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Palazzolo JM, Goble DJ, Labban JD, Ross SE, Duffy DM, Rhea CK. Differences in pre-season balance among student athletes based on level of contact, age, and sex. Gait Posture 2024; 110:35-40. [PMID: 38479339 DOI: 10.1016/j.gaitpost.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/09/2024] [Accepted: 02/23/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Assessing postural control is important for the assessment of motor function after concussion. Data used for postural control assessment typically do not take the sport played, age, or sex of the athlete into consideration. It is plausible these variables may be significant when making return-to-play decisions. RESEARCH QUESTION This study used the BTrackS database to examine differences in postural control in athletes playing different types of sports and across sex and age. METHODS BTrackS data from 9093 high school to college-aged athletes (aged 14-22 years) were examined employing a One-way ANOVA with a post-hoc test to compare CoP path length between sport types. A moderation analysis was used to test interaction effects of sex and age on a CoP/BMI ratio. RESULTS Significant differences were observed between sport types, F(3,9089) = 42.4, p <.001, η2 = 0.014. Post hoc tests indicated that collision (M = 25.0, SD = 7.6) sport athletes exhibited significantly higher CoP measures compared to the contact (M = 23.4, SD = 7.4), limited contact (M = 22.9, SD = 6.9), and non-contact (M = 23.0, SD = 7.4) athletes. There was no difference between other sport types (p >.20). A significant mean sex difference (Mmale = 0.924, Mfemale = 0.898, p <.001) and a quadratic association with age, (β = -0.042, p <.001) was observed. Further, magnitude of those age differences decreased with age (β = 0.011, p <.001). An interaction of age and sex was significant for linear (β = 0.020, p <.001) and quadratic terms (β = -0.006, p <.001). SIGNIFICANCE Athletes exhibited different postural control when the type of sport, age, and sex was taken into consideration. This data possess clinical significance as this suggests that normative postural control data for collision sport athletes should be derived from data based upon type of sport played, age, and sex of the athlete.
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Affiliation(s)
- John M Palazzolo
- Department of Health and Exercise Sciences, Truman State University, Kirksville, MO, USA.
| | - Daniel J Goble
- Department of Humna Movement Science, Oakland University, Rochester, MI, USA
| | - Jeff D Labban
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Scott E Ross
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Donna M Duffy
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
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Vélez-Grau C, Romanelli M, Lindsey MA. Adolescent suicide attempts in the United States: When suicide ideation and suicide capability interact. Suicide Life Threat Behav 2022; 52:549-566. [PMID: 35156223 DOI: 10.1111/sltb.12845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Guided by the interpersonal theory of suicide, this study examined whether the relationship between level of suicide ideation and attempted suicide varies as a function of suicide capability. METHODS Cross-sectional data were obtained from the 2017 and 2019 Youth Risk Behavior Survey in which 28,442 respondents were sampled. Confirmatory factor analysis was conducted to create a latent suicide capability variable. Structural equation modeling was used to test the moderating effects of suicide capability on the relationship between level of suicide ideation and attempted suicide, adjusting for sociodemographic characteristics, sadness/hopelessness, and the sampling design. RESULTS Compared to adolescent with no reported ideation, those reporting single and dual ideation experienced increased odds of attempted suicide. The relationship between level of suicide ideation and attempted suicide significantly varied as a function of capability. While adolescents with dual suicide ideation experienced higher rates of attempted suicide at increasing levels of capability, faster rates of change of attempted suicide at increasing levels of capability were observed among those with single and no reported ideation. CONCLUSION Capability may heighten the risk of suicide attempts among youth, suggesting that treatment efforts could be directed at reducing exposure to painful and provocative experiences associated with suicide behaviors.
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Affiliation(s)
- Carolina Vélez-Grau
- New York University, NYU McSilver Institute for Poverty Policy and Research, New York, New York, USA
| | - Meghan Romanelli
- University of Washington, NYU McSilver Institute for Poverty Policy and Research, Seattle, Washington, USA
| | - Michael A Lindsey
- New York University Silver School of Social Work, NYU McSilver Institute for Poverty Policy and Research, New York, New York, USA
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3
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Crampton A, Teel E, Chevignard M, Gagnon I. Vestibular-ocular reflex dysfunction following mild traumatic brain injury: A narrative review. Neurochirurgie 2021; 67:231-237. [PMID: 33482235 DOI: 10.1016/j.neuchi.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 12/28/2022]
Abstract
Mild traumatic brain injury (mTBI) is a prevalent injury which occurs across many populations, including children and adolescents, athletes, military personnel, and the elderly. mTBI can result in various subjective symptoms and clinical deficits, such as abnormalities to the vestibulo-ocular reflex (VOR). Over 50% of individuals with mTBI are reported to have VOR abnormalities, which strongly contribute to feelings of dizziness and unsteadiness. Dizziness is a strong predictor for prolonged recovery following mTBI and is additionally linked with mental health difficulties and functional limitations affecting likelihood of return to work. Early diagnosis, and subsequent treatment, of VOR deficits following mTBI may greatly improve recovery outcomes and a patient's quality of life, but a thorough comprehension of the related pathophysiology is necessary to understand the assessments used to diagnose VOR abnormalities. Therefore, the purpose of this article is i) provide readers with an introduction on the VOR physiology to facilitate understanding about mTBI-related abnormalities, and ii) to discuss current assessments that are commonly used to measure VOR function following mTBI. As the VOR and oculomotor (OM) systems are heavily linked and often work in tandem, discussion of the relevant aspects of the OM system is also provided.
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Affiliation(s)
- Adrienne Crampton
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.
| | - Elizabeth Teel
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
| | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury and Outreach Team for Children and Adolescents with Acquired Brain Injury, Saint Maurice Hospitals, Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, INSERM, CNRS, Paris, France; GRC 24 HaMCRe, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada; Montreal Children Hospital, McGill University Health Center, Montreal, QC, Canada
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Doroszkiewicz C, Gold D, Green R, Tartaglia MC, Ma J, Tator CH. Anxiety, Depression, and Quality of Life: A Long-Term Follow-Up Study of Patients with Persisting Concussion Symptoms. J Neurotrauma 2020; 38:493-505. [PMID: 32962513 DOI: 10.1089/neu.2020.7313] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Persisting concussion symptoms (PCS) can last for months, years, or indefinitely and affect a considerable number of concussion patients. The objectives of this study were to evaluate the prevalence of clinical symptoms of anxiety and depression and the relationship between PCS and quality of life in patients examined at the Canadian Concussion Centre. The Depression and Anxiety Stress Scale-42 (DASS-42) and the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) were sent to 526 adult patients diagnosed with PCS. Median with interquartile range follow-up time was 5 (4-7) years. Of the 105 respondents, 35.2% displayed mild or greater symptoms of anxiety, depression, or both. Importantly, the number of previous concussions was correlated with elevations on the DASS-42 Anxiety (p = 0.030) and Depression (p = 0.018) subscale scores, suggesting an acquired cause of symptoms. Patients with clinical elevations of depression, anxiety, or both exhibited poorer mean WHOQOL-BREF scores in each domain (p < 0.001) compared to those who scored in the normal range on the DASS-42. These findings indicate that depression and anxiety in PCS can endure for years and are associated with diminished quality of life. Consequently, depression and anxiety should be identified and treated early in PCS populations in order to optimize recovery. Although the underlying etiology of depression and anxiety cannot be ascertained with certainty in the present study, the association between depression and anxiety and the number of concussions may indicate an organic explanation. In the future, quality-of-life measures should be incorporated into treatment and research in PCS to improve intervention strategies and enhance understanding of the trajectory of recovery in this population.
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Affiliation(s)
| | - David Gold
- Neuropsychology Clinic, Krembil Neuroscience Network, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Robin Green
- Canadian Concussion Center, Toronto, Ontario, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Canadian Concussion Center, Toronto, Ontario, Canada.,Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Jin Ma
- Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada
| | - Charles H Tator
- Canadian Concussion Center, Toronto, Ontario, Canada.,Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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Li W, Chang C, Liang S, Bigler ED. Radiographic and neurobehavioral profile of sports-related concussion associated with scholastic wrestling: a case report. Neurocase 2020; 26:147-155. [PMID: 32412324 DOI: 10.1080/13554794.2020.1764977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Sports-related concussions (SRCs) are typically characterized by transient neurologic deficits due to physiologic and metabolic brain injury. However, following an SRC, subsequent insults may lead to severe and permanent injury in the affected brain cells. We present the case of a 15-year-old female scholastic wrestler who developed acute encephalopathy, macroscopic white matter injury on imaging, and chronic behavioral changes from inadequate neuro-recovery after a documented SRC. We also compare her case with established SRC data, demonstrating that wrestling-related concussions and repetitive head impacts can produce similar degrees of diffuse neuroinflammation, myelinated axonopathy, blood-brain barrier disruption, and post-concussive symptoms.
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Affiliation(s)
- Wentao Li
- Department of Neurology, University of California Davis , Sacramento, USA
| | - Celia Chang
- Department of Neurology, Division of Pediatric Neurology, University of California Davis , Sacramento, USA
| | - Shannon Liang
- Department of Neurology, Division of Pediatric Neurology, University of California Davis , Sacramento, USA
| | - Erin D Bigler
- Department of Neurology, University of California Davis , Sacramento, USA.,Department of Psychology and Neuroscience, Magnetic Resonance Imaging (MRI) Research Facility, Brigham Young University , Provo, USA.,Department of Neurology and Department of Psychiatry, University of Utah , Salt Lake City, USA
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Almeida AA, Lorincz MT, Hashikawa AN. Recent Advances in Pediatric Concussion and Mild Traumatic Brain Injury. Pediatr Clin North Am 2018; 65:1151-1166. [PMID: 30446054 DOI: 10.1016/j.pcl.2018.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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. Retirement from sport in the pediatric population remains a controversial issue lacking evidenced-based studies.
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Affiliation(s)
- Andrea Ana Almeida
- Department of Neurology, Michigan Medicine, Michigan NeuroSport, 2301 Commonwealth Boulevard, Suite 1022, Ann Arbor, MI 48105, USA
| | - Matthew Thomas Lorincz
- Department of Neurology, Michigan Medicine, Michigan NeuroSport, 2301 Commonwealth Boulevard, Suite 1022, Ann Arbor, MI 48105, USA
| | - Andrew Nobuhide Hashikawa
- Department of Emergency Medicine, Children's Emergency Services, Michigan Medicine, North Campus Research Complex, University of Michigan Injury Center, 2800 Plymouth Road, Suite G080, NCRC Building 10, Ann Arbor, MI 48105, USA.
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7
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Sahbaie P, Tajerian M, Yang P, Irvine KA, Huang TT, Luo J, Wyss-Coray T, Clark JD. Nociceptive and Cognitive Changes in a Murine Model of Polytrauma. THE JOURNAL OF PAIN 2018; 19:1392-1405. [DOI: 10.1016/j.jpain.2018.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 06/12/2018] [Accepted: 06/19/2018] [Indexed: 12/27/2022]
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Baracks J, Casa DJ, Covassin T, Sacko R, Scarneo SE, Schnyer D, Yeargin SW, Neville C. Acute Sport-Related Concussion Screening for Collegiate Athletes Using an Instrumented Balance Assessment. J Athl Train 2018; 53:597-605. [PMID: 29897278 DOI: 10.4085/1062-6050-174-17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Without a true criterion standard assessment, the sport-related concussion (SRC) diagnosis remains subjective. Inertial balance sensors have been proposed to improve acute SRC assessment, but few researchers have studied their clinical utility. OBJECTIVE To determine if group differences exist when using objective measures of balance in a sample of collegiate athletes with recent SRCs and participants serving as the control group and to calculate sensitivity and specificity to determine the diagnostic utility of the inertial balance sensor for acute SRC injuries. DESIGN Cross-sectional cohort study. SETTING Multicenter clinical trial. PATIENTS OR OTHER PARTICIPANTS We enrolled 48 participants with SRC (age = 20.62 ± 1.52 years, height = 179.76 ± 10.00 cm, mass = 83.92 ± 23.22 kg) and 45 control participants (age = 20.85 ± 1.42 years, height = 177.02 ± 9.59 cm, mass = 74.61 ± 14.92 kg) at 7 clinical sites in the United States. All were varsity or club collegiate athletes, and all participants with SRC were tested within 72 hours of SRC. MAIN OUTCOME MEASURE(S) Balance performance was assessed using an inertial balance sensor. Two measures (root mean square sway and 95% ellipse sway area) were analyzed to represent a range of general balance measures. Balance assessments were conducted in double-legged, single-legged, and tandem stances. RESULTS A main effect for group was associated with the root mean square sway measure ( F1,91 = 11.75, P = .001), with the SRC group demonstrating balance deficits compared with the control group. We observed group differences in the 95% ellipse sway area measure for the double-legged ( F1,91 = 11.59, P = .001), single-legged ( F1,91 = 6.91, P = .01), and tandem ( F1,91 = 7.54, P = .007) stances. Sensitivity was greatest using a cutoff value of 0.5 standard deviations (54% [specificity = 71%]), whereas specificity was greatest using a cutoff value of 2 standard deviations (98% [sensitivity = 33%]). CONCLUSIONS Inertial balance sensors may be useful tools for objectively measuring balance during acute SRC evaluation. However, low sensitivity suggests that they may be best used in conjunction with other assessments to form a comprehensive screening that may improve sensitivity.
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Affiliation(s)
- Joshua Baracks
- Upstate Concussion Center and ¶Department of Physical Therapy Education, Orthopedic Surgery, and Physiology, SUNY Upstate Medical University, Syracuse, NY
| | - Douglas J Casa
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs
| | - Tracey Covassin
- Department of Kinesiology, Michigan State University, East Lansing
| | - Ryan Sacko
- Department of Physical Education and Athletic Training, University of South Carolina, Columbia
| | - Samantha E Scarneo
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs
| | - David Schnyer
- Department of Psychology, University of Texas, Austin
| | - Susan W Yeargin
- Department of Physical Education and Athletic Training, University of South Carolina, Columbia
| | - Christopher Neville
- Upstate Concussion Center and ¶Department of Physical Therapy Education, Orthopedic Surgery, and Physiology, SUNY Upstate Medical University, Syracuse, NY
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Paniccia M, Wilson KE, Hunt A, Keightley M, Zabjek K, Taha T, Gagnon I, Reed N. Postural Stability in Healthy Child and Youth Athletes: The Effect of Age, Sex, and Concussion-Related Factors on Performance. Sports Health 2017; 10:175-182. [PMID: 29131721 PMCID: PMC5857732 DOI: 10.1177/1941738117741651] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Postural stability plays a key role in sport performance, especially after concussion. Specific to healthy child and youth athletes, little is known about the influence development and sex may have on postural stability while considering other subjective clinical measures used in baseline/preinjury concussion assessment. This study aims to describe age- and sex-based trends in postural stability in uninjured child and youth athletes at baseline while accounting for concussion-related factors. Hypotheses: (1) Postural stability performance will improve with age, (2) females will display better postural stability compared to males, and (3) concussion-like symptoms will affect postural stability performance in healthy children and youth. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: This study comprised 889 healthy/uninjured child and youth athletes (54% female, 46% male) between the ages of 9 and 18 years old. Participants completed preseason baseline testing, which included demographic information (age, sex, concussion history), self-report of concussion-like symptoms (Post-Concussion Symptom Inventory [PCSI]–Child and PCSI-Youth), and measures of postural stability (BioSway; Biodex Medical Systems). Two versions of the PCSI were used (PCSI-C, 9- to 12-year-olds; PCSI-Y, 13- to 18-year-olds). Postural stability was assessed via sway index under 4 sway conditions of increasing difficulty by removing visual and proprioceptive cues. Results: In children aged 9 to 12 years old, there were significant age- (P < 0.05) and sex-based effects (P < 0.05) on postural stability. Performance improved with age, and girls performed better than boys. For youth ages 13 to 18 years old, postural stability also improved with age (P < 0.05). In both child and youth subgroups, postural stability worsened with increasing concussion-like symptoms (P < 0.05). Conclusion: There are developmental and baseline symptom trends regarding postural stability performance. Clinical Relevance: These findings provide a preliminary foundation for postconcussion comparisons and highlight the need for a multimodal approach in assessing and understanding physical measures such as postural stability.
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Affiliation(s)
- Melissa Paniccia
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Concussion Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Katherine E Wilson
- Concussion Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Anne Hunt
- Concussion Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Michelle Keightley
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Karl Zabjek
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tim Taha
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Nick Reed
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Concussion Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Yrondi A, Brauge D, LeMen J, Arbus C, Pariente J. Depression and sports-related concussion: A systematic review. Presse Med 2017; 46:890-902. [PMID: 28919268 DOI: 10.1016/j.lpm.2017.08.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 07/03/2017] [Accepted: 08/21/2017] [Indexed: 12/14/2022] Open
Abstract
CONTEXT Head injuries are risk factors for chronic depressive disorders, but this association remains poorly explored with regards to concussion. OBJECTIVES The objective of this review was to evaluate the incidence of depressive symptoms and depression after sports-related concussion. We also endeavored to identify the response elements regarding the pathophysiology of these symptoms. METHODS A systematic search of PubMed and Embase was conducted focusing on papers published until 1st December, 2016, according to PRISMA criteria The following MESH terms were used: (concussion or traumatic brain injury) and sport and (depression or depressive disorder). RESULTS A depressive disorder can appear immediately after a concussion: depressive symptoms seem to be associated with the symptoms of the concussion itself. A depressive disorder can also appear later, and is often linked to the frequency and number of concussions. Furthermore, the existence of a mood disorder prior to a concussion can contribute to the onset of a depressive disorder after a concussion. LIMITS There is an overall limit concerning the definition of a depressive disorder. In addition, when these studies had controls, they were often compared to high-level athletes; yet, practicing sport regularly is a protective factor against mood pathologies. CONCLUSIONS Depressive symptoms after a concussion seem to be associated with postconcussion symptoms. Repeat concussions can contribute to later-onset major depressive disorders. However, playing sports can protect against major depressive disorders: thus, it is essential to evaluate concussions as accurately as possible.
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Affiliation(s)
- Antoine Yrondi
- CHU Toulouse-Purpan, Psychiatry and medical psychology department, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; UPS, Université de Toulouse, TONIC, Toulouse NeuroImaging Center, 31024 Toulouse cedex 3, France; CHU Toulouse, Federation Hospitalo-Universitaire, Cognitive, Psychiatric and Sensory Disabilities, 31059 Toulouse, France.
| | - David Brauge
- CHU Toulouse, Federation Hospitalo-Universitaire, Cognitive, Psychiatric and Sensory Disabilities, 31059 Toulouse, France; CHU Toulouse-Purpan, Neurosurgery department, 31059 Toulouse, France
| | - Johanne LeMen
- CHU Toulouse, Federation Hospitalo-Universitaire, Cognitive, Psychiatric and Sensory Disabilities, 31059 Toulouse, France; CHU Toulouse-Purpan, Neurology department, 31059 Toulouse, France
| | - Christophe Arbus
- CHU Toulouse-Purpan, Psychiatry and medical psychology department, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; UPS, Université de Toulouse, TONIC, Toulouse NeuroImaging Center, 31024 Toulouse cedex 3, France; CHU Toulouse, Federation Hospitalo-Universitaire, Cognitive, Psychiatric and Sensory Disabilities, 31059 Toulouse, France
| | - Jérémie Pariente
- UPS, Université de Toulouse, TONIC, Toulouse NeuroImaging Center, 31024 Toulouse cedex 3, France; CHU Toulouse, Federation Hospitalo-Universitaire, Cognitive, Psychiatric and Sensory Disabilities, 31059 Toulouse, France; CHU Toulouse-Purpan, Neurology department, 31059 Toulouse, France
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11
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Myrdal CN, Huang S, Beach HN, Waterbrook AL. Comparison of knowledge, perception and attitudes of concussion in previously concussed versus non-concussed youth soccer players. PHYSICIAN SPORTSMED 2017. [PMID: 28636426 DOI: 10.1080/00913847.2017.1345569] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To examine if history of concussion is correlated with a difference in knowledge, attitude, and perception of concussive injuries in youth soccer players. METHODS A convenience sample of youth soccer athletes aged 14 to 18 years completed a survey assessing prior history of concussive injury, knowledge of concussive injury, self-reporting attitudes, and perception of the injury. The survey consists of 16 knowledge questions (eleven on a scale of 1-2, and five on a scale of 1-4) and 12 attitude questions (seven on a scale of 1-4, and five on a scale of 1-5). The primary outcomes are the total scores calculated by summing the standardized raw scores for all knowledge questions and attitude questions, respectively. Linear regression was used to estimate the mean difference in the primary outcomes between previously concussed and non-concussed athletes (calculated as previously concussed - non-concussed). RESULTS Surveys were obtained from 90 athletes, with 32 (36%) previously sustaining at least one concussion. Thirty-one out of these 32 concussions were diagnosed by a medical provider. On average, the mean total raw scores of all knowledge questions are 34.6 (82.2% of 42 possible points) and 33.7 (80.2% of 42 total points) for previously concussed and non-concussed athletes, respectively, and the mean total raw scores of all attitude questions are 38.7 (72.9% of 53 possible points) and 39.6 (74.7% of 53 possible points), respectively. Mean differences estimated from univariate linear regression in the standardized total scores of knowledge questions and attitude questions are 1.56(95% confidence interval: -1.52-4.65) and -1.23 (%95 confidence interval: -4.64-2.19), respectively. Adjusting for age and years of playing soccer gave similar results. CONCLUSION Although we did not find significant differences between previously concussed and non-concussed athletes in either the knowledge or the attitude questions as measured by their total scores, this study showed a high level of awareness of concussion in youth soccer players, while still highlighting a need for education. Limited distinctions were made among subgroups of players, suggesting directions of future research in investigating the role that outside factors may have on knowledge and perception of concussion.
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Affiliation(s)
- Caitlyn N Myrdal
- a College of Medicine , The University of Arizona , Tucson , AZ , USA
| | - Shuang Huang
- b Departments of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health , The University of Arizona , Tucson , AZ , USA
| | - Holly N Beach
- c Department of Family and Community Medicine , The University of Arizona , Tucson , AZ , USA
| | - Anna L Waterbrook
- d Department of Emergency Medicine , The University of Arizona , Tucson , AZ , USA
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12
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Di Pietro V, Lazzarino G, Amorini AM, Signoretti S, Hill LJ, Porto E, Tavazzi B, Lazzarino G, Belli A. Fusion or Fission: The Destiny of Mitochondria In Traumatic Brain Injury of Different Severities. Sci Rep 2017; 7:9189. [PMID: 28835707 PMCID: PMC5569027 DOI: 10.1038/s41598-017-09587-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/27/2017] [Indexed: 12/18/2022] Open
Abstract
Mitochondrial dynamics are regulated by a complex system of proteins representing the mitochondrial quality control (MQC). MQC balances antagonistic forces of fusion and fission determining mitochondrial and cell fates. In several neurological disorders, dysfunctional mitochondria show significant changes in gene and protein expression of the MQC and contribute to the pathophysiological mechanisms of cell damage. In this study, we evaluated the main gene and protein expression involved in the MQC in rats receiving traumatic brain injury (TBI) of different severities. At 6, 24, 48 and 120 hours after mild TBI (mTBI) or severe TBI (sTBI), gene and protein expressions of fusion and fission were measured in brain tissue homogenates. Compared to intact brain controls, results showed that genes and proteins inducing fusion or fission were upregulated and downregulated, respectively, in mTBI, but downregulated and upregulated, respectively, in sTBI. In particular, OPA1, regulating inner membrane dynamics, cristae remodelling, oxidative phosphorylation, was post-translationally cleaved generating differential amounts of long and short OPA1 in mTBI and sTBI. Corroborated by data referring to citrate synthase, these results confirm the transitory (mTBI) or permanent (sTBI) mitochondrial dysfunction, enhancing MQC importance to maintain cell functions and indicating in OPA1 an attractive potential therapeutic target for TBI.
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Affiliation(s)
- Valentina Di Pietro
- Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK.,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Edgbaston, B15 2TH, Birmingham, UK
| | - Giacomo Lazzarino
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of Rome, Largo F. Vito 1, 00168, Rome, Italy
| | - Angela Maria Amorini
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of Rome, Largo F. Vito 1, 00168, Rome, Italy
| | - Stefano Signoretti
- Division of Neurosurgery, Department of Neurosciences Head and Neck Surgery, S. Camillo Hospital, Circonvallazione Gianicolense 87, 00152, Rome, Italy
| | - Lisa J Hill
- Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK.,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Edgbaston, B15 2TH, Birmingham, UK
| | - Edoardo Porto
- Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK
| | - Barbara Tavazzi
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of Rome, Largo F. Vito 1, 00168, Rome, Italy.
| | - Giuseppe Lazzarino
- Department of Biomedical and Biotechnological Sciences, Division of Medical Biochemistry, University of Catania, Viale A. Doria 6, 95125, Catania, Italy.
| | - Antonio Belli
- Neuroscience and Ophthalmology Research Group, Institute of Inflammation and Ageing, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK.,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Edgbaston, B15 2TH, Birmingham, UK
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Zamarripa A, Clark SJ, Rogers AJ, Wang-Flores H, Stanley RM. Pediatric Concussion Management in the Emergency Department: A National Survey of Parents. J Pediatr 2017; 181:229-234. [PMID: 27863850 DOI: 10.1016/j.jpeds.2016.10.071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/20/2016] [Accepted: 10/20/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine parental expectations and beliefs about diagnosis and management of pediatric concussion. STUDY DESIGN We conducted a cross-sectional web-based survey of a nationally representative panel of US parents in March 2014. Parents of 10- to 17-year-old children responded to questions about their expectations and beliefs about diagnosis and management of pediatric concussion in the emergency department (ED). Weighted percentages for descriptive statistics were calculated, and χ2 statistics were used for bivariate analysis. RESULTS Survey participation was 53%, and of 912 parent respondents with a child 10-17 years of age who were presented with a scenario of their child having mild symptoms of concussion, 42% would seek immediate ED care. Parents who would seek immediate ED care for this scenario were more likely than parents who would consult their child's usual provider or wait at home to "definitely expect" imaging (65% vs 21%), definitive diagnosis of concussion (77% vs 61%), a timeline for return to activity (80% vs 60%), and a signed return to play form (55% vs 41%). CONCLUSIONS Many parents who bring children to the ED following a possible concussion are likely to expect comprehensive and definitive care, including imaging, a definitive diagnosis, a timeline for return to activity, and a signed return to play form. To manage these expectations, healthcare providers should continue to educate parents about the evaluation and management of concussion.
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Affiliation(s)
- Angela Zamarripa
- Department of Emergency Medicine, Spectrum Health/Helen DeVos Children's Hospital, Michigan State University, Grand Rapids, MI.
| | - Sarah J Clark
- Department of Pediatric, University of Michigan, Ann Arbor, MI; Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, MI
| | - Alexander J Rogers
- Department of Pediatric, University of Michigan, Ann Arbor, MI; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI
| | - Helena Wang-Flores
- Department of Pediatric, University of Michigan, Ann Arbor, MI; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI
| | - Rachel M Stanley
- Nationwide Children's Hospital, Ohio State University, Columbus, OH
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Balaban C, Hoffer ME, Szczupak M, Snapp H, Crawford J, Murphy S, Marshall K, Pelusso C, Knowles S, Kiderman A. Oculomotor, Vestibular, and Reaction Time Tests in Mild Traumatic Brain Injury. PLoS One 2016; 11:e0162168. [PMID: 27654131 PMCID: PMC5031310 DOI: 10.1371/journal.pone.0162168] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 08/18/2016] [Indexed: 12/26/2022] Open
Abstract
Objective Mild traumatic brain injury is a major public health issue and is a particular concern in sports. One of the most difficult issues with respect to mild traumatic brain injury involves the diagnosis of the disorder. Typically, diagnosis is made by a constellation of physical exam findings. However, in order to best manage mild traumatic brain injury, it is critically important to develop objective tests that substantiate the diagnosis. With objective tests the disorder can be better characterized, more accurately diagnosed, and studied more effectively. In addition, prevention and treatments can be applied where necessary. Methods Two cohorts each of fifty subjects with mild traumatic brain injury and one hundred controls were evaluated with a battery of oculomotor, vestibular and reaction time related tests applied to a population of individuals with mild traumatic brain injury as compared to controls. Results We demonstrated pattern differences between the two groups and showed how three of these tests yield an 89% sensitivity and 95% specificity for confirming a current diagnosis of mild traumatic brain injury. Interpretation These results help better characterize the oculomotor, vestibular, and reaction time differences between those the mild traumatic brain injury and non-affected individuals. This characterization will allow for the development of more effective point of care neurologic diagnostic techniques and allow for more targeted treatment which may allow for quicker return to normal activity.
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Affiliation(s)
- Carey Balaban
- University of Pittsburgh, Department of Otolaryngology, Pittsburgh, PA, United States of America
| | - Michael E. Hoffer
- University of Miami, Miller School of Medicine, Department of Otolaryngology, Miami, FL, United States of America
- University of Miami, Miller School of Medicine, Department of Neurological Surgery, Miami, FL, United States of America
- University of Miami Sports Performance and Wellness Institute, Miami, FL, United States of America
- * E-mail:
| | - Mikhaylo Szczupak
- University of Miami, Miller School of Medicine, Department of Otolaryngology, Miami, FL, United States of America
- University of Miami Sports Performance and Wellness Institute, Miami, FL, United States of America
| | - Hillary Snapp
- University of Miami, Miller School of Medicine, Department of Otolaryngology, Miami, FL, United States of America
| | - James Crawford
- Madigan Army Medical Center, Department of Otolaryngology, Tacoma, WA, United States of America
| | - Sara Murphy
- University of Miami, Miller School of Medicine, Department of Otolaryngology, Miami, FL, United States of America
- Naval Medical Center, San Diego, San Diego, CA, United States of America
| | - Kathryn Marshall
- Madigan Army Medical Center, Department of Otolaryngology, Tacoma, WA, United States of America
| | - Constanza Pelusso
- University of Miami, Miller School of Medicine, Department of Otolaryngology, Miami, FL, United States of America
- University of Miami Sports Performance and Wellness Institute, Miami, FL, United States of America
| | - Sean Knowles
- University of Miami, Miller School of Medicine, Department of Otolaryngology, Miami, FL, United States of America
| | - Alex Kiderman
- Neuro–Kinetics, Inc. Pittsburgh, PA, United States of America
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Asken BM, Mihalik JP, Schmidt JD, Littleton AC, Guskiewicz KM, Hopfinger JB. Visual Performance Measures and Functional Implications in Healthy Participants: A Sports Concussion Perspective. ACTA ACUST UNITED AC 2016. [DOI: 10.3928/19425864-20160204-03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Anderson S, Schnebel B. Sideline Neurological Evaluation: a Detailed Approach to the Sideline, In-Game Neurological Assessment of Contact Sport Athletes. Curr Pain Headache Rep 2016; 20:46. [DOI: 10.1007/s11916-016-0575-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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