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Zuzana Novak, Mary Aglipay, Nick Barrowman, Keith O Yeates, Miriam H Beauchamp, Jocelyn Gravel, Stephen B Freedman, Isabelle Gagnon, Gerard Gioia, Kathy Boutis, Emma Burns, Andrée-Anne Ledoux, Martin H Osmond, Roger L Zemek
Importance: Persistent postconcussion symptoms (PPCS) pose long-term challenges and can negatively affect patients' health-related quality of life (HRQoL). To date, no large comprehensive study has addressed the association between PPCS and HRQoL. Objectives: To determine the association between HRQoL and PPCS at 4 weeks after concussion and assess the degree of impairment of HRQoL in the subsequent 12 weeks. Design, Setting, and Participants: In a prospective, multicenter cohort study (Predicting Persistent Postconcussive Problems in Pediatrics [5P]) from August 14, 2013, to September 30, 2014, children aged 5 to 18 years who presented to the emergency department within 48 hours after head injury and were considered to have an acute concussion were enrolled across 9 pediatric emergency departments within the Pediatric Emergency Research Canada Network...
October 24, 2016: JAMA Pediatrics
Tanya Bogoslovsky, Jessica Gill, Andreas Jeromin, Cora Davis, Ramon Diaz-Arrastia
Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. The lack of validated biomarkers for TBI is a major impediment to developing effective therapies and improving clinical practice, as well as stimulating much work in this area. In this review, we focus on different settings of TBI management where blood or cerebrospinal fluid (CSF) biomarkers could be utilized for predicting clinically-relevant consequences and guiding management decisions. Requirements that the biomarker must fulfill differ based on the intended context of use (CoU)...
October 18, 2016: Diagnostics
James M Bjork, Thomas K Burroughs, Laura M Franke, Treven C Pickett, Sade E Johns, F Gerard Moeller, William C Walker
In military populations, traumatic brain injury (TBI) also holds potential to increase impulsivity and impair mood regulation due to blast injury effects on ventral frontal cortex - to put military personnel at risk for suicide or substance abuse. We assessed a linkage between depression and impaired behavioral inhibition in 117 blast-exposed service members (SM) and veterans with post-concussion syndrome (PCS), where PCS was defined using a Rivermead Postconcussive Symptom Questionnaire (RPQ) modified to clarify whether each symptom worsened compared to pre-blast...
October 7, 2016: Psychiatry Research
Adam C Raikes, Sydney Y Schaefer
STUDY OBJECTIVES: A number of subjective and objective studies provide compelling evidence of chronic postconcussion changes in sleep, yet very little is known about the acute effects of concussion on sleep quality and quantity. Therefore, the purpose of this prospective pilot study was to use actigraphy to examine the changes in sleep quality and quantity acutely following concussion at home rather than in a hospital or sleep laboratory. METHODS: Seventeen young adults (7 with acute concussion, 10 controls) were recruited for this study...
October 10, 2016: Sleep
Georgina Perez-Garcia, Miguel A Gama Sosa, Rita De Gasperi, Margaret Lashof-Sullivan, Eric Maudlin-Jeronimo, James R Stone, Fatemeh Haghighi, Stephen T Ahlers, Gregory A Elder
The postconcussion syndrome following mild traumatic brain injuries (mTBI) has been regarded as a mostly benign syndrome that typically resolves in the immediate months following injury. However, in some individuals, symptoms become chronic and persistent. This has been a striking feature of the mostly blast-related mTBIs that have been seen in veterans returning from the recent conflicts in Iraq and Afghanistan. In these veterans a chronic syndrome with features of both the postconcussion syndrome and post-traumatic stress disorder has been prominent...
September 28, 2016: Behavioural Brain Research
Wesley R Cole, Jacques P Arrieux, Elizabeth M Dennison, Brian J Ivins
Computerized neurocognitive assessment tools (NCATs) have become a common way to assess postconcussion symptoms. As there is increasing research directly comparing multiple NCATs to each other, it is important to consider the impact that order of test administration may have on the integrity of the results. This study investigates the impact of administration order in a study of four different NCATs; Automated Neuropsychological Assessment Metrics (ANAM4), CNS Vital Signs (CNS-VS), CogState, and Immediate Post-Concussion Assessment and Cognitive Test (ImPACT)...
October 3, 2016: Journal of Clinical and Experimental Neuropsychology
Michael J Ellis, Dean M Cordingley, Sara Vis, Karen M Reimer, Jeff Leiter, Kelly Russell
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...
September 30, 2016: Journal of Neurosurgery. Pediatrics
Maya Elin O'Neil, Megan Callahan, Kathleen F Carlson, Mai Roost, Benjamin Laman-Maharg, Elizabeth W Twamley, Grant L Iverson, Daniel Storzbach
OBJECTIVE: This study examined symptom reporting related to the 10th Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria for postconcussional syndrome (PCS) in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans. Our aims were to: (a) examine relationships among PCS symptoms by identifying potential subscales of the British Columbia Postconcussion Symptom Inventory (BC-PSI); and (b) examine group differences in BC-PSI items and subscales in Veterans with and without blast exposure, mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD)...
September 28, 2016: Journal of Clinical and Experimental Neuropsychology
Karen A Sullivan, Christina Wade
INTRODUCTION: A controlled experiment of the effect of injury cause on expectations of outcome from mild traumatic brain injury (TBI) was conducted. METHOD: Ninety-three participants were randomly assigned to one of four conditions. The participants read a vignette that described a mild TBI (with fixed injury parameters) from a different cause (sport, domestic assault, fall, or motor vehicle accident). The effect of the manipulation on expectations of persistent postconcussion symptoms and psychological trauma was assessed with standard measures and a novel "threat-to-life" measure...
September 23, 2016: Journal of Clinical and Experimental Neuropsychology
Harold M Olson, Michael J Tunning, Ronnie J Boesch
OBJECTIVE: The purpose of this study is to describe the chiropractic management of a student athlete with postconcussion syndrome. CLINICAL FEATURES: A 14-year-old male hockey player presented to a chiropractic clinic with postconcussion symptoms 13 days after his initial injury. He experienced an occipital headache with a pain rating of 8/10, upset stomach, blurry vision, nausea, dizziness, balance problems, a "foggy feeling," difficulty with concentration, difficulty with memory, fatigue, confusion, drowsiness, and irritability...
September 2016: Journal of Chiropractic Medicine
Henrik Zetterberg, Kaj Blennow
Diagnostic and prognostic biomarkers for mild traumatic brain injury (TBI), also known as concussion, remain a major unmet clinical need. Moderate to severe TBI can be diagnosed definitively by clinical assessment and standard neuroimaging techniques that detect the gross damage to the brain parenchyma. Diagnostic tools for mild TBI are lacking and, currently, the diagnosis has to be made on clinical grounds alone, because most patients show no gross pathological changes on CT. Most patients with mild TBI recover quickly, but about 15% develop an ill-defined condition called postconcussive syndrome (PCS)...
October 2016: Nature Reviews. Neurology
Carolyn A McCarty, Douglas Zatzick, Elizabeth Stein, Jin Wang, Robert Hilt, Frederick P Rivara
BACKGROUND AND OBJECTIVES: Postconcussive and co-occurring psychological symptoms are not uncommon after sports-related concussion and are associated with functional impairment and societal costs. There is no evidence-based treatment targeting postconcussive symptoms in children and adolescents. The goal of this study was to test a collaborative care intervention model with embedded cognitive-behavioral therapy, care management, and psychopharmacological consultation. We hypothesized that patients in collaborative care would demonstrate greater reductions in postconcussive, depressive, and anxiety symptoms and improvement in functioning over the course of 6 months, compared with usual care control...
September 13, 2016: Pediatrics
Jennifer Strahle, Cormac O Maher
No abstract text is available yet for this article.
September 9, 2016: Journal of Neurosurgery
Antoine Chevalier, Kelly Armstrong, C Norwood-Williams, Raman Gokal
Introduction: This case study offers a detailed comparative analysis of the effects of direct-current electroacupuncture (DC-EA) on the autonomic nervous system (ANS), when DC-EA was applied to the cranial sutures and scars of a patient with a history of ischemic stroke and postconcussion syndrome (PCS) pain. Case: A 56-year-old female suffering from severe tremors and debilitating headaches requested acupuncture after conventional biomedicines failed to relieve her symptoms. Evaluations were performed to check the status of 27 ANS functions...
August 1, 2016: Medical Acupuncture
William C Walker, Laura M Franke, Adam P Sima, David X Cifu
BACKGROUND: Blast-related mild traumatic brain injury (blast mTBI) is a signature wound of recent US military conflicts in the Middle East, but the relatedness of postconcussive symptoms (PCS) to the blast mTBI is unclear, and longitudinal symptom data are sparse. OBJECTIVES: To characterize postdeployment symptom levels and trajectories and to determine relationship to blast mTBI. METHODS: A total of 216 participants within 2 years of blast exposure during deployment underwent structured interviews or algorithmic questionnaires for blast mTBI...
September 6, 2016: Journal of Head Trauma Rehabilitation
Xavier A Figueroa, James K Wright
OBJECTIVE: First, to demonstrate that B-level evidence exists for the use of hyperbaric oxygen therapy (HBOT) as an effective treatment in mild to moderate traumatic brain injury/persistent postconcussion syndrome (mTBI/PPCS). Second, to alert readers and researchers that currently used pressurized air controls (≥21% O2, >1.0 ATA) are therapeutically active and cannot be utilized as sham controls without further validation. METHOD: Review of published, peer-reviewed articles of HBOT prospective and controlled clinical trials of mTBI/PPCS symptoms...
September 27, 2016: Neurology
Shira Segev, Maayan Shorer, Yuri Rassovsky, Tammy Pilowsky Peleg, Alan Apter, Silvana Fennig
OBJECTIVE: Persistent postconcussive symptoms (PPCS) are a set of physical, cognitive, emotional, and behavioral symptoms that often follow mild traumatic brain injury (mTBI). Some of these symptoms also occur in posttraumatic stress disorder (PTSD). The current study examined the unique contribution of mTBI and PTSD to PPCS. The roles of neurocognitive and motivational factors were also addressed. METHOD: Sixty one children and adolescents (ages 6-18), at least 3 months post motor vehicle accident (MVA), participated in the study...
October 2016: Neuropsychology
Michael Morin, Pierre Langevin, Philippe Fait
Background. There is a lack of scientific evidence in the literature on the involvement of the cervical spine in mTBI; however, its involvement is clinically accepted. Objective. This paper reviews evidence for the involvement of the cervical spine in mTBI symptoms, the mechanisms of injury, and the efficacy of therapy for cervical spine with concussion-related symptoms. Methods. A keyword search was conducted on PubMed, ICL, SportDiscus, PEDro, CINAHL, and Cochrane Library databases for articles published since 1990...
2016: Journal of Sports Medicine (Hindawi Publishing Corporation)
Dawson Church, Garret Yount, Kenneth Rachlin, Louis Fox, Jerrod Nelms
PURPOSE: To assess the feasibility of measuring changes in gene expression associated with post-traumatic stress disorder (PTSD) treatment using emotional freedom techniques (EFT). DESIGN: Participants were randomized into an EFT group receiving EFT and treatment as usual (TAU) throughout a 10-week intervention period and a group receiving only TAU during the intervention period and then receiving EFT. SETTING: A community clinic and a research institute in California...
August 12, 2016: American Journal of Health Promotion: AJHP
Noah D Silverberg, Grant L Iverson, Michael McCrea, Jennifer N Apps, Thomas A Hammeke, Danny G Thomas
Importance: Recovery from concussion generally follows a trajectory of gradual improvement, but symptoms can abruptly worsen with exertion. This phenomenon is poorly understood. Objectives: To characterize the incidence, course, and clinical significance of symptom exacerbations (spikes) in children after concussion. Design, Setting, and Participants: This secondary analysis of clinical trial data analyzes 63 eligible participants prospectively recruited from an emergency department who were asked to complete a postconcussion symptom scale and record their activities in a structured diary for the next 10 days...
October 1, 2016: JAMA Pediatrics
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