Concussion最新文献

{"title":"Summary of the 2015 University of Michigan Sport Concussion Summit.","authors":"Steven P Broglio, Grant Baldwin, Rudy J Castellani, Sara Pd Chrisman, Stefan Duma, Brian Hainline, Joanne C Gerstner, Kevin Guskiewicz, Jeffrey Kutcher, Adria Lamba, Michael McCrea, Steven Pachman, Christopher Randolph, Tamara C Valovich McLeod","doi":"10.2217/cnc-2016-0007","DOIUrl":"10.2217/cnc-2016-0007","url":null,"abstract":"<p><p>Discussions surrounding concussion have made their way into the public sphere over the previous decade with media attention and coverage of the injury fueling public debate. These conversations have devolved into discussions on banning contact and collision sports and raised legal questions surrounding injury management. Questions raised about concussion eclipse what science can answer, but the University of Michigan Injury Center (MI, USA) hosted a Concussion Summit in September 2015 as a means to condense, solidify and disseminate what is currently known on the topic. Areas for discussion included concussion incidence and prevention, diagnosis and management, legislation and education, legal and social aspects and future directions. A summary of those presentations are included within.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 4","pages":"CNC23"},"PeriodicalIF":0.0,"publicationDate":"2016-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36480303","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":"Subconcussive impacts and imaging findings over a season of contact sports.","authors":"Elizabeth M Davenport,&nbsp;Jillian E Urban,&nbsp;Fatemeh Mokhtari,&nbsp;Ervin L Lowther,&nbsp;John D Van Horn,&nbsp;Christopher G Vaughan,&nbsp;Gerard A Gioia,&nbsp;Christopher T Whitlow,&nbsp;Joel D Stitzel,&nbsp;Joseph A Maldjian","doi":"10.2217/cnc-2016-0003","DOIUrl":"https://doi.org/10.2217/cnc-2016-0003","url":null,"abstract":"<p><p>The effect of repeated subconcussive head impacts in youth and high school sports on the developing brain is poorly understood. Emerging neuroimaging data correlated with biomechanical exposure metrics are beginning to demonstrate relationships across a variety of modalities. The long-term consequences of these changes are unknown. A review of the currently available literature on the effect of subconcussive head impacts on youth and high school-age male football players provides compelling evidence for more focused studies of these effects in these vulnerable populations.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 4","pages":"CNC19"},"PeriodicalIF":0.0,"publicationDate":"2016-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36480298","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":"Identification of hidden health utilization services and costs in adults awaiting tertiary care following mild traumatic brain injury in Toronto, Ontario, Canada.","authors":"Cindy Hunt,&nbsp;Katrina Zanetti,&nbsp;Brian Kirkham,&nbsp;Alicja Michalak,&nbsp;Cheryl Masanic,&nbsp;Chantal Vaidyanath,&nbsp;Shree Bhalerao,&nbsp;Michael D Cusimano,&nbsp;Andrew Baker,&nbsp;Donna Ouchterlony","doi":"10.2217/cnc-2016-0009","DOIUrl":"https://doi.org/10.2217/cnc-2016-0009","url":null,"abstract":"<p><strong>Aim: </strong>The cognitive, emotional, behavioral and physical impairments experienced by adults after mild traumatic brain injury (mTBI) can produce substantial disability, with 15-20% requiring referral to tertiary care (TC) for persistent symptoms.</p><p><strong>Methods: </strong>A convenience sample of 201 adult patients referred to TC as a result of mTBI was studied. Self-reported data were collected at first TC visit, on average 10 months postinjury. Patients reported the type and intensity of healthcare provider visit(s) undertaken while awaiting TC.</p><p><strong>Results: </strong>On average males reported 37 and females 30 healthcare provider visits, resulting in over $500,000 Canadian dollars spent on potentially excess mTBI care over 1 year.</p><p><strong>Discussion: </strong>Based on conservative estimate of 15% of mTBI patients receiving TC, this finding identifies a possible excess in care of $110 million for Ontario. Accurate diagnosis of mTBI and early coordination of follow-up care for those needing TC could increase cost-effectiveness.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 4","pages":"CNC21"},"PeriodicalIF":0.0,"publicationDate":"2016-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36480300","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":"The partner's experience of traumatic brain injury and its recovery.","authors":"Gerard A Riley","doi":"10.2217/cnc-2016-0012","DOIUrl":"https://doi.org/10.2217/cnc-2016-0012","url":null,"abstract":"Traumatic brain injury (TBI) presents significant challenges to the partner of the person with the TBI and to the relationship they share. Struggling to deal with those challenges can have a significant impact on the psychological well-being of the partner, and on the quality and stability of the relationship. Compared with the general population, partners generally report higher levels of anxiety, stress and depression [1,2]; and lower levels of positive well-being, quality of life and life satisfaction [1,2]. Although there may be improvements [2], these difficulties can persist for many years after the TBI [3]. In terms of the impact on the relationship, methodological inadequacies in the research mean that there is, as yet, no clear answer to the question of whether TBI increases the rate of marital breakdown compared with the general population [4]. However, on measures of overall marital quality and satisfaction, partners tend to give their current relationship a poorer rating in comparison to the general population and to the preinjury relationship [4,5]. The primary aim of this overview is to summarize research about the partner’s negative experiences of TBI that may explain this damaging impact that the injury can have on their psychological well-being and the relationship. Understanding the experiences that contribute to the impact will highlight issues that need to be addressed in supporting couples after a TBI. The overview describes experiences both in the initial stages and in the longer term. It addresses the partner’s experience of more severe TBI (i.e., one that requires hospitalization and has long-lasting effects) rather than mild TBI. It should be noted that, although all the research papers cited in the review included at least some participants who were the partners of someone with a more severe TBI, a substantial number used mixed samples that contained participants who had other forms of brain injury (e.g., stroke), other familial relationships with the person with the injury (e.g., parents) or experience of mild TBI. Some partners have more positive experiences of TBI and this research, which is more limited in extent, will also be summarized. Understanding positive experiences may shed light on why some partners cope better than others.","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 3","pages":"CNC18"},"PeriodicalIF":0.0,"publicationDate":"2016-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36480297","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":"Sleep disturbance in patients with chronic concussive effects.","authors":"Andrea Hinds,&nbsp;Carla R Jungquist,&nbsp;John J Leddy,&nbsp;Fnu Seemant,&nbsp;John G Baker,&nbsp;Barry Willer","doi":"10.2217/cnc-2016-0002","DOIUrl":"https://doi.org/10.2217/cnc-2016-0002","url":null,"abstract":"<p><strong>Aim: </strong>Sleep disturbance is relatively overlooked in concussion treatment although sleep disorders may prolong or exacerbate symptoms after a concussion. We looked at the incidence of both sleep disturbance and postconcussion symptoms in a sample of recently concussed individuals.</p><p><strong>Methods & results: </strong>We evaluated scores on the insomnia severity index (ISI) and postconcussion symptom scale (PCSS) in 96 participants with persistent symptoms. Sleep disturbance significantly contributed to the severity of postconcussive symptoms and length of recovery; this effect was less pronounced in athletes.</p><p><strong>Conclusion: </strong>These results suggest a relationship between sleep problems and the time course of recovery from concussive injury. Clinicians who regularly treat concussion would benefit from a more thorough consideration of sleep function in the assessment of postconcussive symptoms.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 3","pages":"CNC15"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36479817","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":"Prolonged cognitive-motor impairments in children and adolescents with a history of concussion.","authors":"Marc Dalecki,&nbsp;David Albines,&nbsp;Alison Macpherson,&nbsp;Lauren E Sergio","doi":"10.2217/cnc-2016-0001","DOIUrl":"https://doi.org/10.2217/cnc-2016-0001","url":null,"abstract":"<p><strong>Aim: </strong>We investigated whether children and adolescents with concussion history show cognitive-motor integration (CMI) deficits.</p><p><strong>Method: </strong>Asymptomatic children and adolescents with concussion history (n = 50; mean 12.84 years) and no history (n = 49; mean: 11.63 years) slid a cursor to targets using their finger on a dual-touch-screen laptop; target location and motor action were not aligned in the CMI task.</p><p><strong>Results: </strong>Children and adolescents with concussion history showed prolonged CMI deficits, in that their performance did not match that of no history controls until nearly 2 years postevent.</p><p><strong>Conclusion: </strong>These CMI deficits may be due to disruptions in fronto-parietal networks, contributing to an increased vulnerability to further injury. Current return-to-play assessments that do not test CMI may not fully capture functional abilities postconcussion.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 3","pages":"CNC14"},"PeriodicalIF":0.0,"publicationDate":"2016-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2016-0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36480294","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":"Update on fluid biomarkers for concussion.","authors":"Henrik Zetterberg,&nbsp;Huw R Morris,&nbsp;John Hardy,&nbsp;Kaj Blennow","doi":"10.2217/cnc-2015-0002","DOIUrl":"https://doi.org/10.2217/cnc-2015-0002","url":null,"abstract":"<p><p>Concussions are difficult to diagnose and symptoms may not appear immediately. As an accurate initial diagnosis has profound implications for the clinical management, there is an unmet need for better diagnostic tools. Fluid biomarkers for CNS injury may represent such tools. These markers are often proteins, peptides or other molecules with selective or high expression in the brain, which can be measured in the cerebrospinal fluid or blood as they leak out or get secreted into the biofluid in response to the injury. Here, we review the literature on fluid markers of neuronal, axonal and astroglial injury and response mechanisms to diagnose CNS injury upon head impact and to determine when the injurious process has resolved.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 3","pages":"CNC12"},"PeriodicalIF":0.0,"publicationDate":"2016-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2015-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36479816","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":"Concussion research at the National Institutes of Health: an update from the National Institute of Neurological Disorders and Stroke.","authors":"Meghan Mott,&nbsp;Walter Koroshetz","doi":"10.2217/cnc.15.10","DOIUrl":"https://doi.org/10.2217/cnc.15.10","url":null,"abstract":"Concussion: the scope of the issue Concussion is an exceedingly common type of traumatic brain injury (TBI), yet little is known about what happens to the brain at the time of concussion. A concussion can be defined as a sudden onset change in neurologic function that occurs immediately after the brain encounters a mechanical force. When the head sustains an injury, direct or rotational biomechanical forces induce physiologic dysfunction; the most characteristic is immediate loss or alteration of consciousness. Each year, between 1.6 and 3.8 million sports-related concussions occur in the USA, particularly in youth athletes [1]. In the US military, it is estimated that roughly 20% of the deployed forces suffered a head injury in the wars in Iraq and Afghanistan, 83% of whom endured a mild, uncomplicated TBI or concussion [2]. While striking, these figures are likely vast underestimates of the actual number of afflicted individuals, since many who suffer concussion do not seek medical attention. The issues surrounding concussion can be divided into three major areas:","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 2","pages":"CNC10"},"PeriodicalIF":0.0,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc.15.10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36479814","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":"Neuroenergetics of traumatic brain injury.","authors":"Kate Karelina,&nbsp;Zachary M Weil","doi":"10.2217/cnc.15.9","DOIUrl":"https://doi.org/10.2217/cnc.15.9","url":null,"abstract":"<p><p>A subset of traumatic brain injury (TBI) patients exhibit cognitive deficits later in life which may be due to the underlying pathology associated with Alzheimer's disease (AD) or chronic traumatic encephalopathy. The similarities between chronic traumatic encephalopathy and AD merit investigation of potentially similar mechanisms underlying the two diseases. Experimental and clinical studies of AD brains have revealed that insulin resistance links metabolic dysfunction to the neurodegeneration and cognitive deficits associated with AD. Recent work in experimental TBI has established that recovery is dependent on the return of normal brain metabolism and mounting evidence for a role of brain insulin in regulating central metabolism suggests that TBI, like AD, results in central insulin resistance. Here, we review the converging evidence from AD, TBI and diabetes research linking insulin insensitivity to neurodegeneration.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 2","pages":"CNC9"},"PeriodicalIF":0.0,"publicationDate":"2015-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc.15.9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36479815","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":"The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature.","authors":"Kristin M Galetta,&nbsp;Mengling Liu,&nbsp;Danielle F Leong,&nbsp;Rachel E Ventura,&nbsp;Steven L Galetta,&nbsp;Laura J Balcer","doi":"10.2217/cnc.15.8","DOIUrl":"https://doi.org/10.2217/cnc.15.8","url":null,"abstract":"<p><strong>Background: </strong>Vision encompasses a large component of the brain's pathways, yet is not represented in current sideline testing.</p><p><strong>Objectives: </strong>We performed a meta-analysis of published data for a vision-based test of rapid number naming (King-Devick [K-D] test).</p><p><strong>Studies & methods: </strong>Pooled and meta-analysis of 15 studies estimated preseason baseline K-D scores and sensitivity/specificity for identifying concussed versus nonconcussed control athletes.</p><p><strong>Result: </strong>Baseline K-D (n = 1419) showed a weighted estimate of 43.8 s (95% CI: 40.2, 47.5; <i>I</i>² = 0.0%; p=0.85 - indicating very little heterogeneity). Sensitivity was 86% (96/112 concussed athletes had K-D worsening; 95% CI: 78%, 92%); specificity was 90% (181/202 controls had no worsening; 95% CI: 85%, 93%).</p><p><strong>Conclusion: </strong>Rapid number naming adds to sideline assessment and contributes a critical dimension of vision to sports-related concussion testing.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"1 2","pages":"CNC8"},"PeriodicalIF":0.0,"publicationDate":"2015-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc.15.8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36479813","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}