Functional Brain Abnormalities Are Related to Clinical Recovery and Time to Return-to-Play in Athletes

Lovell, Mark R.; Pardini, Jamie E.; Welling, Joel; Collins, Michael W.; Bakal, Jeffrey A.; Lazar, Nicole A.; Roush, Rebecca; Eddy, William F.; Becker, James T.

doi:10.1227/01.neu.0000279985.94168.7f

Cited by 182 publications

(115 citation statements)

References 37 publications

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“…In each run subjects performed one block (15 presentations, 3-sec interval, 5 targets per block) each of 0-, 1-, and 2-back tasks for single letters. 30,31 Visual presentation was via fiber-optic goggles (NordicNeuroLab, Bergen, Norway). Subjects responded by dominant index finger via fiberoptic button box (Current Designs, Philadelphia, PA).…”

Section: Neurophysiological Testingmentioning

confidence: 99%

Functionally-Detected Cognitive Impairment in High School Football Players without Clinically-Diagnosed Concussion

Talavage

Nauman²,

Breedlove³

et al. 2014

Journal of Neurotrauma

521

486

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Head trauma and concussion in football players have recently received considerable media attention. Postmortem evidence suggests that accrual of damage to the brain may occur with repeated blows to the head, even when the individual blows fail to produce clinical symptoms. There is an urgent need for improved detection and characterization of head trauma to reduce future injury risk and promote development of new therapies. In this study we examined neurological performance and health in the presence of head collision events in high school football players, using longitudinal measures of collision events (the HIT Ô System), neurocognitive testing (ImPACT, and functional magnetic resonance imaging MRI (fMRI). Longitudinal assessment (including baseline) was conducted in 11 young men (ages 15-19 years) participating on the varsity and junior varsity football teams at a single high school. We expected and observed subjects in two previously described categories: (1) no clinically-diagnosed concussion and no changes in neurological behavior, and (2) clinically-diagnosed concussion with changes in neurological behavior. Additionally, we observed players in a previously undiscovered third category, who exhibited no clinically-observed symptoms associated with concussion, but who demonstrated measurable neurocognitive (primarily visual working memory) and neurophysiological (altered activation in the dorsolateral prefrontal cortex [DLPFC]) impairments. This new category was associated with significantly higher numbers of head collision events to the top-front of the head, directly above the DLPFC. The discovery of this new category suggests that more players are suffering neurological injury than are currently being detected using traditional concussion-assessment tools. These individuals are unlikely to undergo clinical evaluation, and thus may continue to participate in football-related activities, even when changes in brain physiology (and potential brain damage) are present, which will increase the risk of future neurological injury.

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Section: Neurophysiological Testingmentioning

confidence: 99%

Functionally-Detected Cognitive Impairment in High School Football Players without Clinically-Diagnosed Concussion

Talavage

Nauman²,

Breedlove³

et al. 2014

Journal of Neurotrauma

521

486

View full text Add to dashboard Cite

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“…74 Functional neuroimaging will likely provide a more accurate picture of the injury and may help predict recovery better than structural neuroimaging, but further research and wider availability of this imaging modality is needed before it can be recommended. 74,75 …”

Section: Neuroimagingmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

580

445

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Sport-related concussion is a "hot topic" in the media and in medicine. It is a common injury that is likely underreported by pediatric and adolescent athletes. Football has the highest incidence of concussion, but girls have higher concussion rates than boys do in similar sports. A clear understanding of the definition, signs, and symptoms of concussion is necessary to recognize it and rule out more severe intracranial injury. Concussion can cause symptoms that interfere with school, social and family relationships, and participation in sports. Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them. Appropriate management is essential for reducing the risk of long-term symptoms and complications. Cognitive and physical rest is the mainstay of management after diagnosis, and neuropsychological testing is a helpful tool in the management of concussion. Return to sport should be accomplished by using a progressive exercise program while evaluating for any return of signs or symptoms. This report serves as a basis for understanding the diagnosis and management of concussion in children and adolescent athletes.

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“…fMRI has been used to examine functional activation patterns in patients with TBI at all levels of severity in both adults (Cazalis et al, 2006;Christodoulou et al, 2001;Maruishi et al, 2007;McAllister et al, 1999McAllister et al, , 2001Newsome et al, 2007b;Perlstein et al, 2004;Rasmussen et al, 2008;Scheibel et al, 2003Scheibel et al, , 2007Schmitz et al, 2006;Soeda et al, 2005) and children (Lovell et al, 2007;Newsome et al, 2007a;Scheibel et al, 2003). fMRI may also be important in understanding recovery from mild TBI (Chen et al, 2004(Chen et al, , 2007(Chen et al, , 2008Jantzen et al, 2004;Lovell et al, 2007) or in rehabilitation efforts in more severe forms of TBI (Kim, Y. H. et al, 2009;Laatsch, L et al, 2004a,b;Strangman et al, 2005Strangman et al, , 2008. More recently, there has been increasing interest in the concept of what the brain does at rest, and data have been collected with a subject in the scanner, using the BOLD techniques but without any stimulus.…”

Section: Perfusion Imagingmentioning

confidence: 99%

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

Hunter

Wilde

Tong

et al. 2012

Journal of Neurotrauma

114

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This article identifies emerging neuroimaging measures considered by the inter-agency Pediatric Traumatic Brain Injury (TBI) Neuroimaging Workgroup. This article attempts to address some of the potential uses of more advanced forms of imaging in TBI as well as highlight some of the current considerations and unresolved challenges of using them. We summarize emerging elements likely to gain more widespread use in the coming years, because of 1) their utility in diagnosis, prognosis, and understanding the natural course of degeneration or recovery following TBI, and potential for evaluating treatment strategies; 2) the ability of many centers to acquire these data with scanners and equipment that are readily available in existing clinical and research settings; and 3) advances in software that provide more automated, readily available, and cost-effective analysis methods for large scale data image analysis. These include multi-slice CT, volumetric MRI analysis, susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), arterial spin tag labeling (ASL), functional MRI (fMRI), including resting state and connectivity MRI, MR spectroscopy (MRS), and hyperpolarization scanning. However, we also include brief introductions to other specialized forms of advanced imaging that currently do require specialized equipment, for example, single photon emission computed tomography (SPECT), positron emission tomography (PET), encephalography (EEG), and magnetoencephalography (MEG)/magnetic source imaging (MSI). Finally, we identify some of the challenges that users of the emerging imaging CDEs may wish to consider, including quality control, performing multi-site and longitudinal imaging studies, and MR scanning in infants and children.

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Functional Brain Abnormalities Are Related to Clinical Recovery and Time to Return-to-Play in Athletes

Cited by 182 publications

References 37 publications

Functionally-Detected Cognitive Impairment in High School Football Players without Clinically-Diagnosed Concussion

Functionally-Detected Cognitive Impairment in High School Football Players without Clinically-Diagnosed Concussion

Sport-Related Concussion in Children and Adolescents

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

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