussions reported increased with age and by year. The majority of concussions were treated in the outpatient setting, with 1878 (91.7%) being treated and released. The total number of head-to-head injury mechanisms mirrored the total number of concussions by year, which increased throughout the 11-year span. The total number of players experiencing a loss of consciousness increased throughout the study period but did not match the total number of concussions over the 11-year time period. Fractures occurred in 11 (0.5%) patients, with 2 being severe (1 skull fracture and 1 thoracic compression fracture). Conclusion: Within the 5- to 13-year age range, there were a significant number of young athletes who presented to EDs with concussion as a result of playing organized football. Older children may be at greater risk for sustaining concussions, fractures, and catastrophic injuries while playing football when compared with younger children. Clinical Relevance: Younger children are more susceptible to long-term sequelae from head injuries, and thus, improved monitoring systems for these athletes are needed to

  2. Future directions in brain injury research.

    Science.gov (United States)

    Gennarelli, Thomas A

    2014-01-01

    This paper reviews the potential future directions that are important for brain injury research, especially with regard to concussion. The avenues of proposed research are categorized according to current concepts of concussion, types of concussion, and a global schema for globally reducing the burden of concussion.

  3. Self-reported concussion history: impact of providing a definition of concussion

    Directory of Open Access Journals (Sweden)

    Robbins CA

    2014-05-01

    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

  4. Functional Status after Blast-Plus-Impact Complex Concussive Traumatic Brain Injury in Evacuated United States Military Personnel

    Science.gov (United States)

    2014-01-01

    vulnerability to PTSD and depression, blast-related hormonal abnormalities,51 and blast-related injuries to specific parts of the brain causing impaired emotional ...Homaifar, B.Y., Gutierrez, P.M., Staves, P.J., Harwood, J.E., Reeves , D., Adler, L.E., Ivins, B.J., Helmick, K., and Warden, D. (2010

  5. Traumatic Brain Injury (TBI) Data and Statistics

    Science.gov (United States)

    ... The CDC Cancel Submit Search The CDC Traumatic Brain Injury & Concussion Note: Javascript is disabled or is not ... please visit this page: About CDC.gov . Traumatic Brain Injury & Concussion Basic Information Get the Facts Signs and ...

  6. Heart Rate Variability Interventions for Concussion and Rehabilitation

    Directory of Open Access Journals (Sweden)

    Robert Lake Conder

    2014-08-01

    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.

  7. Heart rate variability interventions for concussion and rehabilitation.

    Science.gov (United States)

    Conder, Robert L; Conder, Alanna A

    2014-01-01

    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 HRV implies cardiopathology, morbidity, reduced quality-of-life, and precipitous mortality. On the positive, optimal HRV 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 HRV 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.

  8. Mild Concussion, but Not Moderate Traumatic Brain Injury, Is Associated with Long-Term Depression-Like Phenotype in Mice

    OpenAIRE

    Nikita M Bajwa; Shina Halavi; Mary Hamer; Semple, Bridgette D.; Noble-Haeusslein, Linda J; Mohsen Baghchechi; Alex Hiroto; Hartman, Richard E.; André Obenaus

    2016-01-01

    Mild traumatic brain injuries can lead to long-lasting cognitive and motor deficits, increasing the risk of future behavioral, neurological, and affective disorders. Our study focused on long-term behavioral deficits after repeated injury in which mice received either a single mild CHI (mCHI), a repeated mild CHI (rmCHI) consisting of one impact to each hemisphere separated by 3 days, or a moderate controlled cortical impact injury (CCI). Shams received only anesthesia. Behavioral tests were ...

  9. Parallel Human and Animal Models of Blast- and Concussion-Induced Tinnitus and Related Traumatic Brain Injury (TBI)

    Science.gov (United States)

    2013-01-01

    not be feasible without episodic representation to form a spatial environment map ( Eichenbaum , 1999). Moreover, current study is the first study to...and GABA(B) receptors in the regulation of the nucleus accumbens dopamine response to stress. Brain research. 1150, 62-8. Eichenbaum , H., 1999. The...and hyperactivity following cochlear damage. HearRes 147, 261-274. Sanderson, K.L., Raghupathi, R., Saatman, K.E., Martin , D., Miller, G., and

  10. Magnetoencephalography in the diagnosis of concussion.

    Science.gov (United States)

    Lee, Roland R; Huang, Mingxiong

    2014-01-01

    Magnetoencephalography (MEG) is a biomedical technique which measures the magnetic fields emitted by the brain, generated by neuronal activity. Commercial whole-head MEG units have been available for about 15 years, but currently there are only about 20 such units operating in the USA. Here, we review the basic concepts of MEG and list some of the usual clinical indications: noninvasive localization of epileptic spikes and presurgical mapping of eloquent cortex. We then discuss using MEG to diagnose mild traumatic brain injury (mTBI; concussions). Injured brain tissues in TBI patients generate abnormal low-frequency magnetic activity (delta-waves: 1-4 Hz) that can be measured and localized by MEG. These abnormal delta-waves originate from neurons that experience deafferentation from axonal injury to the associated white matter fiber tracts, also manifested on diffusion tensor imaging as reduced fractional anisotropy. Magnetoencephalographic evaluation of abnormal delta-waves (1-4 Hz) is probably the most sensitive objective test to diagnose concussions. An automated MEG low-frequency (slow wave) source imaging method, frequency-domain vector-based spatiotemporal analysis using a L1-minimum norm (VESTAL), achieved a positive finding rate of 87% for diagnosing concussions (blast-induced plus nonblast), 100% for moderate TBI, and no false-positive diagnoses in normal controls. There were also significant correlations between the number of cortical regions generating abnormal slow waves and the total postconcussive symptom scores in TBI patients.

  11. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... To Concussions Getting Back In The Game Concussion Prevention Resource Center Menu Button Return To Training Downloadable ... concussion than adults and they take longer to recover than adults. D All of the above. Submit ...

  12. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... 2 Which of the following is true? A Most concussions occur without loss of consciousness. B Athletes ... QUIZ QUESTION 3 Concussions affect people differently. While most athletes with a concussion recover quickly and fully, ...

  13. Vestibular Deficits Following Concussion

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2015-05-01

    Full Text Available Investigators from the Division of Emergency Medicine, Sports Medicine, and Department of Pediatrics, Children’s Hospital of Philadelphia, PA, and Sports Medicine, Somerset, NJ, performed a retrospective cohort study of 247 patients ages 5-18 years with concussion referred from July 2010 to Dec 2011; 81% of patients showed a vestibular abnormality on initial clinical examination.

  14. Sports and Concussions

    Science.gov (United States)

    ... teams, you probably know that concussions are a serious issue. Playing sports increases a person's risk of falls and collisions ... it might happen on the sidelines during a game. Sideline testing is common in schools and sports leagues. By watching you and doing a few ...

  15. Postural control deficits identify lingering post-concussion neurological deficits

    Institute of Scientific and Technical Information of China (English)

    Thomas A. Buckley; Jessie R. Oldham; Jaclyn B. Caccese

    2016-01-01

    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.

  16. The effects of fatigue and the post-concussion syndrome on executive functioning in traumatic brain injury and healthy comparisons

    Directory of Open Access Journals (Sweden)

    Enid Schutte

    2010-03-01

    Full Text Available In this study, behavioural manifestations of compromised executive control, including perseveration and reduced inductive reasoning, on the Wisconsin Card Sorting Test (WCST were investigated.Performance was affected by fatigue in both a head-injured and matched population, which has implications for health care professionals involved in rehabilitation and assessment. A fatigue condition was manipulated for 15 moderate to severe traumatic brain injury (TBI individuals through the course of a three-hour neuropsychological testing session. A comparison sample of 15 participants in a group of ‘no history of TBI’ was fatigued through the same approach. All fatigued participants (with and without TBI displayed trends towards increased levels of perseveration and reduced inductive reasoning on the WCST. Thus, the effects of fatigue on high-level functioning are pervasive even when not head-injured. This finding supports the sub-optimal performance in cognitive skills, specifically in executive control, that is often found in fatigued people. These findings are relevant for the manner in which rehabilitation interventions and medico-legal assessments are structured. Importantly, the order of tests, their interpretation and rest sessions should be clearly indicated and interpreted in assessment reports and rehabilitation sessions.

    Opsomming

    In hierdie studie is gedragsmanifestering in individue met gekompromitteerde uitvoerende funksionering, met inbegrip van perseverasie en verminderde induktiewe redenering, op die Wisconsin-kaartsorteringstoets (WCST, bestudeer. Die waarneming dat prestasie deur uitputting beïnvloed word in sowel normale populasies as dié met kopbeserings het implikasies vir gesondheidsorgpersoneel wat by rehabilitasie en assessering betrokke is. ’n Uitputtingstoestand is gemanipuleer vir 15 matig ernstige individue met traumatiese kopbeserings (TKB vir die duur van ’n drie uur lange toetssessie.

  17. Differentiating Concussion From Intracranial Pathology in Athletes.

    Science.gov (United States)

    Cripps, Andrea; Livingston, Scott C

    2017-01-01

    Clinical Scenario: A cerebral concussion is a traumatically induced transient disturbance of brain function characterized by a complex pathophysiologic process and is classified as a subset of mild traumatic brain injury. The occurrence of intracranial lesions after sport-related head injury is relatively uncommon, but the possibility of serious intracranial injury (ICI) should be included in the differential diagnosis. ICIs are potentially life threatening and necessitate urgent medical management; therefore, prompt recognition and evaluation are critical to proper medical management. One of the primary objectives of the initial evaluation is to determine if the concussed athlete has an acute traumatic ICI. Athletic trainers must be able promptly recognize clinical signs and symptoms that will enable them to accurately differentiate between a concussion (ie, a closed head injury not associated with significant ICI) and an ICI. The identification of predictors of intracranial lesions is, however, relatively broad. Focused Clinical Question: Which clinical examination findings (ie, clinical signs and symptoms) indicate possible intracranial pathology in individuals with acute closed head injuries?

  18. Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury: Guidance for the Rehabilitation Provider in Deployed and Non-deployed Settings

    Science.gov (United States)

    2014-01-01

    B., McKey, B., & Whitsett, T., (2004). Blood pressure response to caffeine shows incomplete tolerance after short term regular consumption ...After Concussion sheets available at dvbic.dcoe.mil. Additional patient guidance to abstain from alcohol and to avoid substances such as caffeine and...rest although total bed rest not recommended Sleep as desired Abstain from alcohol Avoid caffeine and nicotine Avoid breath holding RPE Scale

  19. Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury: Guidance for the Primary Care Manager in Deployed and Non-deployed Settings

    Science.gov (United States)

    2014-01-01

    through the stepwise progression of activity.10 Symptoms such as fatigue or headache are rarely completely absent, especially following exertion even...described as “activities that make your heart race” on the “Return to Activity Educational Brochure.” When headache , sleep difficulties or vestibular or...of ‘Return-to-Learn’ in Pediatric and Adolescent Concussion. Pediatric Annals, 41(9), 1-6. 27. Adams, R., Larson, M., Corrigan, J., Horgan, C

  20. A Case for Mental and Physical Rest in Youth Sports Concussion: It's Never too Late.

    Science.gov (United States)

    Moser, Rosemarie Scolaro; Schatz, Philip

    2012-01-01

    Over the past decade, there has been a considerable increase in research on, and media attention to, sports-related concussion. However, despite accurate diagnosis, effective treatment and management of sports-related concussion have remained a challenge. There are approximately 1.8 million traumatic brain injuries in the United States annually (Faul et al., 2010) and emergency department pediatric visits for suspected concussion have doubled in the past decade (Bakhos et al., 2010). However, health care providers and medical researchers have yet to offer an effective, reliable evidence-based treatment for concussive brain injury. The Zurich 2008 Consensus Statement on Concussion in Sport codified the prescription for cognitive and physical rest immediately following a concussion based on clinical acumen and common sense (McCrory et al., 2009). Currently, rest is the considered the best immediate treatment for concussion. Other supportive and anecdotal treatments are often applied throughout the post-concussive recovery process to address persistent symptoms. The need for empirical research to translate current guidelines for rest into evidence-based treatment protocols is essential. A recent study evaluated the efficacy of comprehensive rest and concluded that such rest may be helpful whether applied soon after a concussion or weeks to months later (Moser et al., 2012). Here, we present a case illustrating the effectiveness of rest in a youth athlete, commenced after experiencing 13 months of post-concussion symptoms. There appears to be value in applying a specific period of cognitive and physical rest following concussion, whether immediately or later in the recovery phase.

  1. Recognizing and managing concussion in school sport.

    Science.gov (United States)

    Evans, Vicki

    2014-08-01

    Every country around the world enjoys some sort of sport. The Olympics sees countries from all over the globe participate in elite sport, in both winter and summer competitions. Australia is widely known for cricket and rugby; America is known for baseball and gridiron football (among others). These sports are played at an elite level as well as beginners from early ages as young as 4 years in the backyard. Yet, it is also these sports that can deliver a ball at the speed of 100 km/h (football), 105 km/h (baseball), 112 km/h (rugby), 150 km/h (cricket), and 211 km/h (soccer). This is the same force that a car collision can produce. That force eventually finds a target, and in some cases, unfortunately, it is a head. Damage to the brain is not only from the impact of the ball hitting its target but rather also the shearing forces of acceleration-deceleration injury that can cause extensive injuries. There has been much discussion of late regarding concussion in sport and the accumulative effects of head blows resulting in varying degrees of memory loss and dementia later in life. The media have been saturated with heightened awareness of chronic traumatic encephalopathy. This, however, is still being researched. It is true that each concussion compounds the one before, but rather than focus on the injury, managers/coaches and sporting codes should be focusing on the identification and proper management of a suspected concussion and the return-to-play protocols. This is especially important in our schools where growing brains need nurturing. Neuroscience nurses are at the forefront of educating school children, teachers, and coaches through partnering with local schools. This article will focus on concussion recognition and management in school sport.

  2. More Years Playing Football, Greater Risk of Brain Disease

    Science.gov (United States)

    ... and Human Services. More Health News on: Concussion Sports Injuries Traumatic Brain Injury Recent Health News Related MedlinePlus Health Topics Concussion Sports Injuries Traumatic Brain Injury About MedlinePlus Site Map FAQs Customer Support ...

  3. 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

    Science.gov (United States)

    Kohn, Linda T.

    2010-01-01

    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…

  4. Understanding the neuroinflammatory response following concussion to develop treatment strategies.

    Science.gov (United States)

    Patterson, Zachary R; Holahan, Matthew R

    2012-01-01

    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 impact forces 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 favorable 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 (NGF)] and anti-inflammatory agents as an adjunct for the management of post-concussion symptomology will be explored in this review.

  5. UNDERSTANDING THE NEUROINFLAMMATORY RESPONSE FOLLOWING CONCUSSION TO DEVELOP TREATMENT STRATEGIES

    Directory of Open Access Journals (Sweden)

    Zachary Robert Patterson

    2012-12-01

    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.

  6. 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

    OpenAIRE

    Kiraly, Michael A.; Kiraly, Stephen J.

    2007-01-01

    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...

  7. Functional, Structural, and Neurotoxicity Biomarkers in Integrative Assessment of Concussions

    Directory of Open Access Journals (Sweden)

    Svetlana A Dambinova

    2016-10-01

    Full Text Available Concussion is a complex, heterogenous process affecting the brain. Accurate assessment and diagnosis and appropriate management of concussion are essential to ensure athletes do not prematurely return to play or others to work or active military duty, risking re-injury. To date, clinical diagnosis relies primarily on evaluating subjects for functional impairment using instruments that include neurocognitive testing, subjective symptom report, and neurobehavioral assessments, such as balance and vestibular-ocular reflex testing. Structural biomarkers, defined as advanced neuroimaging techniques and biomarkers assessing neurotoxicity and immunoexcitotoxicity may complement the use of functional biomarkers. We hypothesize that neurotoxicity AMPA, NMDA, and kainite receptor biomarkers might be utilized as a part of comprehensive approach to concussion evaluations, with the goal of increasing diagnostic accuracy and facilitating treatment planning and prognostic assessment.

  8. 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

    Directory of Open Access Journals (Sweden)

    Michael A. Kiraly

    2007-01-01

    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.

  9. Plasma soluble prion protein, a potential biomarker for sport-related concussions: a pilot study.

    Science.gov (United States)

    Pham, Nam; Akonasu, Hungbo; Shishkin, Rhonda; Taghibiglou, Changiz

    2015-01-01

    Sport-related mild traumatic brain injury (mTBI) or concussion is a significant health concern to athletes with potential long-term consequences. The diagnosis of sport concussion and return to sport decision making is one of the greatest challenges facing health care clinicians working in sports. Blood biomarkers have recently demonstrated their potential in assisting the detection of brain injury particularly, in those cases with no obvious physical injury. We have recently discovered plasma soluble cellular prion protein (PrP(C)) as a potential reliable biomarker for blast induced TBI (bTBI) in a rodent animal model. In order to explore the application of this novel TBI biomarker to sport-related concussion, we conducted a pilot study at the University of Saskatchewan (U of S) by recruiting athlete and non-athlete 18 to 30 year-old students. Using a modified quantitative ELISA method, we first established normal values for the plasma soluble PrP(C) in male and female students. The measured plasma soluble PrP(C) in confirmed concussion cases demonstrated a significant elevation of this analyte in post-concussion samples. Data collected from our pilot study indicates that the plasma soluble PrP(C) is a potential biomarker for sport-related concussion, which may be further developed into a clinical diagnostic tool to assist clinicians in the assessment of sport concussion and return-to-play decision making.

  10. Plasma soluble prion protein, a potential biomarker for sport-related concussions: a pilot study.

    Directory of Open Access Journals (Sweden)

    Nam Pham

    Full Text Available Sport-related mild traumatic brain injury (mTBI or concussion is a significant health concern to athletes with potential long-term consequences. The diagnosis of sport concussion and return to sport decision making is one of the greatest challenges facing health care clinicians working in sports. Blood biomarkers have recently demonstrated their potential in assisting the detection of brain injury particularly, in those cases with no obvious physical injury. We have recently discovered plasma soluble cellular prion protein (PrP(C as a potential reliable biomarker for blast induced TBI (bTBI in a rodent animal model. In order to explore the application of this novel TBI biomarker to sport-related concussion, we conducted a pilot study at the University of Saskatchewan (U of S by recruiting athlete and non-athlete 18 to 30 year-old students. Using a modified quantitative ELISA method, we first established normal values for the plasma soluble PrP(C in male and female students. The measured plasma soluble PrP(C in confirmed concussion cases demonstrated a significant elevation of this analyte in post-concussion samples. Data collected from our pilot study indicates that the plasma soluble PrP(C is a potential biomarker for sport-related concussion, which may be further developed into a clinical diagnostic tool to assist clinicians in the assessment of sport concussion and return-to-play decision making.

  11. Longitudinal assessment of white matter abnormalities following sports-related concussion.

    Science.gov (United States)

    Meier, Timothy B; Bergamino, Maurizio; Bellgowan, Patrick S F; Teague, T K; Ling, Josef M; Jeromin, Andreas; Mayer, Andrew R

    2016-02-01

    There is great interest in developing physiological-based biomarkers such as diffusion tensor imaging to aid in the management of concussion, which is currently entirely dependent on clinical judgment. However, the time course for recovery of white matter abnormalities following sports-related concussion (SRC) is unknown. We collected diffusion tensor imaging and behavioral data in forty concussed collegiate athletes on average 1.64 days (T1; n = 33), 8.33 days (T2; n = 30), and 32.15 days post-concussion (T3; n = 26), with healthy collegiate contact-sport athletes (HA) serving as controls (n = 46). We hypothesized that fractional anisotropy (FA) would be increased acutely and partially recovered by one month post-concussion. Mood symptoms were assessed using structured interviews. FA differences were assessed using both traditional and subject-specific analyses. An exploratory analysis of tau plasma levels was conducted in a subset of participants. Results indicated that mood symptoms improved over time post-concussion, but remained elevated at T3 relative to HA. Across both group and subject-specific analyses, concussed athletes exhibited increased FA in several white matter tracts at each visit post-concussion with no longitudinal evidence of recovery. Increased FA at T1 and T3 was significantly associated with an independent, real-world outcome measure for return-to-play. Finally, we observed a nonsignificant trend for reduced tau in plasma of concussed athletes at T1 relative to HA, with tau significantly increasing by T2. These results suggest white matter abnormalities following SRC may persist beyond one month and have potential as an objective biomarker for concussion outcome. Hum Brain Mapp 37:833-845, 2016. © 2015 Wiley Periodicals, Inc.

  12. Clinical Characteristics of Labyrinthine Concussion

    OpenAIRE

    Choi, Mi Suk; Shin, See-Ok; Yeon, Je Yeob; Choi, Young Seok; Kim, Jisung; Park, Soo Kyoung

    2013-01-01

    Background and Objectives Inner ear symptoms like hearing loss, dizziness or tinnitus are often developed after head trauma, even in cases without inner ear destruction. This is also known as labyrinthine concussion. The purpose of this study is to determine the clinical manifestations, characteristics of audiometry and prognostic factors of these patients. Materials and Methods We reviewed the medical records of the 40 patients that had been diagnosed as labyrinthine concussion from 1996 to ...

  13. A Case for Mental and Physical Rest in Youth Sports Concussion: It’s Never Too Late

    Directory of Open Access Journals (Sweden)

    Rosemarie Scolaro Moser

    2012-12-01

    Full Text Available ABSTRACTOver the past decade, there has been a considerable increase in research on, and media attention to, sports-related concussion. However, despite accurate diagnosis, effective treatment and management of sports-related concussion have remained a challenge. There are approximately 1.8 million traumatic brain injuries in the United States annually (Faul, Xu, Wald, & Coronado, 2010 and emergency department pediatric visits for suspected concussion have doubled in the past decade (Bakhos, Lockhart, Myers, & Linakis, 2010. However, health care providers and medical researchers have yet to offer an effective, reliable evidence based treatment for concussive brain injury. The Zurich 2008 Consensus Statement on Concussion in Sport codified the prescription for cognitive and physical rest immediately following a concussion based on clinical acumen and common sense (McCrory et al., 2009. Currently, rest is the considered the best immediate treatment for concussion. Other supportive and anecdotal treatments are often applied throughout the post-concussive recovery process to address persistent symptoms. The need for empirical research to translate current guidelines for rest into evidence-based treatment protocols is essential. A recent study evaluated the efficacy of comprehensive rest and concluded that such rest may be helpful whether applied soon after a concussion or weeks to months later (Moser, Glatts, Schatz, 2012. Here, we present a case illustrating the effectiveness of rest in a youth athlete, commenced after experiencing 13 months of post-concussion symptoms. There appears to be value in applying a specific period of cognitive and physical rest following concussion, whether immediately or later in the recovery phase.

  14. The Sport Concussion Education Project. A brief report on an educational initiative: from concept to curriculum.

    Science.gov (United States)

    Echlin, Paul S; Johnson, Andrew M; Holmes, Jeffrey D; Tichenoff, Annalise; Gray, Sarah; Gatavackas, Heather; Walsh, Joanne; Middlebro, Tim; Blignaut, Angelique; MacIntyre, Martin; Anderson, Chris; Fredman, Eli; Mayinger, Michael; Skopelja, Elaine N; Sasaki, Takeshi; Bouix, Sylvain; Pasternak, Ofer; Helmer, Karl G; Koerte, Inga K; Shenton, Martha E; Forwell, Lorie A

    2014-12-01

    Current research on concussion is primarily focused on injury identification and treatment. Prevention initiatives are, however, important for reducing the incidence of brain injury. This report examines the development and implementation of an interactive electronic teaching program (an e-module) that is designed specifically for concussion education within an adolescent population. This learning tool and the accompanying consolidation rubric demonstrate that significant engagement occurs in addition to the knowledge gained among participants when it is used in a school curriculum setting.

  15. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... Materials on Concussion in Sports Materials for Health Care Providers Materials for School Professionals Learn More about the ... Materials on Concussion in Sports Materials for Health Care Providers Materials for School Professionals Order Large Quantities of ...

  16. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  17. Concussion Management in the Classroom.

    Science.gov (United States)

    Graff, Danielle M; Caperell, Kerry S

    2016-12-01

    There is a new emphasis on the team approach to pediatric concussion management, particularly in the classroom. However, it is expected that educators are unfamiliar with the "Returning to Learning" recommendations. The authors' primary objective was to assess and improve high school educators' knowledge regarding concussions and management interventions using an online education tool. A total of 247 high school educators completed a 12 question pretest to assess core knowledge of concussions and classroom management followed by a 20-minute online literature-based education module. Participants then completed an identical posttest. The improvement in core knowledge was statistically significant (P classroom management also showed a statistically significant increase in scores (P classroom management as well as the significant improvement after an online educational module.

  18. The cognitive effects and decrements following concussion

    Directory of Open Access Journals (Sweden)

    Tracey Covassin

    2010-05-01

    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

  19. Potential Long-Term Consequences of Concussive and Subconcussive Injury.

    Science.gov (United States)

    Huber, Bertrand R; Alosco, Michael L; Stein, Thor D; McKee, Ann C

    2016-05-01

    Repeated concussive and subconcussive trauma is associated with the later development of chronic traumatic encephalopathy (CTE), a neurodegenerative disease associated with clinical symptoms in multiple domains and a unique pattern of pathologic changes. CTE has been linked to boxing and American football; CTE has also been identified in soccer, ice hockey, baseball, rugby, and military service. To date, most large studies of CTE have come from enriched cohorts associated with brain bank donations for traumatic brain injury, although several recent studies re-examining neurodegenerative disease brain banks suggest that CTE is more common than is currently appreciated.

  20. 脑震荡综合征患者脑网络效率的变化%Alterations of brain network efficiency in patients with post-concussion syndrome

    Institute of Scientific and Technical Information of China (English)

    彭楠; 钱若兵; 傅先明; 李顺利; 亢志强; 林彬; 季学兵; 魏祥品; 牛朝诗

    2015-01-01

    Objective To discuss the alterations of brain network efficiency in patients with postconcussion syndrome.Methods A total of 23 patients from Anhui Provincial Hospital in the period from 2013/6 to 2014/3 who have had the concussion for 3 months were enrolled and 23 volunteers paired in sex,age and education were also enrolled as healthy controls.Comparisons of selective attention of both groups were conducted using Stroop Word-Color Test.The data of resting-state functional magnetic resonance imaging (fMRI) in both groups were collected and the data were dealt with Network Construction which is a part of GRETNA software to obtain the Matrix of brain network.Network analysis was used to obtain Global and Nodal efficiency,then independent t-test was used for statistical analyses of the value of Global and Nodal efficiency.Results The difference in Global efficiency of two groups in every threshold value had no statisticalsignificance.Compared with healthy controls,the Nodal efficienciesin patients with post-concussion syndrome weresignificantly different in the brain regionsas below:left orbital middle frontal gyrus,left posterior cingulate,left lingual,left thalamus,left superior temporal gyrus,right anterior cingulate,right posterior cingulate,right supramarginalgyrus.Conclusions Compared with healthy controls,there is no significant changes of Globe efficiency in patients with post-concussion syndrome,and the brain function deficits in these patients may be caused by changes of Nodal efficiency in their brain network.%目的 探讨采用图论的方法对脑震荡综合征患者脑网络效率的改变.方法 2013年6月至2014年3月在安徽医科大学附属省立医院就诊的脑震荡综合征患者23例,有迁延不愈的头晕、头痛、注意力下降、注意力不集中、记忆下降、睡眠障碍等功能障碍,另招募23例健康对照者;两组被试进行Stroop色词实验了解选择性注意功能是否存在差别;采集两

  1. Concussions in Collision Youth Sports

    Directory of Open Access Journals (Sweden)

    Kathleen A. Linzmeier

    2016-03-01

    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.

  2. Taking Care After A Concussion

    Centers for Disease Control (CDC) Podcasts

    2010-03-17

    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.

  3. Neuroimaging Biomarkers of a History of Concussion Observed in Asymptomatic Young Athletes.

    Science.gov (United States)

    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

    2016-05-01

    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.

  4. High school coaches perceptions of physicians’ role in the assessment and management of sports-related concussive injury

    Directory of Open Access Journals (Sweden)

    Nolan eWilliams

    2012-10-01

    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.

  5. Episodic memory in former professional football players with a history of concussion: an event-related functional neuroimaging study.

    Science.gov (United States)

    Ford, Jaclyn H; Giovanello, Kelly S; Guskiewicz, Kevin M

    2013-10-15

    Previous research has demonstrated that sport-related concussions can have short-term effects on cognitive processes, but the long-term consequences are less understood and warrant more research. This study was the first to use event-related functional magnetic resonance imaging (fMRI) to examine long-term differences in neural activity during memory tasks in former athletes who have sustained multiple sport-related concussions. In an event-related fMRI study, former football players reporting multiple sport-related concussions (i.e., three or more) were compared with players who reported fewer than three concussions during a memory paradigm examining item memory (i.e., memory for the particular elements of an event) and relational memory (i.e., memory for the relationships between elements). Behaviorally, we observed that concussion history did not significantly affect behavioral performance, because persons in the low and high concussion groups had equivalent performance on both memory tasks, and in addition, that concussion history was not associated with any behavioral memory measures. Despite demonstrating equivalent behavioral performance, the two groups of former players demonstrated different neural recruitment patterns during relational memory retrieval, suggesting that multiple concussions may be associated with functional inefficiencies in the relational memory network. In addition, the number of previous concussions significantly correlated with functional activity in a number of brain regions, including the medial temporal lobe and inferior parietal lobe. Our results provide important insights in understanding the long-term functional consequences of sustaining multiple sports-related concussions.

  6. Suppression of oxidative stress and 5-lipoxygenase activation by edaravone improves depressive-like behavior after concussion.

    Science.gov (United States)

    Higashi, Youichirou; Hoshijima, Michihiro; Yawata, Toshio; Nobumoto, Atsuya; Tsuda, Masayuki; Shimizu, Takahiro; Saito, Motoaki; Ueba, Tetuya

    2014-10-15

    Brain concussions are a serious public concern and are associated with neuropsychiatric disorders, such as depression. Patients with concussion who suffer from depression often experience distress. Nevertheless, few pre-clinical studies have examined concussion-induced depression, and there is little information regarding its pharmacological management. Edaravone, a free radical scavenger, can exert neuroprotective effects in several animal models of neurological disorders. However, the effectiveness of edaravone in animal models of concussion-induced depression remains unclear. In this study, we examined whether edaravone could prevent concussion-induced depression. Mice were subjected to a weight-drop injury and intravenously administered edaravone (3.0 mg/kg) or vehicle immediately after impact. Serial magnetic resonance imaging showed no abnormalities of the cerebrum on diffusion T1- and T2-weighted images. We found that edaravone suppressed concussion-induced depressive-like behavior in the forced swim test, which was accompanied by inhibition of increased hippocampal and cortical oxidative stress (OS) and suppression of 5-lipoxygenase (5-LOX) translocation to the nuclear envelope in hippocampal astrocytes. Hippocampal OS in concussed mice was also prevented by the nicotinamide adenine dinucleotide phosphate oxidase inhibitor, apocynin, and administration of BWB70C, a 5-LOX inhibitor, immediately and 24 h after injury prevented depressive-like behaviors in concussed mice. Further, antidepressant effects of edaravone were observed in mice receiving 1.0 or 3.0 mg/kg of edaravone immediately after impact, but not at a lower dose of 0.1 mg/kg. This antidepressant effect persisted up to 1 h after impact, whereas edaravone treatment at 3 h after impact had no effect on concussion-induced depressive-like behavior. These results suggest that edaravone protects against concussion-induced depression, and this protection is mediated by suppression of OS and 5

  7. Interprofessional management of concussion in sport.

    Science.gov (United States)

    Pabian, Patrick S; Oliveira, Leonardo; Tucker, Jennifer; Beato, Morris; Gual, Carlos

    2017-01-01

    Due to the high incidence of sports concussion, various health and medical providers are likely to encounter athletes who have sustained such an injury. Management of concussion necessitates coordinated care by the members of the sports medicine team due to its pathophysiology and complexity of management during recovery. All members of the sports medicine team must possess contemporary knowledge of concussion management as well as strong interprofessional communication skills to ensure effective care and safe return to sports participation. Therefore, the aim of this manuscript is to review the current best practices in interdisciplinary management of sports concussion with a special emphasis on the required interprofessional communication among the sports medicine team.

  8. Retirement-from-sport considerations following pediatric sports-related concussion: case illustrations and institutional approach.

    Science.gov (United States)

    Ellis, Michael J; McDonald, Patrick J; Cordingley, Dean; Mansouri, Behzad; Essig, Marco; Ritchie, Lesley

    2016-04-01

    The decision to advise an athlete to retire from sports following sports-related concussion (SRC) remains a persistent challenge for physicians. In the absence of strong empirical evidence to support recommendations, clinical decision making must be individualized and should involve a multidisciplinary team of experts in concussion and traumatic brain injury. Although previous authors have advocated for a more conservative approach to these issues in child and adolescent athletes, there are few reports outlining considerations for this process among this unique population. Here, the authors use multiple case illustrations to discuss 3 subgroups of clinical considerations for sports retirement among pediatric SRC patients including the following: those with structural brain abnormalities identified on neuroimaging, those presenting with focal neurological deficits and abnormalities on physical examination, and those in whom the cumulative or prolonged effects of concussion are suspected or demonstrated. The authors' evolving multidisciplinary institutional approach to return-to-play and retirement decision making in pediatric SRC is also presented.

  9. Concussion management in soccer

    Directory of Open Access Journals (Sweden)

    Jason P. Mihalik

    2014-12-01

    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.

  10. Concussion Education for High School Football Players: A Pilot Study

    Science.gov (United States)

    Manasse-Cohick, Nancy J.; Shapley, Kathy L.

    2014-01-01

    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,…

  11. Biomechanics of sport concussion: quest for the elusive injury threshold.

    Science.gov (United States)

    Guskiewicz, Kevin M; Mihalik, Jason P

    2011-01-01

    Previous concussion biomechanics research has relied heavily on the animal model or laboratory reconstruction of concussive injuries captured on video footage. Real-time data collection involves a novel approach to better understanding the medical issues related to sport concussion. Recent studies suggest that a concussive injury threshold is elusive and may, in fact, be irrelevant when predicting the clinical outcome.

  12. Concussion Education for High School Football Players: A Pilot Study

    Science.gov (United States)

    Manasse-Cohick, Nancy J.; Shapley, Kathy L.

    2014-01-01

    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, "t"(244)…

  13. Concussions More Likely in Female Athletes

    Science.gov (United States)

    ... a higher risk of concussions. For women, the sports included field hockey, soccer, basketball, softball and lacrosse, said study lead author ... that have shown that women participating in similar sports as men -- like soccer, basketball, baseball/softball -- report concussions at a higher ...

  14. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  15. What You Need to Know About Concussion

    Centers for Disease Control (CDC) Podcasts

    2010-03-17

    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.

  16. Sport-Related Concussion and Occupational Therapy: Expanding the Scope of Practice

    Science.gov (United States)

    Reed, Nick

    2011-01-01

    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…

  17. Smartphone-enabled optofluidic exosome diagnostic for concussion recovery

    Science.gov (United States)

    Ko, Jina; Hemphill, Matthew A.; Gabrieli, David; Wu, Leon; Yelleswarapu, Venkata; Lawrence, Gladys; Pennycooke, Wesley; Singh, Anup; Meaney, Dave F.; Issadore, David

    2016-08-01

    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.

  18. A change of the expression of PLP in the prefrontal cortex of brain after pure cerebral concussion and multiple cerebral concussions in rats%一重和多重脑震荡大鼠前额叶髓鞘脂蛋白(PLP)的变化

    Institute of Scientific and Technical Information of China (English)

    江东; 李坪; 朱乔; 于建云; 张桓; 曹珍珍; 郭泽云

    2012-01-01

    Objective; This study aimed to investigate the distribution and expression changes of the myelin protein lipo-protein ( PLP) in prefrontal-septum areas after pure cerebral concussion ( PCC) and multiple cerebral concussions ( MCC). Methods:PCC and MCC rat models were created by using a metallic pendulum-striker concussive device. The rats were randomly divided into PCC 1,2,4,8 and 16 d (n = 6 for each time point) and MCC 1,2,4,8 and 16 d ( n = 6 for each time point) groups after injury. One control (normal) group (n =6) was used. The distribution and immno-expression changes of the PLP were observed by S-P immuno-histochemical staining in the prefrontal-septum areas after injury. Results: The results showed that PLP immunoreactivity was localized in the white matter and was widely associated with the nerve fibers in the molecular and granular layer of cerebral cortex and prefrontal-septum areas including medial forebrain bundle (Mfb) , vertical diagonal band (VDB) , lateral septal nucleus, intermediate part (LSI) , amygdaloid nucleus, corpus callosum (cc) , caudate putamen (Cpu) and anterior commissure (ac) in the control rats. Following PCC, the expression level of PLP in most areas was remained unaltered (P > 0. 05 ) compared to that of the control groups. However, in MCC groups, PLP expression was reduced significantly (P<0.05) in the molecular layer of pre-frontal cortex, VDB as well as the Cpu when compared with the control and PCC rats. Conclusion:The present results suggest that MCC may have cumalative effects on the injury, thus aggravating the damage to the nerve fibers of the pre-frontal-septum.%目的:为探索一重(pure cerebral concussion,PCC)和多重脑震荡(multiple cerebral concussion,MCC)后大鼠前额叶中隔断面髓鞘脂蛋白(myelin protein lipoprotein,PLP)分布与表达变化规律.方法:采用自制单摆式机械打击装置复制PCC和MCC大鼠模型,伤后随机分为PCC中1、2、4、8、16和24 d组(n=6),MCC中1、2、4、8、16

  19. Expression of neuronal nitric oxide synthase gene in the brain tissue of rats with cerebral concussion%神经元型一氧化氮合酶基因在脑震荡大鼠脑组织中的表达

    Institute of Scientific and Technical Information of China (English)

    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

    2004-01-01

    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

  20. Thinner Cortex in Collegiate Football Players With, but not Without, a Self-Reported History of Concussion.

    Science.gov (United States)

    Meier, Timothy B; Bellgowan, Patrick S F; Bergamino, Maurizio; Ling, Josef M; Mayer, Andrew R

    2016-02-15

    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.

  1. The Acute Management of Sport Concussion in Pediatric Athletes.

    Science.gov (United States)

    Resch, Jacob E; Kutcher, Jeffrey S

    2015-10-01

    During the past two decades the focus on sport concussion has increased significantly. Young athletes represent the most vulnerable population to sustain a sport concussion yet receive the least amount of attention. Specifically, young athletes who sustain a sport concussion can go unrecognized and continue to participate in sport putting them at an increased risk for a more significant injury. The purpose of this review is to provide a clinical framework for the evaluation and management of sport concussion. In addition, this review provides considerations for health care professionals in regard to clinical measures and follow-up strategies during the acute phase following concussion in young concussed athletes following injury.

  2. Acute post-traumatic stress symptoms and age predict outcome in military blast concussion.

    Science.gov (United States)

    Mac Donald, Christine L; Adam, Octavian R; Johnson, Ann M; Nelson, Elliot C; Werner, Nicole J; Rivet, Dennis J; Brody, David L

    2015-05-01

    High rates of adverse outcomes have been reported following blast-related concussive traumatic brain injury in US military personnel, but the extent to which such adverse outcomes can be predicted acutely after injury is unknown. We performed a prospective, observational study of US military personnel with blast-related concussive traumatic brain injury (n = 38) and controls (n = 34) enrolled between March and September 2012. Importantly all subjects returned to duty and did not require evacuation. Subjects were evaluated acutely 0-7 days after injury at two sites in Afghanistan and again 6-12 months later in the United States. Acute assessments revealed heightened post-concussive, post-traumatic stress, and depressive symptoms along with worse cognitive performance in subjects with traumatic brain injury. At 6-12 months follow-up, 63% of subjects with traumatic brain injury and 20% of controls had moderate overall disability. Subjects with traumatic brain injury showed more severe neurobehavioural, post-traumatic stress and depression symptoms along with more frequent cognitive performance deficits and more substantial headache impairment than control subjects. Logistic regression modelling using only acute measures identified that a diagnosis of traumatic brain injury, older age, and more severe post-traumatic stress symptoms provided a good prediction of later adverse global outcomes (area under the receiver-operating characteristic curve = 0.84). Thus, US military personnel with concussive blast-related traumatic brain injury in Afghanistan who returned to duty still fared quite poorly on many clinical outcome measures 6-12 months after injury. Poor global outcome seems to be largely driven by psychological health measures, age, and traumatic brain injury status. The effects of early interventions and longer term implications of these findings are unknown.

  3. Link Seen Between Concussions and Alzheimer's

    Science.gov (United States)

    ... fullstory_163025.html Link Seen Between Concussions and Alzheimer's But study didn't prove head injuries cause ... mental decline of people already at risk for Alzheimer's disease? In a new study, researchers examined 160 ...

  4. Sports concussion: management and predictors of outcome.

    Science.gov (United States)

    Reddy, Cara Camiolo; Collins, Michael W

    2009-01-01

    Interest in sports concussion has grown widely in the last two decades among laypersons and medical professionals. Significant contributions of evidence-based research have led to a better understanding of this multifaceted, but still often elusive, injury. This information has transformed all aspects of concussion management, from on-field evaluation through return-to-play guidelines. The aim of this article is to highlight important research regarding predictors of outcome and treatment protocols. This research has been the basis of the paradigm shift from traditional concussion grading scales to individualized care. Today, concussion management requires a patient-centered approach with individualized assessment, including risk factor analysis, neurocognitive testing, and a thorough symptom evaluation.

  5. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... have symptoms that last for days, or even weeks. A more serious concussion can last for months ... is slowly increased over a period of days, weeks, or months depending on the athlete’s response to ...

  6. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  7. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... ON Concussion And Traumatic Brian Injury In The USA Communicating Effectively Sports-Specific Information LESSON 1 QUIZ ... Participating Orginizations Amateur Athletic Union Amateur Softball Association/USA Softball American Academy of Neurology American Academy of ...

  8. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  9. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  10. Heads Up: Concussion in Youth Sports

    Science.gov (United States)

    ... 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 ...

  11. Dance-related concussion: a case series.

    Science.gov (United States)

    Stein, Cynthia J; Kinney, Susan A; McCrystal, Tara; Carew, Elizabeth A; Bottino, Nicole M; Meehan Iii, William P; Micheli, Lyle J

    2014-01-01

    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.

  12. Possible Lingering Effects of Multiple Past Concussions

    Directory of Open Access Journals (Sweden)

    Grant L. Iverson

    2012-01-01

    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.

  13. Treatment with an anti-CD11d integrin antibody reduces neuroinflammation and improves outcome in a rat model of repeated concussion

    OpenAIRE

    2013-01-01

    Background Concussions account for the majority of traumatic brain injuries (TBI) and can result in cumulative damage, neurodegeneration, and chronic neurological abnormalities. The underlying mechanisms of these detrimental effects remain poorly understood and there are presently no specific treatments for concussions. Neuroinflammation is a major contributor to secondary damage following more severe TBI, and recent findings from our laboratory suggest it may be involved in the cumulative pr...

  14. Young Football Players Tackle Greatest Concussion Risk At Practice

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160579.html Young Football Players Tackle Greatest Concussion Risk at Practice But ... Children under the age of 14 who play football are at risk of concussions, and a small ...

  15. Sports-related traumatic brain injury.

    Science.gov (United States)

    Phillips, Shawn; Woessner, Derek

    2015-06-01

    Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools.

  16. Engaging Teammates in the Promotion of Concussion Help Seeking

    Science.gov (United States)

    Kroshus, Emily; Garnett, Bernice R.; Baugh, Christine M.; Calzo, Jerel P.

    2016-01-01

    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…

  17. Management of concussion in disability sport: A different ball game?

    OpenAIRE

    West, L R; Griffin, S.; Weiler, R.; Ahmed, Osman

    2016-01-01

    Concussion management in sport is a serious medical issue. Frequent high-profile incidents coupled with ongoing debate and research surrounding the definition, diagnosis and management of concussion mean that it is likely to remain a hot topic.1 Internationally, concussion has become a key focus for many sporting governing bodies, with a range of educational campaigns aimed at improving recognition and management.

  18. University Football Players, Postural Stability, and Concussions.

    Science.gov (United States)

    Graves, Barbara Sue

    2016-02-01

    Concussion in football athletes is certainly more prevalent and has potentially serious outcomes. With current concerns and increasing return-to-play issues, additional assessment focus is needed. Division 1 college football athletes, from 18 to 20.9 years (n = 177; age, 19.7 ± 1.2 years; height, 182.3 ± 4.5 cm; weight, 97.3 ± 10.6 kg), before fall practice, over a period of 3 years, underwent baseline postural stability testing (sensory organization test [SOT], NeuroCom). Individuals, who were diagnosed with a concussion (headache, dizziness, fatigue, confusion, or loss of consciousness) during practice or actual competition (n = 15; age, 18.9 ± 0.9 years; height, 181.8 ± 2.5 cm; weight, 86.6 ± 3.6 kg), underwent serial evaluation after injury and 24 hours after concussion. As soon as the player was considered asymptomatic, the test was completed on the first and 14th day. A control group of noninjured male athletes (n = 15; age, 19.1 ± 0.4 years; height, 178.2 ± 3.2 cm; weight, 78.6 ± 2.1 kg) were tested for the same time frame. This particular study was only one part of the total evaluation conducted for the concussed athlete's return to play. Results indicated that the concussion group had a statistically significant (p = 0.037) change from their baseline SOT score and the control group (p = 0.025). This change remained significant until day 14 of posttesting. These data indicate that the SOT, when available, may be a positive additional assessment of concussed college-aged football players. Professionals, when dealing with concussion in competitive sports, do need to continue to work together, but awareness of SOT assessments may also contribute to the return-to-play decisions.

  19. Concussion

    Science.gov (United States)

    ... Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well- ...

  20. Concussions From 9 Youth Organized Sports

    Science.gov (United States)

    Buzas, David; Jacobson, Nathan A.; Morawa, Lawrence G.

    2014-01-01

    Background: Youth sports programs are extremely popular throughout the United States, with children starting formal sports participation as young as 4 years. This places children at greater risk for concussions and other trauma. Purpose: To describe the epidemiology of concussions sustained during participation in 9 organized sports prior to participation in high school athletics. Methods: Over an 11-year span from January 2002 to December 2012, the authors reviewed the concussions sustained by athletes aged 4 to 13 years while playing basketball, baseball, football, gymnastics, hockey, lacrosse, soccer, softball, and wrestling, as evaluated in emergency departments (EDs) in the United States and captured by the National Electronic Injury Surveillance System (NEISS) database of the US Consumer Product Safety Commission. Study Design: Descriptive epidemiology study. Results: There were 4864 (national estimate [NE] = 117,845) youth athletes evaluated in NEISS EDs as sustaining concussions from 2002 to 2012. Except for the year 2007, concussion frequencies trended upward throughout the 11-year time frame as well as with increasing age. Loss of consciousness (LOC) occurred in 499 cases (NE, 12,129; 10%). Football had the highest frequency of concussions, with 2013 (NE, 51,220; 41%), followed by basketball, with 977 (NE, 22,099; 20%), and soccer, with 801 (NE, 18,916; 17%). The majority of concussions were treated in the outpatient setting, with 4444 (91.4%) patients being treated and released; 412 (9%) patients required admission and were found to have increased frequencies of LOC (n = 17; 18.0%) compared with LOC in the total group (n = 499, 10%). The total number of player-to-player injury mechanisms mirrored the total number of concussions by year, which increased throughout the 11-year span, except for the year 2007. Subgroup analysis of athletes aged 4 to 7 years demonstrated a difference in the mechanism of injury distribution, with a ball-to-head mechanism

  1. Microstructural changes in memory and reticular formation neural pathway after simple concussion

    Institute of Scientific and Technical Information of China (English)

    Lin Ouyang; Rongyue Shi; Yuhui Xiao; Jiarong Meng; Yihe Guo; Guangming Lu

    2012-01-01

    Patients with concussion often present with temporary disturbance of consciousness.The microstructural and functional changes in the brain associated with concussion,as well as the relationship with transient cognitive disorders,are currently unclear.In the present study,a rabbit model of simple concussion was established.Magnetic resonance-diffusion tensor imaging results revealed that the corona radiata and midbrain exhibited significantly decreased fractional anisotropy values in the neural pathways associated with memory and the reticular formation.In addition,the apparent diffusion coefficient values were significantly increased following injury compared with those before injury.Following a 1-hour period of quiet rest,the fractional anisotropy values significantly increased,and apparent diffusion coefficient values significantly decreased,returning to normal pre-injury levels.In contrast,the fractional anisotropy values and apparent diffusion coefficient values in the corpus callosum,thalamus and hippocampus showed no statistical significant alterations following injury.These findings indicate that the neural pathways associated with memory and the reticular formation pathway exhibit reversible microstructural white matter changes when concussion occurs,and these changes are exhibited to a different extent in different regions.

  2. Post-concussive syndrome in a female basketball player: a case study

    Directory of Open Access Journals (Sweden)

    Str

    2013-05-01

    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

  3. Chronic Exposure to Androgenic-Anabolic Steroids Exacerbates Axonal Injury and Microgliosis in the CHIMERA Mouse Model of Repetitive Concussion.

    Directory of Open Access Journals (Sweden)

    Dhananjay R Namjoshi

    Full Text Available 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.

  4. Sports-related concussions: diagnosis, complications, and current management strategies.

    Science.gov (United States)

    Hobbs, Jonathan G; Young, Jacob S; Bailes, Julian E

    2016-04-01

    Sports-related concussions (SRCs) are traumatic events that affect up to 3.8 million athletes per year. The initial diagnosis and management is often instituted on the field of play by coaches, athletic trainers, and team physicians. SRCs are usually transient episodes of neurological dysfunction following a traumatic impact, with most symptoms resolving in 7-10 days; however, a small percentage of patients will suffer protracted symptoms for years after the event and may develop chronic neurodegenerative disease. Rarely, SRCs are associated with complications, such as skull fractures, epidural or subdural hematomas, and edema requiring neurosurgical evaluation. Current standards of care are based on a paradigm of rest and gradual return to play, with decisions driven by subjective and objective information gleaned from a detailed history and physical examination. Advanced imaging techniques such as functional MRI, and detailed understanding of the complex pathophysiological process underlying SRCs and how they affect the athletes acutely and long-term, may change the way physicians treat athletes who suffer a concussion. It is hoped that these advances will allow a more accurate assessment of when an athlete is truly safe to return to play, decreasing the risk of secondary impact injuries, and provide avenues for therapeutic strategies targeting the complex biochemical cascade that results from a traumatic injury to the brain.

  5. English professional football players concussion knowledge and attitude

    Directory of Open Access Journals (Sweden)

    Joshua M. Williams

    2016-06-01

    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.

  6. Update on concussion management for the Rhode Island clinician.

    Science.gov (United States)

    Waryasz, Gregory R; Tambone, Robert; Kriz, Peter

    2014-02-03

    Concussions are common injuries with increasing diagnostic incidence. The 4th International Conference on Concussion in Sport, held in November 2012 in Zurich, revised consensus statements regarding the definition of a concussion, diagnostic criteria, and management. Return-to-play guidelines require a graded return to activity in which concussed athletes remain symptom-free. In order to improve awareness pertaining to concussion diagnosis and management, legislation has now been enacted in all fifty states. Rhode Island enacted into law the School and Youth Programs Concussion Act in 2010, which increases awareness of concussions for athletes, coaches, teachers, school nurses and parents/guardians through written information and mandatory training for coaches. Athletes must be removed from practice/competition and cannot return until a physician has evaluated and cleared them. [Full text available at http://rimed.org/rimedicaljournal-2015-02.asp, free with no login].

  7. Neuropsychological Assessment Following Concussion: an Evidence-Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion.

    Science.gov (United States)

    Kontos, Anthony P; Sufrinko, Alicia; Womble, Melissa; Kegel, Nathan

    2016-06-01

    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.

  8. Posttraumatic Stress Disorder in Combat Casualties With Burns Sustaining Primary Blast and Concussive Injuries

    Science.gov (United States)

    2009-04-01

    in close proximity to the blast center, can result in eardrum damage (rupture of the tympanic membrane TM), lung damage (pulmonary or alveolar ...rence of psychologic deficit .12,13 The Defense and Veterans Brain Injury Center reports 22% of soldiers returning from OIF/OEF as having evidence of...psychologic deficit , specifically, posttraumatic stress disorder (PTSD).13 This in- creased risk of altered mental status, concussive symptoms, and PTSD

  9. Loss of possession: concussions, informed consent, and autonomy.

    Science.gov (United States)

    Robeson, Richard; King, Nancy M P

    2014-01-01

    The recent explosion of publicity about the dangers of concussion in contact sports - particularly in football - represents the unraveling of a disinformation campaign by the NFL amid growing public and professional concern about the game's long-term risks of harm. The persistence of controversy and denial reflects a cultural view of football players as serving the needs of the team, a resulting evidentiary skepticism, and resistance to rule changes as excessive or unenforceable. This article considers the cultural context of informed decision making by parents of youth football players and suggests that policy changes designed to lower (although they cannot eliminate) risks of brain injury have the potential to change both the culture of football and the way the benefits and harms of the game are regarded for its players, without loss of its essential excitement and appeal.

  10. Heads Up: Concussion in Youth Sports

    Medline Plus

    Full Text Available ... chances for long-term problems. B You can’t see a concussion like you can a broken ... even briefly) Shows behavior or personality changes Can't recall events prior to hit or fall Can' ...

  11. In-office management of sport-related concussion.

    Science.gov (United States)

    Reynolds, Erin; Collins, Michael W

    2014-01-01

    The field of sport-related concussion has grown exponentially over the past decade, with more concussion-specific clinics being identified in major hospital systems as well as independent practitioner's offices. To date, there is no standardized in-office protocol for managing ongoing symptoms. The University of Pittsburgh Medical Center (UPMC) Sports Concussion Program, established in 2000, is one of the largest programs in the USA, pioneering the way in clinical management, research, and education of sport-related concussion. This report will outline the essential components of a successful concussion clinic, using the UPMC Sports Concussion Program as a case example of best practice. We will share several case studies illustrating the individualized and complex nature of this injury, as well as review important rehabilitation components.

  12. Depressive Symptoms and Concussions in Aging Retired NFL Players

    Science.gov (United States)

    Didehbani, Nyaz; Munro Cullum, C.; Mansinghani, Sethesh; Conover, Heather; Hart, John

    2013-01-01

    We examined the relationship between a remote history of concussions with current symptoms of depression in retired professional athletes. Thirty retired National Football League (NFL) athletes with a history of concussion and 29 age- and IQ-matched controls without a history of concussion were recruited. We found a significant correlation between the number of lifetime concussions and depressive symptom severity using the Beck Depression Inventory II. Upon investigating a three-factor model of depressive symptoms (affective, cognitive, and somatic; Buckley et al., 2001) from the BDI-II, the cognitive factor was the only factor that was significantly related to concussions. In general, NFL players endorsed more symptoms of depression on all three Buckley factors compared with matched controls. Findings suggest that the number of self-reported concussions may be related to later depressive symptomology (particularly cognitive symptoms of depression). PMID:23644673

  13. Sports-related concussions - media, science and policy.

    Science.gov (United States)

    Mannix, Rebekah; Meehan, William P; Pascual-Leone, Alvaro

    2016-08-01

    Although growing awareness about the potential long-term deleterious effects of sport-related concussion has led to increased attention to the risks of collision sports, calls to ban these sports, such as American football, might be premature. Collision sports have a relatively high incidence of concussions, but participation in these sports also confers a host of benefits. In addition, the associated risks of participation, including concussion, have not been definitively shown to outweigh the benefits they provide, and the risk-benefit ratio might vary among individuals. The risks of concussion and repetitive concussions associated with collision sports are unknown in the general population and not well characterized even in elite athlete populations. In this article, we discuss current knowledge on sports-related concussion, its neurological consequences, and implications for regulation of the practice of collision sports.

  14. English professional football players concussion knowledge and attitude

    Institute of Scientific and Technical Information of China (English)

    Joshua M. Williams; Jody L. Langdon; James L. McMillan; Thomas A. Buckley

    2016-01-01

    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.

  15. Diet, age, and prior injury status differentially alter behavioral outcomes following concussion in rats.

    Science.gov (United States)

    Mychasiuk, Richelle; Hehar, Harleen; van Waes, Linda; Esser, Michael J

    2015-01-01

    Mild traumatic brain injury (mTBI) or concussion affects a large portion of the population and although many of these individuals recover completely, a small subset of people experience lingering symptomology and poor outcomes. Little is known about the factors that affect individual susceptibility or resilience to poor outcomes after mTBI and there are currently no biomarkers to delineate mTBI diagnosis or prognosis. Based upon the growing literature associated with caloric intake and altered neurological aging and the ambiguous link between repetitive mTBI and progressive neurodegeneration, the current study was designed to examine the effect of a high fat diet (HFD), developmental age, and repetitive mTBI on behavioral outcomes following a mTBI. In addition, telomere length was examined before and after experimental mTBI. Sprague Dawley rats were maintained on a HFD or standard rat chow throughout life (including the prenatal period) and then experienced an mTBI/concussion at P30, P30 and P60, or only at P60. Behavioral outcomes were examined using a test battery that was administered between P61-P80 and included; beam-walking, open field, elevated plus maze, novel context mismatch, Morris water task, and forced swim task. Animals with a P30 mTBI often demonstrated lingering symptomology that was still present during testing at P80. Injuries at P30 and P60 rarely produced cumulative effects, and in some tests (i.e., beam walking), the first injury may have protected the brain from the second injury. Exposure to the high fat diet exacerbated many of the behavioral deficits associated with concussion. Finally, telomere length was shortened following mTBI and was influenced by the animal's dietary intake. Diet, age at the time of injury, and the number of prior concussion incidents differentially contribute to behavioral deficits and may help explain individual variations in susceptibility and resilience to poor outcomes following an mTBI.

  16. History of neuropsychological study of sport-related concussion.

    Science.gov (United States)

    Webbe, Frank M; Zimmer, Adam

    2015-01-01

    Although the medical literature has a long history of description and comment on concussion, the occurrence of concussion within the context of sports other than boxing was not judged to be problematic until the 1980s. Neuropsychological assessment played a critical and integral role in identifying the cognitive sequelae of concussion and mapping out the short- and long-term vagaries in recovery. This paper captures that history and expands upon current applications of neuropsychological assessment in the diagnosis and management of sport-related concussion.

  17. The history of neurosurgical treatment of sports concussion.

    Science.gov (United States)

    Stone, James L; Patel, Vimal; Bailes, Julian E

    2014-10-01

    Concussion has a long and interesting history spanning at least the 5 millennia of written medical record and closely mirrors the development of surgery and neurosurgery. Not surprisingly, much of the past and present experimental head injury and concussion work has been performed within neurosurgically driven laboratories or by several surgically oriented neurologists. This historical review chronicles the key aspects of neurosurgical involvement in sports concussion as related to the diagnosis, treatment, mitigation, and prevention of injury using the example of American football. In addition, we briefly trace the developments that led to our current understanding of the biomechanical and neurophysiological basis of concussion.

  18. Concussions and Osteopathic Manipulative Treatment: An Adolescent Case Presentation.

    Science.gov (United States)

    Castillo, Iris; Wolf, Kimberly; Rakowsky, Alexander

    2016-03-01

    Concussions commonly occur in adolescents. Although the majority of adolescent patients' symptoms resolve, about 11% continue to experience symptoms at 3 months. Standard treatment options for prolonged symptoms are not available, and the role of osteopathic manipulative treatment in the management of adolescent concussions is unclear. The authors describe a case of a 16-year-old girl with a history of 3 head injuries who presented with concussion symptoms. After 6 weekly osteopathic manipulative treatment sessions, the patient was able to return to her normal activities. Further research on the role of osteopathic manipulative treatment to manage concussions is needed.

  19. The Role of Nutritional Supplements in Sports Concussion Treatment.

    Science.gov (United States)

    Ashbaugh, Andrew; McGrew, Christopher

    2016-01-01

    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.

  20. Changes of TNF-α in the Cortex of Rat Brain after Pure Cerebral Concussion%TNF-α在单纯性脑震荡大鼠皮质中的表达变化

    Institute of Scientific and Technical Information of China (English)

    李玉环; 吴德野; 董世峰; 唐红丹; 杨晓燕; 左寒东; 于建云; 李坪

    2015-01-01

    目的 观察单纯性脑震荡(pure cerebral concussion,PCC)大鼠前额叶皮质(prefrontal cortex,PC)、颞叶皮质(temporal cortex,TC)和梨状皮质(piriform cortex,Pir)区炎症因子TNF-α(tumor necrosis factor-α,TNF-α)的表达和时程变化规律,探讨TNF-α与脑损伤之间的病理联系.方法 采用“金属单摆闭合式脑损伤打击装置”制备PCC模型,随机分为伤后3h、12h、1d、2d、3d、7d6个时间点的PCC损伤组(n=5),另设正常对照组(n=5).采用兔抗TNF-α进行免疫组织化学SP法染色,观察PCC组和正常对照组大鼠PC、TC和Pir脑区TNF-α的表达变化.结果 正常对照组大鼠PC、TC和Pir内TNF-α免疫阳性表达很弱,损伤后TNF-α的阳性表达和阳性细胞的数量逐渐增加,3d组达高峰,7d组后有下降趋势,但仍高于正常组(P<0.05).结论 PCC损伤早期PC、TC和Pir中TNF-α的表达量出现明显变化,提示TNF-α参与了PCC致伤后的病理变化.

  1. Sideline concussion testing in high school football on Guam

    Directory of Open Access Journals (Sweden)

    Matthew Duenas

    2014-01-01

    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.

  2. K-12 Students with Concussions: A Legal Perspective

    Science.gov (United States)

    Zirkel, Perry A.; Brown, Brenda Eagan

    2015-01-01

    This article provides a multipart analysis of the public schools' responsibility for students with concussions. The first part provides the prevailing diagnostic definitions of concussions and postconcussive syndrome. The second and central part provides (a) the legal framework of the two overlapping federal laws--the Individuals with Disabilities…

  3. Concussions--The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Diaz, Anne L.; Wyckoff, Leah J.

    2012-01-01

    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…

  4. Acute clinical recovery from sport-related concussion.

    Science.gov (United States)

    Nelson, Lindsay D; Janecek, Julie K; McCrea, Michael A

    2013-12-01

    Concussion is a highly prevalent injury in contact and collision sports that has historically been poorly understood. An influx of sport-concussion research in recent years has led to a dramatic improvement in our understanding of the injury's defining characteristics and natural history of recovery. In this review, we discuss the current state of knowledge regarding the characteristic features of concussion and typical acute course of recovery, with an emphasis on the aspects of functioning most commonly assessed by clinicians and researchers (e.g., symptoms, cognitive deficits, postural stability). While prototypical clinical recovery is becoming better understood, questions remain regarding what factors (e.g., injury severity, demographic variables, history of prior concussions, psychological factors) may explain individual variability in recovery. Although research concerning individual differences in response to concussion is relatively new, and in many cases limited methodologically, we discuss the evidence about several potential moderators of concussion recovery and point out areas for future research. Finally, we describe how increased knowledge about the negative effects of and recovery following concussion has been translated into clinical guidelines for managing concussed athletes.

  5. States Address Concerns about Concussions in Youth Sports

    Science.gov (United States)

    Kreck, Carol

    2014-01-01

    Education Commission of the States (ECS) reviewed legislation in the 50 states to see how state leaders are responding to concerns about concussions in youth sports. This report reviews state responses to concussion concerns, and provides examples of provisions put in place by California, Connecticut, and Texas. Three emerging innovations are…

  6. Effects of multiple concussions on retired national hockey league players.

    Science.gov (United States)

    Caron, Jeffrey G; Bloom, Gordon A; Johnston, Karen M; Sabiston, Catherine M

    2013-04-01

    The purpose of this study was to understand the meanings and lived experiences of multiple concussions in professional hockey players using hermeneutic, idiographic, and inductive approaches within an interpretative phenomenological analysis. The interviewer was an athlete who had suffered multiple concussions, and the interviewees were five former National Hockey League athletes who had retired due to medically diagnosed concussions suffered during their careers. The men discussed the physical and psychological symptoms they experienced as a result of their concussions and how the symptoms affected their professional careers, personal relationships, and quality of life. The former professional athletes related these symptoms to the turmoil that is ever present in their lives. These findings are of interest to athletes, coaches, sport administrators, family members, sport psychology practitioners, and medical professionals, as they highlight the severity of short- and long-term effects of concussions.

  7. 小胶质细胞在单纯性脑震荡大鼠皮质中的变化%Changes of microglia in the cortex of rat brain after pure cerebral concussion

    Institute of Scientific and Technical Information of China (English)

    李晓文; 曾晓锋; 康丽; 吴德野; 郭小兵; 于建云; 李坪

    2014-01-01

    目的:观察单纯性脑震荡(pure cerebral concussion,PCC)大鼠前额叶皮质(prefrontal cortex,PC)、颞叶皮质(temporal cortex,TC)和梨状皮质(piriform cortex,Pir)内小胶质细胞(microglia,MG)的反应和时程变化规律,探讨小胶质细胞与脑损伤之间的病理联系.方法:采用自制金属单摆闭合式脑损伤打击装置制备清醒状态下PCC模型,随机分为伤后3h、12 h、1d、2d、3d、7d六个损伤组(n=5),另设正常对照组(n=5).采用OX-42单克隆抗体(MG特异性标记物)进行免疫组织化学和免疫荧光染色,观察PCC组和正常对照组大鼠PC、TC和Pir中OX-42的表达变化.结果:正常对照组大鼠PC、TC和Pir内OX-42免疫阳性产物的表达很弱,OX-42免疫阳性的小胶质细胞的数量少而轮廓不清.损伤后OX-42免疫阳性产物的表达和阳性细胞的数量逐渐增加,3d时达高峰,7d后有下降趋势,但仍高于正常组(P<0.05).结论:PCC损伤早期PC、TC和Pir中MG出现激活的形态学变化,提示MG可能参与了PCC致伤后的病理变化.

  8. What Can I Do to Help Feel Better After a Mild Traumatic Brain Injury?

    Science.gov (United States)

    ... to Help Feel Better After a Mild Traumatic Brain Injury? Although most people recover after a concussion, how ... Potential Effects Prevention Severe TBI HEADS UP to Brain Injury Awareness Get Email Updates To receive email updates ...

  9. Impulsivity and Concussion in Juvenile Rats: Examining Molecular and Structural Aspects of the Frontostriatal Pathway.

    Directory of Open Access Journals (Sweden)

    Harleen Hehar

    Full Text Available Impulsivity and poor executive control have been implicated in the pathogenesis of many developmental and neuropsychiatric disorders. Similarly, concussions/mild traumatic brain injuries (mTBI have been associated with increased risk for neuropsychiatric disorders and the development of impulsivity and inattention. Researchers and epidemiologists have therefore considered whether or not concussions induce symptoms of attention-deficit/hyperactivity disorder (ADHD, or merely unmask impulsive tendencies that were already present. The purpose of this study was to determine if a single concussion in adolescence could induce ADHD-like impulsivity and impaired response inhibition, and subsequently determine if inherent impulsivity prior to a pediatric mTBI would exacerbate post-concussion symptomology with a specific emphasis on impulsive and inattentive behaviours. As these behaviours are believed to be associated with the frontostriatal circuit involving the nucleus accumbens (NAc and the prefrontal cortex (PFC, the expression patterns of 8 genes (Comt, Drd2, Drd3, Drd4, Maoa, Sert, Tph1, and Tph2 from these two regions were examined. In addition, Golgi-Cox staining of medium spiny neurons in the NAc provided a neuroanatomical examination of mTBI-induced structural changes. The study found that a single early brain injury could induce impulsivity and impairments in response inhibition that were more pronounced in males. Interestingly, when animals with inherent impulsivity experienced mTBI, injury-related deficits were exacerbated in female animals. The single concussion increased dendritic branching, but reduced synaptic density in the NAc, and these changes were likely associated with the increase in impulsivity. Finally, mTBI-induced impulsivity was associated with modifications to gene expression that differed dramatically from the gene expression pattern associated with inherent impulsivity, despite very similar behavioural phenotypes. Our

  10. Educating Coaches about Concussion in Sports: Evaluation of the CDC's "Heads Up: Concussion in Youth Sports" Initiative

    Science.gov (United States)

    Covassin, Tracey; Elbin, R. J.; Sarmiento, Kelly

    2012-01-01

    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…

  11. Evaluation of the anatomical and functional consequences of repetitive mild cervical contusion using a model of spinal concussion.

    Science.gov (United States)

    Jin, Ying; Bouyer, Julien; Haas, Christopher; Fischer, Itzhak

    2015-09-01

    Spinal cord concussion is characterized by a transient loss of motor and sensory function that generally resolves without permanent deficits. Spinal cord concussions usually occur during vehicular accidents, falls, and sport activity, but unlike brain concussions, have received much less attention despite the potential for repeated injury leading to permanent neurological sequelae. Consequently, there is no consensus regarding decisions related to return to play following an episode of spinal concussion, nor an understanding of the short- and long-term consequences of repeated injury. Importantly, there are no models of spinal concussion to study the anatomical and functional sequelae of single or repeated injury. We have developed a new model of spinal cord concussion focusing on the anatomical and behavioral outcomes of single and repeated injury. Rats received a very mild (50 kdyn, IH impactor) spinal contusion at C5 and were separated into two groups three weeks after the initial injury--C1, which received a second, sham surgery, and C2, which received a second contusion at the same site. To track motor function and recovery, animals received weekly behavioral tests--BBB, CatWalk™, cylinder, and Von Frey. Analysis of locomotor activity by BBB demonstrated that rats rapidly recovered, regaining near-normal function by one week after the first and second injury, which was confirmed using the more detailed CatWalk™ analysis. The cylinder test showed that a single contusion did not induce significant deficits of the affected limb, but that repeated injury resulted in significant alteration in paw preference, with animals favoring the unaffected limb. Intriguingly, Von Frey analysis demonstrated an increased sensitivity in the contralateral hindlimb in the C2 group vs. the C1 group. Anatomical analyses revealed that while the lesion volume of both groups was minimal, the area of spared white matter in the C2 group was significantly reduced 1 and 2mm rostral to

  12. 'Heading' Soccer Ball Not Smart for The Brain

    Science.gov (United States)

    ... news/fullstory_163363.html 'Heading' Soccer Ball Not Smart for the Brain It's tied to higher concussion ... Albert Einstein College of Medicine in New York City, said in a college news release. "But our ...

  13. Can helmet design reduce the risk of concussion in football?

    Science.gov (United States)

    Rowson, Steven; Duma, Stefan M; Greenwald, Richard M; Beckwith, Jonathan G; Chu, Jeffrey J; Guskiewicz, Kevin M; Mihalik, Jason P; Crisco, Joseph J; Wilcox, Bethany J; McAllister, Thomas W; Maerlender, Arthur C; Broglio, Steven P; Schnebel, Brock; Anderson, Scott; Brolinson, P Gunnar

    2014-04-01

    Of all sports, football accounts for the highest incidence of concussion in the US due to the large number of athletes participating and the nature of the sport. While there is general agreement that concussion incidence can be reduced through rule changes and teaching proper tackling technique, there remains debate as to whether helmet design may also reduce the incidence of concussion. A retrospective analysis was performed of head impact data collected from 1833 collegiate football players who were instrumented with helmet-mounted accelerometer arrays for games and practices. Data were collected between 2005 and 2010 from 8 collegiate football teams: Virginia Tech, University of North Carolina, University of Oklahoma, Dartmouth College, Brown University, University of Minnesota, Indiana University, and University of Illinois. Concussion rates were compared between players wearing Riddell VSR4 and Riddell Revolution helmets while controlling for the head impact exposure of each player. A total of 1,281,444 head impacts were recorded, from which 64 concussions were diagnosed. The relative risk of sustaining a concussion in a Revolution helmet compared with a VSR4 helmet was 46.1% (95% CI 28.1%-75.8%). When controlling for each player's exposure to head impact, a significant difference was found between concussion rates for players in VSR4 and Revolution helmets (χ(2) = 4.68, p = 0.0305). This study illustrates that differences in the ability to reduce concussion risk exist between helmet models in football. Although helmet design may never prevent all concussions from occurring in football, evidence illustrates that it can reduce the incidence of this injury.

  14. Heads Up! Play it Safe When it Comes to Concussions

    Centers for Disease Control (CDC) Podcasts

    2007-05-21

    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 “Heads 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.

  15. Evaluation of the King-Devick Test to Assess Eye Movements and the Performance of Rapid Number Naming in Concussed and Non-Concussed Service Members

    Science.gov (United States)

    2016-07-01

    Concussed Service Members Log Number 12089007 W81XWH-14-1-0173 PI: Dr. Michael Dretsch Org: The Geneva Foundation Award Amount: $403,671 Study/ Product ...Concussed and Non-Concussed Service Members” PRINCIPAL INVESTIGATOR: Dr. Michael Dretsch CONTRACTING ORGANIZATION: The Geneva Foundation...collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services , Directorate for

  16. Concussions in the NHL: A narrative review of the literature.

    Science.gov (United States)

    Izraelski, Jason

    2014-12-01

    Ice hockey has been identified as a sport with a high risk for concussions. Given the health sequelae associated with the injury, a great deal of attention has been placed on its diagnosis, management and return-to-play protocols. The highest level of ice hockey in North America is played in the National Hockey League (NHL), and concussions pose a serious threat to the health of the players and the game itself. Unfortunately, the scientific literature on concussions in ice hockey is derived mostly from research conducted on youth and amateur levels of play, leaving a gap in our knowledge at the professional level. This narrative review attempts to summarize what is known about concussion incidence, mechanisms of injury and risk factors in the NHL.

  17. Can a Dietary Supplement Treat a Concussion? No!

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Can a Dietary Supplement Treat a Concussion? No! Share Tweet Linkedin Pin it More ... practice for football, soccer and other sports. It’s a time when parents may be thinking about sport ...

  18. Sports-related concussion: the role of the headache specialist.

    Science.gov (United States)

    Conidi, Francis X

    2012-05-01

    Over the past few years, sports-related concussion has received significant media attention making it one of the most, if not highest profile neurological disorder. Thirty-one states now have passed sports concussion laws, with 14 states pending legislation. Most concussions are managed by primary care physicians, ie, family practice trained sports medicine physicians and pediatricians. Symptoms are usually short lived and do not require treatment. The one exception is headache, which is usually present from onset and is often the last symptom to resolve. Headache is the most common reason for referral to a specialist, and therefore it is imperative that the headache specialist have at least a basic understanding of all aspects of sports concussion as they are likely going to be called upon to evaluate these athletes, especially the more refractory cases.

  19. Neuropsychological factors related to college ice hockey concussions.

    Science.gov (United States)

    Pedersen, Heather A; Ferraro, F Richard; Himle, Michael; Schultz, Caitlin; Poolman, Mark

    2014-05-01

    We analyzed data from 74 male collegiate hockey players. Each athlete's season began with a baseline administration of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neuropsychology test battery. Fourteen athletes sustained a sport-related head injury and were readministered the test to assess the impact of the injury. A significant decrease in performance (compared to baseline) on immediate and delayed word recall and designs followed the first concussion. Following a second sport-related concussion, the 4 affected athletes showed significant decrease in visual motor speed. Performance improved on 2 response speed measures (Ps life concussions and head injury on late-life consequences, such as chronic traumatic encephalopathy, and more immediate issues such as return-to-play decisions for athletes.

  20. Driving Skills May Suffer Even After Concussion Symptoms Subside

    Science.gov (United States)

    ... try to determine when concussion patients' driving abilities improve, and to develop guidelines to help recommend when driving should be restricted. The study was published online recently in the Journal of Neurotrauma . SOURCE: University of Georgia, news release, ...

  1. Factors Influencing the Risk and Recovery from Sport-Related Concussion

    Institute of Scientific and Technical Information of China (English)

    R.J.Elbin; Tracey Covassin

    2011-01-01

    @@ 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[1].

  2. The Sport Concussion Assessment Tool: a systematic review.

    Science.gov (United States)

    Yengo-Kahn, Aaron M; Hale, Andrew T; Zalneraitis, Brian H; Zuckerman, Scott L; Sills, Allen K; Solomon, Gary S

    2016-04-01

    OBJECTIVE Over the last 2 decades, sport-related concussion (SRC) has garnered significant attention. Even with increased awareness and athlete education, sideline recognition and real-time diagnosis remain crucial. The need for an objective and standardized assessment of concussion led to the eventual development of the Sport Concussion Assessment Tool (SCAT) during the Second International Conference on Concussion in Sport in 2004, which is now in its third iteration (SCAT3). In an effort to update our understanding of the most well-known sideline concussion assessment, the authors conducted a systematic review of the SCAT and the evidence supporting its use to date. METHODS English-language titles and abstracts published between 1995 and October 2015 were searched systematically across 4 electronic databases and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for the review of a heterogeneous collection of study designs. Peer-reviewed journal articles were included if they reported quantitative data on any iteration of the SCAT, Standardized Assessment of Concussion (SAC), or modified Balance Error Scoring System (mBESS) data at baseline or following concussion in an exclusively athlete population with any portion older than 13 years of age. Studies that included nonathletes, only children less than 13 years old, exclusively BESS data, exclusively symptom scale data, or a non-SCAT-related assessment were excluded. RESULTS The database search process yielded 549 abstracts, and 105 full-text articles were reviewed with 36 meeting criteria for inclusion. Nineteen studies were associated with the SAC, 1 was associated with the mBESS exclusively, and 16 studies were associated with a full iteration of the SCAT. The majority of these studies (56%) were prospective cohort studies. Male football players were the most common athletes studied. An analysis of the studies focused on

  3. Study on expression of endothelin in experimental cerebral concussion in rats%内皮素在大鼠实验性脑震荡脑组织中表达研究

    Institute of Scientific and Technical Information of China (English)

    彭瑞云; 高亚兵; 王德文; 肖兴义; 陈浩宇; 吴小红; 刘杰; 胡文华; 蔡宝仁; 薛官生; 张援平; 尹晓梅

    2002-01-01

    Objective To study changes and significance of endothelin(ET) in rat cerebral concussion.Methods 80 Wistar male rats were used for animal model of cerebral concussion,which were sacrificed on 1,3,7,14 and 30 days after injury and the brain tissue were taken off. The expression of ET was studied in the course of cerebral concussion by means of immunohistochemistry.Results Typical clinical manifestation was observed in the 100 g group in which the pathological changes included cerebral vascular constriction and dilatation,congestion and edema of cerebral tissue,neuronal degeneration,necrosis,and obviously decreased even disappeared Nissl bodies.Increased expression of ET was observed on the first day,the positive area was seen in the plasma of endothelial cells in cerebral cortex,hippocampus,cerebellum and thalamus.ET expression peak occurred on the 7th day,the positive area was also found in the plasma of Purkinje cells in the cerebellum.Decreased ET expression was found on 14th day and returned to normal level on the 30th day.Conclusion The main pathological changes of cerebral concussion contained blood circulation disorder,and degeneration and necrosis of substantial cells.ET was involved in the brain tissue injury during the pathological process of cerebral concussion and might be related to regulation of cerebral vascular reaction,and neuron degeneration and necrosis.

  4. Influence of the severity and location of bodily injuries on post-concussive and combat stress symptom reporting after military-related concurrent mild traumatic brain injuries and polytrauma.

    Science.gov (United States)

    French, Louis M; Lange, Rael T; Marshall, Kathryn; Prokhorenko, Olga; Brickell, Tracey A; Bailie, Jason M; Asmussen, Sarah B; Ivins, Brian; Cooper, Douglas B; Kennedy, Jan E

    2014-10-01

    Traumatic brain injuries (TBI) sustained in combat frequently co-occur with significant bodily injuries. Intuitively, more extensive bodily injuries might be associated with increased symptom reporting. In 2012, however, French et al. demonstrated an inverse relation between bodily injury severity and symptom reporting. This study expands on that work by examining the influence of location and severity of bodily injuries on symptom reporting after mild TBI. Participants were 579 US military service members who sustained an uncomplicated mild TBI with concurrent bodily injuries and who were evaluated at two military medical centers. Bodily injury severity was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C), on average, 2.5 months post-injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relation between symptom reporting and injury severity across the six ISS body regions, three body regions were significant predictors of the NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001) and accounted for 9.3% of the variance (p<0.001). For the PCL-C, two body regions were significant predictors of the PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. There was an inverse relation between bodily injury severity and symptom reporting in this sample. Hypothesized explanations include underreporting of symptoms, increased peer support, disruption of fear conditioning because of acute morphine use, or delayed expression of symptoms.

  5. Relative risk for concussions in young female soccer players.

    Science.gov (United States)

    Strand, Sarah; Lechuga, David; Zachariah, Thomas; Beaulieu, Kathryn

    2015-01-01

    The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p soccer players is significantly higher than in a control group of nonsoccer players of the same sex and age.

  6. CHOA concussion consensus: establishing a uniform policy for academic accommodations.

    Science.gov (United States)

    Popoli, David Michael; Burns, Thomas G; Meehan, William P; Reisner, Andrew

    2014-03-01

    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.

  7. Management of Sport-Related Concussion in the Pediatric and Adolescent Population.

    Science.gov (United States)

    Provance, Aaron J; Engelman, Glenn H; Terhune, E Bailey; Coel, Rachel A

    2016-01-01

    Concussions make up nearly 10% of all high school athletic injuries. Recent changes in concussion management guidelines and legislation aim to make concussion care more standardized and safe but simultaneously pose a challenge for the primary care and sports medicine physician. Pediatric and adolescent concussions may cause anxiety for the treating physician due to concerns over return-to-play decisions, academic issues, and the potential for second impact syndrome. Determining when to refer a patient to an emergency department acutely, to an outpatient concussion clinic, or to other subspecialists may be a difficult decision for the primary care physician. The aim of this article is to review current evidence regarding concussion treatment and return-to-school and return-to-play recommendations to provide the primary care and sports medicine physician with practical guidelines for managing concussions.

  8. Transient suppression of heart rate complexity in concussed athletes.

    Science.gov (United States)

    La Fountaine, Michael F; Heffernan, Kevin S; Gossett, James D; Bauman, William A; De Meersman, Ronald E

    2009-06-15

    Heart rate variability (HRV) and complexity (HRC) were calculated at rest and during an isometric hand grip test (IHGT) within 48-hours (48 h) and two weeks (Week Two) of a concussion in athletes (CG) and control subjects. No differences were present at rest or in HRV during IGHT. HRC was significantly lower in the CG compared to controls at 48 h during IHGT. In CG at Week Two during IHGT, HRC was significantly greater than 48 h observations and not significantly different than controls. The findings suggest that HRC may have utility in detecting efferent cardiac autonomic anomalies within two weeks of concussion.

  9. Heads Up: Concussion in Youth Sports

    Medline Plus

    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 ...

  10. Vision training methods for sports concussion mitigation and management.

    Science.gov (United States)

    Clark, Joseph F; Colosimo, Angelo; Ellis, James K; Mangine, Robert; Bixenmann, Benjamin; Hasselfeld, Kimberly; Graman, Patricia; Elgendy, Hagar; Myer, Gregory; Divine, Jon

    2015-05-05

    There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool and potentially as a supportive component to concussion prevention strategies. This paper is focused on providing detailed methods for select vision training tools and reporting normative data for comparison when vision training is a part of a sports management program. The overall program includes standard vision training methods including tachistoscope, Brock's string, and strobe glasses, as well as specialized light board training algorithms. Stereopsis is measured as a means to monitor vision training affects. In addition, quantitative results for vision training methods as well as baseline and post-testing *A and Reaction Test measures with progressive scores are reported. Collegiate athletes consistently improve after six weeks of training in their stereopsis, *A and Reaction Test scores. When vision training is initiated as a team wide exercise, the incidence of concussion decreases in players who participate in training compared to players who do not receive the vision training. Vision training produces functional and performance changes that, when monitored, can be used to assess the success of the vision training and can be initiated as part of a sports medical intervention for concussion prevention.

  11. Court Decisions Specific to Public School Responses to Student Concussions

    Science.gov (United States)

    Zirkel, Perry A.

    2016-01-01

    This article provides an up-to-date and comprehensive canvassing of the judicial case law concerning the responses to students with concussions in the public school context. The two categories of court decisions are (a) those concerning continued participation in interscholastic athletics, referred to under the rubric of "return to play"…

  12. A prospective pilot investigation of brain volume, white matter hyperintensities and haemorrhagic lesions after mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Michael eJarrett

    2016-02-01

    Full Text Available Traumatic brain injury (TBI is among the most common neurological disorders. Haemorrhagic lesions and white matter hyperintensities (WMH are radiological features associated with moderate and severe traumatic brain injury TBI. Brain volume reductions have also been observed during the months following injury. In concussion, no signs of injury are observed on conventional MRI, which may be a true feature of concussion or merely due to the limited sensitivity of imaging techniques used so far. Moreover, it is not known whether volume reductions are due to the resolution of trauma related edema or a true volume loss. Forty five collegiate level ice hockey players (20 female and 15 controls (9 female 40 players underwent 3T MRI for haemorrhages (multi echo susceptibility weighted imaging (SWI, WMH (three dimensional FLAIR and brain volume at the beginning and the end of the hockey season. Concussed athletes underwent additional imaging and neuropsychological testing atthree days, two weeks, and two months after injury. At the end of the hockey season, brain volume was reduced compared to controls by 0.32% (p<0.034 in the whole cohort and by 0.26% (p<0.09 in the concussed athletes. Two weeks and two months after concussion, brain volume was reduced by -0.08% (p=0.027 and -0.23% (p=0.035, respectively. In athletes, the WMH were significantly closer to the interface between grey matter and white matter compared to controls. No significant changes in thenumber of WMH over the duration of the study were found in athletes. No microhaemorrhages were detected as a result of concussion or playing a season of ice hockey. We conclude that mild TBI does not lead to transient increases in brain volume and no new microbleeds or WMH are detectable after concussion. Brain volume reductions appear by two weeks after concussion and persist until at least two months after concussion. Brain volume is reduced between the beginning and the end of the icehockey season.

  13. Neurological consequences of traumatic brain injuries in sports.

    Science.gov (United States)

    Ling, Helen; Hardy, John; Zetterberg, Henrik

    2015-05-01

    Traumatic brain injury (TBI) is common in boxing and other contact sports. The long term irreversible and progressive aftermath of TBI in boxers depicted as punch drunk syndrome was described almost a century ago and is now widely referred as chronic traumatic encephalopathy (CTE). The short term sequelae of acute brain injury including subdural haematoma and catastrophic brain injury may lead to death, whereas mild TBI, or concussion, causes functional disturbance and axonal injury rather than gross structural brain damage. Following concussion, symptoms such as dizziness, nausea, reduced attention, amnesia and headache tend to develop acutely but usually resolve within a week or two. Severe concussion can also lead to loss of consciousness. Despite the transient nature of the clinical symptoms, functional neuroimaging, electrophysiological, neuropsychological and neurochemical assessments indicate that the disturbance of concussion takes over a month to return to baseline and neuropathological evaluation shows that concussion-induced axonopathy may persist for years. The developing brains in children and adolescents are more susceptible to concussion than adult brain. The mechanism by which acute TBI may lead to the neurodegenerative process of CTE associated with tau hyperphosphorylation and the development of neurofibrillary tangles (NFTs) remains speculative. Focal tau-positive NFTs and neurites in close proximity to focal axonal injury and foci of microhaemorrhage and the predilection of CTE-tau pathology for perivascular and subcortical regions suggest that acute TBI-related axonal injury, loss of microvascular integrity, breach of the blood brain barrier, resulting inflammatory cascade and microglia and astrocyte activation are likely to be the basis of the mechanistic link of TBI and CTE. This article provides an overview of the acute and long-term neurological consequences of TBI in sports. Clinical, neuropathological and the possible pathophysiological

  14. Evaluation of SPECT with N-isopropyl (I-123)-p-iodoamphetamine (IMP) or technetium-99m ( sup 99m Tc)-d,1-hexamethyl-propyleneamine oxime (d,1-HM-PAO) in cerebral concussion patients

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    Torigoe, Ryuichiro; Hayashi, Takashi; Anegawa, Shigetaka (Saint Mary' s Hospital, Kurume, Fukuoka (Japan)); Harada, Katsuhiko; Matsuo, Hiromasa; Yoshikawa, Ichiro

    1991-06-01

    {sup 123}I-IMP and Tc-PAO SPECT were performed in 20 cases of cerebral concussion ranging in age from 4 to 20 years old, including six cases of the juvenile head trauma syndrome (JHTS). The SPECT findings were divided into two main types: six cases in the normal group with no blood flow abnormalities, and 14 cases in abnormal group showing reduced blood flow, mainly in cerebellum and occipital lobe except in one case. In 10 cases of reduced blood flow which could be analyzed, calculation of the blood flow ratio in the temporal and occipital lobes and the cerebellum with the frontal lobe taken as 100 showed values of 93.5% for the temporal lobe, 82.7% for the occipital lobe and 76.8% for the cerebellum. A statistically significant reduction in blood flow occurred in the occipital lobe and cerebellum. In blood examination, abnormally high values of white blood cell counts were observed transiently in 94% of cerebral concussion cases. Abnormalities in brain stem and hypothalamus appeared to cause these abnormal WBC values. From these findings, it was suggested that the blood flow regions of the basilar and posterior cerebral arteries, i.e., the brain stem and hypothalamus are closely connected with the lesions responsible for cerebral concussion. It also appeared that the JHTS occurs in cerebral concussion cases where recovery of the abnormal blood flow in these regions in poor. (author).

  15. Neuropsychological testing as it relates to recovery from sports-related concussion.

    Science.gov (United States)

    Putukian, Margot

    2011-10-01

    Concussion is a challenging injury for the sports medicine team, and neuropsychological testing has been used as an adjunct to other clinical measures for assessment and management, and to guide return-to-play decisions. Understanding the limitations as well as the role of neuropsychological testing in the evaluation and management of sports-related concussion is important for the sports medicine team. This article will review the evidence regarding the utility of neuropsychological testing as it relates to concussion in sports.

  16. Emerging data on the incidence of concussion in football practice at all levels of amateur play.

    Science.gov (United States)

    Guthrie, Robert M

    2015-11-01

    There has been increasing concern, particularly in the US, about potential long-term neurological deterioration syndromes seen in the US football players. Recurrent concussions are a potential area of concern. The authors of this paper have used data bases from three levels of amateur US football to identify the rate and risk of concussion injury in both football games and practice at the youth, high school, and college levels. This information is very important initial data around concussion rates at these levels.

  17. Post-concussive syndrome in a female basketball player: a case study

    OpenAIRE

    2013-01-01

    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...

  18. NASN position statement: Concussions--the role of the school nurse.

    Science.gov (United States)

    Diaz, Anne L; Wyckoff, Leah J

    2013-03-01

    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 education to parents, students, and staff; identify suspected concussions; and help guide the student's post-concussion graduated academic and activity re-entry process. The school nurse collaborates with the team of stakeholders including health care providers, school staff, athletic trainers, and parents.

  19. Development of an iPhone application for sideline concussion testing.

    Science.gov (United States)

    Curaudeau, Guillaume A; Sharma, Nikhil; Rovin, Richard A

    2011-11-01

    Professional athletes are taking concussion very seriously, and missed play due to concussion is no longer stigmatized. One fortuitous consequence is increased awareness of the detrimental effects of concussion among student athletes. Whereas professional athletes have access to formal in-competition evaluation and out-of-competition monitoring programs, the majority of student athletes, especially at the middle school and high school levels, do not. The authors therefore set out to create an easy-to-use iPhone application for sideline concussion testing and serial monitoring of these at-risk athletes.

  20. Heads Up: Concussion in Youth Sports

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    Full Text Available ... Learn More about the Brain and How it Works Order Free Copies of CDC's “Heads Up” Educational ... American Academy of Physical Medicine and Rehabilitation American College of Sports Medicine American Medical Society for Sports ...

  1. Heads Up: Concussion in Youth Sports

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    Full Text Available ... Learn More about the Brain and How it Works Order Free Copies of CDC's “Heads Up” Educational ... Chapel Hill May Clinic MSU, Institute for the Study of Youth Sports National Academy of Neuropsychology National ...

  2. Heads Up: Concussion in Youth Sports

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    Full Text Available ... a Fact Sheet on Overall Sports Safety: Protect the Ones You Love For parents Order Free Copies ... Providers Materials for School Professionals Learn More about the Brain and How it Works Order Free Copies ...

  3. Heads Up: Concussion in Youth Sports

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    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

  4. Autonomic Nervous System Responses to Concussion: Arterial Pulse Contour Analysis

    Directory of Open Access Journals (Sweden)

    Michael F La Fountaine

    2016-02-01

    Full Text Available The arterial pulse wave (APW has a distinct morphology whose contours reflect dynamics in cardiac function and peripheral vascular tone as a result of sympathetic nervous system (SNS control. With a transition from rest to increased metabolic demand, the expected augmentation of SNS outflow will not only affect arterial blood pressure and heart rate, it will also induce changes to the contours of the APW. Following a sports concussion, a transient state cardiovascular autonomic dysfunction is present. How this state affects the APW, has yet to be described. A prospective, parallel-group study on cardiovascular autonomic control (i.e., digital electrocardiogram and continuous beat-to-beat blood pressure was performed in the seated upright position in ten athletes with concussion and 7 non-injured control athletes. Changes in APW were compared at rest and during the first 60 seconds (F60 of an isometric handgrip test (IHGT in concussed athletes and non-injured controls within 48 hours (48hr and 1 week (1wk of injury. The concussion group was further separated by the length of time until they were permitted to return to play (RTP>1wk; RTP≤1wk. SysSlope, an indirect measurement of stroke volume, was significantly lower in the concussion group at rest and during F60 at 48hr and 1wk; a paradoxical decline in SysSlope occurred at each visit during the transition from rest to IHGT F60. The RTP>1wk group had lower SysSlope (405±200; 420±88; 454±236 mmHg/s, respectively at rest 48hr compared to the RTP≤1wk and controls. Similarly at 48hr rest, several measurements of arterial stiffness were abnormal in RTP>1wk compared to RTP≤1wk and controls: Peak-to-Notch Latency (0.12±0.04; 0.16±0.02; 0.17±0.05, respectively, Notch Relative Amplitude (0.70±0.03; 0.71±0.04; 0.66±0.14, respectively and Stiffness Index (6.4±0.2; 5.7±0.4; 5.8±0.5, respectively. Use of APW revealed that concussed athletes have a transient increase in peripheral artery

  5. Effect of Sport Related Concussion on Clinically Measured Simple Reaction Time

    Science.gov (United States)

    Eckner, James T.; Kutcher, Jeffrey S.; Broglio, Steven P.; Richardson, James K.

    2013-01-01

    Background Reaction time (RT) is a valuable component of the sport concussion assessment battery. RT is typically measured using computers running specialized software, which limits its applicability in some athletic settings and populations. To address this, we developed a simple clinical test of RT (RTclin) that involves grasping a falling measuring stick. Purpose To determine the effect of concussion on RTclin and its sensitivity and specificity for concussion. Materials and methods Concussed athletes (n=28) and non-concussed control teammates (n=28) completed RTclin assessments at baseline and within 48 hours of injury. Repeated measures ANOVA compared mean baseline and follow-up RTclin values between groups. Sensitivity and specificity were calculated over a range of reliable change confidence levels. Results RTclin differed significantly between groups (p < .001): there was significant prolongation from baseline to post-injury in the concussed group (p= .003), with a trend toward improvement in the control group (p = .058). Sensitivity and specificity were maximized when a critical change value of 0 ms was applied (i.e., any increase in RTclin from baseline was interpreted as abnormal), which corresponded to a sensitivity of 75%, specificity of 68%, and a 65% reliable change confidence level. Conclusions RTclin appears sensitive to the effects of concussion and distinguished concussed and non-concussed athletes with similar sensitivity and specificity to other commonly used concussion assessment tools. Given its simplicity, low cost, and minimal time requirement, RTclin should be considered a viable component of the sports medicine provider’s multifaceted concussion assessment battery. PMID:23314889

  6. The effects of performing the YMCA Bike protocol on general brain function in athletes with and without mild traumatic brain injury

    Science.gov (United States)

    Gay, Michael

    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

  7. Establishing a clinical service for the management of sports-related concussions.

    Science.gov (United States)

    Reynolds, Erin; Collins, Michael W; Mucha, Anne; Troutman-Ensecki, Cara

    2014-10-01

    The clinical management of sports-related concussions is a specialized area of interest with a lack of empirical findings regarding best practice approaches. The University of Pittsburgh Medical Center Sports Concussion Program was the first of its kind; 13 years after its inception, it remains a leader in the clinical management and research of sports-related concussions. This article outlines the essential components of a successful clinical service for the management of sports-related concussions, using the University of Pittsburgh Medical Center Sports Concussion Program as a case example. Drawing on both empirical evidence and anecdotal conclusions from this high-volume clinical practice, this article provides a detailed account of the inner workings of a multidisciplinary concussion clinic with a comprehensive approach to the management of sports-related concussions. A detailed description of the evaluation process and an in-depth analysis of targeted clinical pathways and subtypes of sports-related concussions effectively set the stage for a comprehensive understanding of the assessment, treatment, and rehabilitation model used in Pittsburgh today.

  8. An Examination of Concussion Injury Rates in Various Models of Football Helmets in NCAA Football Athletes

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    Ryan Moran; Tracey Covassin

    2015-01-01

    While newer, advanced helmet models have been designed with the intentions of decreasing concussions, very little research exists on injury rates in various football helmets at the collegiate level. The aim of this study was to examine concussion injury rates in various models of football helmets in collegiate football athletes. In addition, to compare injury rates of newer, advanced football helmets to older, traditional helmets among collegiate football athletes, a total of 209 concussions and 563,701 AEs (athlete-exposures) among 2,107 collegiate football athletes in seven helmet models were included in the analyses. Concussion injury rates revealed that the Riddell Revolution~ had the highest rate of 0.41 concussions per 1,000 AEs. The Schutt ION 4DTM helmet had the lowest rate of 0.25 concussions per 1,000 AEs. These newer helmet models did not significantly differ from one another (P = 0.74), however, all models significantly differed from the older, traditional helmet model (P 〈 0.001). The findings of this study suggest that concussion rates do not differ between newer and more advanced helmet models. More importantly, there are currently no helmets available to prevent concussions from occurring in football athletes.

  9. The "value added" of neurocognitive testing after sports-related concussion

    NARCIS (Netherlands)

    Van Kampen, Derk A.; Lovell, Mark R.; Pardini, Jamie E.; Collins, Michael W.; Fu, Freddie H.

    2006-01-01

    Background: Neurocognitive testing has been endorsed as a "cornerstone" of concussion management by recent Vienna and Prague meetings of the Concussion in Sport Group. Neurocognitive testing is important given the potential unreliability of athlete self-report after injury. Relying only on athletes'

  10. Concussion and the Student-Athlete: Considerations for the Secondary School Setting

    Science.gov (United States)

    Kolodziej, Andrea; Ploeg, Adam

    2016-01-01

    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…

  11. Prevalence of and Attitudes about Concussion in Irish Schools' Rugby Union Players

    Science.gov (United States)

    Delahunty, Sinéad E.; Delahunt, Eamonn; Condon, Brian; Toomey, David; Blake, Catherine

    2015-01-01

    Background: Youth rugby players represent 45.2% (N?=?69,472) of the Irish rugby union playing population. The risk and consequences of concussion injury are of particular concern in these young athletes, but limited epidemiological data exists. This study investigated annual and lifetime prevalence of concussion in an Irish schoolboy rugby union…

  12. Sideline assessment tools for the evaluation of concussion in athletes: a review.

    Science.gov (United States)

    Okonkwo, David O; Tempel, Zachary J; Maroon, Joseph

    2014-10-01

    Sports-related concussions, which have become more prevalent in the past decade, are an extremely common phenomenon in organized athletics and create a substantial economic burden on the health care system. Furthermore, they can have devastating impacts on the athletic careers and long-term health of athletes. However, concussion evaluation remains a controversy with respect to diagnosis, management, and return-to-play guidelines for sports-related concussions. This is especially true of the immediate evaluation of sports-related concussion on the sidelines, where decisions must be made quickly and effectively with limited diagnostic resources. Considerable effort has been directed toward developing reliable and valid sidelines assessment modalities for concussion evaluation with a goal of accurately determining whether an athlete requires rapid removal from or is able to return to competition. This paper discusses the role of the concussion specialist on the sidelines during athletic competition and examines the current tools and resources available for the sidelines assessment of concussion. Additionally, new technologies, including electronic applications for Smartphones and tablets, as well as future directions in sidelines assessment of concussion are examined.

  13. Return to Play Guidelines Cannot Solve the Football-Related Concussion Problem

    Science.gov (United States)

    Johnson, L. Syd M.

    2012-01-01

    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…

  14. Legislation for Youth Sport Concussion in Canada: Review, Conceptual Framework, and Recommendations.

    Science.gov (United States)

    Russell, Kelly; Ellis, Michael J; Bauman, Shannon; Tator, Charles H

    2017-01-10

    In this article, we conduct a review of introduced and enacted youth concussion legislation in Canada and present a conceptual framework and recommendations for future youth sport concussion laws. We conducted online searches of federal, provincial, and territorial legislatures to identify youth concussion bills that were introduced or successfully enacted into law. Internet searches were carried out from July 26 and 27, 2016. Online searches identified six youth concussion bills that were introduced in provincial legislatures, including two in Ontario and Nova Scotia and one each in British Columbia and Quebec. One of these bills (Ontario Bill 149, Rowan's Law Advisory Committee Act, 2016) was enacted into provincial law; it is not actual concussion legislation, but rather a framework for possible enactment of legislation. Two bills have been introduced in federal parliament but neither bill has been enacted into law. At present, there is no provincial or federal concussion legislation that directly legislates concussion education, prevention, management, or policy in youth sports in Canada. The conceptual framework and recommendations presented here should be used to guide the design and implementation of future youth sport concussion laws in Canada.

  15. Prevalence of and Attitudes about Concussion in Irish Schools' Rugby Union Players

    Science.gov (United States)

    Delahunty, Sinéad E.; Delahunt, Eamonn; Condon, Brian; Toomey, David; Blake, Catherine

    2015-01-01

    Background: Youth rugby players represent 45.2% (N?=?69,472) of the Irish rugby union playing population. The risk and consequences of concussion injury are of particular concern in these young athletes, but limited epidemiological data exists. This study investigated annual and lifetime prevalence of concussion in an Irish schoolboy rugby union…

  16. Near Point of Convergence After a Sport-Related Concussion

    Science.gov (United States)

    Pearce, Kelly L.; Sufrinko, Alicia; Lau, Brian C.; Henry, Luke; Collins, Michael W.; Kontos, Anthony P.

    2016-01-01

    Background Convergence insufficiency (CI) is a common binocular vision deficit after a sport-related concussion (SRC). CI may result in visual discomfort and vision-mediated functional difficulties such as slowed reading and compromised attention, leading to impaired academic, work, and sport performance. Purpose To test the reliability of repeated near point of convergence (NPC) measurements in a sample of athletes after an SRC; compare the symptoms and cognitive impairment of athletes with normal NPC to those with CI after an SRC; and explore the relationship among age, sex, learning disability, migraine history, and CI. Study Design Cross-sectional study; Level of evidence, 3. Methods A total of 78 athletes (mean age, 14.31 ± 2.77 years) who were seen a mean 5.79 ± 5.63 days after an SRC were administered 3 trials of an NPC assessment, along with neurocognitive (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) and symptom assessments. Patients were divided into normal NPC (NPC ≤5 cm; n = 45) and CI (NPC >5 cm; n = 33) groups. Intraclass correlation coefficients (ICCs) and repeated-measures analyses of variance (ANOVAs) assessed the consistency of NPC across the 3 trials. The ANOVAs were employed to examine differences on neurocognitive composites and symptoms between the normal NPC and CI groups. Stepwise regressions (controlling for age and symptom scores on the Post-Concussion Symptom Scale [PCSS]) were conducted to evaluate the predictive utility of the NPC distance for neurocognitive impairment. Results Groups did not differ on demographic or injury characteristics. NPC differed between trial 1 and trials 2 (P = .02) and 3 (P = .01) for the CI group but not the normal NPC group. Internal consistency was high across NPC measurements (ICC range, 0.95–0.98). Patients with CI performed worse on verbal memory (P = .02), visual motor speed (P = .02), and reaction time (P = .001, η2 = .13) and had greater total symptom scores (P = .02

  17. Dazed and confused: sports medicine, conflicts of interest, and concussion management.

    Science.gov (United States)

    Partridge, Brad

    2014-03-01

    Professional sports with high rates of concussion have become increasingly concerned about the long-term effects of multiple head injuries. In this context, return-to-play decisions about concussion generate considerable ethical tensions for sports physicians. Team doctors clearly have an obligation to the welfare of their patient (the injured athlete) but they also have an obligation to their employer (the team), whose primary interest is typically success through winning. At times, a team's interest in winning may not accord with the welfare of an injured player, particularly when it comes to decisions about returning to play after injury. Australia's two most popular professional football codes-rugby league and Australian Rules football-have adopted guidelines that prohibit concussed players from continuing to play on the same day. I suggest that conflicts of interest between doctors, patients, and teams may present a substantial obstacle to the proper adherence of concussion guidelines. Concussion management guidelines implemented by a sport's governing body do not necessarily remove or resolve conflicts of interest in the doctor-patient-team triad. The instigation of a concussion exclusion rule appears to add a fourth party to this triad (the National Rugby League or the Australian Football League). In some instances, when conflicts of interest among stakeholders are ignored or insufficiently managed, they may facilitate attempts at circumventing concussion management guidelines to the detriment of player welfare.

  18. Youth Concussion Laws across the Nation: Implications for the Traveling Team Physician.

    Science.gov (United States)

    Simon, Lauren M; Mitchell, Cory N

    2016-01-01

    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.

  19. Depression as a Modifying Factor in Sport-Related Concussion: A Critical Review of the Literature.

    Science.gov (United States)

    Solomon, Gary S; Kuhn, Andrew W; Zuckerman, Scott L

    2016-01-01

    Since its third iteration in 2008, the international Concussion in Sport Group (CISG) has delineated several 'modifying factors' that have the potential to influence the management of sport-related concussions (SRC). One of these factors is co- and pre-morbidities, which includes migraines, mental health disorders, attention-deficit hyperactive disorder (ADHD), learning disability, and sleep disorders. Mental health disorders, and in particular, depression, have received some attention in the management of SRC and in this review we summarize the empirical evidence for its inclusion as a modifying factor. This review is divided into three main bodies of findings: (1) the incidence and prevalence of depression and depressive symptoms in non-concussed and concussed athletes, with comparison made to the general population; (2) managing the post-concussion athlete and accounting for premorbid depressive symptoms; and (3) depression as a long-term effect of repetitive head trauma. Overall, it has been reported that certain subpopulations of athletes have similar or even higher rates of depressive symptoms when compared to the general population. The challenge of accounting for these baseline-depressive symptoms while managing the post-concussive athlete is stressed. And lastly, the prevalence of depression and its relationship to concussion in later-life is discussed.

  20. Accounting for sampling variability, injury under-reporting, and sensor error in concussion injury risk curves.

    Science.gov (United States)

    Elliott, Michael R; Margulies, Susan S; Maltese, Matthew R; Arbogast, Kristy B

    2015-09-18

    There has been recent dramatic increase in the use of sensors affixed to the heads or helmets of athletes to measure the biomechanics of head impacts that lead to concussion. The relationship between injury and linear or rotational head acceleration measured by such sensors can be quantified with an injury risk curve. The utility of the injury risk curve relies on the accuracy of both the clinical diagnosis and the biomechanical measure. The focus of our analysis was to demonstrate the influence of three sources of error on the shape and interpretation of concussion injury risk curves: sampling variability associated with a rare event, concussion under-reporting, and sensor measurement error. We utilized Bayesian statistical methods to generate synthetic data from previously published concussion injury risk curves developed using data from helmet-based sensors on collegiate football players and assessed the effect of the three sources of error on the risk relationship. Accounting for sampling variability adds uncertainty or width to the injury risk curve. Assuming a variety of rates of unreported concussions in the non-concussed group, we found that accounting for under-reporting lowers the rotational acceleration required for a given concussion risk. Lastly, after accounting for sensor error, we find strengthened relationships between rotational acceleration and injury risk, further lowering the magnitude of rotational acceleration needed for a given risk of concussion. As more accurate sensors are designed and more sensitive and specific clinical diagnostic tools are introduced, our analysis provides guidance for the future development of comprehensive concussion risk curves.

  1. Examination of Teacher Knowledge, Dissemination Preferences, and Classroom Management of Student Concussions: Implications for Return-to-Learn Protocols.

    Science.gov (United States)

    Dreer, Laura E; Crowley, Maria T; Cash, Augusta; O'Neill, Jilian A; Cox, Molly K

    2016-05-26

    Objectives To determine teacher knowledge of (1) concussion symptomatology, (2) dissemination preferences, and (3) classroom management practices of student concussions. Study Design A cross-sectional survey assessing concussion-related information was completed by teachers/instructors in the state of Alabama. Results One-hundred and thirty participants completed the survey. Only a quarter perceived they were "very" or "extremely" confident enough to recognize signs related to a concussion (22.3%), and only 12.4% reported they were "very knowledgeable" about concussions. The majority were able to recognize more common concussion symptoms/challenges: headaches (95.4%), trouble concentrating (86.2%), memory (82.3%), balance problems/dizziness (82.3%), changes vision/hearing (76.2%), difficulty completing tasks (70.8%), difficulty making decisions (66.2%), changes in sleep (61.5%), and fatigue (60.8%); only half recognized emotional symptoms (e.g., mood) or symptoms associated with more prolonged recovery. Concussion informants were school nurses (74.4%), followed by parents (46.2%), students (46.2%), and coaches/athletic trainers (45.4%). A little under half of participants received concussion information as part of their job (41.9%). About 14.1% of teachers reported that someone had come to their school to talk with them as a group about concussions, and 82% felt they needed more information. Of the 37% who taught a concussed student, 83% reported they altered the classroom management strategies. Conclusions In general, teachers were able to recognize the more commonly experienced concussion symptoms as well as management strategies. However, they appear to want greater concussion information and training. Given the daily influence of teachers on student tasks involving cognitive exertion, incorporation of formal concussion education for teachers is warranted.

  2. Wearable nanosensor system for monitoring mild traumatic brain injuries in football players

    Science.gov (United States)

    Ramasamy, Mouli; Varadan, Vijay K.

    2016-04-01

    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.

  3. Resolution of Concussion Symptoms After Osteopathic Manipulative Treatment: A Case Report.

    Science.gov (United States)

    Guernsey, David T; Leder, Adena; Yao, Sheldon

    2016-03-01

    A concussion is the result of a biomechanical force directed toward the head, causing neurologic dysfunction. The inflammatory response and the production of reactive oxygen species are proposed mechanisms for the symptoms and long-term sequelae of concussion. Osteopathic manipulative treatment (OMT) may help reduce inflammation by improving glymphatic flow. The authors describe the effect of OMT on a patient with mild concussion symptoms, including nausea, dizziness, tinnitus, and imbalance. The patient was evaluated with the Sensory Organization Test before and after undergoing a 25-minute session of OMT. After the session, the patient reported resolution of symptoms, and his sensory organization test score improved by 6 points. The role of OMT must be further investigated as an essential and cost-effective tool in the management of concussions.

  4. Self-reported concussion symptoms and training routines in mixed martial arts athletes.

    Science.gov (United States)

    Heath, Christopher J; Callahan, Jennifer L

    2013-01-01

    Mixed martial arts (MMA) is a full-contact, fighting sport that has risen in popularity over recent years, resulting in an increase in both training facilities and sport participants. To date, little research has examined the complications and vulnerability to head trauma, or concussive symptomatology, in MMA athletes. In this study, we assessed relationships between training routines and concussive symptoms, as well as medical care, in MMA athletes. A sample (N = 119) of MMA athletes reported concussive symptoms, training routines, and medical histories through an online survey. Nearly 15% of the MMA athletes reported history of a knockout, and nearly one-third reported a technical knockout. Subjective ratings of concussive symptoms were high for these athletes, with many of them waiting only a brief time after such incidents to return to competition. These findings have important implications for informing the medical treatment and safety decision for returning to participation for these athletes.

  5. Detecting altered postural control after cerebral concussion in athletes with normal postural stability

    OpenAIRE

    Cavanaugh, J; Guskiewicz, K.; Giuliani, C.; Marshall, S.; Mercer, V; Stergiou, N.

    2005-01-01

    Objective: To determine if approximate entropy (ApEn), a regularity statistic from non-linear dynamics, could detect changes in postural control during quiet standing in athletes with normal postural stability after cerebral concussion.

  6. Proceedings from the Ice Hockey Summit on concussion: a call to action.

    Science.gov (United States)

    Smith, A; Stuart, M; Greenwald, R; Benson, B; Dodick, D; Emery, C; Finnoff, J; Mihalik, J; Roberts, W; Sullivan, C A; Meeuwisse, W

    2011-07-01

    The objective of this proceedings is to integrate the concussion in sport literature and sport science research on safety in ice hockey to develop an action plan to reduce the risk, incidence, severity, and consequences of concussion in ice hockey. A rationale paper outlining a collaborative action plan to address concussions in hockey was posted for review two months prior to the Ice Hockey Summit: Action on Concussion. Focused presentations devoted specifically to concussion in ice hockey were presented during the Summit and breakout sessions were used to develop strategies to reduce concussion in the sport. This proceedings and a detailed scientific review (a matrix of solutions) were written to disseminate the evidence-based information and resulting concussion reduction strategies. The manuscripts were reviewed by the authors, advisors and contributors to ensure that the opinions and recommendations reflect the current level of knowledge on concussion in hockey. Six components of a potential solution were articulated in the Rationale paper and became the topics for breakout groups that followed the professional, scientific lectures. Topics that formed the core of the action plan were: metrics and databases; recognizing, managing and return to play; hockey equipment and ice arenas; prevention and education; rules and regulations; and expedient communication of the outcomes. The attendees in breakout sessions identified action items for each section. The most highly ranked action items were brought to a vote in the open assembly, using an Audience Response System (ARS). The strategic planning process was conducted to assess: Where are we at?; Where must we get to?; and What strategies are necessary to make progress on the prioritized action items? Three prioritized action items for each component of the solution and the percentage of the votes received are listed in the body of this proceedings.

  7. The acute symptoms of sport-related concussion: diagnosis and on-field management.

    Science.gov (United States)

    Putukian, Margot

    2011-01-01

    Sport-related concussion is a common injury that occurs in a variety of sports. In recent years, more attention has been focused on the importance of this injury as well as the long-term complications of unrecognized, repetitive, and/or severe injury. The acute presentation of concussion as well as the diagnosis of concussion is often straightforward and obvious, but it can also be subtle and difficult to discern. Most injuries are short lived with complete recovery within a couple of weeks, with a small minority taking several months to resolve. Unfortunately, it is difficult to predict which injuries will linger. This article discusses the on-field presentation, diagnosis, and management of sport-related concussion. It is important to have a concussion protocol for high-risk sports, including a preseason and postinjury assessment, and an individualized yet comprehensive approach that includes evaluating symptoms, and a neurologic examination that includes cognitive function and balance testing. A multifaceted approach to the evaluation and diagnosis of concussion is endorsed for the optimal management of this injury.

  8. The Incidence of Concussion in a Professional Australian Rugby League Team, 1998-2012.

    Science.gov (United States)

    Savage, Jason; Hooke, Chloe; Orchard, John; Parkinson, Richard

    2013-01-01

    Background. Rugby league is a physically demanding team sport and the National Rugby League is the highest-level competition of rugby league in Australia. Frequent tackles and collisions between players result in a high incidence of injury to players. Concussion injuries have been the source of much debate, with reporting varying greatly depending on the definition used. Method. Injury records of 239 players from one professional National Rugby League were analysed during a continuous period of 15 years, with particular interest in the incidence and recurrence of concussions and the change in incidence over time. Result. A total of 191 concussions were recorded, affecting 90 players. The incidence of concussion injuries was found to be 28.33 per 1000 player match hours, with an increase over time (P = 0.0217). Multiple concussions were recorded for 51 players. Conclusion. A statistically significant increase in the incidence of concussion injuries was found, without a concurrent increase in the number of head injuries or total injuries. New rules which mandate removal of players from the field may be beneficial for protection of players on the long term, although they risk being counterproductive, if they make players less likely to report their symptoms during matches.

  9. An Exploratory Study of the Potential Effects of Vision Training on Concussion Incidence in Football

    Directory of Open Access Journals (Sweden)

    Joseph F. Clark, PHD, ATC

    2015-04-01

    Full Text Available Background: Vision training has become a component of sports enhancement training; however, quantifiable and validated improvement in visual performance has not been clearly demonstrated. In addition, there is minimal literature related to the effects of vision training on sports performance and injury risk reduction. The purpose of the current investigation was to determine the effects of vision training on peripheral vision and concussion incidence. Methods: Vision training was initiated among the University of Cincinnati football team at the beginning of the 2010 season and continued for four years (2010 to 2013. The sports vision enhancement was conducted during the two weeks of preseason camp. Typical vision training consisted of Dynavision D2 light board training, Nike strobe glasses, and tracking drills. Nike Strobe glasses and tracking drills were done with pairs of pitch-and-catch drills using footballs and tennis balls, with instructions to vary arc, speed, and trajectory. For skilled players, “high ball” drills were the focus, whereas for linemen, bounce passes and low pitch drills were stressed. Reaction time data was recorded for each athlete during every Dynavision D2 training session. We monitored the incidence of concussion during the four consecutive seasons of vision training, as well as the previous four consecutive seasons, and compared incidence of concussions (2006 to 2009 referent seasons v. 2010 to 2013 vision training seasons. Results: During the 2006-2013 pre- and regular football seasons, there were 41 sustained concussion events reported. The overall concussion incidence rate for the entire cohort was 5.1 cases per 100 player seasons. When the data were evaluated relative to vision trained versus referent untrained player seasons, a statistically significant lower rate of concussion was noted in player season in the vision training cohort (1.4 concussions per 100 player seasons compared to players who did not

  10. Consequences of repeated blood-brain barrier disruption in football players.

    Directory of Open Access Journals (Sweden)

    Nicola Marchi

    Full Text Available 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.

  11. A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder.

    Science.gov (United States)

    Harch, Paul G; Andrews, Susan R; Fogarty, Edward F; Amen, Daniel; Pezzullo, John C; Lucarini, Juliette; Aubrey, Claire; Taylor, Derek V; Staab, Paul K; Van Meter, Keith W

    2012-01-01

    This is a preliminary report on the safety and efficacy of 1.5 ATA hyperbaric oxygen therapy (HBOT) in military subjects with chronic blast-induced mild to moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD). Sixteen military subjects received 40 1.5 ATA/60 min HBOT sessions in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, and neuropsychological and psychological testing were completed before and within 1 week after treatment. Subjects experienced reversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1); one subject withdrew. Post-treatment testing demonstrated significant improvement in: symptoms, neurological exam, full-scale IQ (+14.8 points; pPTSD symptoms (PCL-M: pself-report of percent of normal (pPTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT.

  12. School Nurses' Familiarity and Perceptions of Academic Accommodations for Student-Athletes Following Sport-Related Concussion

    Science.gov (United States)

    Weber, Michelle L.; Welch, Cailee E.; Parsons, John T.; Valovich McLeod, Tamara C.

    2015-01-01

    The purpose of this study was to evaluate school nurses' familiarity and perceptions regarding academic accommodations for student-athletes following sport-related concussion. School nurses (N = 1,246) accessed the survey School Nurses' Beliefs, Attitudes and Knowledge of Pediatric Athletes with Concussions (BAKPAC-SN). The BAKPAC-SN contained…

  13. Semi-Professional Rugby League Players have Higher Concussion Risk than Professional or Amateur Participants: A Pooled Analysis.

    Science.gov (United States)

    King, Doug; Hume, Patria; Gissane, Conor; Clark, Trevor

    2017-02-01

    A combined estimate of injuries within a specific sport through pooled analysis provides more precise evidence and meaningful information about the sport, whilst controlling for between-study variation due to individual sub-cohort characteristics. The objective of this analysis was to review all published rugby league studies reporting injuries from match and training participation and report the pooled data estimates for rugby league concussion injury epidemiology. A systematic literature analysis of concussion in rugby league was performed on published studies from January 1990 to October 2015. Data were extracted and pooled from 25 studies that reported the number and incidence of concussions in rugby league match and training activities. Amateur rugby league players had the highest incidence of concussive injuries in match activities (19.1 per 1000 match hours) while semi-professional players had the highest incidence of concussive injuries in training activities (3.1 per 1000 training hours). This pooled analysis showed that, during match participation activities, amateur rugby league participants had a higher reported concussion injury rate than professional and semi-professional participants. Semi-professional participants had nearly a threefold greater concussion injury risk than amateur rugby league participants during match participation. They also had nearly a 600-fold greater concussion injury risk than professional rugby league participants during training participation.

  14. Predictors of delayed recovery following pediatric sports-related concussion: a case-control study.

    Science.gov (United States)

    Miller, Joseph H; Gill, Clarence; Kuhn, Elizabeth N; Rocque, Brandon G; Menendez, Joshua Y; O'Neill, Jilian A; Agee, Bonita S; Brown, Steven T; Crowther, Marshall; Davis, R Drew; Ferguson, Drew; Johnston, James M

    2016-04-01

    OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a

  15. Persistent Postconcussive Symptoms Are Accompanied by Decreased Functional Brain Oxygenation.

    Science.gov (United States)

    Helmich, Ingo; Saluja, Rajeet S; Lausberg, Hedda; Kempe, Mathias; Furley, Philip; Berger, Alisa; Chen, Jen-Kai; Ptito, Alain

    2015-01-01

    Diagnostic methods are considered a major concern in the determination of mild traumatic brain injury. The authors examined brain oxygenation patterns in subjects with severe and minor persistent postconcussive difficulties and a healthy control group during working memory tasks in prefrontal brain regions using functional near-infrared spectroscopy. The results demonstrated decreased working memory performances among concussed subjects with severe postconcussive symptoms that were accompanied by decreased brain oxygenation patterns. An association appears to exist between decreased brain oxygenation, poor performance of working memory tasks, and increased symptom severity scores in subjects suffering from persistent postconcussive symptoms.

  16. Concussions and youth football: using a public health law framework to head off a potential public health crisis.

    Science.gov (United States)

    Baugh, Christine M; Shapiro, Zachary E

    2015-07-01

    Concussion from sport is increasingly recognized as a public health priority. In response, all states and the District of Columbia have enacted youth concussion legislation. This paper first examines key developments in concussion-related policy and legislation and then uses the findings from recent scientific studies to highlight the need to incorporate evolving scientific evidence into concussion legislation in order to better protect youth and adolescent athletes. Next, the paper discusses the framework of empirical health law research and why it should be applied in the case of concussion legislation. Finally, this paper argues that empirical health law research should be considered in any decision about whether legislation can help improve the health and safety of young players, a particularly vulnerable population whose unique needs have not yet been adequately addressed.

  17. Diffuse white matter tract abnormalities in clinically normal ageing retired athletes with a history of sports-related concussions.

    Science.gov (United States)

    Tremblay, Sebastien; Henry, Luke C; Bedetti, Christophe; Larson-Dupuis, Camille; Gagnon, Jean-François; Evans, Alan C; Théoret, Hugo; Lassonde, Maryse; De Beaumont, Louis

    2014-11-01

    Sports-related concussions have been shown to lead to persistent subclinical anomalies of the motor and cognitive systems in young asymptomatic athletes. In advancing age, these latent alterations correlate with detectable motor and cognitive function decline. Until now, the interacting effects of concussions and the normal ageing process on white matter tract integrity remain unknown. Here we used a tract-based spatial statistical method to uncover potential white matter tissue damage in 15 retired athletes with a history of concussions, free of comorbid medical conditions. We also investigated potential associations between white matter integrity and declines in cognitive and motor functions. Compared to an age- and education-matched control group of 15 retired athletes without concussions, former athletes with concussions exhibited widespread white matter anomalies along many major association, interhemispheric, and projection tracts. Group contrasts revealed decreases in fractional anisotropy, as well as increases in mean and radial diffusivity measures in the concussed group. These differences were primarily apparent in fronto-parietal networks as well as in the frontal aspect of the corpus callosum. The white matter anomalies uncovered in concussed athletes were significantly associated with a decline in episodic memory and lateral ventricle expansion. Finally, the expected association between frontal white matter integrity and motor learning found in former non-concussed athletes was absent in concussed participants. Together, these results show that advancing age in retired athletes presenting with a history of sports-related concussions is linked to diffuse white matter abnormalities that are consistent with the effects of traumatic axonal injury and exacerbated demyelination. These changes in white matter integrity might explain the cognitive and motor function declines documented in this population.

  18. Computerized Cognitive Testing in the Management of Youth Sports-Related Concussion.

    Science.gov (United States)

    De Marco, Anthony P; Broshek, Donna K

    2016-01-01

    Computerized neurocognitive testing has become a growing practice across medical populations, but particularly within sports medicine and the management of sports-related concussion. Although traditional neuropsychological measures are solely administered and interpreted by neuropsychologists, computerized cognitive tests are marketed to and utilized by a wide range of professionals involved in the management of sports-related concussions, many of whom lack specialized psychometric training. Although the benefits of computerized testing allow for many youth athletes to be evaluated quickly, professionals implementing their use should be aware of the potential pitfalls and the high potential for misuse. After briefly reviewing the recommended guidelines set forth by the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology, we review the benefits/limitations of computerized testing in the management of sports-related concussion and the basic psychometric properties of some of the more widely used computerized measures. Lastly, we discuss the practical application of these devices.

  19. Mechanism and treatment principle for cerebral vessel spasm caused by concussion

    Institute of Scientific and Technical Information of China (English)

    肖兴义; 郭新红; 王德文; 薛关生

    2002-01-01

    Objective: To discuss the mechanism of cerebral vessel spasm caused by concussion and the effect of Nimodipine on concussion. Methods: A total of 224 patients who were treated from March 1995 to October 1999 were divided into two groups randomly, ie, Nimodipine group (113 cases) and control group (111 cases). Middle cerebral artery (MCA), basilar artery (BA) and the average peak forward velocity of cerebral blood flow were observed by color three-dimensional transcranial Doppler (3D-TCD) within 24 hours after admission and at the end of 3-6 days of treatment. Cerebral blood flow changes, characteristics and treatment effect were analyzed and determined by clinical main symptom disappearance rate. Results: In concussion, cerebral blood flow was divided into 3 phases: cerebral blood flow low infusion dilation phase, cerebral blood vessel spasm phase and cerebral blood flow recovery phase. In the Nimodipine group, clinical main symptom disappearance rate was higher than that in the control group in the cerebral spasm and recovery phases with a significant difference (P<0.01).  Conclusions: Cerebral vessel spasm, hypoxia and ischemia lesion are the main pathological changes. Whether cerebral dysfunction is reversible or not is mainly determined by spasm time of cerebral blood vessel. Nimodipine has a good effect on releasing spasm and diminishing the cerebral blood flow velocity. It not only improves curative effect on concussion, but also reduces and prevents concussion sequelae. Hence, concussion patients who have cerebral spasm confirmed by 3D-TCD should be given Nimodipine routinely and early.

  20. The Relation of Mild Traumatic Brain Injury to Chronic Lapses of Attention

    Science.gov (United States)

    Pontifex, Matthew B.; Broglio, Steven P.; Drollette, Eric S.; Scudder, Mark R.; Johnson, Chris R.; O'Connor, Phillip M.; Hillman, Charles H.

    2012-01-01

    We assessed the extent to which failures in sustained attention were associated with chronic mild traumatic brain injury (mTBI) deficits in cognitive control among college-age young adults with and without a history of sport-related concussion. Participants completed the ImPACT computer-based assessment and a modified flanker task. Results…

  1. Traumatic brain injury in children in Denmark: a national 15-year study

    DEFF Research Database (Denmark)

    Engberg, A; Teasdale, T W

    1998-01-01

    Demographic trends are reported concerning three types of traumatic brain injury (concussions, cranial fractures, and intracranial contusions/haemorrhages) among children in Denmark of ages up to and including 14 years, for a fifteen year period from 1979 through 1993. The data were derived from ...

  2. Traumatic Brain Injury Induces Genome-Wide Transcriptomic, Methylomic, and Network Perturbations in Brain and Blood Predicting Neurological Disorders.

    Science.gov (United States)

    Meng, Qingying; Zhuang, Yumei; Ying, Zhe; Agrawal, Rahul; Yang, Xia; Gomez-Pinilla, Fernando

    2017-02-01

    The complexity of the traumatic brain injury (TBI) pathology, particularly concussive injury, is a serious obstacle for diagnosis, treatment, and long-term prognosis. Here we utilize modern systems biology in a rodent model of concussive injury to gain a thorough view of the impact of TBI on fundamental aspects of gene regulation, which have the potential to drive or alter the course of the TBI pathology. TBI perturbed epigenomic programming, transcriptional activities (expression level and alternative splicing), and the organization of genes in networks centered around genes such as Anax2, Ogn, and Fmod. Transcriptomic signatures in the hippocampus are involved in neuronal signaling, metabolism, inflammation, and blood function, and they overlap with those in leukocytes from peripheral blood. The homology between genomic signatures from blood and brain elicited by TBI provides proof of concept information for development of biomarkers of TBI based on composite genomic patterns. By intersecting with human genome-wide association studies, many TBI signature genes and network regulators identified in our rodent model were causally associated with brain disorders with relevant link to TBI. The overall results show that concussive brain injury reprograms genes which could lead to predisposition to neurological and psychiatric disorders, and that genomic information from peripheral leukocytes has the potential to predict TBI pathogenesis in the brain.

  3. Traumatic Brain Injury Induces Genome-Wide Transcriptomic, Methylomic, and Network Perturbations in Brain and Blood Predicting Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Qingying Meng

    2017-02-01

    Full Text Available The complexity of the traumatic brain injury (TBI pathology, particularly concussive injury, is a serious obstacle for diagnosis, treatment, and long-term prognosis. Here we utilize modern systems biology in a rodent model of concussive injury to gain a thorough view of the impact of TBI on fundamental aspects of gene regulation, which have the potential to drive or alter the course of the TBI pathology. TBI perturbed epigenomic programming, transcriptional activities (expression level and alternative splicing, and the organization of genes in networks centered around genes such as Anax2, Ogn, and Fmod. Transcriptomic signatures in the hippocampus are involved in neuronal signaling, metabolism, inflammation, and blood function, and they overlap with those in leukocytes from peripheral blood. The homology between genomic signatures from blood and brain elicited by TBI provides proof of concept information for development of biomarkers of TBI based on composite genomic patterns. By intersecting with human genome-wide association studies, many TBI signature genes and network regulators identified in our rodent model were causally associated with brain disorders with relevant link to TBI. The overall results show that concussive brain injury reprograms genes which could lead to predisposition to neurological and psychiatric disorders, and that genomic information from peripheral leukocytes has the potential to predict TBI pathogenesis in the brain.

  4. Los deportes y las conmociones cerebrales 2 PSA (:30) (Concussion in Sports 2)

    Centers for Disease Control (CDC) Podcasts

    2010-01-21

    Una mamá habla con su hija atleta adolescente sobre la gravedad de las conmociones cerebrales. (A mom and her teen athlete discuss the serious nature of concussions.).  Created: 1/21/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/21/2010.

  5. Programmed Physical Exertion in Recovery From Sports-Related Concussion: A Randomized Pilot Study.

    Science.gov (United States)

    Maerlender, Arthur; Rieman, Wanda; Lichtenstein, Jonathan; Condiracci, C

    2015-01-01

    Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery.

  6. Los deportes y las conmociones cerebrales 4 PSA (:30) (Concussion in Sports 4)

    Centers for Disease Control (CDC) Podcasts

    2010-01-21

    Dos cronistas deportivos hablan sobre la gravedad de las conmociones cerebrales. (Two sports announcers discuss the serious nature of concussions.).  Created: 1/21/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/21/2010.

  7. Repeated Concussion Among U.S. Military Personnel During Operation Iraqi Freedom

    Science.gov (United States)

    2011-01-01

    dizziness, tinnitus , and sensitivity to noise or light), and affective ( depression , irritability, and anxiety), utilization of mental health and...concussion and risk of depression in retired professional football players. Med Sci Sports Exerc. 2007;39(6):903–9. [PMID: 17545878] http://dx.doi.org

  8. Los deportes y las conmociones cerebrales 1 PSA (:30) (Concussion in Sports 1)

    Centers for Disease Control (CDC) Podcasts

    2010-01-21

    Un entrenador habla con sus atletas sobre la gravedad de las conmociones cerebrales. (Coach and athletes discuss the serious nature of concussions.).  Created: 1/21/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/21/2010.

  9. Chronic post-concussion neurocognitive deficits. II. Relationship with persistent symptoms

    Directory of Open Access Journals (Sweden)

    Jun eMaruta

    2016-02-01

    Full Text Available Individuals who sustain a concussion may continue to experience problems long after their injury. However, it has been postulated in the literature that the relationship between a concussive injury and persistent complaints attributed to it is mediated largely by the development of symptoms associated with posttraumatic stress disorder and depression. We sought to characterize cognitive deficits of adult patients who had persistent symptoms after a concussion and determine whether the original injury retains associations with these deficits after accounting for the developed symptoms that overlap with posttraumatic stress disorder and depression. We compared the results of neurocognitive testing from 33 patients of both genders aged 18-55 at three months to five years post-injury with those from 140 control subjects. Statistical comparisons revealed that patients generally produced accurate responses on reaction time-based tests, but with reduced efficiency. On visual tracking, patients increased gaze position error variability following an attention demanding task, an effect that may reflect greater fatigability. When neurocognitive performance was examined in the context of demographic- and symptom-related variables, the original injury retained associations with reduced performance at a statistically significant level. For some patients, reduced cognitive efficiency and fatigability may represent key elements of interference when interacting with the environment, leading to varied paths of recovery after a concussion. Poor recovery may be better understood when these deficits are taken into consideration.

  10. A normative study of the sport concussion assessment tool (SCAT2) in children and adolescents.

    Science.gov (United States)

    Snyder, Aliyah R; Bauer, Russell M

    2014-01-01

    Recent clinical practice parameters encourage systematic use of concussion surveillance/management tools that evaluate participating athletes at baseline and after concussion. Office-based tools (Sports Concussion Assessment Tool; SCAT2) require accurate baseline assessment to maximize utility but no normative data exist for children on the SCAT2, limiting identification of "normal" or "impaired" score ranges. The purpose of this study was to develop child and adolescent baseline norms for the SCAT2 to provide reference values for different age groups. A community-based approach was implemented to compile baseline performance data on the SCAT2 in 761 children aged 9 to 18 to create age- and sex-graded norms. Findings indicate a significant age effect on SCAT2 performance such that older adolescents and teenagers produced higher (better) total scores than younger children (ages 9 to 11) driven by age differences on individual components measuring cognition (SAC), postural stability (BESS), and symptom report. Females endorsed greater numbers of symptoms at baseline than males. Normative data tables are presented. Findings support the SCAT2 as a useful clinical tool for assessing baseline functioning in teenagers, but suggest clinical utility may be limited in children under age 11. Follow-up studies after incident concussion are needed to confirm this assumption.

  11. Los deportes y las conmociones cerebrales 3 PSA (:30) (Concussion in Sports 3)

    Centers for Disease Control (CDC) Podcasts

    2010-01-21

    Dos atletas adolescentes hablan sobre la gravedad de las conmociones cerebrales. (Discussion between two teen athletes about the serious nature of concussions.).  Created: 1/21/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/21/2010.

  12. Are divided attention tasks useful in the assessment and management of sport-related concussion?

    Science.gov (United States)

    Register-Mihalik, Johna K; Littleton, Ashley C; Guskiewicz, Kevin M

    2013-12-01

    This article is a systematic review of the literature on divided attention assessment inclusive of a cognitive and motor task (balance or gait) for use in concussion management. The systematic review drew from published papers listed in PubMed, MEDLINE, EMBASE and CINAHL databases. The search identified 19 empirical research papers meeting the inclusion criteria. Study results were considered for the psychometric properties of the paradigms, the influence of divided attention on measures of cognition and postural control and the comparison of divided attention task outcomes between individuals with concussion and healthy controls (all samples were age 17 years or older). The review highlights that the reliability of the tasks under a divided attention paradigm presented ranges from low to high (ICC: 0.1-0.9); however, only 3/19 articles included psychometric information. Response times are greater, gait strategies are less efficient, and postural control deficits are greater in concussed participants compared with healthy controls both immediately and for some period following concussive injury, specifically under divided attention conditions. Dual task assessments in some cases were more reliable than single task assessments and may be better able to detect lingering effects following concussion. Few of the studies have been replicated and applied across various age groups. A key limitation of these studies is that many include laboratory and time-intensive measures. Future research is needed to refine a time and cost efficient divided attention assessment paradigm, and more work is needed in younger (pre-teens) populations where the application may be of greatest utility.

  13. Recognizing the Symptoms of Mental Illness following Concussions in the Sports Community: A Need for Improvement.

    Directory of Open Access Journals (Sweden)

    Jane Topolovec-Vranic

    Full Text Available To evaluate the awareness of concussion-related symptoms amongst members of the sports community in Canada.A cross-sectional national electronic survey was conducted. Youth athletes, parents, coaches and medical professionals across Canada were recruited through mailing lists from sports-related opt-in marketing databases. Participants were asked to identify, from a list of options, the symptoms of a concussion. The proportion of identified symptoms (categorized as physical, cognitive, mental health-related and overall as well as participant factors associated with symptom recognition were analyzed.The survey elicited 6,937 responses. Most of the respondents (92.1% completed the English language survey, were male (57.7%, 35-54 years of age (61.7%, with post-secondary education (58.2%, or high reported yearly household income (>$80,000; 53.0%. There were respondents from all provinces and territories with the majority of respondents from Ontario (35.2% or British Columbia (19.1%. While participants identified most of the physical (mean = 84.2% of symptoms and cognitive (mean = 91.2% of symptoms, they on average only identified 53.5% of the mental health-related symptoms of concussions. Respondents who were older, with higher education and household income, or resided in the Northwest Territories or Alberta identified significantly more of the mental health-related symptoms listed.While Canadian youth athletes, parents, coaches and medical professionals are able to identify most of the physical and cognitive symptoms associated with concussion, identification of mental health-related symptoms of concussion is still lagging.

  14. The Peters/Price (See To Play Vision Concussion Protocol: Diagnosis and Treatment?

    Directory of Open Access Journals (Sweden)

    Michael Peters, OD

    2015-04-01

    Full Text Available Background: Sports-related concussion as a clinical entity has been a growing area of clinical concern. As primary eye care providers for the National Hockey League’s Carolina Hurricanes, we have encountered these cases more and more each season. As a result, we have designed this retrospective study to assess our current evaluation and management protocols for all types of referred concussion cases. Methods: All patients referred to our private practice clinic from 2011 through 2013 for evaluation of concussion were included in this study. Retrospective analysis was performed to determine number of cases with a visual component, change in refractive state, resolution via new glasses, those requiring vision therapy, and average time to return to play. Results: A total of 137 patients were included in this study. Eighty-seven percent of patients (n = 120 demonstrated a visual component. Thirty-one percent (n = 37 of those resolved simply by changing their glasses prescription, while 61% (n = 73 required vision therapy to resolve their symptoms. Those who elected to perform vision therapy returned to play in less than six weeks’ time, while those deferring vision therapy returned to play in more than double the amount of time (12.3 weeks. Conclusion: The protocol studied is geared towards providing a uniform approach to diagnosing and treating concussions that demonstrate a visual component. The methods described not only accurately identify those with a visual component to their concussion but also provide an effective means of returning those individuals to play in a safe and timely manner.

  15. Subject-specific increases in serum S-100B distinguish sports-related concussion from sports-related exertion.

    Directory of Open Access Journals (Sweden)

    Karin Kiechle

    Full Text Available The on-field diagnosis of sports-related concussion (SRC is complicated by the lack of an accurate and objective marker of brain injury.To compare subject-specific changes in the astroglial protein, S100B, before and after SRC among collegiate and semi-professional contact sport athletes, and compare these changes to differences in S100B before and after non-contact exertion.Longitudinal cohort study.From 2009-2011, we performed a prospective study of athletes from Munich, Germany, and Rochester, New York, USA. Serum S100B was measured in all SRC athletes at pre-season baseline, within 3 hours of injury, and at days 2, 3 and 7 post-SRC. Among a subset of athletes, S100B was measured after non-contact exertion but before injury. All samples were collected identically and analyzed using an automated electrochemiluminescent assay to quantify serum S100B levels.Forty-six athletes (30 Munich, 16 Rochester underwent baseline testing. Thirty underwent additional post-exertion S100B testing. Twenty-two athletes (16 Rochester, 6 Munich sustained a SRC, and 17 had S100B testing within 3 hours post-injury. The mean 3-hour post-SRC S100B was significantly higher than pre-season baseline (0.099±0.008 µg/L vs. 0.058±0.006 µg/L, p = 0.0002. Mean post-exertion S100B was not significantly different than the preseason baseline. S100B levels at post-injury days 2, 3 and 7 were significantly lower than the 3-hour level, and not different than baseline. Both the absolute change and proportional increase in S100B 3-hour post-injury were accurate discriminators of SRC from non-contact exertion without SRC (AUC 0.772 and 0.904, respectively. A 3-hour post-concussion S100B >0.122 µg/L and a proportional S100B increase of >45.9% over baseline were both 96.7% specific for SRC.Relative and absolute increases in serum S100B can accurately distinguish SRC from sports-related exertion, and may be a useful adjunct to the diagnosis of SRC.

  16. The neuropathology and neurobiology of traumatic brain injury.

    Science.gov (United States)

    Blennow, Kaj; Hardy, John; Zetterberg, Henrik

    2012-12-06

    The acute and long-term consequences of traumatic brain injury (TBI) have received increased attention in recent years. In this Review, we discuss the neuropathology and neural mechanisms associated with TBI, drawing on findings from sports-induced TBI in athletes, in whom acute TBI damages axons and elicits both regenerative and degenerative tissue responses in the brain and in whom repeated concussions may initiate a long-term neurodegenerative process called dementia pugilistica or chronic traumatic encephalopathy (CTE). We also consider how the neuropathology and neurobiology of CTE in many ways resembles other neurodegenerative illnesses such as Alzheimer's disease, particularly with respect to mismetabolism and aggregation of tau, β-amyloid, and TDP-43. Finally, we explore how translational research in animal models of acceleration/deceleration types of injury relevant for concussion together with clinical studies employing imaging and biochemical markers may further elucidate the neurobiology of TBI and CTE.

  17. The relationship of symptoms and neurocognitive performance to perceived recovery from sports-related concussion among adolescent athletes.

    Science.gov (United States)

    Sandel, Natalie K; Lovell, Mark R; Kegel, Nathan E; Collins, Michael W; Kontos, Anthony P

    2013-01-01

    Sports medicine practitioners often consider athletes' self-reports of recovery for the management of concussion, and it is not clear which factors (i.e., neurocognitive performance and symptoms) athletes consider when forming perceptions of recovery from concussion. The current study assessed the relationship of perceptions of recovery to neurocognitive performance on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery and to symptoms using the Post-Concussion Symptom Scale (PCSS). A total of 101 concussed athletes (62 males, 39 females) aged 12 to 18 years old were included in the study (M(age) = 14.75, SD = 1.76). Athletes were asked to rate their "percent back to normal" (i.e., perception of recovery) at the time of evaluation. A multiple regression for neurocognitive performance and symptoms revealed a significant model that accounted for 58% of the variance in perceptions of recovery. Adolescent athletes base their perceptions primarily on somatic symptoms (e.g., headache, nausea, vomiting, etc.), and these perceptions may be incongruent with objective neurocognitive measures. Athletes' tendency to overlook several factors when forming their perceptions of recovery should caution the sports medicine practitioner from relying on self-reported symptoms as their primary criterion for return-to-play decisions. These data further support the need for valid and reliable measures for concussion management.

  18. The Effect of Hyperbaric Oxygen on Symptoms after Mild Traumatic Brain Injury

    Science.gov (United States)

    2012-11-20

    Journal Article 3. DATES COVERED (From – To) Aug 2008 – Dec 2013 4. TITLE AND SUBTITLE The Effect of Hyperbaric Oxygen on Symptoms after Mild...absolute (ATA) hyperbaric oxygen (HBO2) on post-concussion symptoms in 50 military service members with at least one combat-related, mild traumatic brain...symptoms after mild TBI. 15. SUBJECT TERMS: hyperbaric oxygen, HBOT, HBO, HBO2, traumatic brain injury, TBI, mTBI, post-traumatic stress disorder, PTSD

  19. Migraine with Aura or Sports-Related Concussion: Case Report, Pathophysiology, and Multidisciplinary Approach to Management.

    Science.gov (United States)

    Ellis, Michael J; Cordingley, Dean; Girardin, Richard; Ritchie, Lesley; Johnston, Janine

    The evaluation and management of athletes presenting with clinical features of migraine headache with aura in the setting of sports-related head trauma is challenging. We present a case report of a 15-yr-old boy with a history of migraine with visual aura that developed acute visual disturbance and headache after a head injury during an ice hockey game. The patient underwent comprehensive assessment at a multidisciplinary concussion program, including neuro-ophthalmological examination, neurocognitive testing, and graded aerobic treadmill testing. Clinical history and multidisciplinary assessment was consistent with the diagnosis of coexisting sports-related concussion and migraine with brainstem aura. The authors discuss the pearls and pitfalls of managing patients who develop migraine headache with visual aura after sports-related head injury and the value of a comprehensive multidisciplinary approach to this unique patient population.

  20. Stay aHEAD of the Game: Get the Facts about Concussion in Sports

    Science.gov (United States)

    Boyer, Cynthia

    2011-01-01

    Sports offer so many benefits to kids, from fun and fitness to responsibility and teamwork skills. With sports also come bumps and bruises--and one type of injury requires much more than an ice pack or a band-aid. Head trauma is one of the most common injuries sustained by young athletes, with more than 60,000 concussions occurring each year in…

  1. Mild Traumatic Brain Injury – Case Report

    Directory of Open Access Journals (Sweden)

    2015-06-01

    Full Text Available A mild traumatic brain injury or a concussion represents the majority of all traumatic brain injuries. The consequences show on physical, cognitive, and emotional functioning and even though the injury classifies as mild, it can have a significant effect on a patient, patient’s family and their quality of life. Defects are often overlooked as objective clinical methods are lacking. Neuropsychological evaluation can aid in appraisal of the defect magnitude and determine factors that influence the outcome of the injured. The following case report addresses the importance of neuropsychological evaluation in treating cognitive defects along with the Cognitive Behavioral therapy approach toward emotional and behavioral disorders treatment in mild traumatic brain injury. It has been shown how important it is to find possible causes for slow recovery. The annuity tendencies have been noted as an important factor for prolongation of the post-concussion syndrome. We can detect the symptom simulation with appropriate psychological instruments. Described is a case of 38-year-old man who suffered a mild traumatic brain injury.

  2. Effect of concussion on clinically measured reaction time in nine NCAA Division I collegiate athletes: a preliminary study

    Science.gov (United States)

    Eckner, James T.; Kutcher, Jeffrey S.; Richardson, James K

    2013-01-01

    Objectives To evaluate the effect of concussion on clinically-measured reaction time (RTclin) with comparison to a computerized reaction time measure (RTcomp). Design Prospective, repeated measures observational study. Setting Athletic training clinic at an NCAA Division I university. Participants Data are reported for 9 collegiate athletes with acute concussion who were part of a larger cohort of 209 athletes recruited from the university’s football, women’s soccer, and wrestling teams prior to the start of their respective athletic seasons. Methods Baseline RTclin and RTcomp were measured during pre-participation physical examinations. RTclin measured the time required to catch a suspended vertical shaft by hand closure after its release by the examiner. RTcomp was derived from the simple reaction time component of the CogState-Sport computerized neurocognitive test battery. Athletes who subsequently sustained a physician-diagnosed concussion underwent repeat RTclin and RTcomp testing within 72 hours of injury. A Wilcoxon signed rank test was used to compare baseline and after-injury reaction times. Main Outcome Measurements After-injury changes in RTclin and RTcomp calculated with respect to each athlete’s own pre-season baseline value. Results After-injury RTclin was prolonged in 8 of the 9 concussed athletes, while RTcomp was prolonged in 5 of the 9 concussed athletes. Mean RTclin increased from 193 ± 21 ms to 219 ± 31 ms (p = 0.050), and mean RTcomp increased from 247 ± 75 to 462 ± 120 ms (p = 0.214). Conclusions We conclude that RTclin appears to be sensitive to the known prolongation of reaction time following concussion, and compares favorably to an accepted computerized reaction time measure. This study supports the potential utility of RTclin as part of a multi-faceted concussion assessment battery. PMID:21402367

  3. Contact technique and concussions in the South African under-18 Coca-Cola Craven Week Rugby tournament.

    Science.gov (United States)

    Hendricks, Sharief; O'connor, Sam; Lambert, Michael; Brown, James; Burger, Nicholas; Mc Fie, Sarah; Readhead, Clint; Viljoen, Wayne

    2015-01-01

    In rugby union, understanding the techniques and events leading to concussions is important because of the nature of the injury and the severity and potential long-term consequences, particularly in junior players. Proper contact technique is a prerequisite for successful participation in rugby and is a major factor associated with injury. However, the execution of proper contact technique and its relationship to injury has yet to be studied in matches. Therefore, the aim of this study was to compare contact techniques leading to concussion with a representative sample of similarly matched non-injury (NI) contact events. Injury surveillance was conducted at the 2011-2013 under-18 Craven Week Rugby tournaments. Video footage of 10 concussive events (5 tackle, 4 ruck and 1 aerial collision) and 83 NI events were identified (19 tackle, 61 ruck and 3 aerial collisions). Thereafter, each phase of play was analysed using standardised technical proficiency criteria. Overall score for ruck proficiency in concussive events was 5.67 (out of a total of 15) vs. 6.98 for NI events (n = 54) (effect size = 0.52, small). Overall average score for tackler proficiency was 7.25 (n = 4) and 6.67 (n = 15) for injury and NI tackles, respectively (out of 16) (effect size = 0.19, trivial). This is the first study to compare concussion injury contact technique to a player-matched sample of NI contact techniques. Certain individual technical criteria had an effect towards an NI outcome, and others had an effect towards a concussive event, highlighting that failure to execute certain techniques may substantially increase the opportunity for concussion.

  4. Lack of delayed effects of amphetamine, methoxamine, and prazosin (adrenergic drugs) on behavioral outcome after lateral fluid percussion brain injury in the rat.

    Science.gov (United States)

    Dose, J M; Dhillon, H S; Maki, A; Kraemer, P J; Prasad, R M

    1997-05-01

    This study examined the delayed effects of the administration of d-amphetamine, methoxamine (an alpha1-adrenergic receptor agonist), and prazosin (an alpha1-adrenergic receptor antagonist) on the behavioral outcome of lateral fluid-percussion (FP) brain injury. Rats trained to perform a beam-walking task were subjected to brain injury of moderate severity (2.1 to 2.2 atm). Twenty-four hours after injury, rats were treated with amphetamine, methoxamine, or prazosin at two or three different dose levels. Amphetamine-treated animals displayed no significant improvement in beam-walking ability either during or after drug intoxication (from days 3 to 5 after brain injury). Similarly, neither methoxamine nor prazosin significantly affected beam-walking ability during or after drug intoxication. Neither amphetamine treatment at three different doses nor treatment with methoxamine or prazosin at two different doses affected the spatial learning disabilities of brain-injured animals. These results suggest that (1) unlike amphetamine administration after sensorimotor cortex (SMC) ablation or contusion brain injury models, amphetamine administration at 24 h after concussive FP brain injury does not improve beam-walking performance; (2) unlike amphetamine administration 10 min after concussive FP brain injury amphetamine administration 24 h after injury does not improve cognitive function; and (3) unlike prazosin administration after SMC ablation brain injury, prazosin administration 24 h after concussive FP brain injury does not effect beam-walking performance.

  5. Second time around:Corticospinal responses following repeated sports-related concussions within the same season. A transcranial magnetic stimulation study

    Institute of Scientific and Technical Information of China (English)

    Alan J Pearce; Daniel T Corp; Charlotte B Davies; Brendan P Major; Jerome J Maller

    2014-01-01

    Objective:To investigate the degree of neurophysiological and cognitive performance changes resulting from repeat concussions sustained in a single season ofAustralianRules football. Methods:Three amateur football players were recruited after sustainingtwo concussions during a single season of playing.Each player was assessed at multiple time points by transcranial magnetic stimulation(TMS) and electromyography, as well as tested for fine motor and cognitive performance after each concussion.Results:In all three cases, concussions resulted in reduction in fine dexterity and visuomotor reaction time, cognitive attention performance and increase in intracortical inhibition fromTMS.No changes in performance orTMS outcomes were found as a result of the order of the concussions.However, changes observed were dependent on the severity of the concussion.Conclusions:This multiple-case study has demonstrated that concussion result in increased intracortical inhibition and reduction in cognitive and motor performance. Further,TMS, in conjunction with tests of cognitive and motor performance, can be useful as a prognostic technique in assessing recovery from acute concussion injury.

  6. A preliminary study of longitudinal differences in local dynamic stability between recently concussed and healthy athletes during single and dual-task gait.

    Science.gov (United States)

    Fino, Peter C

    2016-06-14

    Concussed individuals commonly exhibit locomotor deficits during dual-task gait that can last substantially longer than clinical signs and symptoms. Previous studies have examined traditional stability measures, but nonlinear stability may offer further information about the health of the motor control system post-concussion. For up to one year post-concussion, this study longitudinally examined the local dynamic stability of five concussed athletes and four matched healthy controls during single- and dual-task gait. Local dynamic stability (LDS) was estimated using short-term, finite-time maximum Lyapunov exponents calculated from tri-axial accelerometers placed on the trunk and head. No main effects of group or task were found for LDS or stride time variability, but significant group*task interactions were apparent for trunk stability and stride time variability. Concussed individuals exhibited decreased trunk LDS and increased stride time variability during dual-task walking compared to matched controls despite similar single-task stability and variability. These preliminary results reinforce previous reports that concussions persistently affect dual-task processes even when single-tasks may be unaffected. Furthermore, the decreased local dynamic stability during dual-task gait indicates the concussed group attenuated local disturbances less than their healthy teammates. The decreased dynamic stability during dual-task activities was present after the athletes were cleared for competition and may be a contributing factor in the higher rates of musculoskeletal injuries in athletes post-concussion.

  7. 脑震荡后脑功能障碍与相关因素回顾性研究%Rctrospectiv study on the concussion sequelas and correlative factors

    Institute of Scientific and Technical Information of China (English)

    肖兴义; 尹晓梅; 薛关生; 蔡宝仁; 王丽

    2001-01-01

    目的探讨脑震荡后脑功能障碍形成原因、类型和相关因素。方法对1995年3月~1999年10月治疗的86例脑震荡后脑功能障碍临床资料运行回顾性分析.结果 86例脑震荡后脑功能障碍占同期脑震荡的21.6%,通过经颅三维多普勒(3D-TCD)检测显示,尼莫地平组在解除脑震荡引起脑血管痉挛和改善脑血流平均峰速度明显优干治疗组。结论伤后是否残留脑功能障碍取决于颅脑损伤程度和由此广生的意识障碍时间与脑血液循环障碍,治疗时间与采取主要治疗方法等。%Objective To discuss the causes types and correlative factors of brain dysfunction after concussion. Method 86 cases with concussion sequela treated during the period of March 1995 to October 1999 were analyzed retrospectively. Result 86 patients with sequelas accounted for 21.6% of concussion patients in the same period. According to the results of three-dimensional trancranial doppler (3D-TCD)test. In Nimodipine group it was better to release cerebral vessel spasm cassed by concussion and improve the gverage peak velocity of cerebral blood flow, The results were better than other groups. Conclusion Wheather there would be sequelas after head injury depended on the injure degree, unconsciousness duration and cerebral blood circulation malfunction. The correlation factors included injured causes, unconsciousness duration, therapeutical duration and methods of treatment .

  8. Role of neuropsychologists in the evaluation and management of sport-related concussion: an inter-organization position statement.

    Science.gov (United States)

    Echemendia, Ruben J; Iverson, Grant L; McCrea, Michael; Broshek, Donna K; Gioia, Gerard A; Sautter, Scott W; Macciocchi, Stephen N; Barr, William B

    2011-11-01

    Over the past 20 years, clinical neuropsychologists have been at the forefront of both scientific and clinical initiatives aimed at developing evidence-based approaches to the evaluation and management of sport-related concussion. These efforts have directly impacted current policy on strategies for injury assessment and return-to-play by athletes after concussion. Many states are considering legislation requiring (a) education of athletes, parents, coaches, and school/organization officials on the recognition, evaluation, and management of sport-related concussions; (b) removal from play of any youth athlete that is suspected of having sustained a concussion; and (c) not allowing the student to return to participation until the student is evaluated and cleared for return to participation in writing by an appropriate healthcare professional. It is the official position of the American Academy of Clinical Neuropsychology (AACN), American Board of Neuropsychology (ABN), Division 40 (Neuropsychology) of the American Psychological Association (APA), and the National Academy of Neuropsychology (NAN) that neuropsychologists should be included among the licensed health care professionals authorized to evaluate, clinically manage, and provide return to play clearance for athletes who sustain a sport-related concussion.

  9. Comparing post-concussive neurocognitive test data to normative data presents risks for under-classifying "above average" athletes.

    Science.gov (United States)

    Schatz, Philip; Robertshaw, Stacey

    2014-11-01

    We compared classification accuracy of post-concussion test data against baseline and normative data, accounting for baseline level of performance. Athletes (N = 250) completed baseline and post-concussion ImPACT assessments, within 7 days of concussion (verified by sports medicine professionals and self-reported symptoms). Athletes were classified as "below average," "average," or "above average" at baseline. Change from baseline was calculated using reliable change indices (RCIs) and regression-based measures (RBz), and comparison to normative data was achieved using z-scores. Normative comparisons identified fewer symptomatic, concussed athletes than RCIs and RBz. Both RCIs and RBz consistently identified "impairment" at 1 and 1.5 SD, regardless of baseline level, whereas normative comparisons identified 46-48% fewer athletes performing "above average" at baseline using a cut-off of 1 SD and 36-38% fewer using a cut-off of 1.5 SD. The use of normative comparisons may differentially classify concussed, symptomatic athletes who are outside the "average" range at baseline.

  10. NIH Research on Concussion and the Brain | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... is to help determine the connections between repeated head trauma and CTE. The research is led by neuropathologist ... injury (TBI)—including concussion—occurs when a sudden trauma causes damage to the ... other events in which the head strikes or is struck by an object (19 ...

  11. Heart Rate Variability Interventions for Concussion and Rehabilitation

    OpenAIRE

    Robert Lake Conder; Conder, Alanna A.

    2014-01-01

    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 ...

  12. CE the effect of varying diagnostic terminology within patient discharge information on expected mild traumatic brain injury outcome.

    Science.gov (United States)

    Kempe, Chloe B; Sullivan, Karen A; Edmed, Shannon L

    2013-01-01

    This study aimed to determine if systematic variation of the diagnostic terminology embedded within written discharge information (i.e., concussion or mild traumatic brain injury, mTBI) would produce different expected symptoms and illness perceptions. We hypothesized that compared to concussion advice, mTBI advice would be associated with worse outcomes. Sixty-two volunteers with no history of brain injury or neurological disease were randomly allocated to one of two conditions in which they read a mTBI vignette followed by information that varied only by use of the embedded terms concussion (n = 28) or mTBI (n = 34). Both groups reported illness perceptions (timeline and consequences subscale of the Illness Perception Questionnaire-Revised) and expected Postconcussion Syndrome (PCS) symptoms 6 months post injury (Neurobehavioral Symptom Inventory, NSI). Statistically significant group differences due to terminology were found on selected NSI scores (i.e., total, cognitive and sensory symptom cluster scores (concussion > mTBI)), but there was no effect of terminology on illness perception. When embedded in discharge advice, diagnostic terminology affects some but not all expected outcomes. Given that such expectations are a known contributor to poor mTBI outcome, clinicians should consider the potential impact of varied terminology on their patients.

  13. Dental trauma. Combination injuries 1. The risk of pulp necrosis in permanent teeth with concussion injuries and concomitant crown fractures

    DEFF Research Database (Denmark)

    Lauridsen, Eva Fejerskov; Hermann, Nuno Vibe; Gerds, Thomas Alexander;

    2012-01-01

    The reported risk of pulp necrosis (PN) is low in teeth with concussion injuries. A concomitant crown fracture may affect the risk of PN. Aim:  To analyze the influence of a crown fracture (with and without pulp exposure) on the risk of PN in teeth with concussion injury. Material:  The study...... included 469 permanent incisors with concussion from 358 patients (226 male, 132 female). Among these, 292 had a concomitant crown fracture (70 with and 222 without pulp exposure). All teeth were examined and treated according to standardized protocol. Statistical analysis:  The risk of PN was analyzed...... by the Kaplan–Meier method and Cox regression. Risk factors included in the analysis: gender, age, stage of root development, type of crown fracture, and response to electric pulp test (EPT) at the initial examination. The level of significance was set at 5%. Results:  The risk of PN was low in teeth...

  14. Neurological Findings & Symptoms Associated with Acute Combat-Related Concussion: Impact of Migraine and Other Co-morbidities

    Science.gov (United States)

    2012-06-01

    Features Unilateral: 26 (68%)              Aura:  2  (5%) Throbbing: 32 (84%)              Dizziness / Vertigo : 10 (26%) Photophobia:  28 (74%)       Nausea...Prescribed by ANSI Std Z39-18 Causes of Concussion Concussion ‐ 4 Symptom Categories • Physical (10) – Headache – Fatigue  – Dizziness

  15. Disability pensions in relation to traumatic brain injury: a population study

    DEFF Research Database (Denmark)

    Teasdale, T W; Engberg, A W

    2000-01-01

    From a Danish national register of hospitalizations, all patients were identified who had a discharge diagnosis of traumatic brain injury between the years 1979-1993 inclusive, at ages 18-66 years inclusive. These were classified as having suffered either a concussion (n = 74,398), a cranial...... award appeared to be independent of the injury itself. Rather, being awarded a disability pension appeared to be related to conditions which themselves are risk factors for a traumatic brain injury, e.g. chronic skeletomuscular disease and psychiatric disorders including alcoholism. Comparison...... with population statistics revealed that the relative risk of being assigned a low or intermediate disability pension is markedly elevated among the concussion group, especially at younger ages and among males. For the fracture and contusion groups, a clear post-injury elevation in rate was detectable, especially...

  16. Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians.

    Science.gov (United States)

    Moran, Byron; Tadikonda, Prathima; Sneed, Kevin B; Hummel, Michelle; Guiteau, Sergio; Coris, Eric E

    2015-09-01

    Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome.

  17. Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq

    Science.gov (United States)

    2008-01-31

    vet- erans. Am J Epidemiol 2003;157:141-8. Baron RM, Kenny DA. The moderator- mediator variable distinction in social psy- chological research...Neurosci 2005;17: 61-5. Bazarian JJ, Blyth B, Cimpello L. Bench to bedside: evidence for brain injury after concussion — looking beyond the com- puted...BMJ 2002; 324:397.] Ferguson RJ, Mittenberg W, Barone DF, Schneider B. Postconcussion syndrome following sports-related head injury: ex- pectation

  18. The Interaction of Intramuscular Ketorolac (Toradol) and Concussion in a Rat Model.

    Science.gov (United States)

    Esquivel, Amanda O; Sherman, Sarah S; Bir, Cynthia A; Lemos, Stephen E

    2017-02-13

    The purpose of this study was to examine the interaction of a single dose of Toradol and head impact in an in vivo rat model for sport-related concussion using a validated rat concussion model. Thirty-five Sprague-Dawley rats were placed into one of four groups: (1) Control, (2) Impact Only, (3) Toradol Only, (4) Impact and Toradol. Animals in the impact groups were subjected to a single head impact. Animals in the Toradol group received a single intramuscular injection of Toradol prior to impact. We examined magnetic resonance imaging, serum S100-B and cognitive function using a Morris Water Maze. In the control group, latency decreased significantly from day 0 (74.9 s) to 24 h (57.4 s) after anesthesia. There was no statistically significant difference between time zero and 24 h after impact in the Impact only or Impact and Toradol group. Our findings indicate that there were no differences between cognitive ability, MRI findings or S100B in rats that were administered a single dose of Toradol and subjected to a single impact and rats that were subjected to a single impact only. In both impact groups there were transient changes in cognitive ability as measured by the Morris Water Maze.

  19. A two-factor theory for concussion assessment using ImPACT: memory and speed.

    Science.gov (United States)

    Schatz, Philip; Maerlender, Arthur

    2013-12-01

    We present the initial validation of a two-factor structure of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) using ImPACT composite scores and document the reliability and validity of this factor structure. Factor analyses were conducted for baseline (N = 21,537) and post-concussion (N = 560) data, yielding "Memory" (Verbal and Visual) and "Speed" (Visual Motor Speed and Reaction Time) Factors; inclusion of Total Symptom Scores resulted in a third discrete factor. Speed and Memory z-scores were calculated, and test-retest reliability (using intra-class correlation coefficients) at 1 month (0.88/0.81), 1 year (0.85/0.75), and 2 years (0.76/0.74) were higher than published data using Composite scores. Speed and Memory scores yielded 89% sensitivity and 70% specificity, which was higher than composites (80%/62%) and comparable with subscales (91%/69%). This emergent two-factor structure has improved test-retest reliability with no loss of sensitivity/specificity and may improve understanding and interpretability of ImPACT test results.

  20. Patterns of Recovery Following Sport-Related Concussion in Children and Adolescents.

    Science.gov (United States)

    Purcell, Laura; Harvey, Janice; Seabrook, Jamie A

    2016-05-01

    Time to symptom resolution, return to school, and return to play after a sport-related concussion in children and adolescents (8-17 years of age) was examined using a retrospective cohort design. A total of 198 patients aged 8 to 17 years were included, with a mean age of 13.5 years (SD = 2.2). Patients aged 8 to 12 years were symptom-free in a median of 12.0 (range 1-60) days whereas 13- to 17-year olds were symptom-free in a median of 14.0 (range 1-300) days (P = .04). Patients aged 8 to 12 years returned to learn in a median of 4.0 (range 0-30) days compared with 2.5 (range 0-55.0) days in 13- to 17-year-olds (P = .86). Patients aged 8 to 12 years returned to play in a median of 14.0 (range 4-75) days compared with a median of 19.5 (range 5-75) days in 13- to 17-year-olds (P = .06). These results indicate that children and adolescents generally take 2 to 4 weeks to recover from a sport-related concussion.

  1. Contralateral Cochlear Labyrinthine Concussion without Temporal Bone Fracture: Unusual Posttraumatic Consequence

    Science.gov (United States)

    Méndez, D.; Silva, J. M. Duque; del Álamo, P. Ortega

    2016-01-01

    Introduction. Labyrinthine concussion is a term used to describe a rare cause of sensorineural hearing loss with or without vestibular symptoms occurring after head trauma. Isolated damage to the inner ear without involving the vestibular organ would be designated as a cochlear labyrinthine concussion. Hearing loss is not a rare finding in head trauma that involves petrous bone fractures. Nevertheless it generally occurs ipsilateral to the side of the head injury and extraordinarily in the contralateral side and moreover without the presence of a fracture. Case Report. The present case describes a 37-year-old patient with sensorineural hearing loss and tinnitus in his right ear after a blunt head trauma of the left-sided temporal bone (contralateral). Otoscopy and radiological images showed no fractures or any abnormalities. A severe sensorineural hearing loss was found in his right ear with a normal hearing of the left side. Conclusion. The temporal bone trauma requires a complete diagnostic battery which includes a neurotologic examination and a high resolution computed tomography scan in the first place. Hearing loss after a head injury extraordinarily occurs in the contralateral side of the trauma as what happened in our case. In addition, the absence of fractures makes this phenomenon even more unusual.

  2. Logistic regression function for detection of suspicious performance during baseline evaluations using concussion vital signs.

    Science.gov (United States)

    Hill, Benjamin David; Womble, Melissa N; Rohling, Martin L

    2015-01-01

    This study utilized logistic regression to determine whether performance patterns on Concussion Vital Signs (CVS) could differentiate known groups with either genuine or feigned performance. For the embedded measure development group (n = 174), clinical patients and undergraduate students categorized as feigning obtained significantly lower scores on the overall test battery mean for the CVS, Shipley-2 composite score, and California Verbal Learning Test-Second Edition subtests than did genuinely performing individuals. The final full model of 3 predictor variables (Verbal Memory immediate hits, Verbal Memory immediate correct passes, and Stroop Test complex reaction time correct) was significant and correctly classified individuals in their known group 83% of the time (sensitivity = .65; specificity = .97) in a mixed sample of young-adult clinical cases and simulators. The CVS logistic regression function was applied to a separate undergraduate college group (n = 378) that was asked to perform genuinely and identified 5% as having possibly feigned performance indicating a low false-positive rate. The failure rate was 11% and 16% at baseline cognitive testing in samples of high school and college athletes, respectively. These findings have particular relevance given the increasing use of computerized test batteries for baseline cognitive testing and return-to-play decisions after concussion.

  3. Relationship Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion

    Science.gov (United States)

    Alsalaheen, Bara A.; Whitney, Susan L.; Marchetti, Gregory F.; Furman, Joseph M.; Kontos, Anthony P.; Collins, Michael W.; Sparto, Patrick J.

    2016-01-01

    Objective To examine the relationship between cognitive and balance performance in adolescents with concussion. Design Retrospective case series. Setting Tertiary. Patients Sixty patients. Interventions Correlation analyses were performed to describe the relationship between symptoms, cognitive measure, and balance measure at the time of initiation of vestibular physical therapy. Main Outcome Measures Cognitive performance was assessed using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT). The dizziness and balance function measures included dizziness severity rating, Activities-specific Balance Confidence scale (ABC), Dizziness Handicap Inventory (DHI), Functional Gait Assessment, gait speed, Timed “UP and GO,” Five Times Sit to Stand, and Sensory Organization Test (SOT). To account for multiple comparisons, the False Discovery Rate method was used. Results Performance measures of balance were significantly correlated with cognitive measures. Greater total symptom scores were related to greater impairment in the ABC and DHI (r = 0.35-0.39, P ≤ 0.008) and worse performance in condition 2 of the SOT (r = −0.48, P = 0.004). Among the ImPACT composite scores, lower memory scores were correlated with impaired balance performance measures (r = 0.37-0.59, P ≤ 0.012). Lower visual memory was also correlated with worse ABC scores. Conclusions The significant relationships reported between the cognitive performance scores and balance measures may reflect that similar levels of functioning exist across domains in individuals with protracted recovery who receive vestibular physical therapy. PMID:25706663

  4. Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period.

    Directory of Open Access Journals (Sweden)

    Glenn R Wylie

    Full Text Available Functional neuroimaging studies in mild traumatic brain injury (mTBI have been largely limited to patients with persistent post-concussive symptoms, utilizing images obtained months to years after the actual head trauma. We sought to distinguish acute and delayed effects of mild traumatic brain injury on working memory functional brain activation patterns < 72 hours after mild traumatic brain injury (mTBI and again one-week later. We hypothesized that clinical and fMRI measures of working memory would be abnormal in symptomatic mTBI patients assessed < 72 hours after injury, with most patients showing clinical recovery (i.e., improvement in these measures within 1 week after the initial assessment. We also hypothesized that increased memory workload at 1 week following injury would expose different cortical activation patterns in mTBI patients with persistent post-concussive symptoms, compared to those with full clinical recovery. We performed a prospective, cohort study of working memory in emergency department patients with isolated head injury and clinical diagnosis of concussion, compared to control subjects (both uninjured volunteers and emergency department patients with extremity injuries and no head trauma. The primary outcome of cognitive recovery was defined as resolution of reported cognitive impairment and quantified by scoring the subject's reported cognitive post-concussive symptoms at 1 week. Secondary outcomes included additional post-concussive symptoms and neurocognitive testing results. We enrolled 46 subjects: 27 with mild TBI and 19 controls. The time of initial neuroimaging was 48 (+22 S.D. hours after injury (time 1. At follow up (8.7, + 1.2 S.D., days after injury, time 2, 18 of mTBI subjects (64% reported moderate to complete cognitive recovery, 8 of whom fully recovered between initial and follow-up imaging. fMRI changes from time 1 to time 2 showed an increase in posterior cingulate activation in the mTBI subjects

  5. Dynamic analysis of the human brain with complex cerebral sulci.

    Science.gov (United States)

    Tseng, Jung-Ge; Huang, Bo-Wun; Ou, Yi-Wen; Yen, Ke-Tien; Wu, Yi-Te

    2016-07-03

    The brain is one of the most vulnerable organs inside the human body. Head accidents often appear in daily life and are easy to cause different level of brain damage inside the skull. Once the brain suffered intense locomotive impact, external injuries, falls, or other accidents, it will result in different degrees of concussion. This study employs finite element analysis to compare the dynamic characteristics between the geometric models of an assumed simple brain tissue and a brain tissue with complex cerebral sulci. It is aimed to understand the free vibration of the internal brain tissue and then to protect the brain from injury caused by external influences. Reverse engineering method is used for a Classic 5-Part Brain (C18) model produced by 3B Scientific Corporation. 3D optical scanner is employed to scan the human brain structure model with complex cerebral sulci and imported into 3D graphics software to construct a solid brain model to simulate the real complex brain tissue. Obtaining the normal mode analysis by inputting the material properties of the true human brain into finite element analysis software, and then to compare the simplified and the complex of brain models.

  6. Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion.

    Science.gov (United States)

    Ellis, Michael J; Cordingley, Dean M; Vis, Sara; Reimer, Karen M; Leiter, Jeff; Russell, Kelly

    2017-01-01

    OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015. Acute SRS was defined as presenting vision, etc.) and more than 1 objective physical examination finding (abnormal near point of convergence, smooth pursuits, saccades, or vestibulo-ocular reflex testing). Poisson regression analysis was used to identify factors that increased the risk of VOD at initial presentation and the development of PCS. RESULTS Three hundred ninety-nine children, including 306 patients with acute SRC and 93 with PCS, were included. Of these patients, 30.1% of those with acute SRC (65.0% male, mean age 13.9 years) and 43.0% of those with PCS (41.9% male, mean age 15.4 years) met the criteria for VOD at initial consultation. Independent predictors of VOD at initial consultation included female sex, preinjury history of depression, posttraumatic amnesia, and presence of dizziness, blurred vision, or difficulty focusing at the time of injury. Independent predictors of PCS among patients with acute SRC included the presence of VOD at initial consultation, preinjury history of depression, and posttraumatic amnesia at the time of injury. CONCLUSIONS This study identified important potential risk factors for the development of VOD following pediatric SRC. These results provide confirmatory evidence that VOD at initial consultation is associated with prolonged recovery and is an independent predictor for the

  7. 脑震荡伤后症状群发生机制及早期药物治疗探讨%Pathogenesis and early drugs therapy of symptoms after concussion

    Institute of Scientific and Technical Information of China (English)

    游恒星; 杨维; 邱建东; 练晓文; 范紫香; 李良杰; 方向红

    2011-01-01

    energy mixture group ( 22.9% )than in the nimodipine group ( 5.2% ) ( x2 =4.77,P < 0.05 ) and in the erigeron breviscapus group (5.0% )( x2 =5.15,P < 0.05 ) three month after injuries.Conclusion The occurrence of symptoms originated from the organic damage of brain tissue.However,its changes were influenced by psychologic factors after concussion.Early vasodilative drugs therapy could improve the recovery of patients with post-concussion symptoms in time and decrease the occurrence of post-concussion sequelae.%目的 探讨脑震荡伤后症状群发生机制及早期药物治疗的有效作用.方法 选取113例脑震荡患者,随机分为3组早期分别给予灯盏细辛、尼莫地平、能量合剂三种药物治疗,伤后早期、晚期行SCL-90评分及脑电图(EEG)、脑血流经颅多普勒(TCD)检查,并与常模进行对照,分析各检查结果及不同药物疗效情况.结果 113例患者伤后早期躯体化、强迫、抑郁、焦虑、敌对症状因子SCL-90评分(t=10.78、2.08、9.53、11.09、2.52,P<0.01或P<0.05)及晚期12例后遗症患者躯体化、抑郁、焦虑、恐怖和精神病性症状因子评分与正常人群差异有统计学意义(t=3.21、6.85、3.07、3.14、4.73,P均<0.01),早期EEG检查57.4%异常,TCD检查67.0%异常;晚期EEG检查33.3%异常,TCD检查25.0%异常.伤后14 d灯盏细辛组患者脑震荡症状消失率45.0%,明显高于尼莫地平组23.7%(x2=3.91,P<0.05)及能量合剂组20.0%(x2=5.25,P<0.05);伤后1个月症状消失率能量合剂组40.0%明显低于尼莫地平组68.4%(x2=5.94,P<0.05)及灯盏细辛组75.0%(x2=9.43,P<0.01);伤后3个月后遗症发生率能量合剂组22.9%,明显高于尼莫地平组5.2%(x2=4.77,P<0.05)及灯盏细辛组5.0%(x2=5.15,P<0.05).结论 脑震荡伤后症状群的发生主要源于伤后脑组织器质性损伤,伤后心理因素的变化对症状的发生发展有影响;伤后早期应用扩血管药物治疗可

  8. Periodontal healing complications following concussion and subluxation injuries in the permanent dentition: a longitudinal cohort study

    DEFF Research Database (Denmark)

    Hermann, Nuno Vibe; Lauridsen, Eva; Ahrensburg, Søren Steno;

    2012-01-01

    with subluxation were included in the study. All teeth were examined according to a standardized protocol including clinical, photographic, and radiographic registration. Statistics: The risk of repair-related resorption (surface resorption), infection-related resorption (inflammatory resorption), replacement......% CI: 0.3–6.0%) and occurred only in cases where several teeth were injured simultaneously (multiple-trauma cases). The risk of marginal bone loss in teeth with mature root development was 0.7% (95% CI: 0–1.6%). Infection-related resorption, replacement resorption, and tooth loss were not observed...... 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...

  9. A mouse model of human repetitive mild traumatic brain injury

    OpenAIRE

    Kane, Michael J; Pérez, Mariana Angoa; Briggs, Denise I.; Viano, David C.; Kreipke, Christian W.; Kuhn, Donald M.

    2011-01-01

    A novel method for the study of repetitive mild traumatic brain injury (rmTBI) that models the most common form of head injury in humans is presented. Existing animal models of TBI impart focal, severe damage unlike that seen in repeated and mild concussive injuries, and few are configured for repetitive application. Our model is a modification of the Marmarou weight drop method and allows repeated head impacts to lightly anesthetized mice. A key facet of this method is the delivery of an imp...

  10. Sleep deprivation does not affect neuronal susceptibility to mild traumatic brain injury in the rat

    Directory of Open Access Journals (Sweden)

    Caron AM

    2015-06-01

    Full Text Available Aimee M Caron, Richard Stephenson Department of Cell and Systems Biology, University of Toronto, Toronto, ON, Canada Abstract: Mild and moderate traumatic brain injuries (TBIs (and concussion occur frequently as a result of falls, automobile accidents, and sporting activities, and are a major cause of acute and chronic disability. Fatigue and excessive sleepiness are associated with increased risk of accidents, but it is unknown whether prior sleep debt also affects the pathophysiological outcome of concussive injury. Using the “dark neuron” (DN as a marker of reversible neuronal damage, we tested the hypothesis that acute (48 hours total sleep deprivation (TSD and chronic sleep restriction (CSR; 10 days, 6-hour sleep/day affect DN formation following mild TBI in the rat. TSD and CSR were administered using a walking wheel apparatus. Mild TBI was administered under anesthesia using a weight-drop impact model, and the acute neuronal response was observed without recovery. DNs were detected using standard bright-field microscopy with toluidine blue stain following appropriate tissue fixation. DN density was low under home cage and sleep deprivation control conditions (respective median DN densities, 0.14% and 0.22% of neurons, and this was unaffected by TSD alone (0.1%. Mild TBI caused significantly higher DN densities (0.76%, and this was unchanged by preexisting acute or chronic sleep debt (TSD, 0.23%; CSR, 0.7%. Thus, although sleep debt may be predicted to increase the incidence of concussive injury, the present data suggest that sleep debt does not exacerbate the resulting neuronal damage. Keywords: sleep deprivation, concussion, traumatic brain injury, dark neuron, neurodegeneration, rat cortex

  11. Athletes' age, sex, and years of education moderate the acute neuropsychological impact of sports-related concussion: a meta-analysis.

    Science.gov (United States)

    Dougan, Brooke K; Horswill, Mark S; Geffen, Gina M

    2014-01-01

    The objective of this study is to determine which pre-existing athlete characteristics, if any, are associated with greater deficits in functioning following sports-related concussion, after controlling for factors previously shown to moderate this effect (e.g., time since injury). Ninety-one independent samples of concussion were included in a fixed+systematic effects meta-analysis (n = 3,801 concussed athletes; 5,631 controls). Moderating variables were assessed using analogue-to-ANOVA and meta-regression analyses. Post-injury assessments first conducted 1-10 days following sports-related concussion revealed significant neuropsychological dysfunction, postural instability and post-concussion symptom reporting (d = -0.54, -1.10, and -1.14, respectively). During this interval, females (d = -0.87), adolescent athletes competing in high school competitions (d = -0.60), and those with 10 years of education (d = -1.32) demonstrated larger post-concussion neuropsychological deficits than males (d = -0.42), adults (d = -0.25), athletes competing at other levels of competition (d = -0.43 to -0.41), or those with 16 years of education (d = -0.15), respectively. However, these sub-groups' differential impairment/recovery beyond 10 days could not be reliably quantified from available literature. Pre-existing athlete characteristics, particularly age, sex and education, were demonstrated to be significant modifiers of neuropsychological outcomes within 10 days of a sports-related concussion. Implications for return-to-play decision-making and future research directions are discussed.

  12. A retrospective view of concussion in American football, 1900-1959: What was suggested then we now know.

    Science.gov (United States)

    Solomon, Gary; Sills, Allen Kent

    2015-07-01

    While published work and media attention about football-related concussion in the USA have increased exponentially in the past few years, these injuries have in fact been written about for over a century. In this work, we undertook a selective review of the PubMed database of the published reports on concussion in football prior to 1960, with attention to the definitions used, physician attitudes, epidemiology, return to play criteria and recommendations and concerns related to long-term outcomes. Search inclusion criteria were English language, publication between the years 1900 and 1959 and studies written by healthcare professionals treating football-related injuries. Twenty-six studies met the inclusion criteria for this review, and the findings are grouped by topic area and detailed chronologically. Early sports medicine physicians struggled with many of the same issues faced today by clinicians such as honest reporting of symptoms by athletes, lack of uniform diagnosis and treatment and ambiguity over maximum 'safe' number of lifetime concussions.

  13. A systematic review of prognosis after mild traumatic brain injury in the military. Results of the International Collaboration on MTBI Prognosis (ICoMP)

    DEFF Research Database (Denmark)

    Boyle, Eleanor; Cancelliere, Carol; Hartvigsen, Jan

    2014-01-01

    of post-concussive symptoms differed based on the levels of combat stress the individuals experienced. The evidence suggests a slight decline in neurocognitive function post-MTBI, but this decline was in the normal range of brain functioning. Conclusions: This study found limited evidence that combat...... stress, PTSD and post-concussive symptoms affect recovery and prognosis of MTBI in military personnel. Additional high quality research is needed to fully assess the prognosis of MTBI in military personnel.......Objective: The WHO Collaborating Centre Task Force on mild traumatic brain injury (MTBI) published their findings on prognosis of MTBI in 2004. This is an update of that review with a focus on deployed military personnel. Data sources: Relevant literature published between January 2001 and February...

  14. Comparing Post-Concussive Neurocognitive Test Data to Normative Data Presents Risks for Under-Classifying “Above Average” Athletes

    Science.gov (United States)

    Schatz, Philip; Robertshaw, Stacey

    2014-01-01

    We compared classification accuracy of post-concussion test data against baseline and normative data, accounting for baseline level of performance. Athletes (N = 250) completed baseline and post-concussion ImPACT assessments, within 7 days of concussion (verified by sports medicine professionals and self-reported symptoms). Athletes were classified as “below average,” “average,” or “above average” at baseline. Change from baseline was calculated using reliable change indices (RCIs) and regression-based measures (RBz), and comparison to normative data was achieved using z-scores. Normative comparisons identified fewer symptomatic, concussed athletes than RCIs and RBz. Both RCIs and RBz consistently identified “impairment” at 1 and 1.5 SD, regardless of baseline level, whereas normative comparisons identified 46–48% fewer athletes performing “above average” at baseline using a cut-off of 1 SD and 36-38% fewer using a cut-off of 1.5 SD. The use of normative comparisons may differentially classify concussed, symptomatic athletes who are outside the “average” range at baseline. PMID:25178629

  15. Detecting cognitive impairment after concussion: sensitivity of change from baseline and normative data methods using the CogSport/Axon cognitive test battery.

    Science.gov (United States)

    Louey, Andrea G; Cromer, Jason A; Schembri, Adrian J; Darby, David G; Maruff, Paul; Makdissi, Michael; Mccrory, Paul

    2014-08-01

    Concussion-related cognitive impairments are typically evaluated with repeated neuropsychological assessments where post-injury performances are compared with pre-injury baseline data (baseline method). Many cases of concussions, however, are evaluated in the absence of baseline data by comparing post-injury performances with normative data (normative method). This study aimed to compare the sensitivity and specificity of these two methods using the CogSport/Axon test battery. Normative data and reliable change indices were computed from a non-injured athlete sample (n = 235). Test-retest data from non-injured (n = 260) and recently concussed (n = 29) athlete samples were then used to compare the two methods. The baseline method was found to be more sensitive than the normative method, and both methods had high specificity and overall correct classification rates. This suggests that while the normative method identifies most cases of recent concussions, the baseline method remains a more precise approach to assessing concussion-related cognitive impairments.

  16. Expert consensus document: Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions.

    Science.gov (United States)

    Carman, Aaron J; Ferguson, Rennie; Cantu, Robert; Comstock, R Dawn; Dacks, Penny A; DeKosky, Steven T; Gandy, Sam; Gilbert, James; Gilliland, Chad; Gioia, Gerard; Giza, Christopher; Greicius, Michael; Hainline, Brian; Hayes, Ronald L; Hendrix, James; Jordan, Barry; Kovach, James; Lane, Rachel F; Mannix, Rebekah; Murray, Thomas; Seifert, Tad; Shineman, Diana W; Warren, Eric; Wilde, Elisabeth; Willard, Huntington; Fillit, Howard M

    2015-04-01

    Sports-related concussions and repetitive subconcussive exposure are increasingly recognized as potential dangers to paediatric populations, but much remains unknown about the short-term and long-term consequences of these events, including potential cognitive impairment and risk of later-life dementia. This Expert Consensus Document is the result of a 1-day meeting convened by Safe Kids Worldwide, the Alzheimer's Drug Discovery Foundation, and the Andrews Institute for Orthopaedics and Sports Medicine. The goal is to highlight knowledge gaps and areas of critically needed research in the areas of concussion science, dementia, genetics, diagnostic and prognostic biomarkers, neuroimaging, sports injury surveillance, and information sharing. For each of these areas, we propose clear and achievable paths to improve the understanding, treatment and prevention of youth sports-related concussions.

  17. Computerized neurocognitive testing in the management of sport-related concussion: an update.

    Science.gov (United States)

    Resch, Jacob E; McCrea, Michael A; Cullum, C Munro

    2013-12-01

    Since the late nineties, computerized neurocognitive testing has become a central component of sport-related concussion (SRC) management at all levels of sport. In 2005, a review of the available evidence on the psychometric properties of four computerized neuropsychological test batteries concluded that the tests did not possess the necessary criteria to warrant clinical application. Since the publication of that review, several more computerized neurocognitive tests have entered the market place. The purpose of this review is to summarize the body of published studies on psychometric properties and clinical utility of computerized neurocognitive tests available for use in the assessment of SRC. A review of the literature from 2005 to 2013 was conducted to gather evidence of test-retest reliability and clinical validity of these instruments. Reviewed articles included both prospective and retrospective studies of primarily sport-based adult and pediatric samples. Summaries are provided regarding the available evidence of reliability and validity for the most commonly used computerized neurocognitive tests in sports settings.

  18. Suppression of Serum Prolactin Levels after Sports Concussion with Prompt Resolution Upon Independent Clinical Assessment To Permit Return-to-Play.

    Science.gov (United States)

    La Fountaine, Michael F; Toda, Michita; Testa, Anthony; Bauman, William A

    2016-05-01

    A significant outflow of neurotransmitters and metabolites with associated enhanced cortical excitation occurs after concussive head trauma. Cellular changes in the acute post-injury period cannot be observed directly in humans, and as such, require indirect evidence from systems sufficiently sensitive to central neuronal cellular excitation. Dopamine is a neurotransmitter with numerous targets in the central and peripheral nervous system. Changes to central dopaminergic tone result in reciprocal responses to the level of serum prolactin (PRL). Thus, a concussion may lead to abnormal dopaminergic tone, resulting in dynamic perturbations in the serum PRL concentration. To determine the effect of concussion on serum PRL concentrations, venipuncture was performed in the morning in four male intercollegiate athletes (age, 20 ± 1 years; height, 71 ± 5 inches; weight, 174 ± 21 pounds) within 48 h of concussion and again at 7 and 14 days post-injury. Serum PRL concentrations for each visit were categorized by quartile within the normal range. In all athletes, serum PRL concentrations increased from the lower quartiles in samples obtained closer to the time of injury to the higher quartiles at 14 days post-injury. These serum PRL changes accompanied the resolution of symptoms and the clinical decision to permit return-to-play. It may be postulated that transient augmentation of central dopaminergic tone resulted in inhibition of PRL secretion early after concussion and that disinhibition of PRL release occurred when central dopaminergic tone subsequently returned to baseline levels. This novel observation provides evidence for dopaminergic dysfunction after concussion that may be tracked by determination of serum PRL levels.

  19. Brain Basics

    Medline Plus

    Full Text Available ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  20. Brain Basics

    Science.gov (United States)

    ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  1. Plasma micro-RNA biomarkers for diagnosis and prognosis after traumatic brain injury: A pilot study.

    Science.gov (United States)

    Mitra, Biswadev; Rau, Thomas F; Surendran, Nanda; Brennan, James H; Thaveenthiran, Prasanthan; Sorich, Edmond; Fitzgerald, Mark C; Rosenfeld, Jeffrey V; Patel, Sarjubhai A

    2017-04-01

    Prediction of post-concussive syndrome after apparent mild traumatic brain injury (TBI) and subsequent cognitive recovery remains challenging, with substantial limitations of current methods of cognitive testing. This pilot study aimed to determine if levels of micro ribonucleic acids (RNAs) circulating in plasma are altered following TBI, and if changes to levels of such biomarkers over time could assist in determination of prognosis after TBI. Patients were enrolled after TBI on presentation to the Emergency Department and allocated to three groups: A - TBI (physical trauma to the head), witnessed loss of consciousness, amnesia, GCS=15, a normal CT Brain and a recorded first pass after post-traumatic amnesia (PTA) scale; B TBI, witnessed LOC, amnesia, GCS=15, a normal CT brain and a PTA scale test fail and: C - TBI and initial GCS RNA was then assayed using a custom miRNA PCR array. Two micro-RNAs, mir142-3p and mir423-3p demonstrated potential clinical utility differentiating patients after mild head injury into those at greater risk of developing amnesia and therefore, post-concussive syndromes. In addition, these miRNA demonstrated a decrease in expression over time, possibly indicative of brain healing after the injury. Further evaluation of these identified miRNA markers with larger patient cohorts, correlation with clinical symptoms and analysis over longer time periods are essential next steps in developing objective markers of severity of TBI.

  2. 实验性脑震荡大鼠脑皮质肿瘤坏死因子-α的表达%Changes of TNF-αexpression in cerebral cortex of experimental rats with pure cerebral concussion

    Institute of Scientific and Technical Information of China (English)

    严琦敏; 张排旗; 赵波; 张新宇; 付学锋

    2015-01-01

    目的:检测单纯性脑震荡( pure cerebral concussion,PCC)大鼠前额叶皮质( prefrontal cortex,PC)、颞叶皮质( temporal cortex,TC)和梨状皮质( piriform cortex,Pir)肿瘤坏死因子-α( TNF-α)的表达变化,探讨脑损伤早期TNF-α与病理变化的联系。方法采用“金属单摆闭合式脑损伤打击装置”在清醒状态下建立PCC模型大鼠,建立的模型大鼠按时间点随机分为1,12,24,48,72 h和7 d损伤组(n=6),另设正常对照组(n=6)。采用多克隆兔抗TNF-α免疫组织化学SP法观察PCC和正常对照大鼠PC、TC和Pir脑区TNF-α表达变化。结果早期PCC和正常对照大鼠TNF-α在PC、TC和Pir内表达均较弱。PCC大鼠的TNF-α阳性表达和阳性细胞数量逐渐增加,72 h达到峰值(P<0.05-0.01),7 d后有下降趋势,但仍高于正常组(P<0.05)。结论 PCC大鼠PC和TC区TNF-α表达可出现明显改变,提示TNF-α可能参与PCC的病理生理过程。%Objective To investigate the changes of tumor necrosis factor-α( TNF-α) in prefrontal cortex( PC) , temporal cortex( TC) and piriform cortex(Pir) after the pure cerebral concussion(PCC), and to explore its relationship with pathological changes in early stage of brain injury. Methods Under the consciousness condition, the PCC model rats were established by a metallic pendulum-striker concussive device. The model rats were randomly divided into 1,12,24,48,72 h and 7 d PCC groups(n=6 in each group), and six normal rats were chosen as control group. The distribution and changes of TNF-α expression in PC,TC and Pir were observed and compared by the immunohistochemistry with anti-TNF-αmonoclonal antibody between PCC groups and control group. Results The expression of TNF-α-immunoreactivity was weak in control group. The expression of TNF-α-immunoreactivity and the number of the TNF-α-immunopositive cells gradually increased from 1 h to 72 h in the PC and TC after the rat brain injury, and peaked at 72 h (P<0. 05 or 0. 01), and then

  3. Suicide after traumatic brain injury: a population study

    DEFF Research Database (Denmark)

    Teasdale, T W; Engberg, A W

    2001-01-01

    OBJECTIVES: To determine the rates of suicide among patients who have had a traumatic brain injury. METHODS: From a Danish population register of admissions to hospital covering the years 1979-93 patients were selected who had had either a concussion (n=126 114), a cranial fracture (n=7560......), or a cerebral contusion or traumatic intracranial haemorrhage (n=11 766). All cases of deaths by the end of the study period were identified. RESULTS: In the three diagnostic groups there had been 750 (0.59%), 46 (0.61%), and 99 (0.84%) cases of suicide respectively. Standardised mortality ratios, stratified......). There was, however, no evidence of a specific risk period for suicide after injury. CONCLUSION: The increased risk of suicide among patients who had a mild traumatic brain injury may result from concomitant risk factors such as psychiatric conditions and psychosocial disadvantage. The greater risk among...

  4. Hyperbaric oxygen therapy for the treatment of traumatic brain injury: a meta-analysis.

    Science.gov (United States)

    Wang, Fei; Wang, Yong; Sun, Tao; Yu, Hua-Lin

    2016-05-01

    Compelling evidence suggests the advantage of hyperbaric oxygen therapy (HBOT) in traumatic brain injury. The present meta-analysis evaluated the outcomes of HBOT in patients with traumatic brain injury (TBI). Prospective studies comparing hyperbaric oxygen therapy vs. control in patients with mild (GCS 13-15) to severe (GCS 3-8) TBI were hand-searched from medical databases using the terms "hyperbaric oxygen therapy, traumatic brain injury, and post-concussion syndrome". Glasgow coma scale (GCS) was the primary outcome, while Glasgow outcome score (GOS), overall mortality, and changes in post-traumatic stress disorder (PTSD) score, constituted the secondary outcomes. The results of eight studies (average age of patients, 23-41 years) reveal a higher post-treatment GCS score in the HBOT group (pooled difference in means = 3.13, 95 % CI 2.34-3.92, P traumatic brain injury.

  5. Brain herniation

    Science.gov (United States)

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  6. Military-related traumatic brain injury and neurodegeneration.

    Science.gov (United States)

    McKee, Ann C; Robinson, Meghan E

    2014-06-01

    Mild traumatic brain injury (mTBI) includes concussion, subconcussion, and most exposures to explosive blast from improvised explosive devices. mTBI is the most common traumatic brain injury affecting military personnel; however, it is the most difficult to diagnose and the least well understood. It is also recognized that some mTBIs have persistent, and sometimes progressive, long-term debilitating effects. Increasing evidence suggests that a single traumatic brain injury can produce long-term gray and white matter atrophy, precipitate or accelerate age-related neurodegeneration, and increase the risk of developing Alzheimer's disease, Parkinson's disease, and motor neuron disease. In addition, repetitive mTBIs can provoke the development of a tauopathy, chronic traumatic encephalopathy. We found early changes of chronic traumatic encephalopathy in four young veterans of the Iraq and Afghanistan conflict who were exposed to explosive blast and in another young veteran who was repetitively concussed. Four of the five veterans with early-stage chronic traumatic encephalopathy were also diagnosed with posttraumatic stress disorder. Advanced chronic traumatic encephalopathy has been found in veterans who experienced repetitive neurotrauma while in service and in others who were accomplished athletes. Clinically, chronic traumatic encephalopathy is associated with behavioral changes, executive dysfunction, memory loss, and cognitive impairments that begin insidiously and progress slowly over decades. Pathologically, chronic traumatic encephalopathy produces atrophy of the frontal and temporal lobes, thalamus, and hypothalamus; septal abnormalities; and abnormal deposits of hyperphosphorylated tau as neurofibrillary tangles and disordered neurites throughout the brain. The incidence and prevalence of chronic traumatic encephalopathy and the genetic risk factors critical to its development are currently unknown. Chronic traumatic encephalopathy has clinical and

  7. VA/DoD Clinical Practice Guideline for Management of Concussion/Mild Traumatic Brain Injury (mTBI)

    Science.gov (United States)

    2009-04-01

    chronic pain: preliminary findings Archives of Clinical Neuropsychology , Volume 15, Issue 8, , November 2000, Pages 831-832 Borczuk, P.: Mild head...G, Zielinski RE, Fichera S, Rayls KR. Cognitive-behavioral prevention of postconcussion syndrome. Archives of Clinical Neuropsychology 1996;11(2):139

  8. Social Media, Futbol, and Crisis: An exploratory case study examining the FIFA World Cup addressing player concussions

    Directory of Open Access Journals (Sweden)

    Samantha Hughey

    2015-06-01

    Full Text Available Social media strategies and practices continue to be integrated across various athletic sports, particularly futbol. One of the recent global athletic events that occurred where social media played an important role was the 2014 Fédération Internationale de Football Association World Cup in Brazil. While social media brings forth great opportunities for teams to engage with fans and share real-time updates, it also allows active fans to voice concerns around particular issues like player safety i.e. concussions, which could lead to a crisis situation. This particular incident in question involved futbol player Christoph Kramer, who suffered a blow to the head that left him slumped over during the Germany versus Argentina championship match. Fans are linking the lack of concern for player safety to the FIFA brand, making an outcry for protocol to be adapted to tackle the growing issue surrounding players who have suffered from concussions. The FIFA organization waited until September 9, 2014 to address the public and provide a plan for future occurrences of this kind. Based on the theoretical framework of Coombs’ Situational Crisis Communication Theory, the FIFA commission did not properly assessing the crisis at hand and actually implemented the denial posture of crisis response instead of taking proactive actions to address this situation with their stakeholders.

  9. Resilience Is Associated with Outcome from Mild Traumatic Brain Injury.

    Science.gov (United States)

    Losoi, Heidi; Silverberg, Noah D; Wäljas, Minna; Turunen, Senni; Rosti-Otajärvi, Eija; Helminen, Mika; Luoto, Teemu Miikka Artturi; Julkunen, Juhani; Öhman, Juha; Iverson, Grant L

    2015-07-01

    Resilient individuals manifest adaptive behavior and are better able to recover from adversity. The association between resilience and outcome from mild traumatic brain injury (mTBI) is examined, and the reliability and validity of the Resilience Scale and its short form in mTBI research is evaluated. Patients with mTBI (n=74) and orthopedic controls (n=39) completed the Resilience Scale at one, six, and 12 months after injury. Additionally, self-reported post-concussion symptoms, fatigue, insomnia, pain, post-traumatic stress, and depression, as well as quality of life, were evaluated. The internal consistency of the Resilience Scale and the short form ranged from 0.91 to 0.93 for the mTBI group and from 0.86 to 0.95 for controls. The test-retest reliability ranged from 0.70 to 0.82. Patients with mTBI and moderate-to-high resilience reported significantly fewer post-concussion symptoms, less fatigue, insomnia, traumatic stress, and depressive symptoms, and better quality of life, than the patients with low resilience. No association between resilience and time to return to work was found. Resilience was associated with self-reported outcome from mTBI, and based on this preliminary study, can be reliably evaluated with Resilience Scale and its short form in those with mTBIs.

  10. Compensation through Functional Hyperconnectivity: A Longitudinal Connectome Assessment of Mild Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Armin Iraji

    2016-01-01

    Full Text Available Mild traumatic brain injury (mTBI is a major public health concern. Functional MRI has reported alterations in several brain networks following mTBI. However, the connectome-scale brain network changes are still unknown. In this study, sixteen mTBI patients were prospectively recruited from an emergency department and followed up at 4–6 weeks after injury. Twenty-four healthy controls were also scanned twice with the same time interval. Three hundred fifty-eight brain landmarks that preserve structural and functional correspondence of brain networks across individuals were used to investigate longitudinal brain connectivity. Network-based statistic (NBS analysis did not find significant difference in the group-by-time interaction and time effects. However, 258 functional pairs show group differences in which mTBI patients have higher functional connectivity. Meta-analysis showed that “Action” and “Cognition” are the most affected functional domains. Categorization of connectomic signatures using multiview group-wise cluster analysis identified two patterns of functional hyperconnectivity among mTBI patients: (I between the posterior cingulate cortex and the association areas of the brain and (II between the occipital and the frontal lobes of the brain. Our results demonstrate that brain concussion renders connectome-scale brain network connectivity changes, and the brain tends to be hyperactivated to compensate the pathophysiological disturbances.

  11. Developing brain vital signs: Initial framework for monitoring brain function changes over time

    Directory of Open Access Journals (Sweden)

    Sujoy eGhosh Hajra

    2016-05-01

    Full Text Available Clinical assessment of brain function relies heavily on indirect behavior-based tests. Unfortunately, behavior-based assessments are subjective and therefore susceptible to several confounding factors. Event-related brain potentials (ERPs, derived from electroencephalography (EEG, are often used to provide objective, physiological measures of brain function. Historically, ERPs have been characterized extensively within research settings, with limited but growing clinical applications. Over the past 20 years, we have developed clinical ERP applications for the evaluation of functional status following serious injury and/or disease. This work has identified an important gap: the need for a clinically accessible framework to evaluate ERP measures. Crucially, this enables baseline measures before brain dysfunction occurs, and might enable the routine collection of brain function metrics in the future much like blood pressure measures today. Here, we propose such a framework for extracting specific ERPs as potential brain vital signs. This framework enabled the translation/transformation of complex ERP data into accessible metrics of brain function for wider clinical utilization. To formalize the framework, three essential ERPs were selected as initial indicators: 1 the auditory N100 (Auditory sensation; 2 the auditory oddball P300 (Basic attention; and 3 the auditory speech processing N400 (Cognitive processing. First step validation was conducted on healthy younger and older adults (age range: 22-82 years. Results confirmed specific ERPs at the individual level (86.81%-98.96%, verified predictable age-related differences (P300 latency delays in older adults, p<0.05, and demonstrated successful linear transformation into the proposed brain vital sign (BVS framework (basic attention latency sub-component of BVS framework reflects delays in older adults, p<0.05. The findings represent an initial critical step in developing, extracting, and

  12. Traumatic brain injury in modern war

    Science.gov (United States)

    Ling, Geoffrey S. F.; Hawley, Jason; Grimes, Jamie; Macedonia, Christian; Hancock, James; Jaffee, Michael; Dombroski, Todd; Ecklund, James M.

    2013-05-01

    Traumatic brain injury (TBI) is common and especially with military service. In Iraq and Afghanistan, explosive blast related TBI has become prominent and is mainly from improvised explosive devices (IED). Civilian standard of care clinical practice guidelines (CPG) were appropriate has been applied to the combat setting. When such CPGs do not exist or are not applicable, new practice standards for the military are created, as for TBI. Thus, CPGs for prehospital care of combat TBI CPG [1] and mild TBI/concussion [2] were introduced as was a DoD system-wide clinical care program, the first large scale system wide effort to address all severities of TBI in a comprehensive organized way. As TBI remains incompletely understood, substantial research is underway. For the DoD, leading this effort are The Defense and Veterans Brain Injury Center, National Intrepid Center of Excellence and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. This program is a beginning, a work in progress ready to leverage advances made scientifically and always with the intent of providing the best care to its military beneficiaries.

  13. Combat Helmets and Blast Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Duncan Wallace

    2012-01-01

    Full Text Available Background: The conflicts in Iraq and Afghanistan and the prominence of traumatic brain injury (TBI, mostly from improvised explosive devices, have focused attention on the effectiveness of combat helmets. Purpose: This paper examines the importance of TBI, the role and history of the development of combat helmets, current helmet designs and effectiveness, helmet design methodology, helmet sensors, future research and recommendations. Method: A literature review was conducted using search terms – combat helmets, traumatic brain injury, concussion, Iraq, Afghanistan and helmet sensors, searching PubMed, MEDLINE, ProQuest and Google Scholar. Conclusions: At present, no existing helmet is able to fully protect against all threats faced on the battlefield. The prominence of traumatic brain injury from improvised explosive devices in the current conflicts in Iraq and Afghanistan has highlighted the limitations in knowledge about blast and how to provide protection from it. As a result, considerable research is currently occurring in how to protect the head from blast over-pressure. Helmet sensors may provide valuable data. Some new combat helmets may be able to protect against rifle rounds, but may result in injuries occurring behind body armour. Optimal combat helmet design requires a balance between the need for protection from trauma and the comfort and practicality of the helmet for the user to ensure the best outcomes.

  14. Traumatic brain injury and vestibulo-ocular function: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Wallace B

    2016-09-01

    Full Text Available Bridgett Wallace,1–4 Jonathan Lifshitz4–8 1360 Balance and Hearing, Department of Physical Therapy, Austin, TX, 2Concussion Health, Department of Clinical Education, Austin, TX, 3Conquering Concussions, Scottsdale, AZ, 4Barrow Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ, 5Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, 6The CACTIS Foundation, Scottsdale, 7Phoenix VA Healthcare System, Phoenix, AZ, 8Department of Psychology, Arizona State University, Tempe, AZ, USA Abstract: Normal function of the vestibulo-ocular reflex (VOR coordinates eye movement with head movement, in order to provide clear vision during motion and maintain balance. VOR is generated within the semicircular canals of the inner ear to elicit compensatory eye movements, which maintain stability of images on the fovea during brief, rapid head motion, otherwise known as gaze stability. Normal VOR function is necessary in carrying out activities of daily living (eg, walking and riding in a car and is of particular importance in higher demand activities (eg, sports-related activities. Disruption or damage in the VOR can result in symptoms such as movement-related dizziness, blurry vision, difficulty maintaining balance with head movements, and even nausea. Dizziness is one of the most common symptoms following traumatic brain injury (TBI and is considered a risk factor for a prolonged recovery. Assessment of the vestibular system is of particular importance following TBI, in conjunction with oculomotor control, due to the intrinsic neural circuitry that exists between the ocular and vestibular systems. The purpose of this article is to review the physiology of the VOR and the visual-vestibular symptoms associated with TBI and to discuss assessment and treatment guidelines for TBI. Current challenges and future prospects will also be addressed. Keywords: traumatic brain injury, concussion, vestibular, ocular

  15. Brain Basics

    Medline Plus

    Full Text Available ... Basics will introduce you to some of this science, such as: How the brain develops How genes and the environment affect the brain The basic structure of the brain How different parts of the brain communicate and work with each other How changes in the brain ...

  16. Brain Fingerprinting

    Directory of Open Access Journals (Sweden)

    Ravi Kumar

    2012-12-01

    Full Text Available Brain Fingerprinting is a scientific technique to determine whether or not specific information is stored in an individual's brain by measuring a electrical brain wave response to Word, phrases, or picture that are presented on computer screen. Brain Fingerprinting is a controversial forensic science technique that uses electroencephalography (EEG to determine whether specific information is stored in a subject's brain.

  17. Brain Fingerprinting

    Directory of Open Access Journals (Sweden)

    ravi kumar

    2012-12-01

    Full Text Available Brain Fingerprinting is a scientific technique to determine whether or not specific information is stored in an individual's brain by measuring a electrical brain wave response to Word, phrases, or picture that are presented on computer screen. Brain Fingerprinting is a controversial forensic science technique that uses electroencephalograph y (EEG to determine whether specific information is stored in a subject's brain

  18. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are ...

  19. Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report

    Directory of Open Access Journals (Sweden)

    Krishna Ranga

    2012-02-01

    Full Text Available Abstract Introduction Traumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head. Specifically, mild traumatic brain injury is a clinical diagnosis that can have significant effects on an individual's life, yet is difficult to identify through traditional imaging techniques. Case presentation This is the case of a 68-year-old previously healthy African American woman who was involved in a motor vehicle accident that resulted in significant head trauma. After the accident, she experienced symptoms indicative of mild traumatic brain injury and sought a neurological consultation when her symptoms did not subside. She was initially evaluated with a neurological examination, psychological evaluation, acute concussion evaluation and a third-party memory test using software from CNS Vital Signs for neurocognitive function. A diagnosis of post-concussion syndrome was suggested. Diffusion tensor imaging revealed decreased fractional anisotropy in the region immediately adjacent to both lateral ventricles, which was used to confirm the diagnosis. Fractional anisotropy is a scalar value between zero and one that describes the degree of anisotropy of a diffusion process. These results are indicative of post-traumatic gliosis and are undetectable by magnetic resonance imaging. Our patient was treated with cognitive therapy. Conclusion Minor traumatic brain injury is a common injury with variable clinical presentation. The system of diagnosis used in this case found a significant relationship between the clinical assessment and imaging results. This would not have been possible using traditional imaging techniques and highlights the benefits of using diffusion tensor imaging in the sub-acute assessment of minor traumatic brain injury.

  20. Brain components

    Science.gov (United States)

    ... can make complex movements without thinking. The brain stem connects the brain with the spinal cord and is composed of ... structures: the midbrain, pons, and medulla oblongata. The brain stem provides us with automatic functions that are necessary ...

  1. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  2. Brain Malformations

    Science.gov (United States)

    Most brain malformations begin long before a baby is born. Something damages the developing nervous system or causes it ... medicines, infections, or radiation during pregnancy interferes with brain development. Parts of the brain may be missing, ...

  3. Brain Basics

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    Full Text Available ... science, such as: How the brain develops How genes and the environment affect the brain The basic ... that with brain development in people mental disorders. Genes and environmental cues both help to direct this ...

  4. Brain Basics

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    Full Text Available ... can lead to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits ... tailored treatments, and possibly prevention of such illnesses. The Working Brain Neurotransmitters Everything we do relies on ...

  5. Structural Neuroimaging Findings in Mild Traumatic Brain Injury.

    Science.gov (United States)

    Bigler, Erin D; Abildskov, Tracy J; Goodrich-Hunsaker, Naomi J; Black, Garrett; Christensen, Zachary P; Huff, Trevor; Wood, Dawn-Marie G; Hesselink, John R; Wilde, Elisabeth A; Max, Jeffrey E

    2016-09-01

    Common neuroimaging findings in mild traumatic brain injury (mTBI), including sport-related concussion (SRC), are reviewed based on computed tomography and magnetic resonance imaging (MRI). Common abnormalities radiologically identified on the day of injury, typically a computed tomographic scan, are in the form of contusions, small subarachnoid or intraparenchymal hemorrhages as well as subdural and epidural collections, edema, and skull fractures. Common follow-up neuroimaging findings with MRI include white matter hyperintensities, hypointense signal abnormalities that reflect prior hemorrhage, focal encephalomalacia, presence of atrophy and/or dilated Virchow-Robins perivascular space. The MRI findings from a large pediatric mTBI study show low frequency of positive MRI findings at 6 months postinjury. The review concludes with an examination of some of the advanced MRI-based image analysis methods that can be performed in the patient who has sustained an mTBI.

  6. Persistent vertigo and dizziness after mild traumatic brain injury.

    Science.gov (United States)

    Fife, Terry D; Kalra, Deepak

    2015-04-01

    Vertigo, dizziness, and disequilibrium are common symptoms following concussion or mild traumatic brain injury (mTBI). Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner-ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage. Some of these patients exhibit features compatible with vestibular migraine and may be treated successfully with migraine-preventative medications. This paper reviews the nonotogenic causes of persisting dizziness, the possible mechanisms, and the pathophysiology, as a framework for patient management and for future research.

  7. Challenges in Determining the Role of Rest and Exercise in the Management of Mild Traumatic Brain Injury.

    Science.gov (United States)

    Wells, Elizabeth M; Goodkin, Howard P; Griesbach, Grace S

    2016-01-01

    Current consensus guidelines recommending physical and cognitive rest until a patient is asymptomatic after a sports concussion (ie, a mild traumatic brain injury) are being called into question, particularly for patients who are slower to recover and in light of preclinical and clinical research demonstrating that exercise aids neurorehabilitation. The pathophysiological response to mild traumatic brain injury includes a complex neurometabolic cascade of events resulting in a neurologic energy deficit. It has been proposed that this energy deficit leads to a period of vulnerability during which the brain is at risk for additional injury, explains why early postconcussive symptoms are exacerbated by cognitive and physical exertion, and is used to rationalize absolute rest until all symptoms have resolved. However, at some point, rest might no longer be beneficial and exercise might need to be introduced. At both extremes, excessive exertion and prolonged avoidance of exercise (physical and mental) have negative consequences. Individuals who have experienced a concussion need guidance for avoidance of triggers of severe symptoms and a plan for graduated exercise to promote recovery as well as optimal functioning (physical, educational, and social) during the postconcussion period.

  8. The complex clinical issues involved in an athlete's decision to retire from collision sport due to multiple concussions: a case study of a professional athlete

    Directory of Open Access Journals (Sweden)

    Andrew eGardner

    2013-09-01

    Full Text Available The issue of retirement from athletic participation due to repetitive concussive injuries remains controversial. The complexity of providing recommendations to elite athletes is highlighted by the prospect that offering inappropriate advice may foreseeably lead to engagement in a medico-legal challenge. Currently no evidenced-based, scientifically validated guidelines for forming the basis of such a decision exist. The current paper discusses the complexities of this challenge in addition to presenting a case study of a professional athlete. A number of central issues to consider when discussing athlete retirement revolve around the player’s medical and concussion histories, the current clinical profile, the athlete’s long-term life goals and understanding of the potential long-terms risks. Ensuring that thorough investigations of all possible differential diagnosis, that may explain the presenting symptoms, are conducted is also essential. Discussion pertaining to recommendations for guiding the clinical approach to the retirement issue for athletes with a history of multiple concussions is presented.

  9. Pathophysiology of Blood-Brain Barrier in Brain Injury in Cold and Hot Environments: Novel Drug Targets for Neuroprotection.

    Science.gov (United States)

    Sharma, Hari Shanker; Muresanu, Dafin F; Lafuente, José V; Nozari, Ala; Patnaik, Ranjana; Skaper, Stephen D; Sharma, Aruna

    2016-01-01

    The blood-brain barrier (BBB) plays a pivotal role in the maintenance of central nervous system function in health and disease. Thus, in almost all neurodegenerative, traumatic or metabolic insults BBB breakdown occurs, allowing entry of serum proteins into the brain fluid microenvironment with subsequent edema formation and cellular injury. Accordingly, pharmacological restoration of BBB function will lead to neurorepair. However, brain injury which occurs following blast, bullet wounds, or knife injury appears to initiate different sets of pathophysiological responses. Moreover, other local factors at the time of injury such as cold or elevated ambient temperatures could also impact the final outcome. Obviously, drug therapy applied to different kinds of brain trauma occurring at either cold or hot environments may respond differently. This is largely due to the fact that internal defense mechanisms of the brain, gene expression, release of neurochemicals and binding of drugs to specific receptors are affected by external ambient temperature changes. These factors may also affect BBB function and development of edema formation after brain injury. In this review, the effects of seasonal exposure to heat and cold on traumatic brain injury using different models i.e., concussive brain injury and cerebral cortical lesion, on BBB dysfunction in relation to drug therapy are discussed. Our observations clearly suggest that closed head injury and open brain injury are two different entities and the external hot or cold environments affect both of them remarkably. Thus, effective pharmacological therapeutic strategies should be designed with these views in mind, as military personnel often experience blunt or penetrating head injuries in either cold or hot environments.

  10. Anatomy of the Brain

    Science.gov (United States)

    ... Menu Brain Tumor Information Brain Anatomy Brain Structure Neuron Anatomy Brain Tumor Symptoms Diagnosis Types of Tumors Risk Factors ... form Brain Tumor Information Brain Anatomy Brain Structure Neuron Anatomy Brain Tumor Symptoms Diagnosis Types of Tumors Risk Factors ...

  11. Cascade of Traumatic Brain Injury: A Correlational Study of Cognition, Postconcussion Symptoms, and Quality of Life

    Science.gov (United States)

    Reddy, Rajakumari Pampa; Rajeswaran, Jamuna; Devi, B. Indira; Kandavel, Thennarasu

    2017-01-01

    Introduction: Traumatic brain injury (TBI) constitutes a significant burden on health care resources in India. TBI is a dynamic process which involves damage to the brain thus leading to behavior cognitive and emotional consequences. Aim: To study the cognitive profile, post-concussion symptoms (PCS), quality of life (QOL), and their correlation. Methods: A total of 60 patients with TBI were recruited and assessed for neuropsychological profile, PCS, and QOL, the correlation among the variables were analyzed. Results: The results suggest that TBI has series of consequences which is interrelated, and the study has implications for rehabilitation of TBI. Conclusion: The study highlights the deficits of cognition, and its correlation with PCS and QOL, emphasizing integrated rehabilitation approach for patients with TBI.

  12. Blast Concussion mTBI, Hypopituitarism, and Psychological Health in OIF/OEF Veterans

    Science.gov (United States)

    2013-04-01

    more vulnerable to damage because of their location in the pituitary’s exposed lateral wings and their primary dependence on vascular input from the...portal system alone. Gonadotrophs are distributed throughout the anterior pituitary, and the cells in the lateral wings are relatively vulnerable. In...the sphenoid bone, and because of this restriction it is subject to damage from compression resulting from brain movement or edema. Furthermore, the

  13. Effects of soccer heading on brain structure and function

    Directory of Open Access Journals (Sweden)

    Ana Carolina Oliveira Rodrigues

    2016-03-01

    Full Text Available Soccer is the most popular sport in the world, with more than 265 million players worldwide, including professional and amateur ones. Soccer is unique in comparison to other sports, as it is the only sport in which participants purposely use their head to hit the ball. Heading is considered an offensive or defensive move whereby the player’s unprotected head is used to deliberately impact the ball and direct it during play. A soccer player can be subjected to an average of six to twelve incidents of heading the ball per competitive game, where the ball reaches high velocities. Moreover, in practice sessions, heading training, which involves heading the ball repeatedly at low velocities, is common. Although the scientific community, as well as the media, has focused on the effects of concussions in contact sports, the role of subconcussive impacts, as it can occur during heading, has recently gained attention, considering that it may represent an additional mechanism of cumulative brain injury. The purpose of this study is to review the existing literature regarding the effects of soccer heading on brain structure and function. Only in the last years some investigations have addressed the impact of heading on brain structure, by using neuroimaging techniques. Similarly, there have been some recent studies investigating biochemical markers of brain injury in soccer players. There is evidence of association between heading and abnormal brain structure, but the data are still preliminary. Also, some studies have suggested that subconcussive head impacts, as heading, could cause cognitive impairment, whereas others have not corroborated this finding. Questions persist as to whether or not heading is deleterious to cognitive functioning. Further studies, especially with longitudinal designs, are needed to clarify the clinical significance of heading as a cause of brain injury and to identify risk factors. Such investigations might contribute to the

  14. Brain Basics

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    Full Text Available ... have been linked to many mental disorders, including autism , obsessive compulsive disorder (OCD) , schizophrenia , and depression . Brain ... studies show that brain growth in children with autism appears to peak early. And as they grow ...

  15. Brain Basics

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    Full Text Available ... depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of ... but sometimes give rise to disabilities or diseases. neural circuit —A network of neurons and their interconnections. ...

  16. Brain Basics

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    Full Text Available ... than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses ... depression experience when starting treatment. Gene Studies Advanced technologies are also making it faster, easier, and more ...

  17. Brain Basics

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    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... blues" from time to time. In contrast, major depression is a serious disorder that lasts for weeks. ...

  18. Brain Basics

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    Full Text Available ... the brain cannot effectively coordinate the billions of cells in the body, the results can affect many ... unit of the brain and nervous system. These cells are highly specialized for the function of conducting ...

  19. Brain Diseases

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    The brain is the control center of the body. It controls thoughts, memory, speech, and movement. It regulates the function of many organs. When the brain is healthy, it works quickly and automatically. However, ...

  20. Brain Basics

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    Full Text Available ... related to changes in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot ... their final destination. Chemical signals from other cells guide neurons in forming various brain structures. Neighboring neurons ...

  1. Brain Basics

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    Full Text Available ... in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot effectively coordinate the billions ... the basic working unit of the brain and nervous system. These cells are highly specialized for the function ...

  2. Brain Basics

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    Full Text Available ... affect many aspects of life. Scientists are continually learning more about how the brain grows and works ... early brain development. It may also assist in learning and memory. Problems in making or using glutamate ...

  3. Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management.

    Science.gov (United States)

    Howell, David R; Oldham, Jessie R; DiFabio, Melissa; Vallabhajosula, Srikant; Hall, Eric E; Ketcham, Caroline J; Meehan, William P; Buckley, Thomas A

    2017-02-01

    Gait impairments have been documented following sport-related concussion. Whether preexisting gait pattern differences exist among athletes who participate in different sport classifications, however, remains unclear. Dual-task gait examinations probe the simultaneous performance of everyday tasks (ie, walking and thinking), and can quantify gait performance using inertial sensors. The purpose of this study was to compare the single-task and dual-task gait performance of collision/contact and noncontact athletes. A group of collegiate athletes (n = 265) were tested before their season at 3 institutions (mean age= 19.1 ± 1.1 years). All participants stood still (single-task standing) and walked while simultaneously completing a cognitive test (dual-task gait), and completed walking trials without the cognitive test (single-task gait). Spatial-temporal gait parameters were compared between collision/contact and noncontact athletes using MANCOVAs; cognitive task performance was compared using ANCOVAs. No significant single-task or dual-task gait differences were found between collision/contact and noncontact athletes. Noncontact athletes demonstrated higher cognitive task accuracy during single-task standing (P = .001) and dual-task gait conditions (P = .02) than collision/contact athletes. These data demonstrate the utility of a dual-task gait assessment outside of a laboratory and suggest that preinjury cognitive task performance during dual-tasks may differ between athletes of different sport classifications.

  4. Brain Basics

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    Full Text Available ... such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit ... final destination. Chemical signals from other cells guide neurons in forming various brain structures. Neighboring neurons make connections with each other ...

  5. Brain Aneurysm

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    A brain aneurysm is an abnormal bulge or "ballooning" in the wall of an artery in the brain. They are sometimes called berry aneurysms because they ... often the size of a small berry. Most brain aneurysms produce no symptoms until they become large, ...

  6. The Brain.

    Science.gov (United States)

    Hubel, David H.

    1979-01-01

    This article on the brain is part of an entire issue about neurobiology and the question of how the human brain works. The brain as an intricate tissue composed of cells is discussed based on the current knowledge and understanding of its composition and structure. (SA)

  7. Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes.

    Science.gov (United States)

    Biederman, Joseph; Feinberg, Leah; Chan, James; Adeyemo, Bamidele O; Woodworth, K Yvonne; Panis, Walter; McGrath, Neal; Bhatnagar, Saurabha; Spencer, Thomas J; Uchida, Mai; Kenworthy, Tara; Grossman, Rebecca; Zafonte, Ross; Faraone, Stephen V

    2015-11-01

    A recent meta-analysis documented a significant statistical association between mild traumatic brain injury (mTBI) and attention deficit hyperactivity disorder (ADHD) (Adeyemo et al., 2014), but the direction of this effect was unclear. In this study, we hypothesized that ADHD would be an antecedent risk factor for mTBI. Participants were student athletes ages 12 to 25 who had sustained a mTBI and Controls of similar age and sex selected from studies of youth with and without ADHD. Subjects were assessed for symptoms of ADHD, concussion severity, and cognitive function. mTBI subjects had a significantly higher rate of ADHD than Controls, and in all cases the age of onset of ADHD was before mTBI onset. mTBI+ADHD subjects also had more severe concussion symptoms (fatigue and poor concentration) than mTBI-ADHD subjects. These results support ADHD as an antecedent risk factor for mTBI in student athletes and that its presence complicates the course of mTBI.

  8. Arterial Spin Labeling Perfusion Study in the Patients with Subacute Mild Traumatic Brain Injury.

    Directory of Open Access Journals (Sweden)

    Che-Ming Lin

    Full Text Available This study uses a MRI technique, three-dimension pulse continuous arterial spin labeling (3D-PCASL, to measure the patient's cerebral blood flow (CBF at the subacute stage of mild traumatic brain injury (MTBI in order to analyze the relationship between cerebral blood flow and neurocognitive deficits.To provide the relationship between cortical CBF and neuropsychological dysfunction for the subacute MTBI patients.After MTBI, perfusion MR imaging technique (3D-PCASL measures the CBF of MTBI patients (n = 23 within 1 month and that of normal controls (n = 22 to determine the quantity and location of perfusion defect. The correlation between CBF abnormalities and cognitive deficits was elucidated by combining the results of the neuropsychological tests of the patients.We observed a substantial reduction in CBF in the bilateral frontal and left occipital cortex as compared with the normal persons. In addition, there were correlation between post concussive symptoms (including dizziness and simulator sickness and CBF in the hypoperfused areas. The more severe symptom was correlated with higher CBF in bilateral frontal and left occipital lobes.First, this study determined that despite no significant abnormality detected on conventional CT and MRI studies, hypoperfusion was observed in MTBI group using 3D-PCASL technique in subacute stage, which suggested that this approach may increase sensitivity to MTBI. Second, the correlation between CBF and the severity of post concussive symptoms suggested that changes in cerebral hemodynamics may play a role in pathophysiology underlies the symptoms.

  9. The Role of Medical Imaging in the Re-Characterization of Mild Traumatic Brain Injury Using Youth Sports as a Laboratory

    Directory of Open Access Journals (Sweden)

    Thomas M. Talavage

    2016-01-01

    Full Text Available The short- and long-term impact of mild traumatic brain injury is an increasingly vital concern for both military and civilian personnel. Such injuries produce significant social and financial burdens, and necessitate improved diagnostic and treatment methods. Recent integration of neuroimaging and biomechanical studies in youth collision-sport athletes has revealed that significant alterations in brain structure and function occur even in the absence of traditional clinical markers of concussion. While task performance is maintained, athletes exposed to repetitive head accelerations exhibit structural changes to the underlying white matter, altered glial cell metabolism, aberrant vascular response and marked changes in functional network behavior. Moreover, these changes accumulate with accrued years of exposure, suggesting a cumulative trauma mechanism that may culminate in categorization as concussion and long-term neurological deficits. The goal of this review is to elucidate the role of medical imaging in re-characterizing traumatic brain injury, as a whole, to better identify at-risk individuals and improve the development of preventative and interventional approaches.

  10. The clinical spectrum of sport-related traumatic brain injury.

    Science.gov (United States)

    Jordan, Barry D

    2013-04-01

    Acute and chronic sports-related traumatic brain injuries (TBIs) are a substantial public health concern. Various types of acute TBI can occur in sport, but detection and management of cerebral concussion is of greatest importance as mismanagement of this syndrome can lead to persistent or chronic postconcussion syndrome (CPCS) or diffuse cerebral swelling. Chronic TBI encompasses a spectrum of disorders that are associated with long-term consequences of brain injury, including chronic traumatic encephalopathy (CTE), dementia pugilistica, post-traumatic parkinsonism, post-traumatic dementia and CPCS. CTE is the prototype of chronic TBI, but can only be definitively diagnosed at autopsy as no reliable biomarkers of this disorder are available. Whether CTE shares neuropathological features with CPCS is unknown. Evidence suggests that participation in contact-collision sports may increase the risk of neurodegenerative disorders such as Alzheimer disease, but the data are conflicting. In this Review, the spectrum of acute and chronic sport-related TBI is discussed, highlighting how examination of athletes involved in high-impact sports has advanced our understanding of pathology of brain injury and enabled improvements in detection and diagnosis of sport-related TBI.

  11. Neuroinflammation in animal models of traumatic brain injury

    Science.gov (United States)

    Chiu, Chong-Chi; Liao, Yi-En; Yang, Ling-Yu; Wang, Jing-Ya; Tweedie, David; Karnati, Hanuma K.; Greig, Nigel H.; Wang, Jia-Yi

    2016-01-01

    Traumatic brain injury (TBI) is a leading cause of mortality and morbidity worldwide. Neuroinflammation is prominent in the short and long-term consequences of neuronal injuries that occur after TBI. Neuroinflammation involves the activation of glia, including microglia and astrocytes, to release inflammatory mediators within the brain, and the subsequent recruitment of peripheral immune cells. Various animal models of TBI have been developed that have proved valuable to elucidate the pathophysiology of the disorder and to assess the safety and efficacy of novel therapies prior to clinical trials. These models provide an excellent platform to delineate key injury mechanisms that associate with types of injury (concussion, contusion, and penetration injuries) that occur clinically for the investigation of mild, moderate, and severe forms of TBI. Additionally, TBI modeling in genetically engineered mice, in particular, has aided the identification of key molecules and pathways for putative injury mechanisms, as targets for development of novel therapies for human TBI. This Review details the evidence showing that neuroinflammation, characterized by the activation of microglia and astrocytes and elevated production of inflammatory mediators, is a critical process occurring in various TBI animal models, provides a broad overview of commonly used animal models of TBI, and overviews representative techniques to quantify markers of the brain inflammatory process. A better understanding of neuroinflammation could open therapeutic avenues for abrogation of secondary cell death and behavioral symptoms that may mediate the progression of TBI. PMID:27382003

  12. Amphetamine affects the behavioral outcome of lateral fluid percussion brain injury in the rat.

    Science.gov (United States)

    Prasad, R M; Dose, J M; Dhillon, H S; Carbary, T; Kraemer, P J

    1995-01-01

    This study examined the effects of (D)-amphetamine, methoxamine (an al-adrenergic receptor agonist), and prazosin (an al-adrenergic receptor antagonist) on the behavioral outcome of lateral fluid percussion brain injury. Rats trained to perform a beam walking task were subjected to brain injury of moderate severity (2.1-2.2 atm). At 10 min after injury, rats were treated with amphetamine, methoxamine or prazosin at two different dose levels. Amphetamine-treated animals displayed significantly lower impairment in beam walking ability from days 1 to 5 after brain injury. Neither methoxamine nor prazosin significantly affected the impairment in beam walking ability from day 1 to day 7 after injury. However, prazosin treatment at both dose levels increased the post-injury mortality and the incidences of failure to recovery from hemiplegia. Amphetamine-treatment at 4 mg/kg, but not at 2 mg/kg, improved the spatial learning abilities of the injured animals. Neither methoxamine nor prazosin affected the spatial learning abilities. These results indicate that amphetamine facilitated beam walking recovery and improved cognitive function after concussive fluid percussion injury. Although the methoxamine experiments suggest that the norepinephrine-α1-adrenergic receptor system may not be involved in the pathophysiology of fluid percussion brain injury, our results with amphetamine (beneficial effects) and prazosin (deleterious effects) and the results observed in other models of brain injury point out that further investigations are necessary to understand the role of a1-adrenergic receptors in brain injury.

  13. Evaluation of Axonal Strain as a Predictor for Mild Traumatic Brain Injuries Using Finite Element Modeling.

    Science.gov (United States)

    Giordano, Chiara; Kleiven, Svein

    2014-11-01

    Finite element (FE) models are often used to study the biomechanical effects of traumatic brain injury (TBI). Measures based on mechanical responses, such as principal strain or invariants of the strain tensor, are used as a metric to predict the risk of injury. However, the reliability of inferences drawn from these models depends on the correspondence between the mechanical measures and injury data, as well as the establishment of accurate thresholds of tissue injury. In the current study, a validated anisotropic FE model of the human head is used to evaluate the hypothesis that strain in the direction of fibers (axonal strain) is a better predictor of TBI than maximum principal strain (MPS), anisotropic equivalent strain (AESM) and cumulative strain damage measure (CSDM). An analysis of head kinematics-based metrics, such as head injury criterion (HIC) and brain injury criterion (BrIC), is also provided. Logistic regression analysis is employed to compare binary injury data (concussion/no concussion) with continuous strain/kinematics data. The threshold corresponding to 50% of injury probability is determined for each parameter. The predictive power (area under the ROC curve, AUC) is calculated from receiver operating characteristic (ROC) curve analysis. The measure with the highest AUC is considered to be the best predictor of mTBI. Logistic regression shows a statistical correlation between all the mechanical predictors and injury data for different regions of the brain. Peaks of axonal strain have the highest AUC and determine a strain threshold of 0.07 for corpus callosum and 0.15 for the brainstem, in agreement with previously experimentally derived injury thresholds for reversible axonal injury. For a data set of mild TBI from the national football league, the strain in the axonal direction is found to be a better injury predictor than MPS, AESM, CSDM, BrIC and HIC.

  14. Low-frequency connectivity is associated with mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    B.T. Dunkley

    2015-01-01

    Full Text Available Mild traumatic brain injury (mTBI occurs from a closed-head impact. Often referred to as concussion, about 20% of cases complain of secondary psychological sequelae, such as disorders of attention and memory. Known as post-concussive symptoms (PCS, these problems can severely disrupt the patient's quality of life. Changes in local spectral power, particularly low-frequency amplitude increases and/or peak alpha slowing have been reported in mTBI, but large-scale connectivity metrics based on inter-regional amplitude correlations relevant for integration and segregation in functional brain networks, and their association with disorders in cognition and behaviour, remain relatively unexplored. Here, we used non-invasive neuroimaging with magnetoencephalography to examine functional connectivity in a resting-state protocol in a group with mTBI (n = 20, and a control group (n = 21. We observed a trend for atypical slow-wave power changes in subcortical, temporal and parietal regions in mTBI, as well as significant long-range increases in amplitude envelope correlations among deep-source, temporal, and frontal regions in the delta, theta, and alpha bands. Subsequently, we conducted an exploratory analysis of patterns of connectivity most associated with variability in secondary symptoms of mTBI, including inattention, anxiety, and depression. Differential patterns of altered resting state neurophysiological network connectivity were found across frequency bands. This indicated that multiple network and frequency specific alterations in large scale brain connectivity may contribute to overlapping cognitive sequelae in mTBI. In conclusion, we show that local spectral power content can be supplemented with measures of correlations in amplitude to define general networks that are atypical in mTBI, and suggest that certain cognitive difficulties are mediated by disturbances in a variety of alterations in network interactions which are differentially

  15. The military's approach to traumatic brain injury and post-traumatic stress disorder

    Science.gov (United States)

    Ling, Geoffrey S. F.; Grimes, Jamie; Ecklund, James M.

    2014-06-01

    Traumatic brain injury (TBI) and Post Traumatic Stress Disorder (PTSD) are common conditions. In Iraq and Afghanistan, explosive blast related TBI became prominent among US service members but the vast majority of TBI was still due to typical causes such as falls and sporting events. PTS has long been a focus of the US military mental health providers. Combat Stress Teams have been integral to forward deployed units since the beginning of the Global War on Terror. Military medical management of disease and injury follows standard of care clinical practice guidelines (CPG) established by civilian counterparts. However, when civilian CPGs do not exist or are not applicable to the military environment, new practice standards are created. Such is the case for mild TBI. In 2009, the VA-DoD CPG for management of mild TBI/concussion was published and a system-wide clinical care program for mild TBI/concussion was introduced. This was the first large scale effort on an entire medical care system to address all severities of TBI in a comprehensive organized way. In 2010, the VA-DoD CPG for management of PTSD was published. Nevertheless, both TBI and PTS are still incompletely understood. Investment in terms of money and effort has been committed by the DoD to their study. The Defense and Veterans Brain Injury Center, National Intrepid Center of Excellence and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury are prominent examples of this effort. These are just beginnings, a work in progress ready to leverage advances made scientifically and always striving to provide the very best care to its military beneficiaries.

  16. Classification of traumatic brain injury severity using informed data reduction in a series of binary classifier algorithms.

    Science.gov (United States)

    Prichep, Leslie S; Jacquin, Arnaud; Filipenko, Julie; Dastidar, Samanwoy Ghosh; Zabele, Stephen; Vodencarević, Asmir; Rothman, Neil S

    2012-11-01

    Assessment of medical disorders is often aided by objective diagnostic tests which can lead to early intervention and appropriate treatment. In the case of brain dysfunction caused by head injury, there is an urgent need for quantitative evaluation methods to aid in acute triage of those subjects who have sustained traumatic brain injury (TBI). Current clinical tools to detect mild TBI (mTBI/concussion) are limited to subjective reports of symptoms and short neurocognitive batteries, offering little objective evidence for clinical decisions; or computed tomography (CT) scans, with radiation-risk, that are most often negative in mTBI. This paper describes a novel methodology for the development of algorithms to provide multi-class classification in a substantial population of brain injured subjects, across a broad age range and representative subpopulations. The method is based on age-regressed quantitative features (linear and nonlinear) extracted from brain electrical activity recorded from a limited montage of scalp electrodes. These features are used as input to a unique "informed data reduction" method, maximizing confidence of prospective validation and minimizing over-fitting. A training set for supervised learning was used, including: "normal control," "concussed," and "structural injury/CT positive (CT+)." The classifier function separating CT+ from the other groups demonstrated a sensitivity of 96% and specificity of 78%; the classifier separating "normal controls" from the other groups demonstrated a sensitivity of 81% and specificity of 74%, suggesting high utility of such classifiers in acute clinical settings. The use of a sequence of classifiers where the desired risk can be stratified further supports clinical utility.

  17. Brain Autopsy

    Science.gov (United States)

    ... why a family should consider arranging for a brain autopsy upon the death of their loved one. To get a definitive ... study of tissue removed from the body after death. Examination of the whole brain is important in understanding FTD because the patterns ...

  18. Brain Basics

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    Full Text Available ... Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures of ... to slow or stop them from progressing. Functional magnetic resonance imaging (fMRI) is another important research tool in understanding ...

  19. Brain Basics

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    Full Text Available ... and are working to compare that with brain development in people mental disorders. Genes and environmental cues both help to direct ... comparing such children to those with normal brain development may help scientists to pinpoint when and where mental disorders begin and perhaps how to slow or stop ...

  20. Brain peroxisomes.

    Science.gov (United States)

    Trompier, D; Vejux, A; Zarrouk, A; Gondcaille, C; Geillon, F; Nury, T; Savary, S; Lizard, G

    2014-03-01

    Peroxisomes are essential organelles in higher eukaryotes as they play a major role in numerous metabolic pathways and redox homeostasis. Some peroxisomal abnormalities, which are often not compatible with life or normal development, were identified in severe demyelinating and neurodegenerative brain diseases. The metabolic roles of peroxisomes, especially in the brain, are described and human brain peroxisomal disorders resulting from a peroxisome biogenesis or a single peroxisomal enzyme defect are listed. The brain abnormalities encountered in these disorders (demyelination, oxidative stress, inflammation, cell death, neuronal migration, differentiation) are described and their pathogenesis are discussed. Finally, the contribution of peroxisomal dysfunctions to the alterations of brain functions during aging and to the development of Alzheimer's disease is considered.

  1. FDG-PET imaging in mild traumatic brain injury: A critical review

    Directory of Open Access Journals (Sweden)

    Kimberly R Byrnes

    2014-01-01

    Full Text Available 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 inconclusive due to subtle, obscure, or absent changes in anatomical or physiological parameters measured using standard magnetic resonance (MR or computed tomography (CT imaging protocols. Molecular imaging techniques that examine functional processes within the brain, such as measurement of glucose uptake and metabolism using [18F]fluorodeoxyglucose and positron emission tomography (FDG-PET, have the ability to detect changes after mild TBI. Recent technological improvements in the resolution of PET systems, the integration of PET with MRI, and the availability of normal healthy human databases and commercial image analysis software contribute to the growing use of molecular imaging in basic science research and advances in clinical imaging. This review will discuss the technological considerations and limitations of FDG-PET, including differentiation between glucose uptake and glucose metabolism and the significance of these measurements. In addition, the current state of FDG-PET imaging in assessing mild TBI in clinical and preclinical research will be considered. Finally, this review will provide insight into potential critical data elements and recommended standardization to improve the application of FDG-PET to mild TBI research and clinical practice.

  2. The value of neurocognitive testing for acute outcomes after mild traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Latha Ganti; Yasamin Daneshvar; Sarah Ayala; Pratik Shashikant Patel; Aakash N Bodhit; Keith R Peters

    2015-01-01

    Background:Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-term outcomes after acute traumatic brain injury (TBI). Methods:This is an IRB-approved prospective study of adult patients who came to the emergency department of our Level-1 trauma center with TBI. Patients were enrolled prospectively after providing written informed consent and underwent three separate neurocognitive tests: the Galveston Orientation Amnesia Test (GOAT), the Rivermead Post-Concussion Survey Questionnaire (RPCSQ), and the Mini Mental Status Examination (MMSE). Results:A lower GOAT score was significantly associated with hospitalization (P=0.0212) and the development of post-concussion syndrome (PCS) at late follow-up (P=0.0081). A higher RPCSQ score was significantly associated with hospital admission (P=0.0098), re-admission within 30 days of discharge (P=0.0431) and evidence of PCS at early follow-up (P=0.0004). A higher MMSE score was significantly associated with not being admitted to the hospital (P=0.0002) and not returning to the emergency department (ED) within 72 hours of discharge (P=0.0078). Lower MMSE was also significantly associated with bleeding or a fracture on the brain CT (P=0.0431). Conclusions:While neurocognitive testing is not commonly performed in the ED in the setting of acute head injury, it is both feasible and appears to have value in predicting hospital admission and PCS. These data are especially important in terms of helping patients understand what to expect, thus, aiding in their recovery.

  3. Brain radiation - discharge

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    Radiation - brain - discharge; Cancer-brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  4. Brain tumor - primary - adults

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    ... Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults) ... Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, ...

  5. Brain Basics

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    Full Text Available ... highly developed area at the front of the brain that, in humans, plays a role in executive functions such as ... Higher Death Rate Among Youth with Psychosis Delayed Walking Link ...

  6. Brain Basics

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    Full Text Available ... the brain, which is linked to thought and emotion. It is also linked to reward systems in ... or-flight response and is also involved in emotions and memory. anterior cingulate cortex —Is involved in ...

  7. Brain Basics

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    Full Text Available ... Some people who develop a mental illness may recover completely; others may have repeated episodes of illness ... in early detection, more tailored treatments, and possibly prevention of such illnesses. The Working Brain Neurotransmitters Everything ...

  8. Brain Basics

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    Full Text Available ... that contains codes to make proteins and other important body chemicals. DNA also includes information to control ... cells required for normal function and plays an important role during early brain development. It may also ...

  9. Brain Basics

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    Full Text Available ... of the cell from its surrounding environment and controls what enters and leaves the cell, and responds ... via axons) to form brain circuits. These circuits control specific body functions such as sleep and speech. ...

  10. Brain Basics

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    Full Text Available ... in early detection, more tailored treatments, and possibly prevention of such illnesses. The Working Brain Neurotransmitters Everything ... can cause tremors or symptoms found in Parkinson's disease. Serotonin —helps control many functions, such as mood, ...

  11. Brain Basics

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    Full Text Available ... Offices and Divisions Careers@NIMH Advisory Boards and Groups Staff Directories Getting to NIMH National Institutes of ... electrical signals. The brain begins as a small group of cells in the outer layer of a ...

  12. Brain Basics

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    Full Text Available ... These circuits control specific body functions such as sleep and speech. The brain continues maturing well into ... factors that can affect our bodies, such as sleep, diet, or stress. These factors may act alone ...

  13. Diffusion tensor imaging (DTI) findings in adult civilian, military, and sport-related mild traumatic brain injury (mTBI): a systematic critical review.

    Science.gov (United States)

    Asken, Breton Michael; DeKosky, Steven T; Clugston, James R; Jaffee, Michael S; Bauer, Russell M

    2017-03-24

    This review seeks to summarize diffusion tensor imaging (DTI) studies that have evaluated structural changes attributed to the mechanisms of mild traumatic brain injury (mTBI) in adult civilian, military, and athlete populations. Articles from 2002 to 2016 were retrieved from PubMed/MEDLINE, EBSCOhost, and Google Scholar, using a Boolean search string containing the following terms: "diffusion tensor imaging", "diffusion imaging", "DTI", "white matter", "concussion", "mild traumatic brain injury", "mTBI", "traumatic brain injury", and "TBI". We added studies not identified by this method that were found via manually-searched reference lists. We identified 86 eligible studies from English-language journals using, adult, human samples. Studies were evaluated based on duration between injury and DTI assessment, categorized as acute, subacute/chronic, remote mTBI, and repetitive brain trauma considerations. Since changes in brain structure after mTBI can also be affected by other co-occurring medical and demographic factors, we also briefly review DTI studies that have addressed socioeconomic status factors (SES), major depressive disorder (MDD), and attention-deficit hyperactivity disorder (ADHD). The review describes population-specific risks and the complications of clinical versus pathophysiological outcomes of mTBI. We had anticipated that the distinct population groups (civilian, military, and athlete) would require separate consideration, and various aspects of the study characteristics supported this. In general, study results suggested widespread but inconsistent differences in white matter diffusion metrics (primarily fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) following mTBI/concussion. Inspection of study designs and results revealed potential explanations for discrepant DTI findings, such as control group variability, analytic techniques, the manner in which regional differences were reported, and

  14. Patient Characterization Protocols for Psychophysiological Studies of Traumatic Brain Injury and Post-TBI Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Paul E. Rapp

    2013-07-01

    Full Text Available Psychophysiological investigations of traumatic brain injury (TBI are being conducted for several reasons, including the objective of learning more about the underlying physiological mechanisms of the pathological processes that can be initiated by a head injury. Additional goals include the development of objective physiologically based measures that can be used to monitor the response to treatment and to identify minimally symptomatic individuals who are at risk of delayed onset neuropsychiatric disorders following injury. Research programs studying TBI search for relationships between psychophysiological measures, particularly ERP component properties (e.g. timing, amplitude, scalp distribution, and a participant’s clinical condition. Moreover, the complex relationships between brain injury and psychiatric disorders are receiving increased research attention, and ERP technologies are making contributions to this effort. This review has two objectives supporting such research efforts. The first is to review evidence indicating that traumatic brain injury is a significant risk factor for post-injury neuropsychiatric disorders. The second objective is to introduce ERP researchers who are not familiar with neuropsychiatric assessment to the instruments that are available for characterizing traumatic brain injury, post-concussion syndrome, and psychiatric disorders. Specific recommendations within this very large literature are made. We have proceeded on the assumption that, as is typically the case in an ERP laboratory, the investigators are not clinically qualified and that they will not have access to participant medical records.

  15. In vivo characterization of chronic traumatic encephalopathy using [F-18]FDDNP PET brain imaging.

    Science.gov (United States)

    Barrio, Jorge R; Small, Gary W; Wong, Koon-Pong; Huang, Sung-Cheng; Liu, Jie; Merrill, David A; Giza, Christopher C; Fitzsimmons, Robert P; Omalu, Bennet; Bailes, Julian; Kepe, Vladimir

    2015-04-21

    Chronic traumatic encephalopathy (CTE) is an acquired primary tauopathy with a variety of cognitive, behavioral, and motor symptoms linked to cumulative brain damage sustained from single, episodic, or repetitive traumatic brain injury (TBI). No definitive clinical diagnosis for this condition exists. In this work, we used [F-18]FDDNP PET to detect brain patterns of neuropathology distribution in retired professional American football players with suspected CTE (n = 14) and compared results with those of cognitively intact controls (n = 28) and patients with Alzheimer's dementia (AD) (n = 24), a disease that has been cognitively associated with CTE. [F-18]FDDNP PET imaging results in the retired players suggested the presence of neuropathological patterns consistent with models of concussion wherein brainstem white matter tracts undergo early axonal damage and cumulative axonal injuries along subcortical, limbic, and cortical brain circuitries supporting mood, emotions, and behavior. This deposition pattern is distinctively different from the progressive pattern of neuropathology [paired helical filament (PHF)-tau and amyloid-β] in AD, which typically begins in the medial temporal lobe progressing along the cortical default mode network, with no or minimal involvement of subcortical structures. This particular [F-18]FDDNP PET imaging pattern in cases of suspected CTE also is primarily consistent with PHF-tau distribution observed at autopsy in subjects with a history of mild TBI and autopsy-confirmed diagnosis of CTE.

  16. Performance validity test and neuropsychological assessment battery screening module performances in an active-duty sample with a history of concussion.

    Science.gov (United States)

    Grills, Chad E; Armistead-Jehle, Patrick

    2016-01-01

    The current retrospective investigation sought to replicate previous findings demonstrating the significant impact of performance validity test (PVT) performance and evaluation context on neuropsychological testing. We examined differences on performance validity testing between active-duty service members undergoing neurocognitive screening for concussion who were seen in a clinical context and those who were seen in a disability-seeking context, as well as the overall impact of PVT performance on a neurocognitive screening battery. Overall, 38.2% of the sample failed the Word Memory Test (WMT). Of those involved in a disability evaluation, the failure rate was 51.9%, which was significantly higher than the 36.8% failure rate among those evaluated in a clinical context. The effect size of WMT performance on a cognitive screening measure was also large. The current retrospective analysis served to replicate previous work.

  17. Brain death.

    Science.gov (United States)

    Wijdicks, Eelco F M

    2013-01-01

    The diagnosis of brain death should be based on a simple premise. If every possible confounder has been excluded and all possible treatments have been tried or considered, irreversible loss of brain function is clinically recognized as the absence of brainstem reflexes, verified apnea, loss of vascular tone, invariant heart rate, and, eventually, cardiac standstill. This condition cannot be reversed - not even partly - by medical or surgical intervention, and thus is final. Many countries in the world have introduced laws that acknowledge that a patient can be declared brain-dead by neurologic standards. The U.S. law differs substantially from all other brain death legislation in the world because the U.S. law does not spell out details of the neurologic examination. Evidence-based practice guidelines serve as a standard. In this chapter, I discuss the history of development of the criteria, the current clinical examination, and some of the ethical and legal issues that have emerged. Generally, the concept of brain death has been accepted by all major religions. But patients' families may have different ideas and are mostly influenced by cultural attitudes, traditional customs, and personal beliefs. Suggestions are offered to support these families.

  18. IED blast postconcussive syncope and autonomic dysregulation.

    Science.gov (United States)

    Sams, Richard; LaBrie, D Walter; Norris, Jacob; Schauer, Judy; Frantz, Earl

    2012-01-01

    Concussions are the most frequent battle injury sustained in Afghanistan. The Concussion Restoration Care Center provides multidisciplinary care to concussed service members in theater. The Concussion Restoration Care Center has managed over 500 concussions, the majority being from improvised explosive device (IED) blasts. Syncope following a concussion without a loss of consciousness is rarely reported in the literature. The pathophysiology of concussion from a blast injury may be distinct from a concussion secondary to blunt trauma. Two cases of syncope following concussions with an alteration of consciousness are presented, and a mechanism of action is proposed. Post-IED blast concussive symptom frequency at initial presentation on a cohort of patients is reported, with 1.3% of patients experiencing postconcussive syncope. Syncope following an IED blast may be related to centrally mediated autonomic dysregulation at the brain stem level. Syncope should be added to the list of possible symptoms that occur following concussions, in particular concussions following a blast injury.

  19. THE VALVE OF TCD AND EEG FOR PATIENTS WITH BRAIN CONCUSSION%TCD与EEG对脑震荡患者的应用价值

    Institute of Scientific and Technical Information of China (English)

    孙琪

    2012-01-01

    目的:探讨经颅多普乐超声(TCD)和脑电图(EEG)对脑震荡患者的应用价值.方法:对76例脑震荡患者(病例组)和对照组80例正常查体者进行TCD和EEG检查,并分析探讨其特征.结果:脑震荡组TCD异常率为67%,EEG异常率为64%.对照组TCD异常率为15%,EEG异常率为13.5%,脑震荡组与对照组比较差异有显著意义(P<0.01).结论:TCD的应用有助于动态观察脑震荡患者的脑血流变化情况,EEG能客观评价脑震荡病人脑机能状态,两者对伤情变化的判断及预后估计均有重要的临床意义.

  20. Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury: Guidance for the Primary Care Manager in Deployed and Non-deployed Settings (Clinical Support Tool)

    Science.gov (United States)

    2014-01-01

    with provider B. Recommended Parameters for Recovery and Stage 1: Rest • Extremely light basic activities of daily living • Avoid caffeine and tobacco...or smell • Loss of appetite or increased appetite • Poor concentration , can’t pay attention, easily distracted • Forgetfulness, can’t remember

  1. Brain computer

    Directory of Open Access Journals (Sweden)

    Sarah N. Abdulkader

    2015-07-01

    Full Text Available Brain computer interface technology represents a highly growing field of research with application systems. Its contributions in medical fields range from prevention to neuronal rehabilitation for serious injuries. Mind reading and remote communication have their unique fingerprint in numerous fields such as educational, self-regulation, production, marketing, security as well as games and entertainment. It creates a mutual understanding between users and the surrounding systems. This paper shows the application areas that could benefit from brain waves in facilitating or achieving their goals. We also discuss major usability and technical challenges that face brain signals utilization in various components of BCI system. Different solutions that aim to limit and decrease their effects have also been reviewed.

  2. Real-time, whole-brain, temporally resolved pressure responses in translational head impact.

    Science.gov (United States)

    Zhao, Wei; Ji, Songbai

    2016-02-01

    Theoretical debate still exists on the role of linear acceleration ( a lin) on the risk of brain injury. Recent injury metrics only consider head rotational acceleration ( a rot) but not a lin, despite that real-world on-field head impacts suggesting a lin significantly improves a concussion risk function. These controversial findings suggest a practical challenge in integrating theory and real-world experiment. Focusing on tissue-level mechanical responses estimated from finite-element (FE) models of the human head, rather than impact kinematics alone, may help address this debate. However, the substantial computational cost incurred (runtime and hardware) poses a significant barrier for their practical use. In this study, we established a real-time technique to estimate whole-brain a lin-induced pressures. Three hydrostatic atlas pressures corresponding to translational impacts (referred to as 'brain print') along the three major axes were pre-computed. For an arbitrary a lin profile at any instance in time, the atlas pressures were linearly scaled and then superimposed to estimate whole-brain responses. Using 12 publically available, independently measured or reconstructed real-world a lin profiles representative of a range of impact/injury scenarios, the technique was successfully validated (except for one case with an extremely short impulse of approx. 1 ms). The computational cost to estimate whole-brain pressure responses for an entire a lin profile was less than 0.1 s on a laptop versus typically hours on a high-end multicore computer. These findings suggest the potential of the simple, yet effective technique to enable future studies to focus on tissue-level brain responses, rather than solely relying on global head impact kinematics that have plagued early and contemporary brain injury research to date.

  3. Silicon Brains

    Science.gov (United States)

    Hoefflinger, Bernd

    Beyond the digital neural networks of Chap. 16, the more radical mapping of brain-like structures and processes into VLSI substrates has been pioneered by Carver Mead more than 30 years ago [1]. The basic idea was to exploit the massive parallelism of such circuits and to create low-power and fault-tolerant information-processing systems. Neuromorphic engineering has recently seen a revival with the availability of deep-submicron CMOS technology, which allows for the construction of very-large-scale mixed-signal systems combining local analog processing in neuronal cells with binary signalling via action potentials. Modern implementations are able to reach the complexity-scale of large functional units of the human brain, and they feature the ability to learn by plasticity mechanisms found in neuroscience. Combined with high-performance programmable logic and elaborate software tools, such systems are currently evolving into user-configurable non-von-Neumann computing systems, which can be used to implement and test novel computational paradigms. The chapter introduces basic properties of biological brains with up to 200 Billion neurons and their 1014 synapses, where action on a synapse takes ˜10 ms and involves an energy of ˜10 fJ. We outline 10x programs on neuromorphic electronic systems in Europe and the USA, which are intended to integrate 108 neurons and 1012 synapses, the level of a cat's brain, in a volume of 1 L and with a power dissipation design an intelligent technical response.

  4. Robot brains

    NARCIS (Netherlands)

    Babuska, R.

    2011-01-01

    The brain hosts complex networks of neurons that are responsible for behavior in humans and animals that we generally call intelligent. I is not easy to give an exact definition of intelligence – for the purpose of this talk it will suffice to say that we refer to intelligence as a collection of cap

  5. Abnormalities on magnetic resonance imaging seen acutely following mild traumatic brain injury: correlation with neuropsychological tests and delayed recovery

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, David G.; Jackson, Alan [Department of Neuroradiology, Hope Hospital, M6 8HD, Salford (United Kingdom); Mason, Damon L.; Berry, Elizabeth [Department of Behavioural Medicine, Hope Hospital, M6 8HD, Salford (United Kingdom); Hollis, Sally [Medical Statistics Unit, Lancaster University, Lancaster (United Kingdom); Yates, David W. [Department of Emergency Medicine, Hope Hospital, M6 8HD, Salford (United Kingdom)

    2004-07-01

    Mild traumatic brain injury (MTBI) is a common reason for hospital attendance and is associated with significant delayed morbidity. We studied a series of 80 persons with MTBI. Magnetic resonance imaging (MRI) and neuropsychological testing were used in the acute phase and a questionnaire for post-concussion syndrome (PCS) and return to work status at 6 months. In 26 subjects abnormalities were seen on MRI, of which 5 were definitely traumatic. There was weak correlation with abnormal neuropsychological tests for attention in the acute period. There was no significant correlation with a questionnaire for PCS and return to work status. Although non-specific abnormalities are frequently seen, standard MRI techniques are not helpful in identifying patients with MTBI who are likely to have delayed recovery. (orig.)

  6. Angular Impact Mitigation system for bicycle helmets to reduce head acceleration and risk of traumatic brain injury.

    Science.gov (United States)

    Hansen, Kirk; Dau, Nathan; Feist, Florian; Deck, Caroline; Willinger, Rémy; Madey, Steven M; Bottlang, Michael

    2013-10-01

    Angular acceleration of the head is a known cause of traumatic brain injury (TBI), but contemporary bicycle helmets lack dedicated mechanisms to mitigate angular acceleration. A novel Angular Impact Mitigation (AIM) system for bicycle helmets has been developed that employs an elastically suspended aluminum honeycomb liner to absorb linear acceleration in normal impacts as well as angular acceleration in oblique impacts. This study tested bicycle helmets with and without AIM technology to comparatively assess impact mitigation. Normal impact tests were performed to measure linear head acceleration. Oblique impact tests were performed to measure angular head acceleration and neck loading. Furthermore, acceleration histories of oblique impacts were analyzed in a computational head model to predict the resulting risk of TBI in the form of concussion and diffuse axonal injury (DAI). Compared to standard helmets, AIM helmets resulted in a 14% reduction in peak linear acceleration (pbicycle helmet, and may enhance prevention of bicycle-related TBI. Further research is required.

  7. Examination of outcome after mild traumatic brain injury: the contribution of injury beliefs and Leventhal's common sense model.

    Science.gov (United States)

    Snell, Deborah L; Hay-Smith, E Jean C; Surgenor, Lois J; Siegert, Richard J

    2013-01-01

    Associations between components of Leventhal's common sense model of health behaviour (injury beliefs, coping, distress) and outcome after mild traumatic brain injury (MTBI) were examined. Participants (n = 147) were recruited within three months following MTBI and assessed six months later, completing study questionnaires at both visits (Illness Perceptions Questionnaire Revised, Brief COPE, Hospital Anxiety and Depression Scale). Outcome measures included the Rivermead Post-Concussion Symptoms Questionnaire and Rivermead Head Injury Follow-Up Questionnaire. Univariate and multivariate (logistic regression) analyses examined associations between injury beliefs, coping and distress at baseline, and later outcome. Participants endorsing stronger injury identity beliefs (p model. Consistent with Leventhal's model, participant beliefs about their injury and recovery had significant associations with outcome over time. Coping also appeared to have important associations with outcome but more research is required to examine these. Current reassurance-based interventions may be improved by targeting variables such as injury beliefs, coping and adjustment soon after injury.

  8. Brain tumor - children

    Science.gov (United States)

    ... children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children) ... The cause of primary brain tumors is unknown. Primary brain tumors may ... (spread to nearby areas) Cancerous (malignant) Brain tumors ...

  9. Understanding Brain Tumors

    Science.gov (United States)

    ... to Know About Brain Tumors . What is a Brain Tumor? A brain tumor is an abnormal growth
 ... Tumors” from Frankly Speaking Frankly Speaking About Cancer: Brain Tumors Download the full book Questions to ask ...

  10. Brain Tumors (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Brain Tumors KidsHealth > For Parents > Brain Tumors Print A ... radiation therapy or chemotherapy, or both. Types of Brain Tumors There are many different types of brain ...

  11. Brain and Nervous System

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Brain and Nervous System KidsHealth > For Parents > Brain and Nervous System Print ... brain is quite the juggler. Anatomy of the Nervous System If you think of the brain as a ...

  12. Social reintegration of traumatic brain-injured: the French experience.

    Science.gov (United States)

    Truelle, J-L; Wild, K Von; Onillon, M; Montreuil, M

    2010-01-01

    Traumatic Brain Injury (TBI) may lead to specific handicap, often hidden, mainly due to cognitive and behavioural sequelae. Social re-entry is a long-term, fluctuant and precarious process. The French experience will be illustrated by 6 initiatives answering to 6 challenges to do with TBI specificities:1. bridging the gap, between initial rehabilitation and community re-entry, via transitional units dealing with assessment, retraining, social/vocational orientation and follow-up. Today, there are 30 such units based on multidisciplinary teams.2. assessing recovery by TBI-specific and validated evaluation tools: EBIS holistic document, BNI Screening of higher cerebral functions, Glasgow outcome extended, and QOLIBRI, a TBI-specific quality of life tool.3. promoting specific re-entry programmes founded on limited medication, ecological neuro-psychological rehabilitation, exchange groups and workshops, violence prevention, continuity of care, environmental structuration, and "resocialisation".4. taking into account the "head injured family"5. facilitating recovery after sports-related concussion6. facing medico-legal consequences and compensation: In that perspective, we developed guidelines for TBI-specific expert appraisal, including mandatory neuro-psychological assessment, family interview and an annual forum gathering lawyers and health professionals.

  13. Overview of Traumatic Brain Injury: An Immunological Context

    Science.gov (United States)

    Nizamutdinov, Damir; Shapiro, Lee A.

    2017-01-01

    Traumatic brain injury (TBI) afflicts people of all ages and genders, and the severity of injury ranges from concussion/mild TBI to severe TBI. Across all spectrums, TBI has wide-ranging, and variable symptomology and outcomes. Treatment options are lacking for the early neuropathology associated with TBIs and for the chronic neuropathological and neurobehavioral deficits. Inflammation and neuroinflammation appear to be major mediators of TBI outcomes. These systems are being intensively studies using animal models and human translational studies, in the hopes of understanding the mechanisms of TBI, and developing therapeutic strategies to improve the outcomes of the millions of people impacted by TBIs each year. This manuscript provides an overview of the epidemiology and outcomes of TBI, and presents data obtained from animal and human studies focusing on an inflammatory and immunological context. Such a context is timely, as recent studies blur the traditional understanding of an “immune-privileged” central nervous system. In presenting the evidence for specific, adaptive immune response after TBI, it is hoped that future studies will be interpreted using a broader perspective that includes the contributions of the peripheral immune system, to central nervous system disorders, notably TBI and post-traumatic syndromes. PMID:28124982

  14. The Creative Brain.

    Science.gov (United States)

    Herrmann, Ned

    1982-01-01

    Outlines the differences between left-brain and right-brain functioning and between left-brain and right-brain dominant individuals, and concludes that creativity uses both halves of the brain. Discusses how both students and curriculum can become more "whole-brained." (Author/JM)

  15. Brain and Addiction

    Science.gov (United States)

    ... Search Term(s): Teens / Drug Facts / Brain and Addiction Brain and Addiction Print Your Brain Your brain is who you are. It’s what ... solve problems, and make decisions. How Does Your Brain Communicate? The brain is a complex communications network ...

  16. Diffusion MRI: Pitfalls, literature review and future directions of research in mild traumatic brain injury.

    Science.gov (United States)

    Delouche, Aurélie; Attyé, Arnaud; Heck, Olivier; Grand, Sylvie; Kastler, Adrian; Lamalle, Laurent; Renard, Felix; Krainik, Alexandre

    2016-01-01

    Mild traumatic brain injury (mTBI) is a leading cause of disability in adults, many of whom report a distressing combination of physical, emotional and cognitive symptoms, collectively known as post-concussion syndrome, that persist after the injury. Significant developments in magnetic resonance diffusion imaging, involving voxel-based quantitative analysis through the measurement of fractional anisotropy or mean diffusivity, have enhanced our knowledge on the different stages of mTBI pathophysiology. Other diffusion imaging-derived techniques, including diffusion kurtosis imaging with multi-shell diffusion and high-order tractography models, have recently demonstrated their usefulness in mTBI. Our review starts by briefly outlining the physical basis of diffusion tensor imaging including the pitfalls for use in brain trauma, before discussing findings from diagnostic trials testing its usefulness in assessing brain structural changes in patients with mTBI. Use of different post-processing techniques for the diffusion imaging data, identified the corpus callosum as the most frequently injured structure in mTBI, particularly at sub-acute and chronic stages, and a crucial location for evaluating functional outcome. However, structural changes appear too subtle for identification using traditional diffusion biomarkers, thus disallowing expansion of these techniques into clinical practice. In this regard, more advanced diffusion techniques are promising in the assessment of this complex disease.

  17. Quantum Brain?

    CERN Document Server

    Mershin, A; Skoulakis, E M C

    2000-01-01

    In order to create a novel model of memory and brain function, we focus our approach on the sub-molecular (electron), molecular (tubulin) and macromolecular (microtubule) components of the neural cytoskeleton. Due to their size and geometry, these systems may be approached using the principles of quantum physics. We identify quantum-physics derived mechanisms conceivably underlying the integrated yet differentiated aspects of memory encoding/recall as well as the molecular basis of the engram. We treat the tubulin molecule as the fundamental computation unit (qubit) in a quantum-computational network that consists of microtubules (MTs), networks of MTs and ultimately entire neurons and neural networks. We derive experimentally testable predictions of our quantum brain hypothesis and perform experiments on these.

  18. Animating Brains

    Science.gov (United States)

    Borck, Cornelius

    2016-01-01

    A recent paper famously accused the rising field of social neuroscience of using faulty statistics under the catchy title ‘Voodoo Correlations in Social Neuroscience’. This Special Issue invites us to take this claim as the starting point for a cross-cultural analysis: in which meaningful ways can recent research in the burgeoning field of functional imaging be described as, contrasted with, or simply compared to animistic practices? And what light does such a reading shed on the dynamics and effectiveness of a century of brain research into higher mental functions? Reviewing the heated debate from 2009 around recent trends in neuroimaging as a possible candidate for current instances of ‘soul catching’, the paper will then compare these forms of primarily image-based brain research with older regimes, revolving around the deciphering of the brain’s electrical activity. How has the move from a decoding paradigm to a representational regime affected the conceptualisation of self, psyche, mind and soul (if there still is such an entity)? And in what ways does modern technoscience provide new tools for animating brains? PMID:27292322

  19. Myelin Water Fraction Is Transiently Reduced after a Single Mild Traumatic Brain Injury--A Prospective Cohort Study in Collegiate Hockey Players.

    Directory of Open Access Journals (Sweden)

    Alexander D Wright

    Full Text Available Impact-related mild traumatic brain injuries (mTBI are a major public health concern, and remain as one of the most poorly understood injuries in the field of neuroscience. Currently, the diagnosis and management of such injuries are based largely on patient-reported symptoms. An improved understanding of the underlying pathophysiology of mTBI is urgently needed in order to develop better diagnostic and management protocols. Specifically, dynamic post-injury changes to the myelin sheath in the human brain have not been examined, despite 'compromised white matter integrity' often being described as a consequence of mTBI. In this preliminary cohort study, myelin water imaging was used to prospectively evaluate changes in myelin water fraction, derived from the T2 decay signal, in two varsity hockey teams (45 players over one season of athletic competition. 11 players sustained a concussion during competition, and were scanned at 72 hours, 2 weeks, and 2 months post-injury. Results demonstrated a reduction in myelin water fraction at 2 weeks post-injury in several brain areas relative to preseason scans, including the splenium of the corpus callosum, right posterior thalamic radiation, left superior corona radiata, left superior longitudinal fasciculus, and left posterior limb of the internal capsule. Myelin water fraction recovered to pre-season values by 2 months post-injury. These results may indicate transient myelin disruption following a single mTBI, with subsequent remyelination of affected neurons. Myelin disruption was not apparent in the athletes who did not experience a concussion, despite exposure to repetitive subconcussive trauma over a season of collegiate hockey. These findings may help to explain many of the metabolic and neurological deficits observed clinically following mTBI.

  20. Alteration of default mode network in high school football athletes due to repetitive subconcussive mild traumatic brain injury: a resting-state functional magnetic resonance imaging study.

    Science.gov (United States)

    Abbas, Kausar; Shenk, Trey E; Poole, Victoria N; Breedlove, Evan L; Leverenz, Larry J; Nauman, Eric A; Talavage, Thomas M; Robinson, Meghan E

    2015-03-01

    Long-term neurological damage as a result of head trauma while playing sports is a major concern for football athletes today. Repetitive concussions have been linked to many neurological disorders. Recently, it has been reported that repetitive subconcussive events can be a significant source of accrued damage. Since football athletes can experience hundreds of subconcussive hits during a single season, it is of utmost importance to understand their effect on brain health in the short and long term. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) was used to study changes in the default mode network (DMN) after repetitive subconcussive mild traumatic brain injury. Twenty-two high school American football athletes, clinically asymptomatic, were scanned using the rs-fMRI for a single season. Baseline scans were acquired before the start of the season, and follow-up scans were obtained during and after the season to track the potential changes in the DMN as a result of experienced trauma. Ten noncollision-sport athletes were scanned over two sessions as controls. Overall, football athletes had significantly different functional connectivity measures than controls for most of the year. The presence of this deviation of football athletes from their healthy peers even before the start of the season suggests a neurological change that has accumulated over the years of playing the sport. Football athletes also demonstrate short-term changes relative to their own baseline at the start of the season. Football athletes exhibited hyperconnectivity in the DMN compared to controls for most of the sessions, which indicates that, despite the absence of symptoms typically associated with concussion, the repetitive trauma accrued produced long-term brain changes compared to their healthy peers.

  1. Review of the Scientific Evidence of Using Population Normative Values for Post-Concussive Computerized Neurocognitive Assessments

    Science.gov (United States)

    2016-02-10

    currently using at least two NCATs (ANAM and ImPACT) to assess neurocognitive function. There are significant differences in the pricing structure for...Invisible Wounds of War: Psychological and cognitive injuries, their consequences, and services to assist recovery: RAND Center for Military Health...Excellence for Psychological Health and Traumatic Brain Injury. Indications and Conditions for In-Theater Post-Injury Neurocognitive Assessment Tool (NCAT

  2. 2 Kids an Hour Hurt in Strollers, Infant Carriers

    Science.gov (United States)

    ... which is scary considering the fact that traumatic brain injuries (TBIs) and concussions in young children may have ... of stroller injuries were more serious, causing traumatic brain injuries or concussions, the study said. The researchers also ...

  3. Brain glycogen

    DEFF Research Database (Denmark)

    Obel, Linea Lykke Frimodt; Müller, Margit S; Walls, Anne B

    2012-01-01

    activity and memory formation. In line with the great spatiotemporal complexity of the brain and thereof derived focus on the basis for ensuring the availability of the right amount of energy at the right time and place, we here encourage a closer look into the molecular and subcellular mechanisms...... underlying glycogen metabolism. Based on (1) the compartmentation of the interconnected second messenger pathways controlling glycogen metabolism (calcium and cAMP), (2) alterations in the subcellular location of glycogen-associated enzymes and proteins induced by the metabolic status and (3) a sequential...

  4. Neuropsychological test performance of Hawai'i high school athletes: updated Hawai'i immediate post-concussion assessment and cognitive testing data.

    Science.gov (United States)

    Tsushima, William T; Siu, Andrea M

    2014-07-01

    The present study reviewed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline test scores of 247 high school athletes ages 13 to 18 from a private school in Hawai'i. The aim of the research was to update a prior exploratory investigation conducted in 2008 that compared the test scores of Hawai'i public high school athletes with the normative data provided by the ImPACT publishers. The results of this study provide assurance that the present ImPACT scores of the Hawai'i high school athletes are similar to the general ImPACT norms. The present study is a rare effort to compare the ImPACT scores of high school athletes from an ethnically diverse region with the ImPACT norms. The findings offer further support for the use of the ImPACT norms when evaluating high school athletes from Hawai'i. Future research in various regions of the United States and with other sociocultural backgrounds is encouraged.

  5. OCT imaging of acute vascular changes following mild traumatic brain injury in mice (Conference Presentation)

    Science.gov (United States)

    Chico-Calero, Isabel; Shishkov, Milen; Welt, Jonathan; Blatter, Cedric; Vakoc, Benjamin J.

    2016-03-01

    While most people recover completely from mild traumatic brain injuries (mTBIs) and concussions, a subset develop lasting neurological disorders. Understanding the complex pathophysiology of these injuries is critical to developing improved prognostic and therapeutic approaches. Multiple studies have shown that the structure and perfusion of brain vessels are altered after mTBI. It is possible that these vascular injuries contribute to or trigger neurodegeneration. Intravital microscopy and mouse models of TBI offer a powerful platform to study the vascular component of mTBI. Because optical coherence tomography based angiography is based on perfusion contrast and is not significantly degraded by vessel leakage or blood brain barrier disruption, it is uniquely suited to studies of brain perfusion in the setting of trauma. However, existing TBI imaging models require surgical exposure of the brain at the time of injury which conflates TBI-related vascular changes with those caused by surgery. In this work, we describe a modified cranial window preparation based on a flexible, transparent polyurethane membrane. Impact injuries were delivered directly through this membrane, and imaging was performed immediately after injury without the need for additional surgical procedures. Using this model, we demonstrate that mTBI induces a transient cessation of flow in the capillaries and smaller vessels near the injury point. Reperfusion is observed in all animals within 3 hours of injury. This work describes new insight into the transient vascular changes induced by mTBI, and demonstrates more broadly the utility of the OCT/polyurethane window model platform in preclinical studies of mTBI.

  6. Brain Tumor Surgery

    Science.gov (United States)

    ... Meningitis Brain swelling Stroke Excess fluid in the brain Coma Death Recovery Time Recovery time depends on: The procedure performed. The part of the brain where the tumor is/was located. The areas ...

  7. Brain injury - discharge

    Science.gov (United States)

    ... and caregivers. Biausa.org. www.biausa.org/brain-injury-family-caregivers.htm#Manage the Home . Accessed December 8, 2016. ... Caregiver Alliance; National Center on Caregiving. Traumatic brain injury. ... www.caregiver.org/traumatic-brain-injury . Accessed ...

  8. Traumatic Brain Injury

    Science.gov (United States)

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  9. Evaluation of the effectiveness of a novel brain and vestibular rehabilitation treatment modality in PTSD patients who have suffered combat related traumatic brain injuries

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-02-01

    Full Text Available Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a signature injury. Vestibular complaints are the most frequent sequelae of mTBI and vestibular rehabilitation (VR has been established as the most important treatment modality for this group of patients. Material and Methods:We studied the effectiveness of a novel brain and VR treatment PTSD in subjects who had suffered combat related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6. We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS scores pre and post treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%. Results:Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. 41 subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment we observed a large reduction in CAPS severity scores with both statistical and substantive significance. Discussion:Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family and society.

  10. Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Ming-Xiong Huang

    2014-01-01

    Full Text Available Traumatic brain injury (TBI is a leading cause of sustained impairment in military and civilian populations. However, mild TBI (mTBI can be difficult to detect using conventional MRI or CT. Injured brain tissues in mTBI patients generate abnormal slow-waves (1–4 Hz that can be measured and localized by resting-state magnetoencephalography (MEG. In this study, we develop a voxel-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mTBI on a single-subject basis. A normative database of resting-state MEG source magnitude images (1–4 Hz from 79 healthy control subjects was established for all brain voxels. The high-resolution MEG source magnitude images were obtained by our recent Fast-VESTAL method. In 84 mTBI patients with persistent post-concussive symptoms (36 from blasts, and 48 from non-blast causes, our method detected abnormalities at the positive detection rates of 84.5%, 86.1%, and 83.3% for the combined (blast-induced plus with non-blast causes, blast, and non-blast mTBI groups, respectively. We found that prefrontal, posterior parietal, inferior temporal, hippocampus, and cerebella areas were particularly vulnerable to head trauma. The result also showed that MEG slow-wave generation in prefrontal areas positively correlated with personality change, trouble concentrating, affective lability, and depression symptoms. Discussion is provided regarding the neuronal mechanisms of MEG slow-wave generation due to deafferentation caused by axonal injury and/or blockages/limitations of cholinergic transmission in TBI. This study provides an effective way for using MEG slow-wave source imaging to localize affected areas and supports MEG as a tool for assisting the diagnosis of mTBI.

  11. Rapid neuroinflammatory response localized to injured neurons after diffuse traumatic brain injury in swine.

    Science.gov (United States)

    Wofford, Kathryn L; Harris, James P; Browne, Kevin D; Brown, Daniel P; Grovola, Michael R; Mietus, Constance J; Wolf, John A; Duda, John E; Putt, Mary E; Spiller, Kara L; Cullen, D Kacy

    2017-04-01

    Despite increasing appreciation of the critical role that neuroinflammatory pathways play in brain injury and neurodegeneration, little is known about acute microglial reactivity following diffuse traumatic brain injury (TBI) - the most common clinical presentation that includes all concussions. Therefore, we investigated acute microglial reactivity using a porcine model of closed-head rotational velocity/acceleration-induced TBI that closely mimics the biomechanical etiology of inertial TBI in humans. We observed rapid microglial reactivity within 15min of both mild and severe TBI. Strikingly, microglial activation was restrained to regions proximal to individual injured neurons - as denoted by trauma-induced plasma membrane disruption - which served as epicenters of acute reactivity. Single-cell quantitative analysis showed that in areas free of traumatically permeabilized neurons, microglial density and morphology were similar between sham or following mild or severe TBI. However, microglia density increased and morphology shifted to become more reactive in proximity to injured neurons. Microglial reactivity around injured neurons was exacerbated following repetitive TBI, suggesting further amplification of acute neuroinflammatory responses. These results indicate that neuronal trauma rapidly activates microglia in a highly localized manner, and suggest that activated microglia may rapidly influence neuronal stability and/or pathophysiology after diffuse TBI.

  12. Resilience and Other Possible Outcomes After Mild Traumatic Brain Injury: a Systematic Review.

    Science.gov (United States)

    Sullivan, Karen A; Kempe, Chloe B; Edmed, Shannon L; Bonanno, George A

    2016-06-01

    The relation between resilience and mild traumatic brain injury (TBI) outcome has been theorized but empirical studies have been scarce. This systematic review aimed to describe the research in this area. Electronic databases (Medline, CINAHL, PsychINFO, SPORTdiscus, and PILOTS) were searched from inception to August 2015 for studies in which resilience was measured following TBI. The search terms included 'TBI' 'concussion' 'postconcussion' 'resilience' and 'hardiness'. Inclusion criteria were peer reviewed original research reports published in English, human participants aged 18 years and over with brain injury, and an accepted definition of mild TBI. Hand searching of identified articles was also undertaken. Of the 71 studies identified, five studies were accepted for review. These studies were formally assessed for risk of bias by two independent reviewers. Each study carried a risk of bias, most commonly a detection bias, but none were excluded on this basis. A narrative interpretation of the findings was used because the studies reflected fundamental differences in the conceptualization of resilience. No studies employed a trajectory based approach to measure a resilient outcome. In most cases, the eligible studies assessed trait resilience with a scale and used it as a predictor of outcome (postconcussion symptoms). Three of these studies showed that greater trait resilience was associated with better mild TBI outcomes (fewer symptoms). Future research of the adult mild TBI response that predicts a resilient outcome is encouraged. These studies could yield empirical evidence for a resilient, and other possible mild TBI outcomes.

  13. Patient Characterization Protocols for Psychophysiological Studies of Traumatic Brain Injury and Post-TBI Psychiatric Disorders.

    Science.gov (United States)

    Rapp, Paul E; Rosenberg, Brenna M; Keyser, David O; Nathan, Dominic; Toruno, Kevin M; Cellucci, Christopher J; Albano, Alfonso M; Wylie, Scott A; Gibson, Douglas; Gilpin, Adele M K; Bashore, Theodore R

    2013-01-01

    Psychophysiological investigations of traumatic brain injury (TBI) are being conducted for several reasons, including the objective of learning more about the underlying physiological mechanisms of the pathological processes that can be initiated by a head injury. Additional goals include the development of objective physiologically based measures that can be used to monitor the response to treatment and to identify minimally symptomatic individuals who are at risk of delayed-onset neuropsychiatric disorders following injury. Research programs studying TBI search for relationships between psychophysiological measures, particularly ERP (event-related potential) component properties (e.g., timing, amplitude, scalp distribution), and a participant's clinical condition. Moreover, the complex relationships between brain injury and psychiatric disorders are receiving increased research attention, and ERP technologies are making contributions to this effort. This review has two objectives supporting such research efforts. The first is to review evidence indicating that TBI is a significant risk factor for post-injury neuropsychiatric disorders. The second objective is to introduce ERP researchers who are not familiar with neuropsychiatric assessment to the instruments that are available for characterizing TBI, post-concussion syndrome, and psychiatric disorders. Specific recommendations within this very large literature are made. We have proceeded on the assumption that, as is typically the case in an ERP laboratory, the investigators are not clinically qualified and that they will not have access to participant medical records.

  14. High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Charles W. Wilkinson

    2012-02-01

    Full Text Available Studies of traumatic brain injury from all causes have found evidence of chronic hypopituitarism, defined by deficient production of one or more pituitary hormones at least one year after injury, in 25-50% of cases. Most studies found the occurrence of posttraumatic hypopituitarism (PTHP to be unrelated to injury severity. Growth hormone deficiency (GHD and hypogonadism were reported most frequently. Hypopituitarism, and in particular adult GHD, is associated with symptoms that resemble those of PTSD, including fatigue, anxiety, depression, irritability, insomnia, sexual dysfunction, cognitive deficiencies, and decreased quality of life. However, the prevalence of PTHP after blast-related mild TBI (mTBI, an extremely common injury in modern military operations, has not been characterized. We measured concentrations of 12 pituitary and target-organ hormones in two groups of male US Veterans of combat in Iraq or Afghanistan. One group consisted of participants with blast-related mTBI whose last blast exposure was at least one year prior to the study. The other consisted of Veterans with similar military deployment histories but without blast exposure. Eleven of 26, or 42% of participants with blast concussions were found to have abnormal hormone levels in one or more pituitary axes, a prevalence similar to that found in other forms of TBI. Five members of the mTBI group were found with markedly low age-adjusted insulin-like growth factor-I (IGF-I levels indicative of probable GHD, and three had testosterone and gonadotropin concentrations consistent with hypogonadism. If symptoms characteristic of both PTHP and PTSD can be linked to pituitary dysfunction, they may be amenable to treatment with hormone replacement. Routine screening for chronic hypopituitarism after blast concussion shows promise for appropriately directing diagnostic and therapeutic decisions that otherwise may remain unconsidered and for markedly facilitating recovery and

  15. Mild traumatic brain injury with social defeat stress alters anxiety, contextual fear extinction, and limbic monoamines in adult rats

    Directory of Open Access Journals (Sweden)

    Daniel eDavies

    2016-04-01

    Full Text Available Mild traumatic brain injury (mTBI produces symptoms similar to those typifying posttraumatic stress disorder (PTSD in humans. We sought to determine whether a rodent model of stress concurrent with mTBI produces characteristics of PTSD such as impaired contextual fear extinction, while also examining concurrent alterations to limbic monoamine activity in brain regions relevant to fear and anxiety states. Male rats were exposed to social stress or control conditions immediately prior to mTBI induction, and 6 days later were tested either for anxiety-like behavior using the elevated plus maze (EPM, or for contextual fear conditioning and extinction. Brains were collected 24 hr after EPM testing, and tissue from various limbic regions analyzed for content of monoamines, their precursors and metabolites using HPLC with electrochemical detection. Either social defeat or mTBI alone decreased time spent in open arms of the EPM, indicating greater anxiety-like behavior. However, this effect was enhanced by the combination of treatments. Further, rats exposed to both social defeat and mTBI exhibited greater freezing within extinction sessions compared to all other groups, suggesting impaired contextual fear extinction. Social defeat combined with mTBI also had greater effects on limbic monoamines than either insult alone, particularly with respect to serotonergic effects associated with anxiety and fear learning. The results suggest social stress concurrent with mTBI produces provides a relevant animal model for studying the prevention and treatment of post-concussive psychobiological outcomes.

  16. Imaging brain development: the adolescent brain.

    Science.gov (United States)

    Blakemore, Sarah-Jayne

    2012-06-01

    The past 15 years have seen a rapid expansion in the number of studies using neuroimaging techniques to investigate maturational changes in the human brain. In this paper, I review MRI studies on structural changes in the developing brain, and fMRI studies on functional changes in the social brain during adolescence. Both MRI and fMRI studies point to adolescence as a period of continued neural development. In the final section, I discuss a number of areas of research that are just beginning and may be the subject of developmental neuroimaging in the next twenty years. Future studies might focus on complex questions including the development of functional connectivity; how gender and puberty influence adolescent brain development; the effects of genes, environment and culture on the adolescent brain; development of the atypical adolescent brain; and implications for policy of the study of the adolescent brain.

  17. Brain AVM (Arteriovenous Malformation)

    Science.gov (United States)

    ... a brain scan for another health issue or after the blood vessels rupture and cause bleeding in the brain (hemorrhage). Once diagnosed, a brain AVM can often be treated successfully to prevent complications, such as brain damage or stroke. Find out why Mayo Clinic is the best ...

  18. Brain and Nervous System

    Science.gov (United States)

    ... the left side; when you're listening to music, you're using the right side. It's believed that some people are more "right-brained" or "left-brained" while others are more "whole-brained," meaning they use both halves of their brain to the same degree. The outer layer of ...

  19. The salutary effects of DHA dietary supplementation on cognition, neuroplasticity, and membrane homeostasis after brain trauma.

    Science.gov (United States)

    Wu, Aiguo; Ying, Zhe; Gomez-Pinilla, Fernando

    2011-10-01

    The pathology of traumatic brain injury (TBI) is characterized by the decreased capacity of neurons to metabolize energy and sustain synaptic function, likely resulting in cognitive and emotional disorders. Based on the broad nature of the pathology, we have assessed the potential of the omega-3 fatty acid docosahexaenoic acid (DHA) to counteract the effects of concussive injury on important aspects of neuronal function and cognition. Fluid percussion injury (FPI) or sham injury was performed, and rats were then maintained on a diet high in DHA (1.2% DHA) for 12 days. We found that DHA supplementation, which elevates brain DHA content, normalized levels of brain-derived neurotrophic factor (BDNF), synapsin I (Syn-1), cAMP-responsive element-binding protein (CREB), and calcium/calmodulin-dependent kinase II (CaMKII), and improved learning ability in FPI rats. It is known that BDNF facilitates synaptic transmission and learning ability by modulating Syn-I, CREB, and CaMKII signaling. The DHA diet also counteracted the FPI-reduced manganese superoxide dismutase (SOD) and Sir2 (a NAD+-dependent deacetylase). Given the involvement of SOD and Sir2 in promoting metabolic homeostasis, DHA may help the injured brain by providing resistance to oxidative stress. Furthermore, DHA normalized levels of calcium-independent phospholipase A2 (iPLA2) and syntaxin-3, which may help preserve membrane homeostasis and function after FPI. The overall results emphasize the potential of dietary DHA to counteract broad and fundamental aspects of TBI pathology that may translate into preserved cognitive capacity.

  20. Inhibition and Brain Work

    OpenAIRE

    Buzsáki, György; Kaila, Kai; Raichle, Marcus

    2007-01-01

    The major part of the brain’s energy budget (~60%–80%) is devoted to its communication activities. While inhibition is critical to brain function, relatively little attention has been paid to its metabolic costs. Understanding how inhibitory interneurons contribute to brain energy consumption (brain work) is not only of interest in understanding a fundamental aspect of brain function but also in understanding functional brain imaging techniques which rely on measurements related to blood flow...

  1. Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease.

    Science.gov (United States)

    Hayes, Jasmeet P; Logue, Mark W; Sadeh, Naomi; Spielberg, Jeffrey M; Verfaellie, Mieke; Hayes, Scott M; Reagan, Andrew; Salat, David H; Wolf, Erika J; McGlinchey, Regina E; Milberg, William P; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

    2017-01-11

    Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance

  2. Epidemiology of Brain Tumors.

    Science.gov (United States)

    McNeill, Katharine A

    2016-11-01

    Brain tumors are the commonest solid tumor in children, leading to significant cancer-related mortality. Several hereditary syndromes associated with brain tumors are nonfamilial. Ionizing radiation is a well-recognized risk factor for brain tumors. Several industrial exposures have been evaluated for a causal association with brain tumor formation but the results are inconclusive. A casual association between the common mutagens of tobacco, alcohol, or dietary factors has not yet been established. There is no clear evidence that the incidence of brain tumors has changed over time. This article presents the descriptive epidemiology of the commonest brain tumors of children and adults.

  3. Biomechanics of the brain

    CERN Document Server

    Miller, Karol

    2011-01-01

    With contributions from scientists at major institutions, this book presents an introduction to brain anatomy for engineers and scientists. It provides, for the first time, a comprehensive resource in the field of brain biomechanics.

  4. Mild Traumatic Brain Injury

    Science.gov (United States)

    ... Videos mild Traumatic Brain Injury 94447 reads Please Log in You must be logged in to access ... Brain Injury (DCoE) to promote the processes of building resilience, facilitating recovery and supporting reintegration of returning ...

  5. Brain aneurysm repair

    Science.gov (United States)

    ... aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm ... Your scalp, skull, and the coverings of the brain are opened. A metal clip is placed at ...

  6. Aneurysm in the brain

    Science.gov (United States)

    ... aneurysms Medical problems such as polycystic kidney disease , coarctation of the aorta , and endocarditis High blood pressure, ... Read More Aneurysm Brain aneurysm repair Brain surgery Coarctation of the aorta Endovascular embolization Epilepsy - overview Incidence ...

  7. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... Cancer Foundation joins the PBTF Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  8. Genetic Brain Disorders

    Science.gov (United States)

    A genetic brain disorder is caused by a variation or a mutation in a gene. A variation is a different form ... mutation is a change in a gene. Genetic brain disorders affect the development and function of the ...

  9. Childhood Brain Tumors

    Science.gov (United States)

    Brain tumors are abnormal growths inside the skull. They are among the most common types of childhood ... still be serious. Malignant tumors are cancerous. Childhood brain and spinal cord tumors can cause headaches and ...

  10. Brain cancer spreads.

    Science.gov (United States)

    Perryman, Lara; Erler, Janine T

    2014-07-30

    The discovery that ~20% of patients with brain cancer have circulating tumor cells breaks the dogma that these cells are confined to the brain and has important clinical implications (Müller et al., this issue).

  11. Brain Death Determination.

    Science.gov (United States)

    Spinello, Irene M

    2015-09-01

    In the United States, each year 1% to 2% of deaths are brain deaths. Considerable variation in the practice of determining brain death still remains, despite the publication of practice parameters in 1995 and an evidence-based guideline update in 2010. This review is intended to give bedside clinicians an overview of definition, the causes and pitfalls of misdiagnosing brain death, and a focus on the specifics of the brain death determination process.

  12. Brain cancer spreads

    DEFF Research Database (Denmark)

    Perryman, Lara; Erler, Janine Terra

    2014-01-01

    The discovery that ~20% of patients with brain cancer have circulating tumor cells breaks the dogma that these cells are confined to the brain and has important clinical implications (Müller et al., this issue).......The discovery that ~20% of patients with brain cancer have circulating tumor cells breaks the dogma that these cells are confined to the brain and has important clinical implications (Müller et al., this issue)....

  13. Brain-Actuated Interaction

    OpenAIRE

    Millán, José del R.; Renkens, F.; Mouriño, J.; Gerstner, W.

    2004-01-01

    Over the last years evidence has accumulated that shows the possibility to analyze human brain activity on-line and translate brain states into actions such as selecting a letter from a virtual keyboard or moving a robotics device. These initial results have been obtained with either invasive approaches (requiring surgical implantation of electrodes) or synchronous protocols (where brain signals are time-locked to external cues). In this paper we describe a portable noninvasive brain-computer...

  14. Primary lymphoma of the brain

    Science.gov (United States)

    Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain ... The cause of primary brain lymphoma is not known. People with a weakened immune system are at high risk for primary lymphoma of the brain. ...

  15. The connected brain

    NARCIS (Netherlands)

    van den Heuvel, M.P.

    2009-01-01

    The connected brain Martijn van den Heuvel, 2009 Our brain is a network. It is a network of different brain regions that are all functionally and structurally linked to each other. In the past decades, neuroimaging studies have provided a lot of information about the specific functions of each separ

  16. Study of neurometabolic and behavioral alterations in rodent model of mild traumatic brain injury: a pilot study.

    Science.gov (United States)

    Singh, Kavita; Trivedi, Richa; Haridas, Seenu; Manda, Kailash; Khushu, Subash

    2016-12-01

    Mild traumatic brain injury (mTBI) is the most common form of TBI (70-90%) with consequences of anxiety-like behavioral alterations in approximately 23% of mTBI cases. This study aimed to assess whether mTBI-induced anxiety-like behavior is a consequence of neurometabolic alterations. mTBI was induced using a weight drop model to simulate mild human brain injury in rodents. Based on injury induction and dosage of anesthesia, four animal groups were included in this study: (i) injury with anesthesia (IA); (ii) sham1 (injury only, IO); (iii) sham2 (only anesthesia, OA); and (iv) control rats. After mTBI, proton magnetic resonance spectroscopy ((1) H-MRS) and neurobehavioral analysis were performed in these groups. At day 5, reduced taurine (Tau)/total creatine (tCr, creatine and phosphocreatine) levels in cortex were observed in the IA and IO groups relative to the control. These groups showed mTBI-induced anxiety-like behavior with normal cognition at day 5 post-injury. An anxiogenic effect of repeated dosage of anesthesia in OA rats was observed with normal Tau/tCr levels in rat cortex, which requires further examination. In conclusion, this mTBI model closely mimics human concussion injury with anxiety-like behavior and normal cognition. Reduced cortical Tau levels may provide a putative neurometabolic basis of anxiety-like behavior following mTBI.

  17. Traumatic Brain and Spinal Cord Fatalities Among High School and College Football Players - United States, 2005-2014.

    Science.gov (United States)

    Kucera, Kristen L; Yau, Rebecca K; Register-Mihalik, Johna; Marshall, Stephen W; Thomas, Leah C; Wolf, Susanne; Cantu, Robert C; Mueller, Frederick O; Guskiewicz, Kevin M

    2017-01-06

    An estimated 1.1 million high school and 75,000 college athletes participate in tackle football annually in the United States. Football is a collision sport; traumatic injuries are frequent (1,2), and can be fatal (3). This report updates the incidence and characteristics of deaths caused by traumatic brain injury and spinal cord injury (4) in high school and college football and presents illustrative case descriptions. Information was analyzed from the National Center for Catastrophic Sport Injury Research (NCCSIR). During 2005-2014, a total of 28 deaths (2.8 deaths per year) from traumatic brain and spinal cord injuries occurred among high school (24 deaths) and college football players (four deaths) combined. Most deaths occurred during competitions and resulted from tackling or being tackled. All four of the college deaths and 14 (58%) of the 24 high school deaths occurred during the last 5 years (2010-2014) of the 10-year study period. These findings support the need for continued surveillance and safety efforts (particularly during competition) to ensure proper tackling techniques, emergency planning for severe injuries, availability of medical care onsite during competitions, and assessment that it is safe to return to play following a concussion.

  18. Preinjury resilience and mood as predictors of early outcome following mild traumatic brain injury.

    Science.gov (United States)

    McCauley, Stephen R; Wilde, Elisabeth A; Miller, Emmy R; Frisby, Melissa L; Garza, Hector M; Varghese, Reni; Levin, Harvey S; Robertson, Claudia S; McCarthy, James J

    2013-04-15

    There is significant heterogeneity in outcomes following mild traumatic brain injury (mTBI). While several host factors (age, gender, and preinjury psychiatric history) have been investigated, the influence of preinjury psychological resilience and mood status in conjunction with mild TBI remains relatively unexplored. Euthymic mood and high resilience are potentially protective against anxiety and postconcussion symptoms, but their relative contributions are currently unknown. This prospective study obtained preinjury estimates of resilience and mood measures in addition to measures of anxiety (Acute Stress Disorder Scale and PTSD-Checklist-Civilian form) and postconcussion symptom severity (Rivermead Post Concussion Symptoms Questionnaire) resilience or mood status at baseline, but differed significantly on measures of anxiety and postconcussion symptom severity at each subsequent study occasion. Multivariate linear regression analyses were conducted to determine if preinjury resilience and mood were significant contributors to anxiety and postconcussion symptoms during the first month postinjury after accounting for other known host factors (e.g., age at injury, gender, and education). Injury group and preinjury mood status were significant predictors for all three dependent variables at each study occasion (all presilience showed a positive trend only for acute stress severity at baseline, but demonstrated significant prediction of all three dependent measures at one week and one month postinjury. These results suggest that preinjury depressed mood and resilience are significant contributors to the severity of postinjury anxiety and postconcussion symptoms, even after accounting for effects of other specific host factors.

  19. Best practice guidelines for forensic neuropsychological examinations of patients with traumatic brain injury.

    Science.gov (United States)

    Ruff, Ronald

    2009-01-01

    Forensic examiners generally agree that their contributions to the forensic process have to be based on scientific principles, high ethical values, and sound clinical skills and judgment. In part I, the challenges of maintaining high ethical standards as a scientist-practitioner are addressed. In part II, the scientific strengths and weaknesses of our neuropsychological assessments are explored within the context of the 4 articles published in this issue. Specifically, Wood points out that while most traumatic brain injuries (TBIs) compromise the prefrontal cortex (PFC), traditional neuropsychological examinations do not fully capture to what extent PFC damage disrupts cognitive, emotional, and social regulation. New advances in clinical neuroscience are presented to facilitate a more detailed understanding of PFC functioning. Schwarz et al examine how clinical neuropsychology services can adequately handle forensic consultations. Frederick and Bowden, meanwhile, identify the persistent weaknesses of various Symptom Validity Tests in reliably classifying poor effort and malingering. Bailey et al conclude that the findings from sport concussion studies cannot be generalized to clinical populations, who, as a rule, have more premorbid and comorbid vulnerabilities. Finally, part III provides guidelines based on the introductory article by Bigler and Brooks, as well as a synopsis of the main conclusions offered by the contributors in this journal issue. Guidelines for both the diagnosis of mild TBI and the diagnosis of postconcussional disorder are included.

  20. Hyperbaric oxygen in chronic traumatic brain injury: oxygen, pressure, and gene therapy.

    Science.gov (United States)

    Harch, Paul G

    2015-01-01

    Hyperbaric oxygen therapy is a treatment for wounds in any location and of any duration that has been misunderstood for 353 years. Since 2008 it has been applied to the persistent post-concussion syndrome of mild traumatic brain injury by civilian and later military researchers with apparent conflicting results. The civilian studies are positive and the military-funded studies are a mixture of misinterpreted positive data, indeterminate data, and negative data. This has confused the medical, academic, and lay communities. The source of the confusion is a fundamental misunderstanding of the definition, principles, and mechanisms of action of hyperbaric oxygen therapy. This article argues that the traditional definition of hyperbaric oxygen therapy is arbitrary. The article establishes a scientific definition of hyperbaric oxygen therapy as a wound-healing therapy of combined increased atmospheric pressure and pressure of oxygen over ambient atmospheric pressure and pressure of oxygen whose main mechanisms of action are gene-mediated. Hyperbaric oxygen therapy exerts its wound-healing effects by expression and suppression of thousands of genes. The dominant gene actions are upregulation of trophic and anti-inflammatory genes and down-regulation of pro-inflammatory and apoptotic genes. The combination of genes affected depends on the different combinations of total pressure and pressure of oxygen. Understanding that hyperbaric oxygen therapy is a pressure and oxygen dose-dependent gene therapy allows for reconciliation of the conflicting TBI study results as outcomes of different doses of pressure and oxygen.

  1. Brain emotional learning based Brain Computer Interface

    Directory of Open Access Journals (Sweden)

    Abdolreza Asadi Ghanbari

    2012-09-01

    Full Text Available A brain computer interface (BCI enables direct communication between a brain and a computer translating brain activity into computer commands using preprocessing, feature extraction and classification operations. Classification is crucial as it has a substantial effect on the BCI speed and bit rate. Recent developments of brain-computer interfaces (BCIs bring forward some challenging problems to the machine learning community, of which classification of time-varying electrophysiological signals is a crucial one. Constructing adaptive classifiers is a promising approach to deal with this problem. In this paper, we introduce adaptive classifiers for classify electroencephalogram (EEG signals. The adaptive classifier is brain emotional learning based adaptive classifier (BELBAC, which is based on emotional learning process. The main purpose of this research is to use a structural model based on the limbic system of mammalian brain, for decision making and control engineering applications. We have adopted a network model developed by Moren and Balkenius, as a computational model that mimics amygdala, orbitofrontal cortex, thalamus, sensory input cortex and generally, those parts of the brain thought responsible for processing emotions. The developed method was compared with other methods used for EEG signals classification (support vector machine (SVM and two different neural network types (MLP, PNN. The result analysis demonstrated an efficiency of the proposed approach.

  2. The Blue Collar Brain

    Directory of Open Access Journals (Sweden)

    Guy eVan Orden

    2012-06-01

    Full Text Available Much effort has gone into elucidating control of the body by the brain, less so the role of the body in controlling the brain. This essay develops the idea that the brain does a great deal of work in the service of behavior that is controlled by the body, a blue collar role compared to the white collar control exercised by the body. The argument that supports a blue collar role for the brain is also consistent with recent discoveries clarifying the white collar role of synergies across the body's tensegrity structure, and the evidence of critical phenomena in brain and behavior.

  3. Neuroradiology of the Brain.

    Science.gov (United States)

    Yeager, Susan

    2016-03-01

    A variety of imaging modalities are currently used to evaluate the brain. Prior to the 1970s, neurologic imaging involved radiographs, invasive procedures for spinal and carotid artery air and contrast injection, and painful patient manipulation. The brain was considered inaccessible to imaging and referred to as "the dark continent." Since then, advances in neuroradiology have moved the brain from being a dark continent to evaluation techniques that illuminate brain contents and pathology. These advances enable quick acquisition of images for prompt diagnosis and treatment. This article reviews anatomy, diagnostic principles, and clinical application of brain imaging beyond plain radiographs.

  4. Instant BrainShark

    CERN Document Server

    Li, Daniel

    2013-01-01

    Filled with practical, step-by-step instructions and clear explanations for the most important and useful tasks. ""Instant BrainShark"" is a step-by-step guide to creating online presentations using BrainShark. The book covers digital marketing best practices alongside tips for sales conversions. The book is written in an easy-to-read style for anybody to easily pick up and get started with BrainShark.Instant BrainShark is for anyone who wants to use BrainShark to create presentations online and share them around the community. The book is also useful for developers who are looking to explore

  5. Motor, Visual and Emotional Deficits in Mice after Closed-Head Mild Traumatic Brain Injury Are Alleviated by the Novel CB2 Inverse Agonist SMM-189

    Directory of Open Access Journals (Sweden)

    Anton Reiner

    2014-12-01

    Full Text Available We have developed a focal blast model of closed-head mild traumatic brain injury (TBI in mice. As true for individuals that have experienced mild TBI, mice subjected to 50–60 psi blast show motor, visual and emotional deficits, diffuse axonal injury and microglial activation, but no overt neuron loss. Because microglial activation can worsen brain damage after a concussive event and because microglia can be modulated by their cannabinoid type 2 receptors (CB2, we evaluated the effectiveness of the novel CB2 receptor inverse agonist SMM-189 in altering microglial activation and mitigating deficits after mild TBI. In vitro analysis indicated that SMM-189 converted human microglia from the pro-inflammatory M1 phenotype to the pro-healing M2 phenotype. Studies in mice showed that daily administration of SMM-189 for two weeks beginning shortly after blast greatly reduced the motor, visual, and emotional deficits otherwise evident after 50–60 psi blasts, and prevented brain injury that may contribute to these deficits. Our results suggest that treatment with the CB2 inverse agonist SMM-189 after a mild TBI event can reduce its adverse consequences by beneficially modulating microglial activation. These findings recommend further evaluation of CB2 inverse agonists as a novel therapeutic approach for treating mild TBI.

  6. Motor, visual and emotional deficits in mice after closed-head mild traumatic brain injury are alleviated by the novel CB2 inverse agonist SMM-189.

    Science.gov (United States)

    Reiner, Anton; Heldt, Scott A; Presley, Chaela S; Guley, Natalie H; Elberger, Andrea J; Deng, Yunping; D'Surney, Lauren; Rogers, Joshua T; Ferrell, Jessica; Bu, Wei; Del Mar, Nobel; Honig, Marcia G; Gurley, Steven N; Moore, Bob M

    2014-12-31

    We have developed a focal blast model of closed-head mild traumatic brain injury (TBI) in mice. As true for individuals that have experienced mild TBI, mice subjected to 50-60 psi blast show motor, visual and emotional deficits, diffuse axonal injury and microglial activation, but no overt neuron loss. Because microglial activation can worsen brain damage after a concussive event and because microglia can be modulated by their cannabinoid type 2 receptors (CB2), we evaluated the effectiveness of the novel CB2 receptor inverse agonist SMM-189 in altering microglial activation and mitigating deficits after mild TBI. In vitro analysis indicated that SMM-189 converted human microglia from the pro-inflammatory M1 phenotype to the pro-healing M2 phenotype. Studies in mice showed that daily administration of SMM-189 for two weeks beginning shortly after blast greatly reduced the motor, visual, and emotional deficits otherwise evident after 50-60 psi blasts, and prevented brain injury that may contribute to these deficits. Our results suggest that treatment with the CB2 inverse agonist SMM-189 after a mild TBI event can reduce its adverse consequences by beneficially modulating microglial activation. These findings recommend further evaluation of CB2 inverse agonists as a novel therapeutic approach for treating mild TBI.

  7. Whither brain death?

    Science.gov (United States)

    Bernat, James L

    2014-01-01

    The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public.

  8. Study of degrees of brain network in patients with postconcussion syndrome%脑震荡综合征患者脑网络的度属性研究

    Institute of Scientific and Technical Information of China (English)

    彭楠; 傅先明; 钱若兵; 李顺利; 亢志强; 林彬; 季学兵; 魏祥品; 牛朝诗

    2015-01-01

    目的 应用脑网络中的度属性探讨脑震荡综合征患者脑功能的变化. 方法 选择自2013年6月至2015年3月在安徽医科大学附属省立医院就诊的脑震荡综合征患者28例为患者组,同期招募23例年龄、性别、文化程度与患者组相匹配的正常被试为对照组.采集2组成员功能MRI(fMRI)数据,应用GRETNA中网络结构模块进行数据预处理得到脑网络矩阵,网络分析模块分析得到脑网络的度属性,再将度属性的结果行统计学比较以得到有差异的脑区. 结果 患者组成员与对照相比,左侧背外侧额上回、左侧后扣带回、左侧海马、左侧缘上回、左侧角回、右侧后扣带回、右侧缘上回、右侧楔前叶、右侧颞上回、右侧丘脑的度属性差异有统计学意义(P<0.05).结论 脑震荡综合征患者相关脑区的度属性改变可能是脑震荡后脑功能障碍的原因之一.%Objective To discuss the changes of brain functions in patients with post-concussion symptoms by evaluating degrees of brain network.Methods Twenty-eight patients with concussion for 3 months,admitted to our hospital from June 2013 to March 2015,and 23 volunteers paired in gender,age and education (healthy controls) were enrolled.The data were dealt with Network Construction,which was a part of GRETNA to obtain the Martix of brain network.Network Analysis was used to obtain degrees of brain network,and then,independent t-test was used to compare the degrees for significant brain regions.Results The degrees of brain regions with significant difference included left superior frontal gyrus,left posterior cingulate cortex,left hippocampus,left supramarginal gyrus,left angular gyrus,right posterior cingulate cortex,right supramarginal gyrus,right precuneus,right superior temporal gyrus and right thalamus as compared with those in healthy controls.Conclusions The changes of degrees in brain network may cause brain function deficits in patients with post-concussion

  9. Brain size, sex, and the aging brain.

    Science.gov (United States)

    Jäncke, Lutz; Mérillat, Susan; Liem, Franziskus; Hänggi, Jürgen

    2015-01-01

    This study was conducted to examine the statistical influence of brain size on cortical, subcortical, and cerebellar compartmental volumes. This brain size influence was especially studied to delineate interactions with Sex and Age. Here, we studied 856 healthy subjects of which 533 are classified as young and 323 as old. Using an automated segmentation procedure cortical (gray and white matter [GM and WM] including the corpus callosum), cerebellar (GM and WM), and subcortical (thalamus, putamen, pallidum, caudatus, hippocampus, amygdala, and accumbens) volumes were measured and subjected to statistical analyses. These analyses revealed that brain size and age exert substantial statistical influences on nearly all compartmental volumes. Analyzing the raw compartmental volumes replicated the frequently reported Sex differences in compartmental volumes with men showing larger volumes. However, when statistically controlling for brain size Sex differences and Sex × Age interactions practically disappear. Thus, brain size is more important than Sex in explaining interindividual differences in compartmental volumes. The influence of brain size is discussed in the context of an allometric scaling of the compartmental volumes.

  10. Brain iron homeostasis.

    Science.gov (United States)

    Moos, Torben

    2002-11-01

    Iron is essential for virtually all types of cells and organisms. The significance of the iron for brain function is reflected by the presence of receptors for transferrin on brain capillary endothelial cells. The transport of iron into the brain from the circulation is regulated so that the extraction of iron by brain capillary endothelial cells is low in iron-replete conditions and the reverse when the iron need of the brain is high as in conditions with iron deficiency and during development of the brain. Whereas there is good agreement that iron is taken up by means of receptor-mediated uptake of iron-transferrin at the brain barriers, there are contradictory views on how iron is transported further on from the brain barriers and into the brain extracellular space. The prevailing hypothesis for transport of iron across the BBB suggests a mechanism that involves detachment of iron from transferrin within barrier cells followed by recycling of apo-transferrin to blood plasma and release of iron as non-transferrin-bound iron into the brain interstitium from where the iron is taken up by neurons and glial cells. Another hypothesis claims that iron-transferrin is transported into the brain by means of transcytosis through the BBB. This thesis deals with the topic "brain iron homeostasis" defined as the attempts to maintain constant concentrations of iron in the brain internal environment via regulation of iron transport through brain barriers, cellular iron uptake by neurons and glia, and export of iron from brain to blood. The first part deals with transport of iron-transferrin complexes from blood to brain either by transport across the brain barriers or by uptake and retrograde axonal transport in motor neurons projecting beyond the blood-brain barrier. The transport of iron and transport into the brain was examined using radiolabeled iron-transferrin. Intravenous injection of [59Fe-125]transferrin led to an almost two-fold higher accumulation of 59Fe than of

  11. Handbook of Brain Connectivity

    CERN Document Server

    Jirsa, Viktor K

    2007-01-01

    Our contemporary understanding of brain function is deeply rooted in the ideas of the nonlinear dynamics of distributed networks. Cognition and motor coordination seem to arise from the interactions of local neuronal networks, which themselves are connected in large scales across the entire brain. The spatial architectures between various scales inevitably influence the dynamics of the brain and thereby its function. But how can we integrate brain connectivity amongst these structural and functional domains? Our Handbook provides an account of the current knowledge on the measurement, analysis and theory of the anatomical and functional connectivity of the brain. All contributors are leading experts in various fields concerning structural and functional brain connectivity. In the first part of the Handbook, the chapters focus on an introduction and discussion of the principles underlying connected neural systems. The second part introduces the currently available non-invasive technologies for measuring struct...

  12. Brain-gut interactions.

    OpenAIRE

    Bonaz, Bruno

    1994-01-01

    International audience; Our digestive tract has an autonomous functioning but also has a bidirectional relation with our brain known as brain-gut interactions. This communication is mediated by the autonomous nervous system, i.e., the sympathetic and parasympathetic nervous systems, with a mixed afferent and efferent component, and the circumventricular organs located outside the blood-brain barrier. The vagus nerve, known as the principal component of the parasympathetic nervous system, is a...

  13. Consciousness, brain, neuroplasticity

    OpenAIRE

    Askenasy, Jean; Lehmann, Joseph

    2013-01-01

    Subjectivity, intentionality, self-awareness and will are major components of consciousness in human beings. Changes in consciousness and its content following different brain processes and malfunction have long been studied. Cognitive sciences assume that brain activities have an infrastructure, but there is also evidence that consciousness itself may change this infrastructure. The two-way influence between brain and consciousness has been at the center of philosophy and less so, of science...

  14. Consciousness, brain, neuroplasticity.

    Science.gov (United States)

    Askenasy, Jean; Lehmann, Joseph

    2013-01-01

    Subjectivity, intentionality, self-awareness and will are major components of consciousness in human beings. Changes in consciousness and its content following different brain processes and malfunction have long been studied. Cognitive sciences assume that brain activities have an infrastructure, but there is also evidence that consciousness itself may change this infrastructure. The two-way influence between brain and consciousness has been at the center of philosophy and less so, of science. This so-called bottom-up and top-down interrelationship is controversial and is the subject of our article. We would like to ask: how does it happen that consciousness may provoke structural changes in the brain? The living brain means continuous changes at the synaptic level with every new experience, with every new process of learning, memorizing or mastering new and existing skills. Synapses are generated and dissolved, while others are preserved, in an ever-changing process of so-called neuroplasticity. Ongoing processes of synaptic reinforcements and decay occur during wakefulness when consciousness is present, but also during sleep when it is mostly absent. We suggest that consciousness influences brain neuroplasticity both during wakefulness as well as sleep in a top-down way. This means that consciousness really activates synaptic flow and changes brain structures and functional organization. The dynamic impact of consciousness on brain never stops despite the relative stationary structure of the brain. Such a process can be a target for medical intervention, e.g., by cognitive training.

  15. Consciousness, brain, neuroplasticity

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Marcel Askenasy

    2013-07-01

    Full Text Available Subjectivity, intentionality, self-awareness and will are major components of consciousness in human beings. Changes in consciousness and its content following different brain processes and malfunction have long been studied. Cognitive sciences assume that brain activities have an infrastructure, but there is also evidence that consciousness itself may change this infrastructure. The two-way influence between brain and consciousness has been at the center of philosophy and less so, of science. This so-called bottom-up and top-down interrelationship is controversial and is the subject of our article. We would like to ask: how does it happen that consciousness may provoke structural changes in the brain?The living brain means continuous changes at the synaptic level with every new experience, with every new process of learning, memorizing or mastering new and existing skills. Synapses are generated and dissolved, while others are preserved, in an ever-changing process of so-called neuroplasticity. Ongoing processes of synaptic reinforcements and decay occur during wakefulness when consciousness is present, but also during sleep when it is mostly absent.We suggest that consciousness influences brain neuroplasticity both during wakefulness as well as sleep in a top-down way. This means that consciousness really activates synaptic flow and changes brain structures and functional organization. The dynamic impact of consciousness on brain never stops despite the relative stationary structure of the brain. Such a process can be a target for medical intervention e.g. by cognitive training.

  16. Trends in North American newspaper reporting of brain injury in ice hockey.

    Directory of Open Access Journals (Sweden)

    Michael D Cusimano

    Full Text Available The frequency and potential long-term effects of sport-related traumatic brain injuries (TBI make it a major public health concern. The culture within contact sports, such as ice hockey, encourages aggression that puts youth at risk of TBI such as concussion. Newspaper reports play an important role in conveying and shaping the culture around health-related behaviors. We qualitatively studied reports about sport-related TBI in four major North American newspapers over the last quarter-century. We used the grounded-theory approach to identify major themes and then did a content analysis to compare the frequency of key themes between 1998-2000 and 2009-2011. The major themes were: perceptions of brain injury, aggression, equipment, rules and regulations, and youth hockey. Across the full study period, newspaper articles from Canada and America portrayed violence and aggression that leads to TBI both as integral to hockey and as an unavoidable risk associated with playing the game. They also condemned violence in ice hockey, criticized the administrative response to TBI, and recognized the significance of TBI. In Canada, aggression was reported more often recently and there was a distinctive shift in portraying protective equipment as a solution to TBI in earlier years to a potential contributing factor to TBI later in the study period. American newspapers gave a greater attention to 'perception of risks' and the role of protective equipment, and discussed TBI in a broader context in the recent time period. Newspapers from both countries showed similar recent trends in regards to a need for rule changes to curb youth sport-related TBI. This study provides a rich description of the reporting around TBI in contact sport. Understanding this reporting is important for evaluating whether the dangers of sport-related TBI are being appropriately communicated by the media.

  17. Cerebral hemodynamic changes of mild traumatic brain injury at the acute stage.

    Directory of Open Access Journals (Sweden)

    Hardik Doshi

    Full Text Available Mild traumatic brain injury (mTBI is a significant public health care burden in the United States. However, we lack a detailed understanding of the pathophysiology following mTBI and its relation to symptoms and recovery. With advanced magnetic resonance imaging (MRI, we can investigate brain perfusion and oxygenation in regions known to be implicated in symptoms, including cortical gray matter and subcortical structures. In this study, we assessed 14 mTBI patients and 18 controls with susceptibility weighted imaging and mapping (SWIM for blood oxygenation quantification. In addition to SWIM, 7 patients and 12 controls had cerebral perfusion measured with arterial spin labeling (ASL. We found increases in regional cerebral blood flow (CBF in the left striatum, and in frontal and occipital lobes in patients as compared to controls (p = 0.01, 0.03, 0.03 respectively. We also found decreases in venous susceptibility, indicating increases in venous oxygenation, in the left thalamostriate vein and right basal vein of Rosenthal (p = 0.04 in both. mTBI patients had significantly lower delayed recall scores on the standardized assessment of concussion, but neither susceptibility nor CBF measures were found to correlate with symptoms as assessed by neuropsychological testing. The increased CBF combined with increased venous oxygenation suggests an increase in cerebral blood flow that exceeds the oxygen demand of the tissue, in contrast to the regional hypoxia seen in more severe TBI. This may represent a neuroprotective response following mTBI, which warrants further investigation.

  18. Enhanced neurofibrillary tangle formation, cerebral atrophy, and cognitive deficits induced by repetitive mild brain injury in a transgenic tauopathy mouse model.

    Science.gov (United States)

    Yoshiyama, Yasumasa; Uryu, Kunihiro; Higuchi, Makoto; Longhi, Luca; Hoover, Rachel; Fujimoto, Scott; McIntosh, Tracy; Lee, Virginia M-Y; Trojanowski, John Q

    2005-10-01

    Traumatic brain injury (TBI) is a risk factors for Alzheimer's disease (AD), and repetitive TBI (rTBI) may culminate in dementia pugilistica (DP), a syndrome characterized by progressive dementia, parkinsonism, and the hallmark brain lesions of AD, including neurofibrillary tangles (NFTs), formed by abnormal tau filaments and senile plaques (SPs) composed of Abeta fibrils. Previous study showed that mild rTBI (mrTBI) accelerated the deposition of Abeta in the brains of transgenic (Tg) mice (Tg2576) that over-express human Abeta precursor proteins with the familial AD Swedish mutations (APP695swe) and model of AD-like amyloidosis. Here, we report studies of the effects of mrTBI on AD-like tau pathologies in Tg mice expressing the shortest human tau isoform (T44) subjected to mrTBI, causing brain concussion without structural brain damage to simulate injuries linked to DP. Twelve-month-old Tg T44 (n = 18) and wild-type (WT; n = 24) mice were subjected to mrTBI (four times a day, 1 day per week, for 4 weeks; n = 24) or sham treatment (n = 18). Histopathological analysis of mice at 9 months after mrTBI revealed that one of the Tg T44 mice showed extensive telencephalic NFT and cerebral atrophy. Although statistical analysis of neurobehavioral tests at 6 months after mrTBI did not show any significant difference in any of groups of mice, the Tg T44 mouse with extensive NFT had an exceptionally low neurobehavioral score. The reasons for the augmentation of tau pathologies in only one T44 tau Tg mouse subjected to mrTBI remain to be elucidated.

  19. The Emerging Scholarly Brain

    CERN Document Server

    Kurtz, Michael J

    2010-01-01

    It is now a commonplace observation that human society is becoming a coherent super-organism, and that the information infrastructure forms its emerging brain. Perhaps, as the underlying technologies are likely to become billions of times more powerful than those we have today, we could say that we are now building the lizard brain for the future organism.

  20. One brain, two selves

    NARCIS (Netherlands)

    Reinders, AATS; Nijenhuis, ERS; Paans, AMJ; Korf, J; Willemsen, ATM; den Boer, JA

    2003-01-01

    Having a sense of self is an explicit and high-level functional specialization of the human brain. The anatomical localization of self-awareness and the brain mechanisms involved in consciousness were investigated by functional neuroimaging different emotional mental states of core consciousness in

  1. Demystifying the Adolescent Brain

    Science.gov (United States)

    Steinberg, Laurence

    2011-01-01

    Understanding the nature of brain development in adolescence helps explain why adolescents can vacillate so often between mature and immature behavior. Early and middle adolescence, in particular, are times of heightened vulnerability to risky and reckless behavior because the brain's reward center is easily aroused, but the systems that control…

  2. The Resilient Brain

    Science.gov (United States)

    Brendtro, Larry K.; Longhurst, James E.

    2005-01-01

    Brain research opens new frontiers in working with children and youth experiencing conflict in school and community. Blending this knowledge with resilience science offers a roadmap for reclaiming those identified as "at risk." This article applies findings from resilience research and recent brain research to identify strategies for reaching…

  3. Radiation Injury to the Brain

    Science.gov (United States)

    ... Tumors Brain Tumors Brain Disorders AVMs Radiosurgery Gamma Knife Linac Radiotherapy Overview Childhood Brain Tumors IMRT Radiation Therapy Radiation Injury Treatment Day Making a Decision Centers of Excellence Publications Definitions Q & ...

  4. Teen Brain: Still Under Construction

    Science.gov (United States)

    ... Brain Reprints For more information Share The Teen Brain: Still Under Construction Download PDF Download ePub Order ... the ups and downs of adolescence. The "Visible" Brain A clue to the degree of change taking ...

  5. Coping changes the brain

    Directory of Open Access Journals (Sweden)

    Jordan M. Nechvatal

    2013-02-01

    Full Text Available One of the earliest and most consistent findings in behavioral neuroscience research is that learning changes the brain. Here we consider how learning as an aspect of coping in the context of stress exposure induces neuroadaptations that enhance emotion regulation and resilience. A systematic review of the literature identified 15 brain imaging studies in which humans with specific phobias or posttraumatic stress disorder were randomized to stress exposure therapies that diminished subsequent indications of anxiety. Most of these studies focused on functional changes in the amygdala and anterior corticolimbic brain circuits that control cognitive, motivational, and emotional aspects of physiology and behavior. Corresponding structural brain changes and the timing, frequency, and duration of stress exposure required to modify brain functions remain to be elucidated in future research. These studies will advance our understanding of coping as a learning process and provide mechanistic insights for the development of new interventions that promote stress coping skills.

  6. Epilepsy and Brain Tumors

    Institute of Scientific and Technical Information of China (English)

    Zhi-yi Sha

    2009-01-01

    @@ Epidemiology It is estimated 61,414 new cases of primary brain tumors are expected to be diagnosed in 2009 in the U.S. The incidence statistic of 61,414 persons diagnosed per year includes both malignant (22,738) and non-malignant (38,677) brain tumors. (Data from American Brain Tumor Association). During the years 2004-2005, approximately 359,000 people in the United States were living with the diagnosis of a primary brain or central nervous system tumor. Specifically, more than 81,000 persons were living with a malignant tumor, more than 267,000 persons with a benign tumor. For every 100,000 people in the United States, approximately 131 are living following the diagnosis of a brain tumor. This represents a prevalence rate of 130.8 per 100,000 person years[1].

  7. Brain Fingerprinting Technology

    Directory of Open Access Journals (Sweden)

    Ms.J.R.Rajput

    2015-01-01

    Full Text Available Brain Fingerprinting is a new computer-based technology to identify the perpetrator of a crime accurately and scientifically by measuring brain-wave responses to crime-relevant words or pictures presented on a computer screen. Brain Fingerprinting has proven 100% accurate in over 120 tests, including tests on FBI agents, tests for a US intelligence agency and for the US Navy, and tests on real-life situations including felony crimes. Brain fingerprinting is based on finding that the brain generates a unique brain wave pattern when a person encounters a familiar stimulus Use of functional magnetic resonance imaging in lie detection derives from studies suggesting that persons asked to lie show different patterns of brain activity than they do when being truthful. Issues related to the use of such evidence in courts are discussed. The author concludes that neither approach is currently supported by enough data regarding its accuracy in detecting deception to warrant use in court. In the field of criminology, a new lie detector has been developed in the United States of America. This is called “brain fingerprinting”. This invention is supposed to be the best lie detector available as on date and is said to detect even smooth criminals who pass the polygraph test (the conventional lie detector test with ease. The new method employs brain waves, which are useful in detecting whether the person subjected to the test, remembers finer details of the crime. Even if the person willingly suppresses the necessary information, the brain wave is sure to trap him, according to the experts, who are very excited about the new kid on the block.

  8. Selective vulnerability in brain hypoxia

    DEFF Research Database (Denmark)

    Cervos-Navarro, J.; Diemer, Nils Henrik

    1991-01-01

    Neuropathology, selective vulnerability, brain hypoxia, vascular factors, excitotoxicity, ion homeostasis......Neuropathology, selective vulnerability, brain hypoxia, vascular factors, excitotoxicity, ion homeostasis...

  9. Lutein and Brain Function

    Directory of Open Access Journals (Sweden)

    John W. Erdman

    2015-10-01

    Full Text Available Lutein is one of the most prevalent carotenoids in nature and in the human diet. Together with zeaxanthin, it is highly concentrated as macular pigment in the foveal retina of primates, attenuating blue light exposure, providing protection from photo-oxidation and enhancing visual performance. Recently, interest in lutein has expanded beyond the retina to its possible contributions to brain development and function. Only primates accumulate lutein within the brain, but little is known about its distribution or physiological role. Our team has begun to utilize the rhesus macaque (Macaca mulatta model to study the uptake and bio-localization of lutein in the brain. Our overall goal has been to assess the association of lutein localization with brain function. In this review, we will first cover the evolution of the non-human primate model for lutein and brain studies, discuss prior association studies of lutein with retina and brain function, and review approaches that can be used to localize brain lutein. We also describe our approach to the biosynthesis of 13C-lutein, which will allow investigation of lutein flux, localization, metabolism and pharmacokinetics. Lastly, we describe potential future research opportunities.

  10. Cannabinoids on the Brain

    Directory of Open Access Journals (Sweden)

    Andrew J. Irving

    2002-01-01

    Full Text Available Cannabis has a long history of consumption both for recreational and medicinal uses. Recently there have been significant advances in our understanding of how cannabis and related compounds (cannabinoids affect the brain and this review addresses the current state of knowledge of these effects. Cannabinoids act primarily via two types of receptor, CB1 and CB2, with CB1 receptors mediating most of the central actions of cannabinoids. The presence of a new type of brain cannabinoid receptor is also indicated. Important advances have been made in our understanding of cannabinoid receptor signaling pathways, their modulation of synaptic transmission and plasticity, the cellular targets of cannabinoids in different central nervous system (CNS regions and, in particular, the role of the endogenous brain cannabinoid (endocannabinoid system. Cannabinoids have widespread actions in the brain: in the hippocampus they influence learning and memory; in the basal ganglia they modulate locomotor activity and reward pathways; in the hypothalamus they have a role in the control of appetite. Cannabinoids may also be protective against neurodegeneration and brain damage and exhibit anticonvulsant activity. Some of the analgesic effects of cannabinoids also appear to involve sites within the brain. These advances in our understanding of the actions of cannabinoids and the brain endocannabinoid system have led to important new insights into neuronal function which are likely to result in the development of new therapeutic strategies for the treatment of a number of key CNS disorders.

  11. Bilirubin oxidation in brain.

    Science.gov (United States)

    Hansen, T W

    2000-01-01

    Bilirubin is a product of heme catabolism which by virtue of its lipid solubility can cross the blood-brain barrier and enter the brain. Neonatal jaundice is a common transitional phenomenon which is due to the combination of increased heme catabolism and rate limitations as far as hepatic conjugation and biliary excretion of bilirubin. In the great majority of cases this is an innocuous condition, which is even posited to have some beneficial effects due to the ability of bilirubin to quench free oxygen radicals. However, because bilirubin is neurotoxic, hyperbilirubinemia in the newborn may exceptionally result in death in the neonatal period, or survival with severe neurological sequelae (kernicterus). Bilirubin enters the brain through an intact blood-brain barrier. Clearance of bilirubin from brain partly involves retro-transfer through the blood-brain barrier, and possibly also through the brain-CSF barrier into CSF. Work in our lab during the past 5 years has substantiated earlier work which had suggested that bilirubin may also be metabolized in brain. The responsible enzyme is found on the inner mitochondrial membrane, and oxidizes bilirubin at a rate of 100-300 pmol bilirubin/mg protein/minute. The enzyme activity is lower in the newborn compared with the mature animal, and is also lower in neurons compared with glia. Studies of different rat strains have documented genetic variability. The enzyme is cytochrome-c-dependent, but has as yet not been unequivocally identified. The rate of oxidation of bilirubin is such that this enzyme probably contributes meaningfully to the clearance of bilirubin from brain.

  12. [Soul and brain].

    Science.gov (United States)

    Lain Entralgo, P

    1993-01-01

    After an overview of Medieval and Modern World thought on the questions of relations between the soul and the brain, the author presents the ideas--mostly representative of the majority of medical thinking--of two medical authors from the end of the XIX and beginning of the XX centuries: Paul Flechsig and Santiago Ramón y Cajal. Both support the idea that research into the brain may prove to be the principal resource for the construction of a scientific theory on the soul. Brain research would therefore result in the rational belief in the inmortality of the soul and the rational knowledge and government of Man's psychic life.

  13. Brain Projects Think Big

    OpenAIRE

    Segev, Idan; Schürmann, Felix

    2013-01-01

    When you read these words, hundreds of millions of nerve cells are electrically and chemically active in your brain. This activity enables you to recognize words, sense the world, learn, enjoy, and create new things, and be curious about the world around you. Indeed, our brains – those of Homo sapiens – are the most fascinating physical substances ever to have emerged on earth, some 200,000 years ago. The brain is so curious and ambitious that it strives to understand itself and cure its frag...

  14. Brain Drain: A Child's Brain on Poverty. Poverty Fact Sheet

    Science.gov (United States)

    Damron, Neil

    2015-01-01

    "Brain Drain: A Child's Brain on Poverty," released in March 2015 and prepared by intern Neil Damron, explores the brain's basic anatomy and recent research findings suggesting that poverty affects the brain development of infants and young children and the potential lifelong effects of the changes. The sheet draws from a variety of…

  15. Traumatic Brain Injury Studies in Britain during World War II.

    Science.gov (United States)

    Lanska, Douglas J

    2016-01-01

    As a result of the wartime urgency to understand, prevent, and treat patients with traumatic brain injury (TBI) during World War II (WWII), clinicians and basic scientists in Great Britain collaborated on research projects that included accident investigations, epidemiologic studies, and development of animal and physical models. Very quickly, investigators from different disciplines shared information and ideas that not only led to new insights into the mechanisms of TBI but also provided very practical approaches for preventing or ameliorating at least some forms of TBI. Neurosurgeon Hugh Cairns (1896-1952) conducted a series of influential studies on the prevention and treatment of head injuries that led to recognition of a high rate of fatal TBI among motorcycle riders and subsequently to demonstrations of the utility of helmets in lowering head injury incidence and case fatality. Neurologists Derek Denny-Brown (1901-1981) and (William) Ritchie Russell (1903-1980) developed an animal model of TBI that demonstrated the fundamental importance of sudden acceleration (i.e., jerking) of the head in causing concussion and forced a distinction between head injury associated with sudden acceleration/deceleration and that associated with crush or compression. Physicist A.H.S. Holbourn (1907-1962) used theoretical arguments and simple physical models to illustrate the importance of shear stress in TBI. The work of these British neurological clinicians and scientists during WWII had a strong influence on subsequent clinical and experimental studies of TBI and also eventually resulted in effective (albeit controversial) public health campaigns and legislation in several countries to prevent head injuries among motorcycle riders and others through the use of protective helmets. Collectively, these studies accelerated our understanding of TBI and had subsequent important implications for both military and civilian populations. As a result of the wartime urgency to understand

  16. Postnatal brain development

    DEFF Research Database (Denmark)

    Jernigan, Terry L; Baaré, William F C; Stiles, Joan;

    2011-01-01

    constantly with the environment. This is a protracted process, beginning in the third week of gestation and continuing into early adulthood. Reviewed here are studies using structural imaging techniques, with a special focus on diffusion weighted imaging, describing age-related brain maturational changes......After birth, there is striking biological and functional development of the brain's fiber tracts as well as remodeling of cortical and subcortical structures. Behavioral development in children involves a complex and dynamic set of genetically guided processes by which neural structures interact...... in children and adolescents, as well as studies that link these changes to behavioral differences. Finally, we discuss evidence for effects on the brain of several factors that may play a role in mediating these brain-behavior associations in children, including genetic variation, behavioral interventions...

  17. Postnatal brain development

    DEFF Research Database (Denmark)

    Jernigan, Terry L; Baaré, William F C; Stiles, Joan

    2011-01-01

    After birth, there is striking biological and functional development of the brain's fiber tracts as well as remodeling of cortical and subcortical structures. Behavioral development in children involves a complex and dynamic set of genetically guided processes by which neural structures interact...... constantly with the environment. This is a protracted process, beginning in the third week of gestation and continuing into early adulthood. Reviewed here are studies using structural imaging techniques, with a special focus on diffusion weighted imaging, describing age-related brain maturational changes...... in children and adolescents, as well as studies that link these changes to behavioral differences. Finally, we discuss evidence for effects on the brain of several factors that may play a role in mediating these brain-behavior associations in children, including genetic variation, behavioral interventions...

  18. Brain versus Machine Control.

    Directory of Open Access Journals (Sweden)

    Jose M Carmena

    2004-12-01

    Full Text Available Dr. Octopus, the villain of the movie "Spiderman 2", is a fusion of man and machine. Neuroscientist Jose Carmena examines the facts behind this fictional account of a brain- machine interface

  19. Brains on video games.

    Science.gov (United States)

    Bavelier, Daphne; Green, C Shawn; Han, Doug Hyun; Renshaw, Perry F; Merzenich, Michael M; Gentile, Douglas A

    2011-11-18

    The popular press is replete with stories about the effects of video and computer games on the brain. Sensationalist headlines claiming that video games 'damage the brain' or 'boost brain power' do not do justice to the complexities and limitations of the studies involved, and create a confusing overall picture about the effects of gaming on the brain. Here, six experts in the field shed light on our current understanding of the positive and negative ways in which playing video games can affect cognition and behaviour, and explain how this knowledge can be harnessed for educational and rehabilitation purposes. As research in this area is still in its early days, the contributors of this Viewpoint also discuss several issues and challenges that should be addressed to move the field forward.

  20. Right Hemisphere Brain Damage

    Science.gov (United States)

    ... or hemispheres. Each hemisphere is responsible for different body functions and skills. In most people, the left side of the brain contains the person's language functions. The right side contributes to a number ...

  1. Brain Tumors and Fatigue

    Science.gov (United States)

    ... can help calm the mind. Meditation, guided imagery, music therapy, and yoga are just a few worth investigating. Home Donor and Privacy Policies Find Resources Disclaimer Donate Subscribe Login American Brain Tumor Association 8550 W. Bryn Mawr Ave. Ste ...

  2. Deep brain stimulation

    Science.gov (United States)

    ... a device called a neurostimulator to deliver electrical signals to the areas of the brain that control ... neurostimulator, which puts out the electric current. The stimulator is similar to a heart ...

  3. Expressions of enkephalin and dopamine in brain tissue and their significance in cerebral coneussionai rats%脑啡肽和多巴胺在实验性脑震荡大鼠脑组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    彭瑞云; 高亚兵; 王德文; 肖兴义; 陈浩宇; 杨瑞; 刘杰; 胡文华; 马俊杰

    2004-01-01

    BACKGROUND: The mechanisms of cerebral concussion have remained poorly understood, and so do the expression profiles of enkephalin and dopamine and their significance in this injury.OBJECTIVE: To investigate the expressions of enkephalin and dopamine and explore their significance in rat cerebral concussion tissue.DESIGN: A randomized controlled trial.SETTING and MATERIALS: This study was conducted in the Academy of Military Medical Sciences of PLA. Totally 80 male Wistar rats of clean grade, provided by the Animal Center of Academy of Military Medical Sciences and given free access to water and food, were used for preparing animal models of cerebral concussion. The rats were randomly divided into 4 groups according to the different cerebral impact for model establishment using counterweights, namely the control group, 50, 100 and 200 g groups.INTERVENTIONS: The rats were sacrificed on the day 1, 3, 7, 14 and 30 following brain concussion, respectively, and the brain tissue were taken for examination of the expressions of enkephalin and dopamine by means of immunohistochemical staining.MAIN OUTCOME MEASURES: The manifestations, pathological changes, and the result of immunohistochemical staining on enkephalin and dopamine were observed.RESULTS: Typical features of cerebral concussion were seen in rats of the 100 g group. The main pathological changes .included cerebral vascular constriction and dilation, hemostasis and edema of the cerebral tissue and neuronal degeneration and necrosis. Enkephalin expression was enhanced on the day 1 after the injury, as seen in the cytoplasm of the endothelial cells in the cerebral cortex, hippocampus and cerebellum, and reached the peak level on day 7. From day 14, the expression of enkephalin decreased gradually, but still remained at higher-than-normal level until day 30. The expression of dopamine increased on day 7 and was seen in the cytoplasm of the endothelial cells and in the vascular wall in the cerebral cortex

  4. Pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Poussaint, Tina Y. [Department of Radiology, Boston, MA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Huisman, Thierry A.G.M. [Charlotte R. Bloomberg Children' s Center, Johns Hopkins Hospital, Division of Pediatric Radiology and Pediatric Neuroradiology, Baltimore, MD (United States)

    2015-09-15

    Among all causes of death in children from solid tumors, pediatric brain tumors are the most common. This article includes an overview of a subset of infratentorial and supratentorial tumors with a focus on tumor imaging features and molecular advances and treatments of these tumors. Key to understanding the imaging features of brain tumors is a firm grasp of other disease processes that can mimic tumor on imaging. We also review imaging features of a common subset of tumor mimics. (orig.)

  5. Brain derived neurotrophic factor

    DEFF Research Database (Denmark)

    Mitchelmore, Cathy; Gede, Lene

    2014-01-01

    Brain Derived Neurotrophic Factor (BDNF) is a neurotrophin with important functions in neuronal development and neuroplasticity. Accumulating evidence suggests that alterations in BDNF expression levels underlie a variety of psychiatric and neurological disorders. Indeed, BDNF therapies are curre......Brain Derived Neurotrophic Factor (BDNF) is a neurotrophin with important functions in neuronal development and neuroplasticity. Accumulating evidence suggests that alterations in BDNF expression levels underlie a variety of psychiatric and neurological disorders. Indeed, BDNF therapies...

  6. Operation Brain Trauma Therapy

    Science.gov (United States)

    2014-10-01

    positive reports. However, recent reviews from the field of cancer suggest that often the literature on pre-clinical work is over-inflated –even when...in microglia cells in the brain, although it is also present in macrophages in the peripheral compartments. Importantly Iba-1 is highly up- regulated... ultrastructural analyses were performed. These studies confirmed the diffuse nature of the axonal injury while also confirming that the brain regions assessed

  7. Strategies to avoid a missed diagnosis of co-occurring concussion in post-acute patients having a spinal cord injur y

    Institute of Scientific and Technical Information of China (English)

    David S. Kushner

    2015-01-01

    Research scientists and clinicians should be aware that missed diagnoses of mild-moderate trau-matic brain injuries in post-acute patients having spinal cord injuries may approach 60–74%with certain risk factors, potentially causing clinical consequences for patients, and confounding the results of clinical research studies. Factors leading to a missed diagnosis may include acute trau-ma-related life-threatening issues, sedation/intubation, subtle neuropathology on neuroimaging, failure to collect Glasgow Coma Scale scores or duration of posttraumatic amnesia, or lack of va-lidity of this information, and overlap in neuro-cognitive symptoms with emotional responses to spinal cord injuries. Strategies for avoiding a missed diagnosis of mild-moderate traumatic brain injuries in patients having a spinal cord injuries are highlighted in this perspective.

  8. A Novel Closed-head Model of Mild Traumatic Brain Injury Caused by Primary Overpressure Blast to the Cranium Produces Sustained Emotional Deficits in Mice

    Directory of Open Access Journals (Sweden)

    Scott A Heldt

    2014-01-01

    Full Text Available Emotional disorders are a common outcome from mild traumatic brain injury (TBI in humans, but their pathophysiological basis is poorly understood. We have developed a mouse model of closed-head blast injury using an air pressure wave delivered to a small area on one side of the cranium, which we have used to create mild TBI. We found that 20-psi blasts in 3-month old C57BL/6 male mice yielded no obvious behavioral or histological evidence of brain injury, while 25-40 psi blasts produced transient anxiety in an open field arena but little histological evidence of brain damage. By contrast, 50-60 psi blasts resulted in anxiety-like behavior in an open field arena that became more evident with time after blast. In additional behavioral tests conducted 2-8 weeks after blast, 50-60 psi mice also demonstrated increased acoustic startle, perseverance of learned fear, and enhanced contextual fear, as well as depression-like behavior and diminished prepulse inhibition. We found no evident cerebral pathology, however, and only scattered axonal degeneration in brain sections from 50-60 psi mice 3-8 weeks after blast. Thus, the TBI caused by single 50-60 psi blasts in mice exhibits the minimal neuronal loss coupled to diffuse axonal injury characteristic of human mild TBI. A reduction in the abundance of a subpopulation of excitatory projection neurons in basolateral amygdala enriched in Thy1 was, however, observed. The reported link of this neuronal population to fear suppression suggests their damage by mild TBI may contribute to the heightened anxiety and fearfulness observed after blast in our mice. Our overpressure air blast model of concussion in mice will enable further studies of the mechanisms underlying the diverse emotional deficits seen after mild TBI.

  9. The Effects of Explosive Blast as Compared to Post-traumatic Stress Disorder on Brain Function and Structure

    Science.gov (United States)

    2013-04-01

    Archives of Clinical Neuropsychology , 25, 713-23. Final Report W81XWH-08-2-0038 18 Key Research Accomplishments  As part of this study...impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion. Archives of Clinical Neuropsychology , 25, 713-23...Sponheim, S.R. (2010). Evaluation context impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion. Archives of Clinical

  10. The Effects of Explosive Blast as Compared to Post-Traumatic Stress Disorder on Brain Function and Stucture

    Science.gov (United States)

    2011-04-01

    OIF veterans with reported combat-related concussion. Archives of Clinical Neuropsychology , 25, 713-23. 4. Nelson N.W., Hoelzle J.B., McGuire K.A...A controlled study. Archives of Clinical Neuropsychology 2002;17:319–334. 9. Radanov BP, Dvorak J, Valach L. Cognitive deficits in patients after soft...of OEF/ OIF veterans with reported combat-related concussion. Archives of Clinical Neuropsychology 2010;25:713–723. 22. Iverson GL, Langlois JA

  11. Transcranial brain stimulation: closing the loop between brain and stimulation

    DEFF Research Database (Denmark)

    Karabanov, Anke; Thielscher, Axel; Siebner, Hartwig Roman

    2016-01-01

    PURPOSE OF REVIEW: To discuss recent strategies for boosting the efficacy of noninvasive transcranial brain stimulation to improve human brain function. RECENT FINDINGS: Recent research exposed substantial intra- and inter-individual variability in response to plasticity-inducing transcranial brain...... transcranial brain stimulation. Priming interventions or paired associative stimulation can be used to ‘standardize’ the brain-state and hereby, homogenize the group response to stimulation. Neuroanatomical and neurochemical profiling based on magnetic resonance imaging and spectroscopy can capture trait......-related and state-related variability. Fluctuations in brain-states can be traced online with functional brain imaging and inform the timing or other settings of transcranial brain stimulation. State-informed open-loop stimulation is aligned to the expression of a predefined brain state, according to prespecified...

  12. Brain hypoxia imaging

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Chun [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2007-04-15

    The measurement of pathologically low levels of tissue pO{sub 2} is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowadays have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. {sup 18}F-MISO PET and {sup 99m}Tc-EC-metronidazole SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using {sup 123}I-IAZA in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

  13. Pediatric brain death determination.

    Science.gov (United States)

    Mathur, Mudit; Ashwal, Stephen

    2015-04-01

    Clinical guidelines for the determination of brain death in children were first published in 1987. These guidelines were revised in 2011 under the auspices of the Society of Critical Care Medicine, the American Academy of Pediatrics, and the Child Neurology Society, and provide the minimum standards that must be satisfied before brain death can be declared in infants and children. After achieving physiologic stability and exclusion of confounders, two examinations including apnea testing separated by an observation period (24 hours for term newborns up to 30 days of age, and 12 hours for infants and children from 31 days up to 18 years) are required to establish brain death. Apnea testing should demonstrate a final arterial PaCO2 20 mm Hg above the baseline and ≥ 60 mm Hg with no respiratory effort during the testing period. Ancillary studies (electroencephalogram and radionuclide cerebral blood flow) are not required to establish brain death and are not a substitute for the neurologic examination. The committee concluded that ancillary studies may be used (1) when components of the examination or apnea testing cannot be completed, (2) if uncertainty about components of the neurologic examination exists, (3) if a medication effect may be present, or (4) to reduce the interexamination observation period. When ancillary studies are used, a second clinical examination and apnea test should still be performed and components that can be completed must remain consistent with brain death.

  14. Imaging brain plasticity after trauma

    Institute of Scientific and Technical Information of China (English)

    Zhifeng Kou; Armin Iraji

    2014-01-01

    The brain is highly plastic after stroke or epilepsy;however, there is a paucity of brain plasticity investigation after traumatic brain injury (TBI). This mini review summarizes the most recent evidence of brain plasticity in human TBI patients from the perspective of advanced magnetic resonance imaging. Similar to other forms of acquired brain injury, TBI patients also demonstrat-ed both structural reorganization as well as functional compensation by the recruitment of other brain regions. However, the large scale brain network alterations after TBI are still unknown, and the ifeld is still short of proper means on how to guide the choice of TBI rehabilitation or treat-ment plan to promote brain plasticity. The authors also point out the new direction of brain plas-ticity investigation.

  15. Scintigraphic evaluation of brain death

    Energy Technology Data Exchange (ETDEWEB)

    Park, C. H.; Bai, M. S.; Cho, K. K.; Kim, S. J.; Yoon, S. N.; Cho, C. W. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    A law recognizing brain death is a life saving legal measure in patients suffering from badly diseased organs such as kidney, liver, heart, and lung. Such law is being discussed for legalization at the Korean National Assembly. There are various criteria used for brain death in western world and brain scintiscan is one of them. However, the scintiscan is not considered in establishing brain death in the draft of the law. The purpose of this report is to spread this technique in nuclear medicine society as well as in other medical societies. We evaluated 7 patients with clinical suspicion of brain death by various causes. The patient's age ranged from 5 to 39 years. We used 5-20mCi {sup 99m}Tc-HMPAO (d.1-hexamethyl propylene amine oxime) or ECD (Ethyl Cysteinate Dimer), lipophilic agents that cross BBB (blood brain barrier). A dynamic study followed by static or SPECT (single photon emission tomography) was performed. Interpretive criteria used for brain death were 1) no intracranial circulation 2) no brain uptake. The second criteria is heavily used. Five of 7 patients were scintigraphically brain dead and the remaining 2 had some brain uptake excluding the diagnosis of scintigraphic brain death. In conclusion, cerebral perfusion study using a lipophilic brain tracer offers a noninvasive, rapid, easy, accurate and reliable mean in the diagnosis of brain death. We believe that this modality should be included in the criteria of brain death in the draft of the proposed Korean law.

  16. Brain Network Modelling

    DEFF Research Database (Denmark)

    Andersen, Kasper Winther

    Three main topics are presented in this thesis. The first and largest topic concerns network modelling of functional Magnetic Resonance Imaging (fMRI) and Diffusion Weighted Imaging (DWI). In particular nonparametric Bayesian methods are used to model brain networks derived from resting state f...... for their ability to reproduce node clustering and predict unseen data. Comparing the models on whole brain networks, BCD and IRM showed better reproducibility and predictability than IDM, suggesting that resting state networks exhibit community structure. This also points to the importance of using models, which...... allow for complex interactions between all pairs of clusters. In addition, it is demonstrated how the IRM can be used for segmenting brain structures into functionally coherent clusters. A new nonparametric Bayesian network model is presented. The model builds upon the IRM and can be used to infer...

  17. Mind, brain and psychotherapy

    Directory of Open Access Journals (Sweden)

    Sheth Hitesh

    2009-01-01

    Full Text Available There is long-standing debate about superiority of mind over brain, in other words about superiority of mind over matter. And outcome of this debate is going to decide future of psychiatry. The psychiatrists believing in materialism may say that brain is all and by changing neurotransmitters level with new molecules of drugs would cure all illnesses. On the other hand, antipsychiatry activists and some psychotherapists oppose all types of treatment despite of convincing evidence that drug therapy is effective (although sometimes it is not as effective as it claims to be. However, truth lies somewhere in between. Pharmacotherapy and psychotherapy are like two legs of psychiatry and psychiatry cannot walk into a future on one leg. The studies have shown that judicious use of pharmacotherapy along with psychotherapy gives better outcome than any one of them used alone. We must heal dichotomy between mind and brain before we heal the patients.

  18. Brain abscess: Current management

    Directory of Open Access Journals (Sweden)

    Hernando Alvis-Miranda

    2013-01-01

    Full Text Available Brain abscess (BA is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA.

  19. Brain abscess: Current management

    Science.gov (United States)

    Alvis Miranda, Hernando; Castellar-Leones, Sandra Milena; Elzain, Mohammed Awad; Moscote-Salazar, Luis Rafael

    2013-01-01

    Brain abscess (BA) is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA. PMID:24174804

  20. Brains, genes, and primates.

    Science.gov (United States)

    Izpisua Belmonte, Juan Carlos; Callaway, Edward M; Caddick, Sarah J; Churchland, Patricia; Feng, Guoping; Homanics, Gregg E; Lee, Kuo-Fen; Leopold, David A; Miller, Cory T; Mitchell, Jude F; Mitalipov, Shoukhrat; Moutri, Alysson R; Movshon, J Anthony; Okano, Hideyuki; Reynolds, John H; Ringach, Dario; Sejnowski, Terrence J; Silva, Afonso C; Strick, Peter L; Wu, Jun; Zhang, Feng

    2015-05-06

    One of the great strengths of the mouse model is the wide array of genetic tools that have been developed. Striking examples include methods for directed modification of the genome, and for regulated expression or inactivation of genes. Within neuroscience, it is now routine to express reporter genes, neuronal activity indicators, and opsins in specific neuronal types in the mouse. However, there are considerable anatomical, physiological, cognitive, and behavioral differences between the mouse and the human that, in some areas of inquiry, limit the degree to which insights derived from the mouse can be applied to understanding human neurobiology. Several recent advances have now brought into reach the goal of applying these tools to understanding the primate brain. Here we describe these advances, consider their potential to advance our understanding of the human brain and brain disorders, discuss bioethical considerations, and describe what will be needed to move forward.