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Wang S, Eckstein KN, Guertler CA, Johnson CL, Okamoto RJ, McGarry MD, Bayly PV. Post-mortem changes of anisotropic mechanical properties in the porcine brain assessed by MR elastography. BRAIN MULTIPHYSICS 2024; 6:100091. [PMID: 38933498 PMCID: PMC11207183 DOI: 10.1016/j.brain.2024.100091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Knowledge of the mechanical properties of brain tissue in vivo is essential to understanding the mechanisms underlying traumatic brain injury (TBI) and to creating accurate computational models of TBI and neurosurgical simulation. Brain white matter, which is composed of aligned, myelinated, axonal fibers, is structurally anisotropic. White matter in vivo also exhibits mechanical anisotropy, as measured by magnetic resonance elastography (MRE), but measurements of anisotropy obtained by mechanical testing of white matter ex vivo have been inconsistent. The minipig has a gyrencephalic brain with similar white matter and gray matter proportions to humans and therefore provides a relevant model for human brain mechanics. In this study, we compare estimates of anisotropic mechanical properties of the minipig brain obtained by identical, non-invasive methods in the live (in vivo) and dead animals (in situ). To do so, we combine wave displacement fields from MRE and fiber directions derived from diffusion tensor imaging (DTI) with a finite element-based, transversely-isotropic nonlinear inversion (TI-NLI) algorithm. Maps of anisotropic mechanical properties in the minipig brain were generated for each animal alive and at specific times post-mortem. These maps show that white matter is stiffer, more dissipative, and more anisotropic than gray matter when the minipig is alive, but that these differences largely disappear post-mortem, with the exception of tensile anisotropy. Overall, brain tissue becomes stiffer, less dissipative, and less mechanically anisotropic post-mortem. These findings emphasize the importance of testing brain tissue properties in vivo. Statement of Significance In this study, MRE and DTI in the minipig were combined to estimate, for the first time, anisotropic mechanical properties in the living brain and in the same brain after death. Significant differences were observed in the anisotropic behavior of brain tissue post-mortem. These results demonstrate the importance of measuring brain tissue properties in vivo as well as ex vivo, and provide new quantitative data for the development of computational models of brain biomechanics.
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Affiliation(s)
- Shuaihu Wang
- Washington University in St. Louis, Mechanical Engineering and Material Science, United States
| | - Kevin N. Eckstein
- Washington University in St. Louis, Mechanical Engineering and Material Science, United States
| | - Charlotte A. Guertler
- Washington University in St. Louis, Mechanical Engineering and Material Science, United States
| | | | - Ruth J. Okamoto
- Washington University in St. Louis, Mechanical Engineering and Material Science, United States
| | | | - Philip V. Bayly
- Washington University in St. Louis, Mechanical Engineering and Material Science, United States
- Washington University in St. Louis, Biomedical Engineering, United States
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Khalil M, Teunissen CE, Lehmann S, Otto M, Piehl F, Ziemssen T, Bittner S, Sormani MP, Gattringer T, Abu-Rumeileh S, Thebault S, Abdelhak A, Green A, Benkert P, Kappos L, Comabella M, Tumani H, Freedman MS, Petzold A, Blennow K, Zetterberg H, Leppert D, Kuhle J. Neurofilaments as biomarkers in neurological disorders - towards clinical application. Nat Rev Neurol 2024; 20:269-287. [PMID: 38609644 DOI: 10.1038/s41582-024-00955-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/14/2024]
Abstract
Neurofilament proteins have been validated as specific body fluid biomarkers of neuro-axonal injury. The advent of highly sensitive analytical platforms that enable reliable quantification of neurofilaments in blood samples and simplify longitudinal follow-up has paved the way for the development of neurofilaments as a biomarker in clinical practice. Potential applications include assessment of disease activity, monitoring of treatment responses, and determining prognosis in many acute and chronic neurological disorders as well as their use as an outcome measure in trials of novel therapies. Progress has now moved the measurement of neurofilaments to the doorstep of routine clinical practice for the evaluation of individuals. In this Review, we first outline current knowledge on the structure and function of neurofilaments. We then discuss analytical and statistical approaches and challenges in determining neurofilament levels in different clinical contexts and assess the implications of neurofilament light chain (NfL) levels in normal ageing and the confounding factors that need to be considered when interpreting NfL measures. In addition, we summarize the current value and potential clinical applications of neurofilaments as a biomarker of neuro-axonal damage in a range of neurological disorders, including multiple sclerosis, Alzheimer disease, frontotemporal dementia, amyotrophic lateral sclerosis, stroke and cerebrovascular disease, traumatic brain injury, and Parkinson disease. We also consider the steps needed to complete the translation of neurofilaments from the laboratory to the management of neurological diseases in clinical practice.
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Affiliation(s)
- Michael Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria.
| | - Charlotte E Teunissen
- Neurochemistry Laboratory Department of Laboratory Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands
| | - Sylvain Lehmann
- LBPC-PPC, Université de Montpellier, INM INSERM, IRMB CHU de Montpellier, Montpellier, France
| | - Markus Otto
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Fredrik Piehl
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Stefan Bittner
- Department of Neurology, Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Maria Pia Sormani
- Department of Health Sciences, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Simon Thebault
- Multiple Sclerosis Division, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Abdelhak
- Weill Institute for Neurosciences, Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
| | - Ari Green
- Weill Institute for Neurosciences, Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
| | - Pascal Benkert
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital and University of Basel, Basel, Switzerland
| | - Ludwig Kappos
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital and University of Basel, Basel, Switzerland
| | - Manuel Comabella
- Neurology Department, Multiple Sclerosis Centre of Catalonia, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Hayrettin Tumani
- Department of Neurology, CSF Laboratory, Ulm University Hospital, Ulm, Germany
| | - Mark S Freedman
- Department of Medicine, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Axel Petzold
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, MS Centre and Neuro-ophthalmology Expertise Centre Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
- Moorfields Eye Hospital, The National Hospital for Neurology and Neurosurgery and the Queen Square Institute of Neurology, UCL, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, and Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei, P. R. China
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - David Leppert
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital and University of Basel, Basel, Switzerland
| | - Jens Kuhle
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland.
- Department of Neurology, University Hospital and University of Basel, Basel, Switzerland.
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3
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Shafik A, Lota KS, Mifsud D, Bennett P, Rosenbloom C, Okholm Kryger K, Carmody S, Power J. Sport-related concussion knowledge and attitudes of staff working in English elite women's football: a survey-based study. SCI MED FOOTBALL 2024:1-11. [PMID: 38661312 DOI: 10.1080/24733938.2024.2339497] [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] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Sport-related concussion (SRC) remains an injury of concern in sport, including football(soccer). There has been little investigation into SRC knowledge and attitudes of support staff working in the professional setting. METHODS An amended version of the Rosenbaum Concussion Knowledge and Attitudes Survey(RoCKAS) was distributed online to coaching staff, and medical and performance staff, working at clubs in the English Football Association Women's SuperLeague (WSL) and Championship. Completion of the survey generated two scores: concussion knowledge index (CKI) and concussion attitudes index (CAI). RESULTS Sixty-three completed surveys were returned. Eighteen respondents were coaching staff, and 45 were medical and performance staff. The median CKI in medical and performance staff was significantly greater than in coaching staff. There was no significant difference in CAIbetween coaching staff and medical and performance staff. There was no correlation between CKI and CAI across all staff. CONCLUSION Medical and performance staff working in elite women's football have greater knowledge of SRC than coaching staff. However, this does not always translate into safe behaviours on the field. Education should continue to be mandated across the professional game amongst support staff in order to maximise player welfare and enhance injury outcomes, whilst also reinforcing present SRC guidance.
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Affiliation(s)
- Andrew Shafik
- Department of Health, University of Bath, Bath, UK
- Sport and Exercise Medicine, University of Leeds, Leeds, UK
| | - Kabir Singh Lota
- Centre for Sports and Exercise Medicine, Queen Mary, University of London, London, UK
| | - Daniela Mifsud
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, Wales
| | - Pippa Bennett
- Medical Department, The Football Association, Needwood, Burton-Upon-Trent, UK
| | - Craig Rosenbloom
- Centre for Sports and Exercise Medicine, Queen Mary, University of London, London, UK
| | - Katrine Okholm Kryger
- Centre for Sports and Exercise Medicine, Queen Mary, University of London, London, UK
- Faculty of Sport, Health and Applied Science, St Mary's University Twickenham, London, UK
| | - Sean Carmody
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jonathan Power
- Sport and Exercise Medicine, University of Leeds, Leeds, UK
- Medical Department, Liverpool Football Club, Liverpool, UK
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Neill MG, Burma JS, Miutz LN, Kennedy CM, Penner LC, Newel KT, Smirl JD. Transcranial Doppler Ultrasound and Concussion-Supplemental Symptoms with Physiology: A Systematic Review. J Neurotrauma 2024. [PMID: 38468559 DOI: 10.1089/neu.2023.0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Sport-related concussion (SRC) can impair the cerebrovasculature both acutely and chronically. Transcranial Doppler (TCD) ultrasound assessment has the potential to illuminate the mechanisms of impairment and provide an objective evaluation of SRC. The current systematic review investigated studies employing TCD ultrasound assessment of intracranial arteries across three broad categories of cerebrovascular regulation: neurovascular coupling (NVC), cerebrovascular reactivity (CVR), and dynamic cerebral autoregulation (dCA). The current review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021275627). The search strategy was applied to PubMed, as this database indexes all biomedical journals. Original articles on TCD for athletes with medically diagnosed SRC were included. Title/abstract and full-text screening were completed by three authors. Two authors completed data extraction and risk of bias using the Methodological Index for Non-Randomized Studies and Scottish Intercollegiate Guideline Network checklists. Of the 141 articles identified, 14 met the eligibility criteria. One article used an NVC challenge, eight assessed CVR, and six investigated dCA. Methodologies varied widely among studies, and results were heterogeneous. There was evidence of cerebrovascular impairment in all three domains roughly 2 days post-SRC, but the magnitude and recovery of these impairments were not clear. There was evidence that clinical symptom resolution occurred before cerebrovascular function, indicating that physiological deficits may persist despite clinical recovery and return to play. Collectively, this emphasizes an opportunity for the use of TCD to illuminate the cerebrovascular deficits caused by SRC. It also highlights that there is need for consistent methodological rigor when employing TCD in a SRC population.
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Affiliation(s)
- Matthew G Neill
- Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Joel S Burma
- Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Lauren N Miutz
- Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
- Department of Health and Sport Science, University of Dayton, Dayton, Ohio, USA
| | - Courtney M Kennedy
- Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Linden C Penner
- Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Kailey T Newel
- Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, British Columbia, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan D Smirl
- Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
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Wallis WEG, Al-Alem Q, Lorimer H, Smail OJ, Williams GKR, Bond B. The acute influence of amateur boxing on dynamic cerebral autoregulation and cerebrovascular reactivity to carbon dioxide. Eur J Appl Physiol 2024; 124:993-1003. [PMID: 37768343 PMCID: PMC10879355 DOI: 10.1007/s00421-023-05324-y] [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: 04/25/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE The purpose of this study was to investigate the acute effect of head impacts, sustained over the course of three rounds of amateur boxing, on indices of cerebrovascular function. METHODS Eighteen university amateur boxers (six female) completed three experimental trials in a randomised order; (1) three rounds of boxing (BOX), (2) an equivalent bout of pad boxing (where no blows to the head were sustained; PAD), and (3) a time-matched seated control trial (CON). Indices of cerebrovascular function were determined immediately before and 45 min after each trial. Specifically, dynamic cerebral autoregulation (dCA) was determined by considering the relationship between changes in cerebral blood velocity and mean arterial pressure during 5 min of squat-stand manoeuvres at 0.05 and 0.10 Hz. Cerebrovascular reactivity was determined using serial breath holding and hyperventilation attempts. RESULTS Participants received an average of 40 ± 16 punches to the head during the BOX trial. Diastolic, mean and systolic dCA phase during squat stand manoeuvres at 0.05 Hz was lower after BOX compared to pre BOX (P ≤ 0.02, effect size (d) ≥ 0.74). No other alterations in dCA outcomes were observed at 0.05 or 0.10 Hz. The number of head impacts received during the BOX trial was associated with the change in systolic phase (r = 0.50, P = 0.03). No differences in cerebrovascular reactivity to breath holding or hyperventilation were observed. CONCLUSIONS A typical bout of amateur boxing (i.e., three rounds) can subtly alter cerebral pressure-flow dynamics, and the magnitude of this change may be related to head impact exposure.
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Affiliation(s)
- W E G Wallis
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - Q Al-Alem
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - H Lorimer
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - O J Smail
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - G K R Williams
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - B Bond
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK.
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Twohey E, Velasco G, Neidecker J, Giovane R. Knockout rates across the states as a way of predicting injury and knockout based on fighter sex, weight, or experience. PHYSICIAN SPORTSMED 2023:1-5. [PMID: 37990916 DOI: 10.1080/00913847.2023.2285716] [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] [Received: 08/27/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023]
Abstract
Combat sports, such as boxing and mixed martial arts [MMA], have the unique objective to finish a bout by way of knockout [KO] or technical knockout [TKO]. There are potentially both short- and long-term neurological injuries that can happen as a result of the repeated head trauma sustained in bouts, and thus it is imperative to identify the athletes that are at increased risk. Using an online database of professional boxing bouts [boxrec.com] over a 6-month period, KO/TKO rates were calculated across different states, weight classes, sex, and Fight Exposure Score [FES] categories. There was found to be a significant association between KO/TKO rates and weight class, sex, and FES category with heavyweights, males and FES 0 boxers having higher KO/TKO rates. KO/TKO rates were increased in winless boxers. KO/TKO rates across the states are documented in the study.
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Affiliation(s)
- Eric Twohey
- Mayo Clinic Department of Physical Medicine and Rehabilitation, Rochester, USA
| | - George Velasco
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - John Neidecker
- Sports Medicine, Orthopaedic Specialists of North Carolina, Raleigh, NC, USA
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Field B, Waddington G, McKune A, Goecke R, Gardner AJ. Validation of an instrumented mouthguard in rugby union-a pilot study comparing impact sensor technology to video analysis. Front Sports Act Living 2023; 5:1230202. [PMID: 38053522 PMCID: PMC10694248 DOI: 10.3389/fspor.2023.1230202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 10/25/2023] [Indexed: 12/07/2023] Open
Abstract
Background To better understand the biomechanical profile of direct head impacts and the game scenarios in which they occur in Rugby Union, there is a need for an on-field validation of a new instrumented mouthguard (IMG) against the reference standard. This study considers the potential of a combined biomechanical (IMG) and video analysis approach to direct head impact recognition, both of which in isolation have limitations. The aim of this study is to assess the relationship between an instrumented mouthguard and video analysis in detection of direct head impacts in rugby union. Design Pilot Study - Observational Cohort design. Methods The instrumented mouthguard was worn by ten (3 backs, 7 forwards) professional Rugby Union players during the 2020-21 Gallagher Premiership (UK) season. Game-day video was synchronized with timestamped head acceleration events captured from the instrumented mouthguard. Direct Head Impacts were recorded in a 2 × 2 contingency table to determine sensitivity. Impact characteristics were also collected for all verified head impacts to further the understanding of head biomechanics during the game. Results There were 2018 contact events that were reviewed using video analysis. Of those 655 were categorized as direct head impacts which also correlated with a head acceleration event captured by the IMG. Sensitivity analysis showed an overall sensitivity of 93.6% and a positive predictive value (PPV of 92.4%). When false positives were excluded due to ball out of play, mouthguard removal or handling after a scoring situation or stoppage, PPV was improved (98.3%). Most verified head impacts occurred in and around the ruck contest (31.2%) followed by impacts to the primary tackler (28.4%). Conclusion This pilot validation study demonstrates that this IMG provides a highly accurate measurement device that could be used to complement video verification in the recognition of on-field direct head impacts. The frequency and magnitude of direct head impacts derived from specific game scenarios has been described and allows for greater recognition of high-risk situations. Further studies with larger sample sizes and in different populations of Rugby Union players are required to develop our understanding of head impact and enable strategies for injury mitigation.
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Affiliation(s)
- Byron Field
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Andrew McKune
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT, Australia
- Discipline of Biokinetics, Exercise, and Leisure Sciences, School of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Roland Goecke
- Research Institute for Sport and Exercise, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia
| | - Andrew J. Gardner
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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8
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Valdés-Badilla P, Guzmán-Muñoz E, Herrera-Valenzuela T, Branco BHM, Hernandez-Martinez J, Nobari H. Impact of adapted taekwondo vs. multicomponent training on health status in independent older women: a randomized controlled trial. Front Public Health 2023; 11:1236402. [PMID: 37886049 PMCID: PMC10598459 DOI: 10.3389/fpubh.2023.1236402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/29/2023] [Indexed: 10/28/2023] Open
Abstract
This study, called the TKD and Aging Project, aimed to analyze and compare the effects of an adapted taekwondo program concerning multicomponent training on blood pressure, morphological variables, food consumption frequency, health-related quality of life (HRQoL), physical fitness, handgrip strength, and postural balance in independent older women. A randomized controlled trial study was conducted with parallel groups for 8 weeks (24 sessions of 60 min each), employing a double-blind design and incorporating repeated measures. Twenty-eight older women initially participated in the intervention. Three participants were excluded because they did not participate in the re-assessments. Thus, 14 older women from the adapted taekwondo group (TKD; age: 62.86 ± 2.38 years) and 11 from the multicomponent training group (MCT; age: 63.18 ± 1.94 years) participated in the final analysis. A two-factor mixed analysis of variance (ANOVA) model with repeated measures was performed to measure the time × group effect. The TKD showed significant improvements in the mental health (p = 0.024; ES = 0.91) and general health (p < 0.001; ES = 0.75) dimensions of the HRQoL, as well as in the chair stand (p = 0.001; ES = 1.18), arm curl (p < 0.001; ES = 2.10), 2-min step (p < 0.001; ES = 1.73), and chair sit-and-reach (p = 0.001; ES = 0.91) tests. Additionally, it showed a significant reduction in postural balance for the eyes-closed condition in the center of the pressure area (p = 0.021; ES = 0.89), mean velocity (p = 0.004; ES = 0.79), and mediolateral velocity (p < 0.001; ES = 1.26). However, the MCT showed significant increases in the general health (p = 0.013; ES = 0.95) dimension of the HRQoL and a significant reduction (p = 0.039; ES = 0.28) in the mediolateral velocity of postural balance for the eyes-closed condition. Multiple comparisons showed that the TKD scored significantly higher in the chair stand (p = 0.017; ES = 1.79), arm curl (p = 0.003; ES = 1.77), and 2-min step (p = 0.018; ES = 0.91) tests than the MCT. Compared to multicomponent training, taekwondo improves postural balance and provides better benefits in terms of physical fitness and HRQoL for older women. Therefore, it is possible to recommend it as a safe physical activity strategy, as long as it is well-dosed, since it showed high adherence to intervention in older women.
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Affiliation(s)
- Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, Chile
| | - Eduardo Guzmán-Muñoz
- School of Kinesiology, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- School of Kinesiology, Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| | - Tomás Herrera-Valenzuela
- Department of Physical Activity, Sports and Health Sciences, Faculty of Medical Sciences, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | | | - Jordan Hernandez-Martinez
- Programa de Investigación en Deporte, Sociedad y Buen Vivir, Universidad de los Lagos, Osorno, Chile
- Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno, Chile
| | - Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
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9
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Delic V, Karp JH, Guzman M, Arismendi GR, Stalnaker KJ, Burton JA, Murray KE, Stamos JP, Beck KD, Sokratian A, West AB, Citron BA. Repetitive mild TBI causes pTau aggregation in nigra without altering preexisting fibril induced Parkinson's-like pathology burden. Acta Neuropathol Commun 2022; 10:170. [PMID: 36435806 PMCID: PMC9701434 DOI: 10.1186/s40478-022-01475-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 11/28/2022] Open
Abstract
Population studies have shown that traumatic brain injury (TBI) is associated with an increased risk for Parkinson's disease (PD) and among U.S. Veterans with a history of TBI this risk is 56% higher. The most common type of TBI is mild (mTBI) and often occurs repeatedly among athletes, military personnel, and victims of domestic violence. PD is classically characterized by deficits in fine motor movement control resulting from progressive neurodegeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc) midbrain region. This neurodegeneration is preceded by the predictable spread of characteristic alpha synuclein (αSyn) protein inclusions. Whether repetitive mTBI (r-mTBI) can nucleate PD pathology or accelerate prodromal PD pathology remains unknown. To answer this question, an injury device was constructed to deliver a surgery-free r-mTBI to rats and human-like PD pathology was induced by intracranial injection of recombinant αSyn preformed fibrils. At the 3-month endpoint, the r-mTBI caused encephalomalacia throughout the brain reminiscent of neuroimaging findings in patients with a history of mTBI, accompanied by astrocyte expansion and microglial activation. The pathology associated most closely with PD, which includes dopaminergic neurodegeneration in the SNpc and Lewy body-like αSyn inclusion burden in the surviving neurons, was not produced de novo by r-mTBI nor was the fibril induced preexisting pathology accelerated. r-mTBI did however cause aggregation of phosphorylated Tau (pTau) protein in nigra of rats with and without preexisting PD-like pathology. pTau aggregation was also found to colocalize with PFF induced αSyn pathology without r-mTBI. These findings suggest that r-mTBI induced pTau aggregate deposition in dopaminergic neurons may create an environment conducive to αSyn pathology nucleation and may add to preexisting proteinaceous aggregate burden.
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Affiliation(s)
- Vedad Delic
- Laboratory of Molecular Biology, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA.
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers- New Jersey Medical School, Newark, NJ, 07103, USA.
- Rutgers School of Graduate Studies, Newark, NJ, 07103, USA.
| | - Joshua H Karp
- Laboratory of Molecular Biology, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Rutgers School of Graduate Studies, Newark, NJ, 07103, USA
| | - Maynard Guzman
- Laboratory of Molecular Biology, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Rutgers School of Graduate Studies, Newark, NJ, 07103, USA
| | - Gabriel R Arismendi
- Laboratory of Molecular Biology, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Neurology Service, VA New Jersey Health Care System, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Department of Neurology, Rutgers- New Jersey Medical School, Newark, NJ, 07103, USA
| | - Katherine J Stalnaker
- Neuro Behavioral Research Laboratory, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Rutgers School of Graduate Studies, Newark, NJ, 07103, USA
| | - Julia A Burton
- Neuro Behavioral Research Laboratory, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
| | - Kathleen E Murray
- Laboratory of Molecular Biology, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Rutgers School of Graduate Studies, Newark, NJ, 07103, USA
| | - Joshua P Stamos
- Neuro Behavioral Research Laboratory, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
| | - Kevin D Beck
- Neuro Behavioral Research Laboratory, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers- New Jersey Medical School, Newark, NJ, 07103, USA
- Rutgers School of Graduate Studies, Newark, NJ, 07103, USA
| | - Arpine Sokratian
- Neurobiology Department, Department of Pharmacology and Cancer Biology, Duke Center for Neurodegeneration Research, Duke University School of Medicine, Durham, NC, 27710, USA
- Duke University School of Medicine, Durham, NC, 27710, USA
| | - Andrew B West
- Neurobiology Department, Department of Pharmacology and Cancer Biology, Duke Center for Neurodegeneration Research, Duke University School of Medicine, Durham, NC, 27710, USA
- Duke University School of Medicine, Durham, NC, 27710, USA
| | - Bruce A Citron
- Laboratory of Molecular Biology, VA New Jersey Health Care System, Research and Development (Mailstop 15), Bldg. 16, Rm. 16-130, 385 Tremont Ave, East Orange, NJ, 07018, USA
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers- New Jersey Medical School, Newark, NJ, 07103, USA
- Rutgers School of Graduate Studies, Newark, NJ, 07103, USA
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10
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Bueno JCA, Faro H, Lenetsky S, Gonçalves AF, Dias SBCD, Ribeiro ALB, da Silva BVC, Filho CAC, de Vasconcelos BM, Serrão JC, Andrade A, Souza-Junior TP, Claudino JG. Exploratory Systematic Review of Mixed Martial Arts: An Overview of Performance of Importance Factors with over 20,000 Athletes. Sports (Basel) 2022; 10:sports10060080. [PMID: 35736820 PMCID: PMC9227211 DOI: 10.3390/sports10060080] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/03/2022] [Accepted: 04/28/2022] [Indexed: 02/01/2023] Open
Abstract
This review aimed to analyze the findings in the literature related to Mixed Martial Arts (MMA) through an exploratory systematic review and to present the state of the art from a multifactorial perspective. The review was conducted in accordance with the PRISMA statement, with a search performed in the Scopus, PubMed, and Web of Science databases. Participants were competitive athletes (amateurs or professionals) of regional, national, or international levels. Of the 2763 registries identified, 112 studies met the eligibility criteria. The pooled sample size and age were 20,784 participants, with a mean age of 27.7 ± 6 years for male and 28.9 ± 3 years for female, with the vast majority of athletes being male (94.9%). MMA athletes were 17.2% amateurs, 73.8% professionals, and 9% were not reported. The scientific literature related to MMA reported injuries (n = 28), weight loss (n = 21), technical and tactical analysis (n = 23), physical fitness (n = 8), physiological responses and training characteristics (n = 13), psychobiological parameters (n = 12), and interventions applied to MMA athletes (n = 7). Therefore, this exploratory systematic review presents practitioners and researchers with seven broad summaries of each facet of performance of importance in this population of athletes.
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Affiliation(s)
- João C. A. Bueno
- Research Group on Metabolism, Nutrition and Strength Training, Department of Physical Education, Jardim Botânico Campus, Federal University of Paraná, Curitiba 80210-132, PR, Brazil;
- Sciences Center of Health and Sport, Laboratory of Sport and Exercise Psychology, Physical Education Department, State University of Santa, Catarina 88080-350, FLN, Brazil;
- Correspondence: ; Tel.: +55-41-99907-2389
| | - Heloiana Faro
- Associate Graduate Program in Physical Education, Federal University of Paraíba, João Pessoa 58059-900, PB, Brazil;
| | - Seth Lenetsky
- Sport Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland 1010, New Zealand;
- Canadian Sport Institute Pacific, Victoria, BC V9E 2C5, Canada;
| | - Aleksandro F. Gonçalves
- Laboratory of Psychophysiology and Performance in Sports & Combats, School of Physical Education and Sport, Federal University of Rio de Janeiro, Rio de Janeiro 21941-599, RDJ, Brazil;
| | - Stefane B. C. D. Dias
- Exercise and Sport Science Laboratory, Keiser University Orlando, Sports Medicine & Fitness Tech/Exercise Science, 5600 Lake Underhill Road Orlando, Florida, FL 32807, USA;
| | - André L. B. Ribeiro
- Department of Physiology and Product Development Limber Software, Balsam 15140-000, SP, Brazil;
| | - Bruno V. C. da Silva
- Department of Physical Education, University of Itaúna, Highway MG 431-Km 45, Itaúna 35680-142, MG, Brazil;
| | - Carlos A. Cardoso Filho
- Laboratory of Biomechanics, School of Physical Education and Sport, Campus São Paulo, Universidade de São Paulo, São Paulo 05508-030, SAO, Brazil; (C.A.C.F.); (J.C.S.); or (J.G.C.)
- Research and Development Department, LOAD CONTROL, Contagem 32000-000, MG, Brazil
| | | | - Júlio C. Serrão
- Laboratory of Biomechanics, School of Physical Education and Sport, Campus São Paulo, Universidade de São Paulo, São Paulo 05508-030, SAO, Brazil; (C.A.C.F.); (J.C.S.); or (J.G.C.)
| | - Alexandro Andrade
- Sciences Center of Health and Sport, Laboratory of Sport and Exercise Psychology, Physical Education Department, State University of Santa, Catarina 88080-350, FLN, Brazil;
| | - Tácito P. Souza-Junior
- Research Group on Metabolism, Nutrition and Strength Training, Department of Physical Education, Jardim Botânico Campus, Federal University of Paraná, Curitiba 80210-132, PR, Brazil;
| | - João G. Claudino
- Laboratory of Biomechanics, School of Physical Education and Sport, Campus São Paulo, Universidade de São Paulo, São Paulo 05508-030, SAO, Brazil; (C.A.C.F.); (J.C.S.); or (J.G.C.)
- Research and Development Department, LOAD CONTROL, Contagem 32000-000, MG, Brazil
- Center for Health Sciences, Group of Research, Innovation and Technology Applied to Sport (GSporTech), Department of Physical Education, Federal University of Piauí, Teresina 64000-850, PI, Brazil
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11
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Video Biomechanical Analysis of Shoulder Impact Kinematics in Tai-Otoshi and Morote-Seoi-Nage Judo Throws: A Cross-Sectional Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Shoulder injuries in judo are common as the falling player (uke) lands. Two throws implicated in shoulder injury are tai-otoshi and morote-seoi-nage. Kinematic investigation can provide insight into possible shoulder injury mechanisms and allow for appropriate preventative measures to be suggested. We used two-dimensional (2D) video analysis to measure and compare: (a) the peak acceleration and (b) the peak velocity of uke’s shoulder when tai-otoshi and morote-seoi-nage were performed by elite adult judoka. Methods: Eight male participants were recruited from the Budokwai Judo Club in London, UK. The mean age, height, and weight of participants were 25.4 ± 5.2 years (18–34), 1.7 ± 0.0 m (1.7–1.8), and 75.0 ± 5.2 kg (66–80), respectively. Throws were recorded using an iPhone 6S camera and uploaded onto Kinovea for subsequent processing. Results: The peak acceleration (m/s2) was greater in tai-otoshi (71.6 ± 12.4) compared to morote-seoi-nage (67.9 ± 9.9), although this was statistically insignificant. The peak velocity (m/s) was significantly greater (p = 0.030) in tai-otoshi (5.1 ± 0.8) than in morote-seoi-nage (4.5 ± 0.6). Conclusions: A greater peak velocity in tai-otoshi suggests that the shoulder is subjected to increased loads upon impact. This may indicate that tai-otoshi carries a greater risk of shoulder injury. Nage-komi (repetitive throwing) practices in training should follow gradual loading principles—beginning with morote-seoi-nage, before moving to tai-otoshi, for example. We must be aware of any assumptions made in estimations of impact force, and future in vivo research is required to provide more definitive values. Meanwhile, coaches must continue to ensure that correct ukemi (breakfall) technique is displayed by athletes before performing throws.
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