Sheldon C Yao, Hallie Zwibel, Nicole Angelo, Adena Leder, Jayme Mancini
Context: Concussion, a type of mild traumatic brain injury, is a disruption in normal brain function due to head injury. New-onset symptoms from concussion vary, likely depending on the areas of the head and neck affected; they can be severe and debilitating. Current treatment options are limited and difficult to individualize. Osteopathic manipulative medicine (OMM) can aid musculoskeletal restrictions that can potentially improve concussion symptoms. Objective: To assess concussion symptom number and severity in participants with concussion who received either OMM or an educational intervention...
August 7, 2020: Journal of the American Osteopathic Association
Lauren Schwartzberg, Lilit Aslanyan, Nicole Angelo, Jayme Mancini, Patricia S Kooyman, Reem Abu-Sbaih, Hallie Zwibel, Sheldon C Yao
Context: Concussions can cause cognitive impairment, somatic symptoms, and behavioral changes. Symptoms may vary in severity, depending on the degree of traumatic force. Due to the biomechanical nature of this trauma, cranial somatic dysfunctions may commonly be seen in patients with concussion. Objective: To determine whether patients were more likely to have nonphysiologic cranial somatic dysfunctions than physiologic cranial somatic dysfunctions after sustaining a concussion...
August 6, 2020: Journal of the American Osteopathic Association
Erica Underwood, John B Redell, Jing Zhao, Anthony N Moore, Pramod K Dash
The survival and function of brain cells requires uninterrupted ATP synthesis. Different brain structures subserve distinct neurological functions, and therefore have different energy production/consumption requirements. Typically, mitochondrial function is assessed following their isolation from relatively large amounts of starting tissue, making it difficult to ascertain energy production/failure in small anatomical locations. In order to overcome this limitation, we have developed and optimized a method to measure mitochondrial function in brain tissue biopsy punches excised from anatomically defined brain structures, including white matter tracts...
August 6, 2020: Scientific Reports
Jennifer R Marin, Jonathan Rodean, Matt Hall, Elizabeth R Alpern, Paul L Aronson, Pradip P Chaudhari, Eyal Cohen, Stephen B Freedman, Rustin B Morse, Alon Peltz, Margaret Samuels-Kalow, Samir S Shah, Harold K Simon, Mark I Neuman
Importance: There is increased awareness of radiation risks from computed tomography (CT) in pediatric patients. In emergency departments (EDs), evidence-based guidelines, improvements in imaging technology, and availability of nonradiating modalities have potentially reduced CT use. Objective: To evaluate changes over time and hospital variation in advanced imaging use. Design, Setting, and Participants: This cross-sectional study assessed 26 082 062 ED visits by children younger than 18 years from the Pediatric Health Information System administrative database from January 1, 2009, through December 31, 2018...
August 3, 2020: JAMA Pediatrics
Jean M Lewis, Sanjay Dhawan, Augustine C Obirieze, Benjamin Sarno, Johnny Akers, Michael J Heller, Clark C Chen
Background: Technology platforms that afford biomarker discovery in patients suffering from traumatic brain injury (TBI) remain an unmet medical need. Here, we describe an observational pilot study to explore the utility of an alternating current electrokinetic (ACE) microchip device in this context. Methods: Blood samples were collected from participating subjects with and without minor TBI. Plasma levels of glial fibrillary acidic protein (GFAP), Tau, ubiquitin C-terminal hydrolase L1 (UCH-L1), and cell-free DNA (cfDNA) were determined in subjects with and without minor TBI using ACE microchip device followed by on-chip immunofluorescent analysis...
2020: Frontiers in Neurology
Nathan W Churchill, Michael G Hutchison, Simon J Graham, Tom A Schweizer
Neuroimaging has identified significant disturbances in cerebrovascular reactivity (CVR) in the early symptomatic phase of sport-related concussion. However, less is known about how whole-brain alterations in CVR evolve after concussion and whether they remain present beyond medical clearance to return to play (RTP). In the present study, CVR was evaluated using blood-oxygenation-level-dependent functional magnetic resonance imaging (BOLD fMRI) during a respiratory challenge. Imaging data were collected for 110 university-level athletes, including 39 concussed athletes and 71 athletic controls...
2020: Frontiers in Neurology
Josh W Faulkner, Alice Theadom, Susan Mahon, Deborah L Snell, Suzanne Barker-Collo, Kay Cunningham
Persistent symptoms following a mild traumatic brain injury (mTBI) can have profound implications on all aspects of an individual's functioning. Psychological factors have a significant role in contributing to the development of persistent post-concussion symptoms and predicting outcomes. Biopsychosocial explanations have therefore been applied to prognostic models of mTBI. What is not evident in the literature to date is an understanding of the psychological mechanisms that may be important in mediating the various psychological factors in these models...
July 30, 2020: Medical Hypotheses
Tyler C Duffield, Miranda M Lim, Melissa Novak, Amber Lin, Madison Luther, Cydni N Williams, Juan Piantino
OBJECTIVE: Ongoing exploration of factors related to poor sleep in collegiate athletes is important as understanding of the risks and consequences of poor sleep in this specific population increases. DESIGN: Retrospective cohort study. SETTING: University in the Pacific Northwest. PARTICIPANTS: One-hundred thirty-seven male and female collegiate athletes across 5 collision, contact, and limited contact team sports. MEASUREMENTS: Depressive symptoms (Patient Health Questionnaire 9; PHQ-9), anxiety symptoms (General Anxiety Disorder 7; GAD-7), and somatic complaints (Patient Health Questionnaire 15; PHQ-15)...
August 2, 2020: Sleep Health
Seper Ekhtiari, Ibrahim Yusuf, Yosra AlMakadma, Austin MacDonald, Timothy Leroux, Moin Khan
CONTEXT: The opioid epidemic has been well-documented in the general population, but the literature pertaining to opioid use and misuse in the athletic population remains limited. OBJECTIVES: The objectives of this study were to seek answers to the following questions: (1) what are the rates of opioid use and misuse among athletes, (2) do these rates differ compared with the nonathletic population, and (3) are there specific subgroups of the athletic population (eg, based on sport, level of play) who may be at higher risk? DATA SOURCES: The Embase, MEDLINE, and PubMed were used for the literature search...
August 6, 2020: Sports Health
Daniel J Corwin, Kristy B Arbogast, Casey Swann, Rebecca Haber, Matthew F Grady, Christina L Master
BACKGROUND: Visio-vestibular examination (VVE) deficits are common following pediatric concussion. Guidelines recommend assessing these deficits on all potentially concussed youth given their diagnostic and prognostic value, however test psychometrics of the VVE in the emergency department (ED) setting are unknown. Our objective was to determine the inter-rater (IRR) and test-retest reliability (TRR) of the VVE in a pediatric ED. METHODS: We enrolled 155 patients (112 IRR; 43 TRR) age 6-18 years with head injury presenting to the ED of a tertiary care children's hospital...
June 11, 2020: American Journal of Emergency Medicine
Lindsay Sullivan, Alison Newton, Junxin Shi, Teng-Jen Chang, Jingzhen Yang
PURPOSE: The current study examines rural-urban differences in trends in rates and type of concussion-related health care utilization over time from 2008 to 2016 among Medicaid insured children in Ohio. METHODS: We analyzed Medicaid claims for health care utilization for diagnosed concussions among children aged ≤18 years between April 1, 2008, and December 31, 2016. We compared the trends in rates of concussion-related health care utilization between children who lived in rural and urban areas using Poisson regressions...
August 3, 2020: Journal of Rural Health
Parviz Mojgani, Maryam Jalali, Abdalsamad Keramatfar
Purpose: This paper aims to present a bibliometric analysis of scientific documents in the field of traumatic brain injury rehabilitation. Methods: Web of Science was used to collect bibliographic data of traumatic brain injury rehabilitation documents from 1983 until the end of 2017. Results: Of a total of 6069 documents retrieved, 78.2% were journal articles. The average annual growth of the documents as of the year 2000 was 9.4%. The most frequent subject categories in this field were Rehabilitation, Neurosciences and Neurology, Sport Sciences, Psychology, and General and Internal Medicine...
August 2, 2020: Neuropsychological Rehabilitation
Pashtun Shahim, Jessica M Gill, Kaj Blennow, Henrik Zetterberg
Chronic traumatic encephalopathy (CTE) is a neuropathological condition that has been described in individuals who have been exposed to repetitive head impacts, including concussions and subconcussive trauma. Currently, there is no fluid or imaging biomarker for diagnosing CTE during life. Based on retrospective clinical data, symptoms of CTE include changes in behavior, cognition, and mood, and may develop after a latency phase following the injuries. However, these symptoms are often nonspecific, making differential diagnosis based solely on clinical symptoms unreliable...
August 2, 2020: Seminars in Neurology
Elizabeth C Pasipanodya, Benjamin Dirlikov, Kathleen Castillo, Kazuko L Shem
OBJECTIVE: To examine predictors of profiles of cognitive functioning among individuals receiving acute inpatient spinal cord injury (SCI) rehabilitation as well as associations between their cognitive functioning and psychological well-being (life satisfaction and depression) 6 months after the baseline assessment. DESIGN: Prospective observational study design, with two assessments approximately 6 months apart. SETTING: A rehabilitation unit at a Level 1 Trauma hospital during acute SCI hospitalization and outpatient setting after discharge...
July 30, 2020: Archives of Physical Medicine and Rehabilitation
Kyle M Petit, Tracey Covassin
CONTEXT: Cognitive and physical rest are commonly utilized when managing a sport-related concussion (SRC); however, emerging research now suggests that excessive rest may negatively impact recovery. Despite current research recommendations, athletic trainers (ATs) may be behind in implementing this emerging research into clinical practice. OBJECTIVE: To assess college ATs' perceptions and implementation of an emerging SRC management approach (cognitive and physical rest and activity)...
July 31, 2020: Journal of Sport Rehabilitation
Jason M Avedesian, Tracey Covassin, Janet S Dufek
Recent evidence suggests previously concussed athletes are at greater risk for lower-extremity (LE) injuries than are controls. However, little is known regarding the influence of sports-related concussion (SRC) on landing biomechanics that may provide a mechanistic rationale for LE injury risk. The purpose of this investigation was to examine LE drop-landing biomechanics in adolescent athletes with and without a previous SRC history. Participants included 10 adolescent athletes with an SRC history and 11 controls from multiple sports...
July 31, 2020: Journal of Applied Biomechanics
Stefania Mondello, Vivian A Guedes, Chen Lai, Andreas Jeromin, Jeffrey J Bazarian, Jessica M Gill
Sex differences in molecular biomarkers after sports-related concussion (SRC) could steadily advance our understanding of injury heterogeneity and complexity, and help capture phenotypic characteristics, by unveiling sex-dependent pathobiological processes and disease mechanisms. Such knowledge will help improve diagnosis, clinical management, and prognosis. Total-tau (t-tau) has recently emerged as a promising blood marker showing sex-associated differences in neurodegenerative diseases. Nonetheless, to date, little is known about the potential influence of sex on its injury-related concentration and dynamics after SRC...
2020: Frontiers in Neurology
Ainaz Shamshiri, Iman Rezaei, Ehsan Sinaei, Saeed Heidari, Ali Ghanbari
CONTEXT: The Balance Error Scoring System (BESS), originally designed to diagnose and assess athletes with concussion syndrome, is now widely used to evaluate postural stability. To interpret balance status, a normative database can be a reliable source. However, different anthropometric characteristics and sociocultural backgrounds across populations hinder the application of previously developed databases in different populations. OBJECTIVE: The present study was designed to develop a normative data set for the general population of healthy Iranian adults according to their age groups and to study the correlation between BESS scores and the participants' sex, height, weight, and body mass index...
July 30, 2020: Journal of Sport Rehabilitation
Emily Kroshus, Deborah Bowen, Douglas Opel, Sara P D Chrisman, Frederick P Rivara
Many families are concerned about their child's risk of concussion, and some seek counsel from clinicians about whether or not to return to contact sports participation postinjury. The present study sought to identify factors that parents weight most heavily in forming their preferences regarding whether their child should return to contact sport after recovering from a concussion. Survey data were collected from 568 parents of youth football players (aged 7-14 years) in the Pacific Northwest region of the United States (73% response rate)...
July 30, 2020: Health Promotion Practice
Neil K McGroarty, Symone M Brown, Mary K Mulcahey
Background: Female athletes are more susceptible to sport-related concussions (SRCs) and experience worse outcomes compared with male athletes. Although numerous studies on SRC have compared the outcomes of concussions in male and female athletes after injury, research pertaining to why female athletes have worse outcomes is limited. Purpose: To determine the factors that predispose female athletes to more severe concussions than their male counterparts. Study Design: Systematic review; Level or evidence, 3...
July 2020: Orthopaedic Journal of Sports Medicine
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