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Imaging Concussion

Zack Zdenek Cernovsky, Paul Victor Fayez Istasy, Yves Bureau, Simon Chiu
The retrospective diagnosis of concussion is often missed by clinicians. We present a brief scale for retrospective assessment of the immediate concussion symptoms (ICS) to facilitate the diagnosis of patients without visible head injury or full loss of consciousness. We administered the scale to 90 survivors of car accidents (mean age 42.0, SD=13.6; 33 males, 57 females) at 2 to 33 months after their accident. Our scale consists of 6 items and these were endorsed by the following % of our respondents: feeling dazed (64...
November 6, 2018: Mental Illness
Meghan E Robinson, Ann C McKee, David H Salat, Ann M Rasmusson, Lauren J Radigan, Ciprian Catana, William P Milberg, Regina E McGlinchey
Military personnel are often exposed to multiple instances of various types of head trauma. As a result, there has been increasing concern recently over identifying when head trauma has resulted in a brain injury and what, if any, long-term consequences those brain injuries may have. Efforts to develop equipment to protect soldiers from these long-term consequences will first require understanding the types of head trauma that are likely responsible. In this study, we sought to identify the types of head trauma most likely to lead to the deposition of tau, a protein identified as a likely indicator of long-term negative consequences of brain injury...
January 3, 2019: NeuroImage: Clinical
Xinyu Zhao, D Rangaprakash, Thomas S Denney, Jeffrey S Katz, Michael N Dretsch, Gopikrishna Deshpande
This article provides data for five different neuropsychiatric disorders-Attention Deficit Hyperactivity Disorder, Alzheimer's Disease, Autism Spectrum Disorder, Post-Traumatic Stress Disorder, and Post-Concussion Syndrome-along with healthy controls. The data includes clinical diagnostic labels, phenotypic variables, and resting-state functional magnetic resonance imaging connectivity features obtained from individuals. In addition, it provides the source MATLAB codes used for data analyses. Three existing clustering methods have been incorporated into the provided code, which do not require a priori specification of the number of clusters...
February 2019: Data in Brief
Andrew P Klein, Julie E Tetzlaff, Joshua M Bonis, Lindsay D Nelson, Andrew Mayer, Daniel L Huber, Jaroslaw Harezlak, Vince P Mathews, John L Ulmer, Grant P Sinson, Andrew S Nencka, Kevin M Koch, Yu-Chien Wu, Andrew J Saykin, John P DiFiori, Christopher C Giza, Joshua Goldman, Kevin K Guskiewicz, Jason Mihalik, Stefan M Duma, Steven Rowson, Alison Brooks, Steven P Broglio, Thomas McAllister, Michael McCrea, Timothy Meier
Previous studies have shown that mild traumatic brain injury (mTBI) can cause abnormalities in clinically relevant MRI sequences. No large-scale study, however, has prospectively assessed this in athletes with sport-related concussion (SRC). The goal of the current study was to characterize and compare the prevalence of acute, trauma-related MRI findings and clinically significant, non-specific MRI findings in athletes with and without SRC. College and high-school athletes were prospectively enrolled and participated in scanning sessions between January 2015 through August 2017...
January 8, 2019: Journal of Neurotrauma
Kathryn Y Hardin, James P Kelly
The Marcus Institute for Brain Health (MIBH) provides interdisciplinary care for adults struggling with persistent effects of mild traumatic brain injury and accompanying changes in behavioral health, with specific emphases on Veterans and retired elite athletes. The cognitive, physical, and behavioral symptoms associated with mild traumatic brain injury are interrelated, with neurobiopsychosocial modeling encompassing the factors related to recovery from a traumatic brain injury. The diffuse impacts of chronic concussive injuries require multiple clinical providers to address the breadth of symptoms, facilitating both interdisciplinary and transdisciplinary care models...
February 2019: Seminars in Speech and Language
Charmaine Childs, Lynne A Barker, Alex Md Gage, Mike Loosemore
Purpose: Changes to retina have been reported after a number of neurodegenerative conditions. The purpose of this study was to investigate retinal structures in Olympic boxers exposed to frequent head blows. Methods: Retinal imaging offers potential as a non-invasive biomarker of neuropathology. Macula and retinal nerve fiber layer (RNFL) thickness was measured using optical coherence tomography (OCT) in UK Olympic boxers attending two mandatory eye screening programs, 18 months apart...
2018: Eye and Brain
Nathan W Churchill, Eduardo Caverzasi, Simon J Graham, Michael G Hutchison, Tom A Schweizer
Concussion pathophysiology in humans remains incompletely understood. Diffusion tensor imaging (DTI) has identified microstructural abnormalities in otherwise normal appearing brain tissue, using measures of fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD). The results of prior DTI studies suggest that acute alterations in microstructure persist beyond medical clearance to return to play (RTP), but these measures lack specificity. To better understand the observed effects, this study combined DTI with neurite orientation dispersion and density imaging (NODDI), which employs a more sophisticated description of water diffusion in the brain...
December 26, 2018: Human Brain Mapping
Valerie A Cubon, Murali Murugavel, Katharine W Holmes, Annegret Dettwiler
OBJECTIVES: We compared the integrity of white matter (WM) microstructure to the course of recovery in athletes who sustained one sports-related concussion (SRC), assessing individual longitudinal changes in WM fiber tracts following SRC using pre- and post-injury measurements. MATERIALS AND METHODS: Baseline diffusion tensor imaging (DTI) scans and neuropsychological tests were collected on 53 varsity contact-sport college athletes. Participants (n = 13) who subsequently sustained an SRC underwent DTI scans and neuropsychological testing at 2 days, 2 weeks, and 2 months following injury...
November 22, 2018: Brain and Behavior
Ashley L Ware, Elisabeth A Wilde, Mary R Newsome, Paolo Moretti, Tracy Abildskov, Gregory S Vogt, Stephen R McCauley, Gerri Hanten, Jill V Hunter, Zili D Chu, Harvey S Levin
Microstructural neuropathology occurs in the corpus callosum (CC) after repetitive sports concussion in boxers and can be dose-dependent. However, the specificity and relation of CC changes to boxing exposure extent and post-career psychiatric and neuropsychological outcomes are largely unknown. Using deterministic diffusion tensor imaging (DTI) techniques, boxers and demographically-matched, noncontact sport athletes were compared to address literature gaps. Ten boxers and 9 comparison athletes between 26 and 59 years old (M = 44...
December 18, 2018: Brain Imaging and Behavior
Kathryn Y Manning, Alberto Llera, Gregory A Dekaban, Robert Bartha, Christy Barreira, Arthur Brown, Lisa Fischer, Tatiana Jevremovic, Kevin Blackney, Timothy J Doherty, Douglas D Fraser, Jeff Holmes, Christian F Beckmann, Ravi S Menon
Acute brain changes are expected after concussion, yet there is growing evidence of persistent abnormalities well beyond clinical recovery and clearance to return to play. Multiparametric MRI is a powerful approach to non-invasively study structure-function relationships in the brain, however it remains challenging to interpret the complex and heterogeneous cascade of brain changes that manifest after concussion. Emerging conjunctive, data-driven analysis approaches like linked independent component analysis can integrate structural and functional imaging data to produce linked components that describe the shared inter-subject variance across images...
December 3, 2018: NeuroImage: Clinical
Steve H Monk, Andrew D Legarreta, Paul Kirby, Benjamin L Brett, Aaron M Yengo-Kahn, Aashim Bhatia, Gary S Solomon, Scott L Zuckerman
Sport-related concussion (SRC) has emerged as a major public health problem. The results of brain imaging studies following SRC have raised questions about long-term neurologic health, but the clinical implications of these findings remain unknown. A systematic review of brain imaging findings after SRC was performed utilizing the following inclusion criteria: football players, brain imaging within 6 months of SRC, and sample size >5. Studies were assessed for: 1) methodology, 2) imaging outcomes, and 3) number of positive statistical comparisons...
November 26, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Kenneth A Rostowsky, Alexander S Maher, Andrei Irimia
With the advent of susceptibility-weighted imaging (SWI), the ability to identify cerebral microbleeds (CMBs) associated with mild traumatic brain injury (mTBI) has become increasingly commonplace. Nevertheless, the clinical significance of post-traumatic CMBs remains controversial partly because it is unclear whether mTBI-related CMBs entail brain circuitry disruptions which, although structurally subtle, are functionally significant. This study combines magnetic resonance and diffusion tensor imaging (MRI and DTI) to map white matter (WM) circuitry differences across 6 months in 26 healthy control volunteers and in 26 older mTBI victims with acute CMBs of traumatic etiology...
2018: Frontiers in Neurology
Alexander Lin, Molly Charney, Martha E Shenton, Inga Katharina Koerte
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with repetitive head impact exposure, such as that resulting from sports-related concussive and subconcussive brain trauma. Currently, the only way to diagnose CTE is by using neuropathologic markers obtained postmortem. To diagnose CTE earlier, so that possible treatment interventions may be employed, there is a need to develop noninvasive in vivo biomarkers of CTE. Neuroimaging provides promising biomarkers for the diagnosis of CTE and may also help elucidate pathophysiologic changes that occur with chronic sports-related brain injury...
2018: Handbook of Clinical Neurology
Asif K Suri, Michael L Lipton
Computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the assessment of traumatic brain injury (TBI) by permitting rapid detection and localization of acute intracranial injuries. In concussion, the most common presentation of sports-related head trauma, CT and MRI are unrevealing. This normal appearance of the brain on standard neuroimaging, however, belies the structural and functional pathology that underpins concussion-related symptoms and dysfunction. Advances in neuroimaging have expanded our ability to gain insight into this microstructural and functional brain pathology...
2018: Handbook of Clinical Neurology
Henrik Zetterberg, Bengt Winblad, Charles Bernick, Kristine Yaffe, Marek Majdan, Gunilla Johansson, Virginia Newcombe, Lars Nyberg, David Sharp, Olli Tenovuo, Kaj Blennow
Traumatic brain injury (TBI) is clinically divided into a spectrum of severities, with mild TBI being the least severe form and a frequent occurrence in contact sports, such as ice hockey, American football, rugby, horse riding and boxing. Mild TBI is caused by blunt non-penetrating head trauma that causes movement of the brain and stretching and tearing of axons, with diffuse axonal injury being a central pathogenic mechanism. Mild TBI is in principle synonymous with concussion; both have similar criteria in which the most important elements are acute alteration or loss of consciousness and/or post-traumatic amnesia following head trauma and no apparent brain changes on standard neuroimaging...
November 27, 2018: Journal of Internal Medicine
Jeong Bin Lee, Bethann M Affeldt, Yaritxa Gamboa, Mary Hamer, Jeff F Dunn, Andrea C Pardo, Andre Obenaus
Concussion or mild traumatic brain injury (mTBI) is often accompanied by long-term behavioral and neuropsychological deficits. Emerging data suggest that these deficits can be exacerbated following repeated injuries. However, despite the overwhelming prevalence of mTBI in children due to falls and sports-related activities, the effects of mTBI on white matter (WM) structure and its development in children have not been extensively examined. Moreover, the effect of repeated mTBI (rmTBI) on developing WM has not yet been studied, despite the possibility of exacerbated outcomes with repeat injuries...
November 22, 2018: Developmental Neuroscience
Mayank Kaushal, Lezlie Y España, Andrew S Nencka, Yang Wang, Lindsay D Nelson, Michael A McCrea, Timothy B Meier
There has been a recent call for longitudinal imaging studies to better characterize the time course of physiological recovery following sport-related concussion (SRC) and its relationship with clinical recovery. To address this, we evaluated changes to resting-state functional connectivity (rs-FC) of the whole-brain network following SRC and explored associations between rs-FC and measures of clinical outcome. High school and collegiate football athletes were enrolled during preseason. Athletes that suffered SRC (N = 62) were assessed across the acute (within 48 hr) and sub-acute (days 8, 15, and 45) phases...
November 19, 2018: Human Brain Mapping
Nathan Churchill, Michael Hutchison, Simon Graham, Tom A Schweizer
Cerebrovascular reactivity (CVR) indexes the ability of blood vessels to respond to vasoactive stimuli and may be a sensitive biomarker of concussion. However, alterations in whole-brain CVR remain poorly understood during the early symptomatic phase of injury. In this study, CVR was assessed using blood-oxygenation level dependent functional magnetic resonance imaging (BOLD fMRI) combined with a respiratory challenge paradigm; resting cerebral blood flow (CBF) was also evaluated using arterial spin labelling (ASL)...
November 18, 2018: Journal of Neurotrauma
Andrea Ana Almeida, Matthew Thomas Lorincz, Andrew Nobuhide Hashikawa
Concussions after a head injury among children continues to be a substantial public health concern. An increasing number of concussions are being managed initially by primary care physicians. The diagnosis of concussion remains a clinical diagnosis despite the availability of ancillary tests such as computerized neuropsychological testing, advanced imaging, and blood biomarkers. Clinically, overlooking other injuries and comorbidities may lead to prolonged recovery for the patient. Addressing concussions in a multidisciplinary approach may help in reducing recovery time for patients...
December 2018: Pediatric Clinics of North America
Martha E Shenton, Bruce H Price, Laura Levin, Judith G Edersheim
Important advances in neuroscience and neuroimaging have revolutionized our understanding of the human brain. Many of these advances provide new evidence regarding compensable injuries that have been used to support changes in legal policy. For example, we now know that regions of the brain involved in decision making continue to develop into the mid-20s, and this information weighs heavily in determining that execution or automatic sentence of life without the possibility of parole for someone younger than 18 years old, at the time of the crime, violates the 8th Amendment prohibition against "cruel and unusual punishment...
November 2018: International Journal of Law and Psychiatry
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