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Concussion, mild traumatic brain injury

Zhihui Yang, Fan Lin, Amanda S Weissman, Emily Jaalouk, Qing-Shan Xue, Kevin K W Wang
Despite the concussion/ mild traumatic brain injury (mTBI) being the most frequent occurrence of traumatic brain injury, there is still a lack of knowledge on the injury and its effects. To develop a better understanding of concussions, animals are often used because they provide a controlled, rigorous, and efficient model. Studies have adapted traditional animal models to perform mTBI to stimulate mild injury severity by changing the injury parameters. These models have been used because they can produce morphologically similar brain injuries to the clinical condition and provide a spectrum of injury severities...
October 12, 2016: Journal of Visualized Experiments: JoVE
Mingxiong Huang, Deborah L Harrington, Ashley Robb, Annemarie Angeles, Sharon Nichols, Angela I Drake, Tao Song, Mithun Diwakar, Charles W Huang, Victoria Risbrough, Anders M Dale, Hauke Bartsch, Scott Matthews, Jeffrey W Huang, Roland R Lee, Dewleen G Baker
Blast mild traumatic brain injury (mTBI) is a leading cause of sustained impairment in military service members and Veterans. However, the mechanism of persistent disability is not fully understood. The present study investigated disturbances in brain functioning in mTBI participants using a source-imaging-based approach to analyze functional connectivity (FC) from resting-state magnetoencephalography (rs-MEG). Study participants included 26 active-duty service members or Veterans who had blast mTBI with persistent post-concussive symptoms and 22 healthy control active-duty service members or Veterans...
October 20, 2016: Journal of Neurotrauma
William Peacock
Dear Editor I read with great interest the manuscript titled "A New Panel of Blood Biomarkers for the Diagnosis of Mild Traumatic Brain Injury/Concussion in Adults" by Shan R, et al, published in the January issue of the Journal. (1) I do have some questions. The key to marker discovery studies is a precise and accurate description of how the population was identified, including controls. I have significant concerns about the control population in the manuscript. In the presentation the characteristics of the control group are unclear, described only as "not patients in the ED" and with the same exclusion criteria of the other cohorts...
October 18, 2016: Journal of Neurotrauma
Michael W Collins, Anthony P Kontos, David O Okonkwo, Jon Almquist, Julian Bailes, Mark Barisa, Jeffrey Bazarian, O Josh Bloom, David Brody, Robert Cantu, Javier Cardenas, Jay Clugston, Randall Cohen, Ruben Echemendia, R J Elbin, Richard Ellenbogen, Janna Fonseca, Gerard Gioia, Kevin Guskiewicz, Robert Heyer, Gillian Hotz, Grant L Iverson, Barry Jordan, Geoffrey Manley, Joseph Maroon, Thomas McAllister, Michael McCrea, Anne Mucha, Elizabeth Pieroth, Kenneth Podell, Matthew Pombo, Teena Shetty, Allen Sills, Gary Solomon, Danny G Thomas, Tamara C Valovich McLeod, Tony Yates, Ross Zafonte
BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion...
October 12, 2016: Neurosurgery
Leonard A Temme, Paul St Onge, Joseph Bleiberg
INTRODUCTION: Physiological and emotional stressors increase symptoms of concussion in recently injured individuals and both forms of stress-induced symptoms in people recovering from mild traumatic brain injury (mTBI), but who are asymptomatic when not stressed or are at rest. METHODS: Healthy asymptomatic adults (25.0 ± 5.1 years) with a history of mTBI (n = 36) and matched healthy controls (HC) (n = 36) with no mTBI history were exposed to three levels of normobaric hypoxic stress generated with the Reduced Oxygen Breathing Device (ROBD) (Environics, Inc...
2016: Frontiers in Neurology
Edrea Khong, Nicole Odenwald, Eyesha Hashim, Michael D Cusimano
OBJECTIVES: To review the evidence for the use of diffusion tensor imaging (DTI) parameters in the human brain as a diagnostic tool for and predictor of post-concussion syndrome (PCS) after a mild traumatic brain injury (mTBI). DESIGN: Systematic review. DATA SOURCES: All relevant studies in AMED, Embase, MEDLINE, Ovid, PubMed, Scopus, and Web of Science through 20 May, 2016. STUDY SELECTION: Studies that analyze traditional DTI measures [fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD)] and the severity of PCS symptoms or the development of PCS in humans after an mTBI...
2016: Frontiers in Neurology
David V Walsh, José E Capó-Aponte, Thomas Beltran, Wesley R Cole, Ashley Ballard, Joseph Y Dumayas
OBJECTIVES: The Department of Defense reported that 344,030 cases of traumatic brain injury (TBI) were clinically confirmed from 2000 to 2015, with mild TBI (mTBI) accounting for 82.3% of all cases. Unfortunately, warfighters with TBI are often identified only when moderate or severe head injuries have occurred, leaving more subtle mTBI cases undiagnosed. This study aims to identify and validate an eye-movement visual test for screening acute mTBI. METHODS: Two-hundred active duty military personnel were recruited to perform the King-Devick® (KD) test...
September 11, 2016: Journal of the Neurological Sciences
Osman Hassan Ahmed, Eric E Hall
BACKGROUND/AIMS: Concussion is widely discussed in online sports news articles, but the terms used to report this injury vary. This study aimed to use a systematic search strategy and explore the description of sports concussion in online sports news articles. METHODS: A systematic approach was employed to obtain online articles related to sports concussion from four sports associated with concussion (hockey, football, soccer, and rugby). Included articles were evaluated for the descriptors used in relation to concussion and possible consequences associated with concussion...
July 15, 2016: Physical Therapy in Sport
Joshua Kamins, Christopher C Giza
Concussion is increasingly recognized as a major public health issue. Most patients will return to baseline and experience full recovery, although a subset experiences persistent symptoms. Newer animal models and imaging studies are beginning to demonstrate that metabolic and neurovascular resolution may actually take longer than symptomatic recovery. Repeat traumatic brain injury within the metabolic window of dysfunction may result in worsened symptoms and prolonged recovery. The true risk for second impact syndrome appears to be small, and development of cerebral edema after a mild impact may be related to genetic risks rather than serial impacts...
October 2016: Neurosurgery Clinics of North America
Ingo Helmich
BACKGROUND: Concussions are common incidences in sports. However, game-specific characteristics such as tactics, field positions, etc. might positively/negatively contribute to the occurrence of mild traumatic brain injuries (mTBI) in various sports such as soccer, volleyball, handball, or basketball. Thus, the intention of this study was to analyze game- specific characteristics of concussive incidents in active players from the perspective of different sportive disciplines. METHODS: Four sport-specific questionnaires for soccer, handball, volleyball and basketball were established using an online survey tool...
September 14, 2016: Journal of Sports Medicine and Physical Fitness
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
Ping-Hong Yeh, Cheng Guan Koay, Binquan Wang, John Morissette, Elyssa Sham, Justin Senseney, David Joy, Alex Kubli, Chen-Haur Yeh, Victora Eskay, Wei Liu, Louis M French, Terrence R Oakes, Gerard Riedy, John Ollinger
The aim of this study was to apply recently developed automated fiber segmentation and quantification methods using diffusion tensor imaging (DTI) and DTI-based deterministic and probabilistic tractography to access local and global diffusion changes in blast-induced mild traumatic brain injury (bmTBI). Two hundred and two (202) male active US service members who reported persistent post-concussion symptoms for more than 6 months after injury were recruited. An additional forty (40) male military controls were included for comparison...
September 15, 2016: Human Brain Mapping
Coco O Bernard, Jennie A Ponsford, Audrey McKinlay, Dean McKenzie, David Krieser
OBJECTIVES: A notable minority of children will experience persistent post-concussive symptoms (PCS) following mild traumatic brain injury (mTBI), likely maintained by a combination of injury and non-injury related factors. Adopting a prospective longitudinal design, this study aimed to investigate the relative influence of child, family, and injury factors on both acute and persistent PCS in young children. METHODS: Participants were 101 children aged 2-12 who presented to an Emergency Department, with either mTBI or minor bodily trauma (control)...
September 2016: Journal of the International Neuropsychological Society: JINS
Rachel K Rowe, Daniel R Griffiths, Jonathan Lifshitz
Research models of traumatic brain injury (TBI) hold significant validity towards the human condition, with each model replicating a subset of clinical features and symptoms. After 30 years of characterization and implementation, fluid percussion injury (FPI) is firmly recognized as a clinically relevant model of TBI, encompassing concussion through severe injury. The midline variation of FPI may best represent mild and diffuse clinical brain injury, because of the acute behavioral deficits, the late onset of subtle behavioral morbidities, and the absence of gross histopathology...
2016: Methods in Molecular Biology
Gretchen M Thomsen, Annie Ma, Ara Ko, Megan Y Harada, Livia Wyss, Patricia Haro, Jean-Philippe Vit, Oksana Shelest, Peter Rhee, Clive N Svendsen, Eric J Ley
BACKGROUND: Concussion injury is the most common form of traumatic brain injury (TBI). How recurrent concussions alter long-term outcomes is poorly understood especially as related to the development of neurodegenerative disease. We evaluated the functional and pathological consequences of repeated TBI over time in wild type (WT) rats as well as rats harboring the human SOD1 mutation ("SOD1") - a model of familial amyotrophic lateral sclerosis (ALS). METHODS: A total of 42 rats, 26 WT and 16 SOD1, were examined over a study period of 25 weeks (or endpoint)...
September 3, 2016: Journal of Trauma and Acute Care Surgery
Tracy A Klein, Janessa M Graves
BACKGROUND: Nurse practitioners (NPs) are statutorily authorized to provide assessment and cognitive recommendations for concussion in most states. Their scope of practice includes assessment and management of concussion sequalae including anxiety, insomnia, and depression, as well as return to school and activity guidance. OBJECTIVES: Analysis of symptom-based diagnosis of mild traumatic brain injury (TBI) in adolescents, including return to school and school workload recommendations comparing psychiatric and nonpsychiatric NPs...
September 6, 2016: Journal of the American Psychiatric Nurses Association
Kathleen R Bell, Jesse R Fann, Jo Ann Brockway, Wesley R Cole, Nigel E Bush, Sureyya Dikmen, Tessa Hart, Ariel J Lang, Gerald Grant, Gregory Gahm, Mark A Reger, Jef St De Lore, Joan Machamer, Karin Ernstrom, Rema Raman, Sonia Jain, Murray B Stein, Nancy Temkin
Mild traumatic brain injury (mTBI) is a common injury for service members in recent military conflicts. There is insufficient evidence of how best to treat the consequences of mTBI. In a randomized, clinical trial, we evaluated the efficacy of telephone-delivered problem-solving treatment (PST) on psychological and physical symptoms in 356 post-deployment active duty service members from Joint Base Lewis McChord, Washington, and Fort Bragg, North Carolina. Members with medically confirmed mTBI sustained during deployment to Iraq and Afghanistan within the previous 24 months received PST or education-only (EO) interventions...
October 13, 2016: Journal of Neurotrauma
Channing A Sofko, Joseph M Currier, Benjamin D Hill, Kent D Drescher
OBJECTIVE: This study was conducted (1) to examine differences in post-traumatic stress disorder (PTSD) symptoms, perceived quality-of-life (QoL) and post-concussive symptoms (PCS) among veterans who experienced deployment-related mild traumatic brain injuries (mTBIs) with or without loss of consciousness (LOC) and (2) to test the additive role of PCS on QOL. DESIGN: Two hundred and twelve Iraq/Afghanistan veterans who were admitted to a residential programme for PTSD were assessed shortly following intake...
August 26, 2016: Brain Injury: [BI]
Ralph G DePalma, Stuart W Hoffman
Between April 2007 and December 2015, the Veterans Health Administration (VHA) screened one million combat veterans for traumatic brain injury (TBI), among 2.6 million deployed during operations Enduring Freedom, Iraqi Freedom and New Dawn (OEF/OIF/OND). Since 2007, among those reporting, screened and referred for definitive evaluation, approximately 8.4% of these Veterans received a diagnosis of TBI, the majority characterized as mTBI/Concussion (mTBI) and, in great proportion, related to blast exposures. Mild Traumatic brain injury called "a signature injury" is also known as 'the invisible injury' of these conflicts...
August 20, 2016: Behavioural Brain Research
Hailong Song, Jiankun Cui, Agnes Simonyi, Catherine E Johnson, Graham K Hubler, Ralph G DePalma, Zezong Gu
Blast exposures are associated with traumatic brain injury (TBI) and blast-induced TBIs are common injuries affecting military personnel. Department of Defense and Veterans Administration (DoD/VA) reports for TBI indicated that the vast majority (82.3%) has been mild TBI (mTBI)/concussion. mTBI and associated posttraumatic stress disorders (PTSD) have been called "the invisible injury" of the current conflicts in Iraq and Afghanistan. These injuries induce varying degrees of neuropathological alterations and, in some cases, chronic cognitive, behavioral and neurological disorders...
August 20, 2016: Behavioural Brain Research
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