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Ingram EO, Karr JE. The Sport Concussion Assessment Tool: A multidimensional symptom model for detecting elevated post-concussion symptoms. Clin Neuropsychol 2024; 38:1683-1706. [PMID: 38369485 PMCID: PMC11330539 DOI: 10.1080/13854046.2024.2315735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 12/20/2023] [Indexed: 02/20/2024]
Abstract
Objective: Investigate whether a four-factor model of post-concussion symptoms (i.e. cognitive, physical, affective, and sleep-arousal) aids in identifying student-athletes with persistent concerns not reflected by a total symptom score. Method: Collegiate student-athletes (N = 32,066) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool, 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e. beginning RTP and 6-month). Confirmatory factor analysis was used to compare a one- and four-factor model of post-concussion symptoms. Normative reference data were compared across stratifications (e.g. sex, prior concussions, and number of pre-existing conditions) using Mann-Whitney U tests, and elevation rates (i.e. ≥ 84th percentile) for subscales and the total score were recorded. Results: The four-factor model fit well before and after injury (CFIs > .95). Greater symptom severity on the subscale and total scores was associated with female sex (ps<.001, r range: .07 to .14) and more pre-existing conditions (ps<.001, η 2 range: .01 to .04), while having more prior concussions was only related to total symptom scores (ps<.001, η 2<.01). After a concussion, a sizeable portion of student-athletes (i.e., RTP = 11.8%; 6-month = 8.3%) had subscale elevations despite no total score elevation. Physical subscale elevations at RTP were the most common (i.e., 11.9%), driven by head and neck pain. Conclusion: After a sport-related concussion, a four-factor symptom model can be used to assess persistent symptoms in collegiate student-athletes. Identifying athletes with domain-specific elevations may help clinicians identify areas for further assessment and, in some cases, personalized rehabilitation plans.
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Affiliation(s)
- Eric O Ingram
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Justin E Karr
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
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Kar SK, Choudhary P, Raje D, Bharti V. Multi-modal intervention for neuropsychological symptoms following traumatic brain injury: A case report. Indian J Psychiatry 2024; 66:311-312. [PMID: 39100119 PMCID: PMC11293285 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_823_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/14/2024] [Accepted: 02/20/2024] [Indexed: 08/06/2024] Open
Affiliation(s)
- Sujita K Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Priyanshi Choudhary
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Devika Raje
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Vikas Bharti
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
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Jennings T, Islam MS. Examining the interdisciplinary approach for treatment of persistent post-concussion symptoms in adults: a systematic review. BRAIN IMPAIR 2023; 24:290-308. [PMID: 38167190 DOI: 10.1017/brimp.2022.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The objective of this review is to examine the evidence for the interdisciplinary approach in treatment of persistent post-concussion symptoms in adults. METHODS This systematic literature search was undertaken according to the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) guidelines. Five electronic databases were searched: CINAHL, Informit, ProQuest, PubMed and Scopus. After screening and quality assessment, the review included six studies published in English and peer-reviewed journals, between 2011 and 2021 to return contemporary evidence. RESULTS The results revealed that there was significant variation between measures used and the timing of the pre- and post-treatment assessment. The studies found an interdisciplinary approach to be beneficial, however, the challenges of inherent heterogeneity, lack of clarity for definitions and diagnosis, and mixed results were apparent. The interdisciplinary interventions applied in all identified studies were found to reduce post-concussion symptoms across the symptom subtypes: headache/migraine, vestibular, cognitive, ocular motor and anxiety/mood. CONCLUSIONS The results demonstrated evidence for a reduction in persistent post-concussion symptoms following interdisciplinary intervention. This evidence will inform health services, clinicians, sports administrators and researchers with regard to concussion clinic and rehabilitation team design and service delivery.
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Affiliation(s)
- Tamara Jennings
- Master of Health Management, Barwon Health, Geelong 3215, Victoria, Australia
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
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Babov KD, Zabolotna IB, Plakida AL, Volyanska VS, Babova IK, Gushcha SG, Kolker IA. The effectiveness of high-tone therapy in the complex rehabilitation of servicemen with post-traumatic stress disorder complicated by traumatic brain injury. Neurol Sci 2023; 44:1039-1048. [PMID: 36417014 DOI: 10.1007/s10072-022-06510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/14/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION As a result of local military conflicts that have become more frequent over the past decades, the number of military personnel subjected to combat stress has sharply increased. More than 50% of them suffer from combat posttraumatic stress disorder. The most common comorbidity in this category of patients is a traumatic brain injury. Due to the undesirability of the long-term use of pharmacological agents, for rehabilitation, preference should be given to physiotherapeutic procedures. OBJECTS AND METHODS We examined 50 patients with post-traumatic stress disorder in combination with a closed craniocerebral injury. Group 1-25 patients received standard complex treatment at the sanatoriumresort rehabilitation stage (diet therapy, climatotherapy, balneotherapy, exercise therapy, psychotherapy). Group 2-25 patients, in addition to the standard complex treatment, received a course of high-tone therapy. RESULTS Complex rehabilitation of patients with the use of high-tone therapy contributes to a significant decrease in astheno-neurotic (p < 0.05) and asthenic depressive (p < 0.01) syndromes and has a psycho-relaxing effect on anxiety syndrome (p < 0.01). There was also a decrease in the severity of pyramidal symptoms and regression of the vestibulo-atactic syndrome (p < 0.05). The course application of hightone therapy was accompanied by a significant restoration of the elastotonic properties of the vascular wall and an improvement in cerebral perfusion (p < 0.05). Positive dynamics of electrophysiological indicators were noted: a decrease in the intensity of slow rhythms against the background of an increase in the frequency and intensity of the alpha rhythm in both hemispheres (p < 0.05), which indicates the harmonization of the bioelectrical activity of the brain.
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Affiliation(s)
- Kostyantyn D Babov
- State Institution "Ukrainian Research Institute of Medical Rehabilitation Therapy of Ministry of Health of Ukraine", Odessa, 65014, Ukraine
| | - Iryna B Zabolotna
- State Institution "Ukrainian Research Institute of Medical Rehabilitation Therapy of Ministry of Health of Ukraine", Odessa, 65014, Ukraine
| | - Alexander L Plakida
- State Institution "Ukrainian Research Institute of Medical Rehabilitation Therapy of Ministry of Health of Ukraine", Odessa, 65014, Ukraine.
| | | | - Iryna K Babova
- State Institution "South Ukrainian National Pedagogical University Named After K.D. Ushynsky", Odessa, 65020, Ukraine
| | - Sergey G Gushcha
- State Institution "Ukrainian Research Institute of Medical Rehabilitation Therapy of Ministry of Health of Ukraine", Odessa, 65014, Ukraine
| | - Iryna A Kolker
- Odessa National Medical University, Odessa, 65000, Ukraine
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Taylor MV, Stephenson PL. Sports Concussions: A Webliography. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2022. [DOI: 10.1080/15398285.2022.2045131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mary Virginia Taylor
- Retired, former Chief Librarian, Overton Brooks VA Medical Center, Shreveport, Louisiana, USA
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Mila-Grande JC, Granadillo-Daza RL, Agudelo-Rios DA, Lozada-Martínez ID. Regarding: Management of unfavorable outcome after mild traumatic brain injury: Review of physical and cognitive rehabilitation and of psychological care in post-concussive syndrome. Neurochirurgie 2021; 68:243-244. [PMID: 34171350 DOI: 10.1016/j.neuchi.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 12/19/2022]
Affiliation(s)
- J C Mila-Grande
- School of Medicine, Universidad Antonio Nariño, Bogotá, Colombia
| | | | - D A Agudelo-Rios
- School of Medicine, Fundación Universitaria San Martin, Medellín, Colombia
| | - I D Lozada-Martínez
- Colombian Clinical Research Group in Neurocritical Care, School of Medicine, University of Cartagena, Cartagena, Colombia; Latin American Council of Neurocritical Care, Cartagena, Colombia.
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Argyriou AA, Mitsikostas DD, Mantovani E, Litsardopoulos P, Panagiotopoulos V, Tamburin S. An updated brief overview on post-traumatic headache and a systematic review of the non-pharmacological interventions for its management. Expert Rev Neurother 2021; 21:475-490. [PMID: 33682560 DOI: 10.1080/14737175.2021.1900734] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Post-traumatic headache (PTH), a common type of headache secondary to traumatic brain injury (TBI) or whiplash, carries a relevant burden on patients. PTH is still an undertreated condition because of limited pharmacological treatment options. Therefore, multimodal non-pharmacologic approaches, which account for comorbidities and biopsychosocial factors, are often used in PTH patients. AREAS COVERED After providing a brief overview of PTH, a systematic review was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations on recently published (2015-2020) papers on non-pharmacological interventions for PTH. We also collected data on ongoing trials on this topic. Studies and results are reviewed and discussed. EXPERT OPINION PTH is one of the most common complications of TBI and accounts for almost 4% of symptomatic headache disorders. The most common clinical presentations of PTH are migraine-like or tension type (TTH)-like headache, neck pain, cognitive complaints, and psychological/psychiatric symptoms. Growing evidence suggests that combined pharmacological and non-pharmacological interventions, encompassing noninvasive neuromodulation, physical therapy, cognitive-behavioral treatment, and education, may be the best approaches for PTH and related comorbidities. Acute/preemptive pharmacological treatments for PTH include drugs used for migraine and TTH. When PTH management is multidisciplinary, the patient benefits most.
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Affiliation(s)
- Andreas A Argyriou
- Headache Outpatient Clinic, Department of Neurology, Saint Andrew's State General Hospital of Patras, Greece
| | - Dimos-Dimitrios Mitsikostas
- 1st Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Pantelis Litsardopoulos
- Headache Outpatient Clinic, Department of Neurology, Saint Andrew's State General Hospital of Patras, Greece
| | | | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Moyron RB, Vallejos PA, Fuller RN, Dean N, Wall NR. Neuroimaging and advanced research techniques may lead to improved outcomes in military members suffering from traumatic brain injury. Trauma Surg Acute Care Open 2021; 6:e000608. [PMID: 33490604 PMCID: PMC7797256 DOI: 10.1136/tsaco-2020-000608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/07/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022] Open
Abstract
Recent military conflicts in Iraq and Afghanistan have resulted in the significant increase in blast-related traumatic brain injury (TBI), leading to increased Department of Defense interest in its potential long-term effects ranging from the mildest head injuries termed subconcussive trauma to the most debilitating termed chronic traumatic encephalopathy (CTE). Most patients with mild TBI will recover quickly while others report persistent symptoms called postconcussive syndrome. Repeated concussive and subconcussive head injuries result in neurodegenerative conditions that may hinder the injured for years. Fundamental questions about the nature of these injuries and recovery remain unanswered. Clinically, patients with CTE present with either affective changes or cognitive impairment. Genetically, there have been no clear risk factors identified. The discovery that microglia of the cerebral cortex discharged small extracellular vesicles in the injured and adjacent regions to a TBI may soon shed light on the immediate impact injury mechanisms. The combination of neuroimaging and advanced research techniques may, one day, fill critical knowledge gaps and lead to significant TBI research and treatment advancements.
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Affiliation(s)
- Ron B Moyron
- Department of Basic Sciences, Loma Linda University, Loma Linda, California, USA
| | - Paul A Vallejos
- Department of Basic Sciences, Loma Linda University, Loma Linda, California, USA
| | - Ryan N Fuller
- Department of Basic Sciences, Loma Linda University, Loma Linda, California, USA
| | - Natasha Dean
- Department of Biology, La Sierra University, Riverside, California, USA
| | - Nathan R Wall
- Department of Basic Sciences, Loma Linda University, Loma Linda, California, USA
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