Concussion最新文献

{"title":"Auditory comprehension performance of college students with and without sport concussion on Computerized-Revised Token Test Subtest VIII.","authors":"Anthony P Salvatore,&nbsp;Michael Cannito,&nbsp;Heather E Brassil,&nbsp;Edina R Bene,&nbsp;Bess Sirmon-Taylor","doi":"10.2217/cnc-2016-0024","DOIUrl":"https://doi.org/10.2217/cnc-2016-0024","url":null,"abstract":"<p><strong>Aim: </strong>Auditory comprehension (AC) and visually assessed cognitive functions were compared in early stage postconcussed (PC) athletes and healthy controls using the Subtest VIII of the Computerized-Revised Token Test (C-RTT) and Immediate Postconcussion Assessment and Cognitive Test (ImPACT).</p><p><strong>Results: </strong>As compared with healthy controls (n = 30), PC subjects (n = 30) had significantly lower C-RTT efficiency scores (p = 0.018), and lower ImPACT scores; total symptom score (p = 0.000.), verbal memory (p = 0.000), visual memory (p = 0.000), visual motor speed (p = 0.000) and reaction time (p = 0.004) in this post-test only matched subject design. Impulse Control was not significant (p = 0.613). Multiple regression and ANOVA indicated an association with reaction time only (p = 0.012) for the PC subjects. After controlling for reaction time, a significant difference in AC remained.</p><p><strong>Conclusion: </strong>The relationship between AC and other visually assessed cognitive functions was inconsistent suggesting that the C-RTT and ImPACT assessed different functional systems.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 2","pages":"CNC37"},"PeriodicalIF":0.0,"publicationDate":"2017-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36481189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helmets in women's lacrosse: what the evidence shows.","authors":"Rebecca L Acabchuk,&nbsp;Blair T Johnson","doi":"10.2217/cnc-2017-0005","DOIUrl":"https://doi.org/10.2217/cnc-2017-0005","url":null,"abstract":"US Women’s lacrosse ranks second only to American football in incidence rate of concussions, according to a study that compiled data from over 200 high schools and 26 colleges [1]. Other studies confirm head injury is a significant risk in the sport; the largest, an epidemiological study using over 1 million athletic exposures in high school and college men’s and women’s lacrosse over four seasons, found that although women’s lacrosse has a no-contact rule, women players had a higher rate of head, face and eye injuries than men; 40% of these injuries were concussions [2]. Stick or ball contact is the primary mechanism of injury to the head in women’s lacrosse. In men’s lacrosse, a contact sport, most concussions arise from player collisions. Men’s lacrosse requires a full protective helmet but, until now, the only approved headgear for women’s lacrosse has been eye protection. For the first time this season, women’s lacrosse players have the option to wear approved headgear. Following a concussion, immediate neurological symptoms (i.e., dizziness, confusion, disorientation and blurred vision) generally resolve spontaneously, and no abnormalities are typically found on routine imaging (computed tomography or MRI); however, prolonged symptoms are more likely to occur following a more severe hit or when an athlete has suffered more than one concussion [3]. A growing body of evidence has linked repeated mild traumatic brain injury to debilitating long-term consequences that may silently accumulate; symptoms vary but may include headaches, memory and attention impairment, emotional instability and the progressive neurodegenerative disease chronic traumatic encephalopathy, also known as CTE ([4] and many others). Given the statistics above demonstrating high incident rates of concussion in women’s lacrosse, along with the potential for long-term impairment from repeated or severe brain trauma, it is easy to agree on the importance of reducing the risk of head injury in the sport of women’s lacrosse. Nonetheless, there is a large debate as to whether adding headgear to the women’s game will help solve the problem. This spring season of 2017 marks the arrival of long awaited new headgear designed specifically for the women’s game. The website of US Lacrosse, the sport’s governing body, currently states: “The ASTM standard is the first ever performance standard for women’s lacrosse headgear, developed to help reduce impact forces associated with stick and ball contact in women’s lacrosse.” [5]. ASTM International (originally established under the name American Society Helmets in women’s lacrosse: what the evidence shows","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 2","pages":"CNC39"},"PeriodicalIF":0.0,"publicationDate":"2017-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2017-0005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36481190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White matter changes in patients with mild traumatic brain injury: MRI perspective.","authors":"Ponnada A Narayana","doi":"10.2217/cnc-2016-0028","DOIUrl":"https://doi.org/10.2217/cnc-2016-0028","url":null,"abstract":"<p><p>This review focuses on white matter (WM) changes in mild traumatic brain injury (mTBI) as assessed by multimodal MRI. All the peer reviewed publications on WM changes in mTBI from January 2011 through September 2016 are included in this review. This review is organized as follows: introduction to mTBI, the basics of multimodal MRI techniques that are potentially useful for probing the WM integrity, summary and critical evaluation of the published literature on the application of multimodal MRI techniques to assess the changes of WM in mTBI, and correlation of MRI measures with behavioral deficits. The MRI-pathology correlation studies based on preclinical models of mTBI are also reviewed. Finally, the author's perspective of future research directions is described.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 2","pages":"CNC35"},"PeriodicalIF":0.0,"publicationDate":"2017-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36481191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential for use of creatine supplementation following mild traumatic brain injury.","authors":"Philip John Ainsley Dean,&nbsp;Gozdem Arikan,&nbsp;Bertram Opitz,&nbsp;Annette Sterr","doi":"10.2217/cnc-2016-0016","DOIUrl":"https://doi.org/10.2217/cnc-2016-0016","url":null,"abstract":"<p><p>There is significant overlap between the neuropathology of mild traumatic brain injury (mTBI) and the cellular role of creatine, as well as evidence of neural creatine alterations after mTBI. Creatine supplementation has not been researched in mTBI, but shows some potential as a neuroprotective when administered prior to or after TBI. Consistent with creatine's cellular role, supplementation reduced neuronal damage, protected against the effects of cellular energy crisis and improved cognitive and somatic symptoms. A variety of factors influencing the efficacy of creatine supplementation are highlighted, as well as avenues for future research into the potential of supplementation as an intervention for mTBI. In particular, the slow neural uptake of creatine may mean that greater effects are achieved by pre-emptive supplementation in at-risk groups.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 2","pages":"CNC34"},"PeriodicalIF":0.0,"publicationDate":"2017-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36478192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable sensing and mobile devices: the future of post-concussion monitoring?","authors":"William Johnston,&nbsp;Cailbhe Doherty,&nbsp;Fionn Cleirigh Büttner,&nbsp;Brian Caulfield","doi":"10.2217/cnc-2016-0025","DOIUrl":"https://doi.org/10.2217/cnc-2016-0025","url":null,"abstract":"In the past decade, concussion has received large amounts of attention in public, medical and research circles. While our understanding of the nature and management of concussion has greatly improved, there are still major limitations which need to be addressed surrounding the identification of the injury, determining when an individual is safe to return to normal activity, and what factors may contribute to the development of post-concussion syndrome (PCS). The current model of concussion management involves a triage evaluation in the acute stage of injury, focusing on the classic signs and symptoms of concussion. Next, the clinician attempts to evaluate key components of cerebral function through clinical symptom evaluation, and traditional assessments of motor and neurocognitive function [1]. The development of the sports concussion assessment tool saw a massive leap forward in the strategies employed in the management of concussion, as it acknowledged the multifactorial nature of concussion, and provided a standardized means for clinicians to assess the many domains of cerebral function [2]. While these methods have demonstrated some promise in the acute stage, they are not designed for serial monitoring (particularly in instances where PCS develops) [3], and provide us with very little clinically relevant information that can assist clinicians in the return to learn/sport/performance process. The traditional model of concussion assessment coincides with a graduated return-to-play protocol. This protocol is simply dictated by the length of time since the injury, and symptom resolution with physiological exertion [4]; it does not reflect the athlete’s true readiness to return to sport, as determined by a multi-modal objective assessment of the variety of impairments that manifest following concussion or during PCS. Indeed, this methodology is fraught with a number of key limitations: these assessments represent the individual’s status at discrete points in time, are focused on quantifying parameters that are subject to a level of hourly and daily variability independent of the concussive injury, and do not acknowledge the heterogeneous and evolving nature of the injury. In addition, while we know that concussion affects short-term physical (such as balance and gait) and cognitive (such as memory and concentration) competencies, the evolving nature of PCS for these competencies is not well understood. There is a dearth of evidence quantifying exactly how an injury such as concussion, with widespread symptomatology, disturbs an individual’s capacity for physical activity. Improving the evidence base in these areas is vital considering recent evidence which has suggested that concussion has long term effects on physical competencies, with increased musculoskeletal injury rates being observed for 3/12 months’ post injury [5–7]. Furthermore, concern has been raised as to the long term effects of repeated concussions on cognitive Wearable sensing an","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 1","pages":"CNC28"},"PeriodicalIF":0.0,"publicationDate":"2017-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36478186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric aspects of concussion: acute and chronic sequelae.","authors":"Vani Rao,&nbsp;Arshiya Syeda,&nbsp;Durga Roy,&nbsp;Matthew E Peters,&nbsp;Sandeep Vaishnavi","doi":"10.2217/cnc-2016-0018","DOIUrl":"https://doi.org/10.2217/cnc-2016-0018","url":null,"abstract":"<p><p>Concussion - also known as mild traumatic brain injury - is a transient disturbance of neurological function resulting from traumatic forces imparted to the brain that often produce cognitive, behavioral and systemic symptoms. In this review of the literature, we discuss the pathophysiology of both acute and chronic neuropsychiatric sequelae of concussions, followed by a brief overview of evaluation and management of these sequelae.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 1","pages":"CNC29"},"PeriodicalIF":0.0,"publicationDate":"2017-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36478187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the validity of computerized neurocognitive assessment tools in mild traumatic brain injury assessment.","authors":"Jacques P Arrieux,&nbsp;Wesley R Cole,&nbsp;Angelica P Ahrens","doi":"10.2217/cnc-2016-0021","DOIUrl":"https://doi.org/10.2217/cnc-2016-0021","url":null,"abstract":"<p><p>Computerized neurocognitive assessment tools (NCATs) offer potential advantages over traditional neuropsychological tests in postconcussion assessments. However, their psychometric properties and clinical utility are still questionable. The body of research regarding the validity and clinical utility of NCATs suggests some support for aspects of validity (e.g., convergent validity) and some ability to distinguish between concussed individuals and controls, though there are still questions regarding the validity of these tests and their clinical utility, especially outside of the acute injury timeframe. In this paper, we provide a comprehensive summary of the existing validity literature for four commonly used and studied NCATs (automated neuropsychological assessment metrics, CNS vital signs, cogstate and immediate post-concussion and cognitive testing) and lay the groundwork for future investigations.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 1","pages":"CNC31"},"PeriodicalIF":0.0,"publicationDate":"2017-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36478188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic findings in sport-related concussions: potential for individualized medicine?","authors":"Jane McDevitt,&nbsp;Evgeny Krynetskiy","doi":"10.2217/cnc-2016-0020","DOIUrl":"https://doi.org/10.2217/cnc-2016-0020","url":null,"abstract":"<p><p>Concussion is a traumatic transient disturbance of the brain. In sport, the initial time and severity of concussion is known giving an opportunity for subsequent analysis. Variability in susceptibility and recovery between individual athletes depends, among other parameters, on genetic factors. The genes-encoding polypeptides that determine incidence, severity and prognosis for concussion are the primary candidates for genetic analysis. Genetic polymorphisms in the genes contributing to plasticity and repair (<i>APOE</i>), synaptic connectivity (<i>GRIN2A</i>), calcium influx (<i>CACNA1E</i>), uptake and deposit of glutamate (<i>SLC17A7</i>) are potential biomarkers of concussion incidence and recovery rate. With catalogued genetic variants, prospective genotyping of athletes at the beginning of their career will allow medical professionals to improve concussion management and return-to-play decisions.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 1","pages":"CNC26"},"PeriodicalIF":0.0,"publicationDate":"2017-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36478184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educating the masses: suggestions for improving online concussion information via the mainstream media.","authors":"Osman Hassan Ahmed,&nbsp;Tracy Blake,&nbsp;Eric E Hall","doi":"10.2217/cnc-2016-0026","DOIUrl":"https://doi.org/10.2217/cnc-2016-0026","url":null,"abstract":"It was said by Jim Morrison that “whoever controls the media controls the mind” [1] and the power of the media to shape and inform opinions has never been greater. Mainstream news outlets play a pivotal role in the modern age, and public health is included in the scope of influence of the media [2]. Previous research has explored how social media has portrayed sports concussion; Twitter has been highlighted for its rapid dissemination mechanisms [3], while concussion-related content on YouTube predominantly arose from news and media organizations [4]. Given the current high profile of sports concussion in the news, it is unsurprising that attention has turned toward its representation and portrayal in the media. A recent study from Ahmed and Hall [5] discussed the description of sports concussion in online news articles, and demonstrated inconsistencies in the terminology used to describe concussion. From 200 news articles retrieved, the terms ‘head injury’ and ‘brain injury’ were only used in 30 and 21% of cases, respectively, suggesting that the seriousness of these injuries may be downplayed by the terminology used to describe them. In addition, 10% of the articles used inappropriate modifiers, that is, words such as ‘mild’ or ‘moderate’ to describe the concussive injury. These descriptions were often made by journalists, leading the authors to create a checklist (the ‘Media Concussion Checklist’) in order to educate journalists and facilitate consistency in reporting about concussions. The descriptions used by the media in reference to concussion-related decision-making are noteworthy; for example, the decision by a 2016 Olympic Games gymnast to continue competing after a head injury being described as ‘lionhearted’ [6]. This phrasing creates a link between an individual’s personal character and healthcare decision-making that is inherently problematic. Although this scenario generated a debate regarding the logic of their decision to continue competing [7], this form of value-based description of concussion decision-making opens the doors for the opposite decision (i.e., removal from play) to be construed negatively (e.g., using descriptors such as ‘mouselike’ or ‘cowardly’). This is especially true given that decisionmaking processes surrounding injury disclosure and return to play are complex and multifactorial. Symptom-reporting remains a cornerstone of current concussion evaluation practice standards, however studies have demonstrated that athletes are not always consistent in disclosing potential concussive injuries [8]. The role that masculinity plays in association with concussion reporting has also been explored; Anderson and Kian [9] have suggested that there is a historical underpinning of masculinity to concussion reporting with regard to football in the USA, and similar cultural underpinnings are discussed by Hokowhitu toward Maori rugby Educating the masses: suggestions for improving online concussion information via the mainstr","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"2 1","pages":"CNC27"},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36478185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of traumatic brain injury and mental health problems among individuals within the criminal justice system.","authors":"Audrey McKinlay,&nbsp;Michelle Albicini","doi":"10.2217/cnc-2016-0011","DOIUrl":"https://doi.org/10.2217/cnc-2016-0011","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is associated with increased aggression and antisocial behavior. This review examined existing literature regarding TBI prevalence and associated adverse mental health among individuals within the criminal justice system. TBI prevalence varied between 12 and 82% for youths, and 23 and 87% for adults. TBI was associated with a range of negative outcomes, particularly substance abuse. However, confounding factors, including differing control groups, lack of information for timing and severity of TBI, and use of self-report measures for TBI history made it difficult to determine whether TBI was a risk factor. Future research should eliminate or counter for these confounds, to provide accurate prevalence rates of TBI and the direction of association between TBI and offending behaviors.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 4","pages":"CNC25"},"PeriodicalIF":0.0,"publicationDate":"2016-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36480302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}