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Christopher A Abeare, Isabelle Messa, Brandon G Zuccato, Bradley Merker, Laszlo Erdodi
Importance: Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. Objectives: To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator...
March 12, 2018: JAMA Neurology
Douglas B Cooper, Glenn Curtiss, Patrick Armistead-Jehle, Heather G Belanger, David F Tate, Matthew Reid, Amy O Bowles, Carmen S Velez, Jan E Kennedy, Rodney D Vanderploeg
OBJECTIVE: To examine differences in objective neurocognitive performance and subjective cognitive symptoms in individuals with a history of a single concussion, multiple concussions, orthopedic injuries, and posttraumatic stress disorder (PTSD). METHOD: Participants included 116 military service members who sustained a mild traumatic brain injury (mTBI) during combat deployment. Subjects were subdivided into groups based on concussion frequency: a single concussion (n = 42), 2 concussions (n = 21), and 3 or more concussions (n = 53)...
March 2018: Journal of Head Trauma Rehabilitation
Arundhati Undurti, Elizabeth A Colasurdo, Carl L Sikkema, Jaclyn S Schultz, Elaine R Peskind, Kathleen F Pagulayan, Charles W Wilkinson
The most frequent injury sustained by US service members deployed to Iraq or Afghanistan is mild traumatic brain injuries (mTBI), or concussion, by far most often caused by blast waves from improvised explosive devices or other explosive ordnance. TBI from all causes gives rise to chronic neuroendocrine disorders with an estimated prevalence of 25-50%. The current study expands upon our earlier finding that chronic pituitary gland dysfunction occurs with a similarly high frequency after blast-related concussions...
2018: Frontiers in Neurology
Samuel R Walton, Donna K Broshek, Jason Freeman, C Munro Cullum, Jacob E Resch
PURPOSE: To investigate the frequency of valid yet suboptimal Immediate Postconcussion Assessment and Cognitive Test© (ImPACT) performance in university athletes and to explore the benefit of subsequent ImPACT administrations. METHODS: This descriptive laboratory study involved baseline administration of ImPACT to 769 university athletes per the institution's concussion management protocol. Testing was proctored in groups of ≤ 2 participants. Participants who scored below the 16th percentile according to ImPACT normative data were re-administered ImPACT up to two additional times as these scores were thought to be potentially indicative of suboptimal effort or poor understanding of instructions...
February 27, 2018: Medicine and Science in Sports and Exercise
Lisa M Koehl, Brittany D Walls, Stacey L Brothers, Sarah N Morris, Amanda C Glueck, Frederick A Schmitt, David T R Berry, Dong Y Han
Sports concussions are recognized as significant injuries among young athletes. Research demonstrates that return-to-play prior to becoming asymptomatic has significant repercussions including sustained cognitive deficits. Many programs have begun to use computerized testing rather than traditional neuropsychological tests to (a) determine baseline performance, (b) track symptoms, and (c) measure symptoms following concussion. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is one such tool...
February 21, 2018: Applied Neuropsychology. Child
Meeryo Choe, Karen M Barlow
PURPOSE OF REVIEW: This article summarizes the impact and complications of mild traumatic brain injury and concussion in children and outlines the recent evidence for its assessment and early management. Useful evidence-based management strategies are provided for children who have a typical recovery following concussion as well as for those who have persistent postconcussion syndrome. Cases are used to demonstrate the commonly encountered pathologies of headache, cognitive issues, and mood disturbances following injury...
February 2018: Continuum: Lifelong Learning in Neurology
Giedre Matuseviciene, Jan Johansson, Marika Möller, Alison K Godbolt, Tony Pansell, Catharina Nygren Deboussard
OBJECTIVES: To assess (1) whether visual disturbances can be demonstrated with objective measures more often in patients with mild traumatic brain injury (mTBI) than in orthopaedic controls and non-injured controls, (2) whether such objectively demonstrated disturbances change over time and (3) whether self-reported visual symptoms after mTBI correlate with objectively measurable changes in visuomotor performance. DESIGN: A prospective, controlled, observational study, with assessments planned 7-10 and 75-100 days after injury...
February 3, 2018: BMJ Open
W Alan C Mutch, Michael J Ellis, Lawrence N Ryner, Patrick J McDonald, Marc P Morissette, Philip Pries, Marco Essig, David J Mikulis, James Duffin, Joseph A Fisher
Background: Preliminary studies suggest that sports-related concussion (SRC) is associated with alterations in cerebral blood flow (CBF) regulation. Here, we use advanced magnetic resonance imaging (MRI) techniques to measure CBF and cerebrovascular responsiveness (CVR) in individual SRC patients and healthy control subjects. Methods: 15 SRC patients (mean age = 16.3, range 14-20 years) and 27 healthy control subjects (mean age = 17.6, range 13-21 years) underwent anatomical MRI, pseudo-continuous arterial spin labeling (pCASL) MRI and model-based prospective end-tidal targeting (MPET) of CO2 during blood oxygenation level-dependent (BOLD) MRI...
2018: Frontiers in Neurology
Randolph W Evans, Kamalika Ghosh
BACKGROUND AND OBJECTIVES: Postconcussion syndrome (PCS) has been controversial for more than 150 years. As there have not been any surveys of PCS among neurologists in the United States since 1992, another was performed using most of the prior items to assess current opinions and practices and whether there have been any changes since 1992. METHODS: Two hundred and eighty-nine neurologists attending the Texas Neurological Society 20th Annual Winter Conference continuing medical education meeting in 2017 were supplied the survey instrument with registration materials...
February 7, 2018: Headache
Davin K Quinn, Andrew R Mayer, Christina L Master, Jesse R Fann
No abstract text is available yet for this article.
February 1, 2018: American Journal of Psychiatry
Christine L Mac Donald, Jason Barber, Jason Wright, David Coppel, Nina De Lacy, Steve Ottinger, Suzanne Peck, Chris Panks, Kody Zalewski, Samantha Sun, Nancy Temkin
OBJECTIVE: Prior work suggests that younger athletes may be more vulnerable to postconcussive syndrome. We investigated measures of clinical outcome and quantitative volumetric imaging in 10- to 14-year-old adolescent athletes to better understand the impact of concussion on this younger population. SETTING: Outpatient clinics. PARTICIPANTS: Ten- to 14-year-old symptomatic pediatric sports concussion patients and typically developing active controls...
January 30, 2018: Journal of Head Trauma Rehabilitation
Donald C Olsen, Chelsea C Hays, Henry J Orff, Amy J Jak, Elizabeth W Twamley
PRIMARY OBJECTIVE: About 20% of Iraq and Afghanistan Veterans have sustained a traumatic brain injury (TBI), which can result in postconcussive symptoms and difficulty transitioning from the military to civilian employment and postsecondary education. To better inform programs help Veterans transition back into civilian life, we evaluated correlates of employment and postsecondary education enrolment among treatment-seeking Veterans with a history of TBI. RESEARCH DESIGN: A cross-sectional design, using an archival database of VA medical records, was used to answer these research questions...
January 25, 2018: Brain Injury: [BI]
Lauren Petley, Tim Bardouille, Darrell Chiasson, Patrick Froese, Steve Patterson, Aaron Newman, Antonina Omisade, Steven Beyea
PRIMARY OBJECTIVE: To examine the effect of concussion on indices of attention using magnetoencephalography. METHODS AND PROCEDURES: Thirteen patients were recruited from the emergency department and scanned within 3-6 days of injury. Five returned for follow-up scans one and three months post-injury. Thirteen healthy controls also completed testing. During MEG acquisition, participants performed the Attention Network Test (ANT). Cognitive evoked responses to this task include a cue-evoked P300m, a contingent magnetic variation (CMV) and a target-evoked P300m...
January 22, 2018: Brain Injury: [BI]
David R Howell, Michael J OʼBrien, Joana Fraser, William P Meehan
OBJECTIVE: To determine whether continuing to play after a concussion is associated with higher symptom burden or prolonged symptom duration. DESIGN: Patients who presented for care at a sport concussion clinic within the first 3 weeks of injury were asked whether they continued to play immediately after their injury. SETTING: Sport concussion clinic within a regional tertiary care hospital. MAIN OUTCOME MEASURES: Clinical outcomes including symptom severity, symptom duration, age, time from injury-clinical presentation, sex, sport type, previous concussion history, and whether or not they experienced loss of consciousness or amnesia at the time of injury were recorded...
January 15, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Julianne D Schmidt, Douglas P Terry, Jihyun Ko, Karl M Newell, L Stephen Miller
CONTEXT:   Subclinical postural-control changes may persist beyond the point when athletes are considered clinically recovered postconcussion. OBJECTIVE:   To compare postural-control performance between former high school football players with or without a history of concussion using linear and nonlinear metrics. DESIGN:   Case-control study. SETTING:   Clinical research laboratory. PATIENTS OR OTHER PARTICIPANTS:   A total of 11 former high school football players (age range, 45-60 years) with 2 or more concussions and 11 age- and height-matched former high school football players without a history of concussion...
January 13, 2018: Journal of Athletic Training
Tamara C Valovich McLeod, Alyssa J Wagner, Cailee E Welch Bacon
Background: Previous studies have identified the effect of sport-related concussion on health-related quality of life through the use of patient-reported outcome measures. However, there has been little research exploring the underlying mechanisms that influence these perceptions of health-related quality of life among adolescent athletes who have sustained a sport-related concussion. Purpose: To explore the psychosocial aspects of concussion among adolescent athletes...
December 2017: Orthopaedic Journal of Sports Medicine
Stine Fjendbo Galili, Bodil Hammer Bech, Claus Vestergaard, Morten Fenger-Gron, Jakob Christensen, Mogens Vestergaard, Jette Ahrensberg
OBJECTIVES: Traumatic brain injury (TBI) is commonly seen in the emergency department (ED). Approximately 85%-90% of TBIs are mild (mTBI). Some cause symptoms such as headache, dizziness, anxiety, blurred vision, insomnia and concentration difficulties, collectively known as postconcussion syndrome (PCS). Some studies suggest that recovery from mTBI is complete. Others find that symptoms persist for months, even years. The aim of this study was to describe the use of general practice, before and after mTBI, as a proxy for symptoms in a large cohort...
December 15, 2017: BMJ Open
Ivona Berger, Joyce Obeid, Brian W Timmons, Carol DeMatteo
This study examines accelerometer-based and self-report assessment of sleep disturbance from a larger prospective cohort of youth 5 to 18 years of age with postconcussive injury. Twenty-one participants with self-reported sleep disturbance were evaluated using accelerometers. Participants completed the Pittsburgh Sleep Quality Index (PSQI) every 48 hours and also measured sleep via accelerometry. Correlations were conducted matching PSQI scores to accelerometry assessment. PSQI scores were significantly correlated only with "average number of awakenings" (r = -0...
2017: Global Pediatric Health
Thaer S Manaseer, Douglas P Gross, Liz Dennett, Kathryn Schneider, Jackie L Whittaker
BACKGROUND: Gait deviations resulting from concussion are important to consider in the diagnosis, treatment progression, and return to activity after a concussion. OBJECTIVE: To identify quantifiable gait deviations associated with concussion across populations and time since injury. METHODS AND MATERIALS: Six electronic databases were systematically searched from January 1974 to September 2016. Studies selected included original data, had an analytic design, and reported a quantifiable gait parameter in individuals who had sustained a concussion as defined by the American Congress of Rehabilitation Medicine or related definitions...
November 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Lauren Shaw, Maria Morozova, Ishaq Abu-Arafeh
The aim of this systematic review is to determine the prevalence and clinical features of chronic post-traumatic headache (CPTH) in children and adolescents. Literature search of PubMed, Embase, Cochrane databases and Google Scholar was carried out for all studies reporting on CPTH in children and young people under the age of 18 years between January 1980 and November 2016. Search command included post-traumatic headache, postconcussion syndrome, child and adolescent. Demographic data, diagnostic criteria of headache disorders, occurrence of headache after head injury and headache phenotypes were collected...
January 2018: Pain Management
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