Traumatic brain injury (TBI) is a common condition that is often complicated by neuropsychiatric sequelae that can have major impacts on function and quality of life. An alteration in the sense of smell is recognized as a relatively common complication of TBI; however in clinical practice, this complication may not be sought or adequately characterized. We conducted a systematic review of studies concerned with olfactory functioning following TBI. Our predetermined criteria led to the identification of 25 studies published in English, which we examined in detail. We have tabulated the data from these studies in eight separate tables, beginning with Table 1, which highlights each study’s key findings, and we provide a summary/synthesis of the findings in the accompanying results and discussion sections. Despite widely differing methodologies, the studies attest to a high frequency of post-TBI olfactory dysfunction and indicate that its presence can serve as a potential marker of additional structural or functional morbidities.

The National Rugby League (NRL) in Australia introduced a new 'concussion interchange rule' (CIR) in 2014, whereby a player suspected of having sustained a concussion can be removed from play, and assessed, without an interchange being tallied against the player's team. We conducted a video analysis, describing player and injury characteristics, situational factors, concussion signs, and return to play for each "CIR" event for the 2014 season. There were 167 reported uses of the CIR. Apparent loss of consciousness/unresponsiveness was observed in 32% of cases, loss of muscle tone in 54%, clutching the head in 70%, unsteadiness of gait in 66%, and a vacant stare in 66%. More than half of the players who were removed under the CIR returned to play later in the same match (57%). Most incidences occurred from a hit up (62%) and occurred during a tackle where the initial contact was with the upper body (80%). The new concussion interchange rule has been used frequently during the first season of its implementation. In many cases, there appeared to be video evidence of injury but the athlete was cleared to return to play. More research is needed on the usefulness of video review for identifying signs of concussive injury.

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Background:We have recently demonstrated the use of an innovative and sensitive behavioral assay, the Visual Paired Comparison (VPC) task, to successfully predict the transition from healthy aging to mild cognitive impairment (MCI), and from MCI to Alzheimer's disease (AD) (Zola, et al., 2013). For a subset of subjects, however, predictability is less clear ("gray zone"). We report here that the application of Machine Learning algorithms and eye movement characteristics can significantly improve the predictive ability of the task for this subset of individuals. Methods: The VPC task measures how individuals view side-by-side novel and familiar images. Normal individuals typically look at the novel image about two-thirds of the viewing time. Previous work has relied on a single parameter, i.e., percent time viewing the novel image (novelty preference, NP). In the present study we used a Machine Learning-based approach that uses additional variables, namely, distribution of NP across multiple trials, and latent factor decompositionbased analysis of eye movement trajectories, to develop a more accurate prediction algorithm. Results: For subjects in the "gray zone", NP alone is not sufficient to distinguish between the subjects who will convert to MCI/AD and those who will not, resulting in ROC AUC of 0.70. Our new approach achieves AUC of 0.87, which represents a 24% relative improvement in predictive ability for the subjects in the "gray zone". Conclusions: The VPC task can offer early detection of impending cognitive decline as much as 3 years prior to clinical diagnosis. To our knowledge, this is the first behavioral task that can identify healthy subjects who will soon develop MCI and possibly progress to AD within the next few years. For individuals in the "gray zone", Machine Learning approaches can enhance still further the predictive capabilities of the VPC task. Finally, when combined with biomarker assays, this approach may provide a new way of interrogating the underlying dynamics of AD, as well as other illnesses in which impaired cognition is a leading symptom. P2-288CONCURRENT Background: Accurate detection of cognitive change on serial testing depends in part on cognitive instrument test-retest reliability. We developed the ARCS, which tests five cognitive domains using an audio device. Patients are unsupervised throughout the testing and respond to the questions on the audio by writing their responses in a special booklet for later scoring. Two versions of the ARCS are available. Here we examine results of alternate-form retesting with the ARCS within a sample of outpatients. We examined for possible learning effects and test-retest reliability over two different time frames, dichotomised at the median inter-test interval in our available data. Methods: The ARCS was administered to neuropsychiatry outpatient attendees on clinical grounds and in the absence of contraindications such as illiteracy, inability to write because of motor or other problems, or profound hearing deficit. Testing was conducte...