Journal of concussion最新文献

{"title":"Sleep quality in the chronic stage of concussion is associated with poorer recovery: A systematic review","authors":"Rebecca Ludwig, Eryen Nelson, P. Vaduvathiriyan, M. Rippee, C. Siengsukon","doi":"10.1177/20597002211020881","DOIUrl":"https://doi.org/10.1177/20597002211020881","url":null,"abstract":"Background Recovery from a concussion varies based on a multitude of factors. One such factor is sleep disturbances. In our prior review, it was observed that in the acute phase, sleep disturbances are predictive of poor outcomes following a concussion. The literature gap remains on how sleep in the chronic phase of recovery affects outcomes. Objective To examine the association between sleep quality during the chronic stage of concussion and post-concussion outcomes. Literature Survey: Literature searches were performed during 1 July to 1 August 2019 in selected databases along with searching grey literature. Out of the 733 results, 702 references were reviewed after duplicate removal. Methods Three reviewers independently reviewed and consented on abstracts meeting eligibility criteria (n = 35). The full-text articles were assessed independently by two reviewers. Consensus was achieved, leaving four articles. Relevant data from each study was extracted using a standard data-extraction table. Quality appraisal was conducted to assess potential bias and the quality of articles. Results One study included children (18–60 months) and three studies included adolescents and/or adults (ranging 12–35 years). The association between sleep and cognition (two studies), physical activity (one study), and emotion symptoms (one study) was examined. Sleep quality was associated with decreased cognition and emotional symptoms, but not with meeting physical activity guidelines six months post-concussion injury. Conclusions The heterogeneity in age of participants and outcomes across studies and limited number of included studies made interpretations difficult. Future studies may consider if addressing sleep quality following concussion will improve outcomes.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20597002211020881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45925240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-concussion states: How do we improve our patients’ outcomes? An Australian perspective","authors":"Elizabeth Thomas, M. Fitzgerald, Gill Cowen","doi":"10.1177/2059700220960313","DOIUrl":"https://doi.org/10.1177/2059700220960313","url":null,"abstract":"There is limited data surrounding incidence and prevalence of concussion and the resulting post-concussion states. This creates difficulty when investigating ways to optimise patient management. It is proposed that a registry of patients presenting with symptoms and signs after a concussion, as part of a large scale TBI registry across Australia, would provide a starting point for future research with a view to improving the outcomes of patients experiencing symptoms and signs after concussion.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220960313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49253228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interval-censored survival analysis of mild traumatic brain injury with outcome based neuroimaging clinical applications","authors":"C. Vanier, Trisha Pandey, Shaunaq Parikh, A. Rodriguez, T. Knoblauch, John Peralta, Amanda Hertzler, Leonov Ma, Ruslan Nam, S. Musallam, Hallie Taylor, T. Vickery, Yolanda Zhang, L. Ranzenberger, Andrew Nguyen, Mike Kapostasy, Alex Asturias, E. Fazzini,, Travis Snyder","doi":"10.1177/2059700220947194","DOIUrl":"https://doi.org/10.1177/2059700220947194","url":null,"abstract":"Objective The purpose of this study was to assess the relationship between MRI findings and clinical presentation and outcomes in patients following mild traumatic brain injury (mTBI). We hypothesize that imaging findings other than hemorrhages and contusions may be used to predict symptom presentation and longevity following mTBI. Methods Patients (n = 250) diagnosed with mTBI and in litigation for brain injury underwent 3T magnetic resonance imaging (MRI). A retrospective chart review was performed to assess symptom presentation and improvement/resolution. To account for variable times of clinical presentation, nonuniform follow-up, and uncertainty in the dates of symptom resolution, a right censored, interval censored statistical analysis was performed. Incidence and resolution of headache, balance, cognitive deficit, fatigue, anxiety, depression, and emotional lability were compared among patients. Image findings analyzed included white matter hyperintensities (WMH), Diffusion Tensor Imaging (DTI) fractional anisotropy (FA) values, MR perfusion, auditory functional MRI (fMRI) activation, hippocampal atrophy (HA) and hippocampal asymmetry as defined by NeuroQuant ® volumetric software. Results Patients who reported LOC were significantly more likely to present with balance problems (p < 0.001), cognitive deficits (p = 0.010), fatigue (p = 0.025), depression (p = 0.002), and emotional lability (p = 0.002). Patients with LOC also demonstrated significantly slower recovery of cognitive function than those who did not lose consciousness (p = 0.044). Patients over the age of 40 had significantly higher odds of presenting with balance problems (p = 0.006). Additionally, these older patients were slower to recover cognitive function (p = 0.001) and less likely to experience improvement of headaches (p = 0.007). Abnormal MRI did not correlate significantly with symptom presentation, but was a strong indicator of symptom progression, with slower recovery of balance (p = 0.009) and cognitive deficits (p < 0.001). Conclusion This analysis demonstrates the utility of clinical data analysis using interval-censored survival statistical technique in head trauma patients. Strong statistical associations between neuroimaging findings and aggregate clinical outcomes were identified in patients with mTBI.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220947194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47330955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The possible role of hydration in concussions and long-term symptoms of concussion for athletes. A review of the evidence","authors":"James E Clark, E. Sirois","doi":"10.1177/2059700220939404","DOIUrl":"https://doi.org/10.1177/2059700220939404","url":null,"abstract":"The purpose of this review is to address what is known, speculated, and hypothesized regarding the issue of hydration and concussions. Based on the question, “What impact does hydration have on the relative risk for suffering concussive injuries along with long-term ramifications that have been associated with concussive (and repeated subconcussive) traumas to the cerebral cortex?,” a search of available literature was performed through June 2019. Deducing from the available literature, we can stipulate that changes in hydration within the cerebral cortex increase the likelihood for disruption of neurofilament proteins, dysregulation of membrane dynamics of the neurons and exacerbate inflammation responses following head trauma. As such, it can be speculated that differences in incidence rates may be attributed to difference in tissue fluid based on athlete demographics, level of whole-body water balance, and degree of tissue dehydration more than selection of sport. Moreover, tissue hydration in combination with other inflammation factors provides the scaffolding for the development of long-term issues (e.g. chronic traumatic encephalopathy) associated with repetitive head trauma in athletes.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220939404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43246858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situational factors associated with concussion in cricket identified from video analysis","authors":"A. Saw, David J Howard, A. Kountouris, A. McIntosh, J. Orchard, R. Saw, T. Hill","doi":"10.1177/2059700220947197","DOIUrl":"https://doi.org/10.1177/2059700220947197","url":null,"abstract":"Video analysis of situational factors associated with head impacts and concussion has been completed in several sports, however has yet to be completed in cricket. This study aimed to identify situational factors associated with concussion in elite Australian male and female cricket. Match video of head impacts were coded for player position, impacting object, source of ball, location of impact, and where the ball went after impact. Head impacts were then categorised as either concussion or no concussion based on clinical diagnosis. Data for 197 head impacts included 35 (18%) which were diagnosed as concussion. Head impacts typically occurred to an on-strike batter facing a pace bowler (84%). If the ball stopped or rebounded towards the source, 21% were diagnosed as concussion (13% if the ball deflected away from the source). If impact was to an unprotected head, 38% were diagnosed as concussion (16% if impact was to a helmet). If impact was to the back of the helmet or head, 40% were diagnosed as concussion (11–21% for other areas of the head or helmet). The combination of situational factors most consistent with concussion were impact from ball that hit the back of helmet or head and stopped or rebounded towards the source (PPV 80%, p = 0.002). Consideration of the situational factors of a head impact may improve the speed and accuracy of clinical decision making on whether to remove a player from the field for further assessment, particularly if clinical signs are unclear. Video may be used as a tool to support this process. Improved impact attenuation of cricket helmets, particularly at the back, may reduce the risk of concussion.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220947197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46497291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing concussion rates as reported by hockey Canada with head contact events as observed across minor ice-hockey age categories","authors":"M. Robidoux, M. Kendall, Y. Laflamme, A. Post, C. Karton, T. Hoshizaki","doi":"10.1177/2059700220911285","DOIUrl":"https://doi.org/10.1177/2059700220911285","url":null,"abstract":"Head injuries in elite and youth sport have garnered growing public attention in part because of high-profile cases of professional athletes suffering career-ending/threatening concussions and because of the increase in medical studies identifying how repeated concussive events can lead to long-term health problems, most notably degenerative brain disease. Public concerns around youth ice hockey are intensifying in light of recent evidence which suggests that effects of head injury are worse for youth than they are for athletes in later stages of life. To better understand concussion injury rate trends across all levels of youth hockey, this paper provides a retrospective analysis of concussion related hockey injury as recorded in Hockey Canada’s Injury Reporting System from the period covering 2009 to 2016, combined with two years of observational research documenting head contact events in minor hockey in the Ottawa and Gatineau regions of Ontario and Quebec. By comparing two different data sets through different methodological designs, it provides important insight into the levels of head contact in youth hockey, how head contact is occurring, and offers commentary about the levels of risk players are exposed to in minor hockey in Canada.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220911285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46211722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accident reconstructions of falls, collisions, and punches in sports","authors":"M. Kendall, Anna Oeur, S. Brien, M. Cusimano, S. Marshall, M. Gilchrist, T. Hoshizaki","doi":"10.1177/2059700220936957","DOIUrl":"https://doi.org/10.1177/2059700220936957","url":null,"abstract":"Objective Impacts to the head are the primary cause of concussive injuries in sport and can occur in a multitude of different environments. Each event is composed of combinations of impact characteristics (striking velocity, impact mass, and surface compliance) that present unique loading conditions on the head and brain. The purpose of this study was to compare falls, collisions, and punches from accident reconstructions of sports-related head impacts using linear, rotational accelerations and maximal principal strain of brain tissue from finite element simulation. Methods This study compared four types of head impact events through reconstruction. Seventy-two head impacts were taken from medical reports of accidental falls and game video of ice hockey, American football, and mixed-martial arts. These were reconstructed using physical impact systems to represent helmeted and unhelmeted falls, player-to-player collisions, and punches to the head. Head accelerations were collected using a Hybrid III headform and were input into a finite element brain model used to approximate strain in the cerebrum associated with the external loading conditions. Results Significant differences (p < 0.01) were found for peak linear and rotational accelerations magnitudes (30–300 g and 3.2–7.8 krad/s2) and pulse durations between all impact event types characterized by unique impact parameters. The only exception was found where punch impacts and helmeted falls had similar rotational durations. Regression analysis demonstrated that increases to strain from unhelmeted falls were significantly influenced by both linear and rotational accelerations, meanwhile helmeted falls, punches, and collisions were influenced by rotational accelerations alone. Conclusion This report illustrates that the four distinct impact events created unique peak head kinematics and brain tissue strain values. These distinct patterns of head acceleration characteristics suggest that it is important to keep in mind that head injury can occur from a range of low to high acceleration magnitudes and that impact parameters (surface compliance, striking velocity, and impact mass) play an important role on the duration-dependent tolerance to impact loading.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220936957","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43938209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concussion disclosure in middle and high school youth: Who gets the message and are they trained to receive it?","authors":"A. Wicklund, J. Coatsworth","doi":"10.1177/2059700220924499","DOIUrl":"https://doi.org/10.1177/2059700220924499","url":null,"abstract":"Background Disclosure of concussion is vital for proper diagnosis and treatment. Youth have many stakeholders to whom they may disclose concussion, including parents, peers, coaches, and school personnel. We examined whom high school and middle school youth report concussion and the level of concussion education of the recipients of the disclosure. Methods Data were analyzed from 2362 students, 680 parents, and 150 school personnel who completed an online survey about concussion reporting, education, and training. Results Youth were most likely to disclose concussions to parents, particularly mothers, and their peer group. Middle school youth reported to teachers and school nurses at higher rates than high school youth. High school youth were more likely to disclose concussion to coaches and athletic trainers than middle school youth. While mothers were the most likely recipient of youths’ reporting, they were least likely to have received concussion education. Conclusions Recipients of youth concussion disclosure differs by school level. Parents are the most common recipients of disclosure. The role of school personnel and coaches changes as youth enter high school. Youth primarily report concussions to parents, yet parents receive the least amount of concussion training. These findings highlight the need for targeted concussion training for stakeholder groups as their role in disclosure may differ by school age.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220924499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42273558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative soccer heading amplifies the effects of brain activity observed during concurrent moderate exercise and continuous performance task in female youth soccer players","authors":"A. Harriss, Andrew M. Johnson, James W. G. Thompson, D. Walton, J. Dickey","doi":"10.1177/2059700220912654","DOIUrl":"https://doi.org/10.1177/2059700220912654","url":null,"abstract":"Objectives To determine whether youth female soccer players demonstrate spectral changes in electroencephalogram activity during a continuous performance test, related to cumulative soccer heading at rest and during exercise. Setting Community soccer facilities. Participants Twenty-four female youth soccer players (age: 13.1 ± 0.8 years, mass: 49.5 ± 8.6 kg, height: 1.6 ± 0.1 m). Methods Players completed testing at four time points during the soccer season. The continuous performance test involved players responding to target stimuli or refraining from responding to non-target stimuli. Omission errors (player failed to respond to target stimuli) and commission errors (player responded to non-target stimuli) were assessed for each continuous performance test. Electroencephalogram frequency bandwidths were divided into Theta (4.0–7.9 Hz), Alpha1 (8.0–9.9 Hz), Alpha2 (10.0–12.9 Hz), Beta1 (13.0–17.9 Hz), and Beta2 (18.0–29.9 Hz). Linear mixed-effects modeling was performed on electroencephalogram power at electrode locations Fp1, Fp2, F3, F4, F7, F8, C3, and C4. Participants completed a continuous performance test during rest and moderate exercise. Results Omission errors significantly increased during exercise compared to rest at all time points (p < 0.05), but not commission errors. Linear mixed-effects models revealed that there was a statistically significant increase in electroencephalogram power during exercise across all frequency bands (p < 0.05); the number of cumulative headers amplified this difference for Alpha1, Alpha2, and Beta2 (p < 0.05). There were no statistically significant differences between cumulative number of headers and remaining electroencephalogram frequency bands (all p values > 0.05). Conclusion Moderate exercise may help to elicit sub-clinical changes in youth female soccer players due to cumulative head impacts, which are not apparent at rest.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220912654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45927849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of coach and parent knowledge of concussion","authors":"Robyn S Feiss, Molly Lutz, Justin R Moody, Melissa M. Pangelinan","doi":"10.1177/2059700219900053","DOIUrl":"https://doi.org/10.1177/2059700219900053","url":null,"abstract":"Coach and parent knowledge of concussion is essential for the prevention, appropriate diagnosis, management, and return-to-play of youth athletes. This systematic review examined concussion knowledge of coaches and parents of youth athletes including general knowledge, sign and symptom recognition, management, and return-to-play protocols. Six databases were searched for studies that evaluated baseline knowledge levels of coaches and parents of youth athletes regarding concussion. A total of 17 articles (out of 1500 articles) met selection criteria. Coaches and parents could identify common signs and symptoms of concussion (e.g. headaches, dizziness, etc.) but were less aware of emotional symptoms (e.g. sadness or mood swings). Coaches were unaware that youth athletes may require more time to recover from a concussion compared to adults. Parents lacked knowledge regarding proper concussion management and return-to-play guidelines. Physicians were the main source of information for parents, while coaches and athletic trainers were the least utilized. There were clear gaps in both coach and parent knowledge of concussion. Future education programs should provide pediatric-specific information for concussion management, recovery, and return-to-play. Additional efforts are needed to increase communication and knowledge transfer between coaches, medical staff, and parents.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219900053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43510723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}