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Caeyenberghs K, Imms P, Irimia A, Monti MM, Esopenko C, de Souza NL, Dominguez D JF, Newsome MR, Dobryakova E, Cwiek A, Mullin HAC, Kim NJ, Mayer AR, Adamson MM, Bickart K, Breedlove KM, Dennis EL, Disner SG, Haswell C, Hodges CB, Hoskinson KR, Johnson PK, Königs M, Li LM, Liebel SW, Livny A, Morey RA, Muir AM, Olsen A, Razi A, Su M, Tate DF, Velez C, Wilde EA, Zielinski BA, Thompson PM, Hillary FG. ENIGMA's simple seven: Recommendations to enhance the reproducibility of resting-state fMRI in traumatic brain injury. Neuroimage Clin 2024; 42:103585. [PMID: 38531165 PMCID: PMC10982609 DOI: 10.1016/j.nicl.2024.103585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024]
Abstract
Resting state functional magnetic resonance imaging (rsfMRI) provides researchers and clinicians with a powerful tool to examine functional connectivity across large-scale brain networks, with ever-increasing applications to the study of neurological disorders, such as traumatic brain injury (TBI). While rsfMRI holds unparalleled promise in systems neurosciences, its acquisition and analytical methodology across research groups is variable, resulting in a literature that is challenging to integrate and interpret. The focus of this narrative review is to address the primary methodological issues including investigator decision points in the application of rsfMRI to study the consequences of TBI. As part of the ENIGMA Brain Injury working group, we have collaborated to identify a minimum set of recommendations that are designed to produce results that are reliable, harmonizable, and reproducible for the TBI imaging research community. Part one of this review provides the results of a literature search of current rsfMRI studies of TBI, highlighting key design considerations and data processing pipelines. Part two outlines seven data acquisition, processing, and analysis recommendations with the goal of maximizing study reliability and between-site comparability, while preserving investigator autonomy. Part three summarizes new directions and opportunities for future rsfMRI studies in TBI patients. The goal is to galvanize the TBI community to gain consensus for a set of rigorous and reproducible methods, and to increase analytical transparency and data sharing to address the reproducibility crisis in the field.
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Affiliation(s)
- Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia.
| | - Phoebe Imms
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; Alfred E. Mann Department of Biomedical Engineering, Andrew & Erna Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA; Department of Quantitative & Computational Biology, Dana and David Dornsife College of Arts & Sciences, University of Southern California, Los Angeles, CA, USA.
| | - Martin M Monti
- Department of Psychology, UCLA, USA; Brain Injury Research Center (BIRC), Department of Neurosurgery, UCLA, USA.
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, NY, USA.
| | - Nicola L de Souza
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, NY, USA.
| | - Juan F Dominguez D
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia.
| | - Mary R Newsome
- Michael E. DeBakey VA Medical Center, Houston, TX, USA; H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA.
| | - Ekaterina Dobryakova
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ, USA; Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Andrew Cwiek
- Department of Psychology, Penn State University, State College, PA, USA.
| | - Hollie A C Mullin
- Department of Psychology, Penn State University, State College, PA, USA.
| | - Nicholas J Kim
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; Alfred E. Mann Department of Biomedical Engineering, Andrew & Erna Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
| | - Andrew R Mayer
- Mind Research Network, Albuquerque, NM, USA; Departments of Neurology and Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA.
| | - Maheen M Adamson
- Women's Operational Military Exposure Network (WOMEN) & Rehabilitation Department, VA Palo Alto, Palo Alto, CA, USA; Rehabilitation Service, VA Palo Alto, Palo Alto, CA, USA; Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.
| | - Kevin Bickart
- UCLA Steve Tisch BrainSPORT Program, USA; Department of Neurology, David Geffen School of Medicine at UCLA, USA.
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA, USA; Department of Radiology, Harvard Medical School, Boston, MA, USA.
| | - Emily L Dennis
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Courtney Haswell
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
| | - Cooper B Hodges
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA; Department of Psychology, Brigham Young University, Provo, UT, USA.
| | - Kristen R Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University College of Medicine, OH, USA.
| | - Paula K Johnson
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; Neuroscience Center, Brigham Young University, Provo, UT, USA.
| | - Marsh Königs
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, The Netherlands; Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
| | - Lucia M Li
- C3NL, Imperial College London, United Kingdom; UK DRI Centre for Health Care and Technology, Imperial College London, United Kingdom.
| | - Spencer W Liebel
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Rajendra A Morey
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC, USA.
| | - Alexandra M Muir
- Department of Psychology, Brigham Young University, Provo, UT, USA.
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; NorHEAD - Norwegian Centre for Headache Research, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR London, United Kingdom; CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, ON, Canada.
| | - Matthew Su
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
| | - David F Tate
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Carmen Velez
- TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Elisabeth A Wilde
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; TBI and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA; George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | - Brandon A Zielinski
- Departments of Pediatrics, Neurology, and Neuroscience, University of Florida, Gainesville, FL, USA; Departments of Pediatrics, Neurology, and Radiology, University of Utah, Salt Lake City, UT, USA.
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA, USA.
| | - Frank G Hillary
- Department of Psychology, Penn State University, State College, PA, USA; Department of Neurology, Hershey Medical Center, PA, USA.
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Bower D, Herbert E, Breedlove KM, Lacy APM, Casa D, Bowman TG. Mechanical characterization of athletic helmet shells. Sports Biomech 2024; 23:241-252. [PMID: 33660587 DOI: 10.1080/14763141.2020.1837926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/12/2020] [Indexed: 10/22/2022]
Abstract
Our purpose was to compare the mechanical properties of the protective outer shells of various athletic helmets in their final, fully manufactured form. Sections were taken from 3 different helmet shells (Bauer RE-AKT hockey helmet, Cascade R lacrosse helmet, and Riddell Speedflex football helmet) at 4 different locations (front, side, top, and rear) for a total of 12 test specimens. The 4 specimens from each helmet shell were potted together in epoxy resin moulds and mechanically polished. The hardness, elastic modulus and phase angle were measured using dynamic nanoindentation performed at 100 Hz with an oscillation amplitude of 1 nm (rms). Repeated ANOVA analysis was used to compare each of the dependent variables for each of the 3 helmets across the 4 different locations. The interaction between helmet type and location was significant for hardness (F6,63 = 2.84, P = 0.032, Pη2 = 0.21), elastic modulus (F6,63 = 6.412, P < 0.001, Pη2 = 0.38), and phase angle (F6,63 = 7.65, P < 0.001, Pη2 = 0.42). Polycarbonate has a higher ability to dissipate mechanical energy making it the recommended superior choice for helmet shells. In addition, the results lead us to speculate that manufacturing causes changes in the molecular weight or the distribution of fillers across locations for polyethylene but not for polycarbonate since mechanical properties are fairly uniform over the surface of football helmets, at least within a given helmet.
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Affiliation(s)
- Dane Bower
- Department of Athletic Training, University of Lynchburg, Lynchburg, VA, USA
| | - Erik Herbert
- Materials Science and Engineering, Michigan Technological University, Houghton, MI, USA
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Alicia Pike M Lacy
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ, USA
- Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
| | - Douglas Casa
- Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Thomas G Bowman
- Department of Athletic Training, University of Lynchburg, Lynchburg, VA, USA
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Lempke LB, Breedlove KM, Caccese JB, McCrea MA, McAllister TW, Broglio SP, Schmidt JD, Lynall RC, Buckley TA. Preinjury Measures Do Not Predict Future Concussion Among Collegiate Student-Athletes: Findings From the CARE Consortium. Am J Phys Med Rehabil 2023; 102:823-828. [PMID: 37339057 DOI: 10.1097/phm.0000000000002302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
ABSTRACT This prospective cohort study aimed to determine whether preinjury characteristics and performance on baseline concussion assessments predicted future concussions among collegiate student-athletes. Participant cases (concussed = 2529; control = 30,905) completed preinjury: demographic forms (sport, concussion history, sex), Immediate Post-Concussion Assessment and Cognitive Test, Balance Error Scoring System, Sport Concussion Assessment Tool symptom checklist, Standardized Assessment of Concussion, Brief Symptom Inventory-18 item, Wechsler Test of Adult Reading, and Brief Sensation Seeking Scale. We used machine-learning logistic regressions with area under the curve, sensitivity, and positive predictive values statistics for univariable and multivariable analyses. Primary sport was determined to be the strongest univariable predictor (area under the curve = 64.3% ± 1.4, sensitivity = 1.1% ± 1.4, positive predictive value = 4.9% ± 6.5). The all-predictor multivariable model was the strongest (area under the curve = 68.3% ± 1.6, sensitivity = 20.7% ± 2.7, positive predictive value = 16.5% ± 2.0). Despite a robust sample size and novel analytical approaches, accurate concussion prediction was not achieved regardless of modeling complexity. The strongest positive predictive value (16.5%) indicated only 17 of every 100 individuals flagged would experience a concussion. These findings suggest preinjury characteristics or baseline assessments have negligible utility for predicting subsequent concussion. Researchers, healthcare providers, and sporting organizations therefore should not use preinjury characteristics or baseline assessments for future concussion risk identification at this time.
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Affiliation(s)
- Landon B Lempke
- From the Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan (LBL, SPB); Center for Clinical Spectroscopy and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (KMB); School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio (JBC); Center for Neurotrauma Research, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin (MAM); Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana (TWM); UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia (JDS, RCL); and Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware (TAB)
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Esopenko C, Sollmann N, Bonke EM, Wiegand TLT, Heinen F, de Souza NL, Breedlove KM, Shenton ME, Lin AP, Koerte IK. Current and Emerging Techniques in Neuroimaging of Sport-Related Concussion. J Clin Neurophysiol 2023; 40:398-407. [PMID: 36930218 PMCID: PMC10329721 DOI: 10.1097/wnp.0000000000000864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
SUMMARY Sport-related concussion (SRC) affects an estimated 1.6 to 3.8 million Americans each year. Sport-related concussion results from biomechanical forces to the head or neck that lead to a broad range of neurologic symptoms and impaired cognitive function. Although most individuals recover within weeks, some develop chronic symptoms. The heterogeneity of both the clinical presentation and the underlying brain injury profile make SRC a challenging condition. Adding to this challenge, there is also a lack of objective and reliable biomarkers to support diagnosis, to inform clinical decision making, and to monitor recovery after SRC. In this review, the authors provide an overview of advanced neuroimaging techniques that provide the sensitivity needed to capture subtle changes in brain structure, metabolism, function, and perfusion after SRC. This is followed by a discussion of emerging neuroimaging techniques, as well as current efforts of international research consortia committed to the study of SRC. Finally, the authors emphasize the need for advanced multimodal neuroimaging to develop objective biomarkers that will inform targeted treatment strategies after SRC.
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Affiliation(s)
- Carrie Esopenko
- Department of Rehabilitation and Movement Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Nico Sollmann
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Elena M. Bonke
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Tim L. T. Wiegand
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Felicitas Heinen
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Nicola L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Katherine M. Breedlove
- Center for Clinical Spectroscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Alexander P. Lin
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Center for Clinical Spectroscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Inga K. Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Singichetti B, Marshall SW, Breedlove KM, Cameron KL, McCrea MA, McAllister TW, Broglio SP. School-level determinants of incidence of sports-related concussion: Findings from the CARE Consortium. PLoS One 2023; 18:e0284259. [PMID: 37036887 PMCID: PMC10085044 DOI: 10.1371/journal.pone.0284259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/27/2023] [Indexed: 04/11/2023] Open
Abstract
OBJECTIVE Epidemiologic research on sports-related concussion (SRC) has focused on individual risk factors, with limited research on institutional risk factors and variability in concussion rates. METHODS This study used data from 53,822 athletes-seasons collected at 30 United States sites (26 civilian institutions and 4 military service academies), from 2014/15 to 2018/19 academic years, by the Concussion Assessment, Research, and Education Consortium. School-level risk factors included competitive division (DI, DII, DIII), school type (military/civilian) and a Sport Risk Index (SRI; Low, Medium, High). For comparability between civilian institutions and military academies, only NCAA athletes and concussions in sports games and practices were included. Random intercepts log-binomial regression was used to estimate Risk Ratios (RRs) and model variability in SRC risk. RESULTS A total of 2,503 SRCs were observed during the study period, including 829 competition SRCs (33%) and 1,674 practice SRCs (67%). Most variability in SRC risk was at the level of athlete or team (within-school), rather than at the school-level. Specifically, across the three SRC outcomes (all [competition and practice combined], competition-only, and practice-only), within-school variability was 5 to 7 times greater than between-school variability. Three school-level risk factors (Division, School Type, and SRI) accounted for over one-third (36%) of between-school variability. SRI was the strongest school-level predictor of SRC risk (RR = 5.7; 95%CI: 4.2, 7.6 for High vs. Low). SRC risk was higher for Division I compared to Divisions II/III (RR = 1.6; 95%CI: 0.9, 2.9 for DI vs. DIII), and military academies had a moderately elevated risk of SRC (RR = 1.4; 95%CI: 0.7, 2.7). CONCLUSION A large portion of the apparent variability between schools was attributable to structural factors (sport risk and competitive level), suggesting that there were minimal systemic differences in concussion identification between schools. While most variability is within-school, understanding school-level determinants of concussion risk may still be important in providing the implementation science context for individual-level interventions.
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Affiliation(s)
- Bhavna Singichetti
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Stephen W Marshall
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Katherine M Breedlove
- Department of Radiology, Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Kenneth L Cameron
- John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, NY, United States of America
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, United States of America
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States of America
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Gallo CA, Breedlove KM, Johnson CL, DiFabio MS, Buckley TA. Effect Of Ice Hockey Repetitive Head Impacts On Dual Task Tandem Gait Performance. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000875864.96902.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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DiFabio MS, Smith DR, Breedlove KM, Buckley TA, Johnson CL. Relationships between aggression, sensation seeking, brain stiffness, and head impact exposure: Implications for head impact prevention in ice hockey. Brain Behav 2022; 12:e2627. [PMID: 35620849 PMCID: PMC9304837 DOI: 10.1002/brb3.2627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The objectives of this study were to (1) examine the relationship between the number of head impacts sustained in a season of men's collegiate club ice hockey and behavioral traits of aggression and sensation seeking, and (2) explore the neural correlates of these behaviors using neuroimaging. DESIGN Retrospective cohort study. METHODS Participants (n = 18) completed baseline surveys to quantify self-reported aggression and sensation-seeking tendencies. Aggression related to playing style was quantified through penalty minutes accrued during a season. Participants wore head impact sensors throughout a season to quantify the number of head impacts sustained. Participants (n = 15) also completed baseline anatomical and magnetic elastography neuroimaging scans to measure brain volumetric and viscoelastic properties. Pearson correlation analyses were performed to examine relationships between (1) impacts, aggression, and sensation seeking, and (2) impacts, aggression, and sensation seeking and brain volume, stiffness, and damping ratio, as an exploratory analysis. RESULTS Number of head impacts sustained was significantly related to the number of penalty minutes accrued, normalized to number of games played (r = .62, p < .01). Our secondary, exploratory analysis revealed that number of impacts, sensation seeking, and aggression were related to stiffness or damping ratio of the thalamus, amygdala, hippocampus, and frontal cortex, but not volume. CONCLUSIONS A more aggressive playing style was related to an increased number of head impacts sustained, which may provide evidence for future studies of head impact prevention. Further, magnetic resonance elastography may aid to monitor behavior or head impact exposure. Researchers should continue to examine this relationship and consider targeting behavioral modification programs of aggression to decrease head impact exposure in ice hockey.
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Affiliation(s)
- Melissa S DiFabio
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA.,Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximillians-Universität München, Munich, Germany
| | - Daniel R Smith
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Curtis L Johnson
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
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8
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DiFabio MS, Smith DR, Breedlove KM, Pohlig RT, Buckley TA, Johnson CL. Altered Brain Functional Connectivity in the Frontoparietal Network following an Ice Hockey Season. Eur J Sport Sci 2022; 23:684-692. [PMID: 35466861 DOI: 10.1080/17461391.2022.2069512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractSustaining sports-related head impacts has been reported to result in neurological changes that potentially lead to later-life neurological disease. Advanced neuroimaging techniques have been used to detect subtle neurological effects resulting from head impacts, even after a single competitive season. The current study used resting-state functional magnetic resonance imaging to assess changes in functional connectivity of the frontoparietal network, a brain network responsible for executive functioning, in collegiate club ice hockey players over one season. Each player was scanned before and after the season and wore accelerometers to measure head impacts at practices and home games throughout the season. We examined pre- to post-season differences in connectivity within the frontoparietal and default mode networks, as well as the relationship between the total number of head impacts sustained and changes in connectivity. We found a significant interaction between network region of interest and time point (p = 0.016), in which connectivity between the left and right posterior parietal cortex seed regions increased over the season (p < 0.01). Number of impacts had a significant effect on frontoparietal network connectivity, such that more impacts were related to greater connectivity differences over the season (p = 0.042). Overall, functional connectivity increased in ice hockey athletes over a season between regions involved in executive functioning, and sensory integration, in particular. Furthermore, those who sustained more impacts had the greatest changes in connectivity. Consistent with prior findings in resting-state sports-related head impact literature, these findings have been suggested to represent brain injury.
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Affiliation(s)
- Melissa S DiFabio
- Department of Biomedical Engineering, University of Delaware, Newark, DE.,Department of Child and Adolescent Psychiatry, Psychomatics, and Psychotherapy, Ludwig-Maximilans-Universität München - University of Munich, Munich, Germany
| | - Daniel R Smith
- Department of Biomedical Engineering, University of Delaware, Newark, DE
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA.,Department of Radiology, Harvard Medical School, Boston, MA
| | - Ryan T Pohlig
- Biostatistics Core Facility, College of Health Sciences, University of Delaware, Newark, DE
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Curtis L Johnson
- Department of Biomedical Engineering, University of Delaware, Newark, DE
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Memmini AK, Van Pelt KL, Wicklund A, Breedlove KM, Broglio SP. Evaluating Adult Decision-Making Modifiers in Support of Youth Contact-Sport Participation. J Athl Train 2022; 57:44-50. [PMID: 35040986 PMCID: PMC8775283 DOI: 10.4085/1062-6050-0125.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT Nearly 44 million youth participate in organized youth sports programs in the United States each year. However, approximately 25% of parents have considered removing their children from sports due to the fear of concussion. OBJECTIVE To determine which adult decision-making modifiers (eg, gender, educational attainment, career type) influenced support for youth contact-sports participation. DESIGN Cross-sectional study. SETTING Midwestern university and medical center. PATIENTS OR OTHER PARTICIPANTS Convenience sample of staff and faculty (N = 5761; 73.9% female) from 2017 to 2018. MAIN OUTCOME MEASURE(S) Support for youth contact-sports participation using multivariate binary logistic regression to calculate odds ratios and 95% CIs. RESULTS The sample was split between adults with children (AWCs; n = 3465, age = 45.39 ± 13.27 years, 76.72% female) and adults without children (AWOCs; n = 2296, age = 30.84 ± 9.01 years, 70.26% female). Among AWCs, those who obtained a bachelor's degree or higher were more likely to support contact-sports participation. Females were more inclined to allow all contact sports, specifically football (odds ratio [OR] = 2.22; 95% CI = 1.64, 3.01) and ice hockey (OR = 1.98; 95% CI = 1.42, 2.78). Overall, previous adult sport participation, increasing number of children, and child gender were significant modifying variables in greater support of youth contact-sports participation among AWCs (P < .001). Among AWOCs, previous sport participation in football (OR = 3.27; 95% CI = 2.14, 4.87), ice hockey (OR = 4.26; 95% CI = 2.23, 8.17), or soccer (OR = 2.29; 95% CI = 1.48, 3.54) increased the likelihood of an adult supporting contact-sports participation. Lastly, all adults were less inclined to support a daughter participating in any contact sport than a son. CONCLUSIONS These results reveal adult- and child-specific variables that may influence youth contact-sports participation. These decisions may be developed through the lens of certain gender role beliefs and may lead adults to perceive certain sports as more appropriate for sons than daughters.
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Affiliation(s)
| | | | | | - Katherine M. Breedlove
- Department of Radiology, Harvard Medical School, Boston, MA
,Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA
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Wittrup EM, Fox LA, Breedlove KM, Memmini AK, Broglio SP. Evaluation of Musculoskeletal Re-Injury Occurrence in Previously Concussed National Football League Athletes. Open Access J Sports Med 2020; 11:169-176. [PMID: 33364861 PMCID: PMC7751585 DOI: 10.2147/oajsm.s280841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/03/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Increased risk of musculoskeletal (MSK) injury post-concussion has been reported in collegiate athletes, yet it is unknown if professional football athletes are at the same risk of secondary injury. The objective of this study was to determine if the risk of MSK injury in National Football League (NFL) athletes increases after concussion. Methods NFL injury reports from 2013 to 2017 were collected from public websites. Concussed athletes (n=91) were equally matched to a non-injured control and an athlete with an incident of musculoskeletal (MSK) injury. Results Following their return to sport, concussed athletes were 2.35 times more likely to have a subsequent MSK injury relative to non-injured controls (95% CI: 2.35 [1.25, 4.44], P = 0.01), but were no more likely than athletes with an incident MSK injury (P = 0.55). Likewise, athletes with an incident MSK injury were no more likely to have a subsequent MSK injury than controls (P = 0.08). Discussion Increased odds of MSK injury in the 12-week period following a concussion in professional football athletes warrants future research on the acute effects of concussion and the relationship to MSK injury risk.
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Affiliation(s)
- Emily M Wittrup
- Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - Lucas A Fox
- Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
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DiFabio MS, Smith DR, Breedlove KM, Buckley TA, Johnson CL. Fronto-parietal Network Hyperconnectivity As A Result Of Head Impacts In College Ice Hockey. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000685916.33928.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Feinberg GJ, Lapointe AP, Van Pelt KL, Dougherty LA, Memmini AK, Breedlove KM, Broglio SP. Analyzing Chronic Balance Deficits In A Concussed Population. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000680020.47518.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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13
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Fox LA, Wittrup EM, Memmini AK, Breedlove KM, Broglio SP. How Do Concussions Affect National Basketball Association Player Performance Measurements? Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000676984.55876.d5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Saunders TD, Le RK, Breedlove KM, Bradney DA, Bowman TG. Sex differences in mechanisms of head impacts in collegiate soccer athletes. Clin Biomech (Bristol, Avon) 2020; 74:14-20. [PMID: 32097766 DOI: 10.1016/j.clinbiomech.2020.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND There has been growing interest in head impacts related to sports participation due to potential long- and short-term consequences of head injuries. Our purpose was to compare head impact magnitude and frequency between men's and women's intercollegiate soccer players based on head impact mechanism. METHODS 28 collegiate soccer players (16 women: age = 19.94 (1.06) years, height = 163.75 (5.15) cm, mass = 61.21 (5.09) kg; 12 men: age = 20.25 (1.14) years, height = 180.34 (6.03) cm, mass = 74.09 (9.32) kg) wore xPatch (X2 Biosystems, Seattle, WA) head impact sensors. Each practice and game was video recorded in order to confirm head impacts. The independent variable was impact mechanism (head to head, head to body (other than head), head to ground, ball to head, goal to head, and combination). Sensors collected linear and rotational accelerations and frequency of head impacts per 1000 athlete exposures. FINDINGS Men were more likely to sustain head impacts than women (IRR = 1.74, CI95 = 1.59-1.92). The highest head impact incidence rate for men was head to body (IR = 611.68, CI95 = 553.11-670.25) while the highest impact incidence rate for women was ball to head (IR = 302.29, CI95 = 270.93-333.64). The interaction between sex and mechanism was significant for rotational accelerations (F4, 1720 = 3.757, P = .005, ω2 = 0.013) but not for linear accelerations (F4,1720 = 0.680, P = .606, ω2 < 0.001, 1 - β = 0.223). INTERPRETATION To reduce the frequency of head impacts in men, perhaps rules governing player to player contact should be more strictly enforced as these data confirm frequent player-to-head contact during soccer practices and games. Prevention efforts for women should be focused on limiting the amount of purposeful heading (planned contact between the head and ball) occurring during play especially since these impacts had higher magnitudes compared to men.
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Affiliation(s)
| | - Rachel K Le
- Department of Athletic Training, University of Lynchburg, USA
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, USA; Department of Radiology, Harvard Medical School, USA
| | | | - Thomas G Bowman
- Department of Athletic Training, University of Lynchburg, USA.
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Bowman TG, Breedlove KM, Lininger MR, Caswell SV. Impact Mitigation Properties of Women's Lacrosse Headgear. Ann Biomed Eng 2020; 48:1491-1498. [PMID: 32002735 DOI: 10.1007/s10439-020-02467-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/23/2020] [Indexed: 12/01/2022]
Abstract
Recently, protective headgear has been released for women's lacrosse despite the fact that contact to the head is illegal. The purposes of this study were to (1) compare the linear and rotational impact attenuation properties of 2 brands of lacrosse headgear at 4 different locations during laboratory pendulum impacts and (2) determine impact dissipation of new and used lacrosse headgear. We measured peak rotational acceleration (PRA; rad/s2) and linear acceleration (PLA; g) at 4 impact locations (side, rear boss non-centric (NC), front boss, and front) in two headgear brands (Cascade LX, Hummingbird). Two headgear service lives (new headgear, used headgear) were included for the second analysis. During the slower speed, there was a significant interaction between impact location and helmet brand (p = 0.002) for PLA. No other findings were significant. While the Hummingbird headgear reduced linear and rotational accelerations of the headform better than the Cascade headgear during slow velocity impacts to the front and front boss locations, it did so due to extreme motion of the helmet upon impact that we believe may compromise protection of the head and face from lacerations and other injuries.
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Affiliation(s)
- Thomas G Bowman
- University of Lynchburg, 1501 Lakeside Drive, Lynchburg, VA, 24501, USA.
| | - Katherine M Breedlove
- University of Wisconsin - Eau Claire, Eau Claire, WI, USA.,Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Breedlove KM, Ortega JD, Kaminski TW, Harmon KG, Schmidt JD, Kontos AP, Clugston JR, Chrisman SPD, McCrea MA, McAllister TW, Broglio SP, Buckley TA. King-Devick Test Reliability in National Collegiate Athletic Association Athletes: A National Collegiate Athletic Association-Department of Defense Concussion Assessment, Research and Education Report. J Athl Train 2019; 54:1241-1246. [PMID: 31618072 DOI: 10.4085/1062-6050-219-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The King-Devick (KD) test has received considerable attention in the literature as an emerging concussion assessment. However, important test psychometric properties remain to be addressed in large-scale independent studies. OBJECTIVE To assess (1) test-retest reliability between trials, (2) test-retest reliability between years 1 and 2, and (3) reliability of the 2 administration modes. DESIGN Cross-sectional study. SETTING Collegiate athletic training facilities. PATIENTS OR OTHER PARTICIPANTS A total of 3248 intercollegiate student-athletes participated in year 1 (male = 55.3%, age = 20.2 ± 2.3 years, height = 1.78 ± 0.11 m, weight = 80.7 ± 21.0 kg) and 833 participated in both years. MAIN OUTCOME MEASURE(S) Time, in seconds, to complete the KD error free. The KD test reliability was assessed between trials and between annual tests over 2 years and stratified by test modality (spiral-bound cards [n = 566] and tablet [n = 264]). RESULTS The KD test was reliable between trials (trial 1 = 43.2 ± 8.3 seconds, trial 2 = 40.8 ± 7.8 seconds; intraclass correlation coefficient [ICC] (2,1) = 0.888, P < .001), between years (year 1 = 40.8 ± 7.4 seconds, year 2 = 38.7 ± 7.7 seconds; ICC [2,1] = 0.827, P < .001), and for both spiral-bound cards (ICC [2,1] = 0.834, P < .001) and tablets (ICC [2,1] = 0.827, P < .001). The mean change between trials for a single test was -2.4 ± 3.8 seconds. Although most athletes improved from year 1 to year 2, 27.1% (226 of 883) of participants demonstrated worse (slower) KD times (3.2 ± 3.9 seconds) in year 2. CONCLUSIONS The KD test was reliable between trials and years and when stratified by modality. A small improvement of 2 seconds was identified with annual retesting, likely due to a practice effect; however, 27% of athletes displayed slowed performance from year 1 to year 2. These results suggest that the KD assessment was a reliable test with modest learning effects over time and that the assessment modality did not adversely affect baseline reliability.
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Affiliation(s)
- Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital and Department of Radiology, Harvard Medical School, Boston, MA
| | - Justus D Ortega
- Department of Kinesiology and Recreation Administration, Humboldt State University, Arcata, CA
| | - Thomas W Kaminski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark
| | | | | | | | - James R Clugston
- Department of Community Health and Family Medicine, Department of Neurology, and Division of Sports Health, University Athletic Association, University of Florida, Gainesville
| | - Sara P D Chrisman
- Seattle Children's Research Institute and Department of Pediatrics, University of Washington, Seattle
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee
| | | | | | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark
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Feinberg GJ, Lapointe AP, Van Pelt KL, Dougherty LA, Memmini A, Breedlove KM, Broglio SP. Examining Persistent Deficits in Gait Utilizing Inertial Measurement Units. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562238.72588.cd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Breedlove KM, Memmini AK, Broglio SP. Evaluation of Concussion Prediction with Head Impact Density by Receiver Operating Characteristic. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561915.69292.00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Dougherty LA, Van Pelt KL, Lapointe AP, Feinberg GJ, Memmini AK, Breedlove KM, Broglio SP. Long Term Effects of Concussion on Eye Tracking Patterns. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561735.04312.1c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Wittrup EM, Fox LA, Breedlove KM, Lapointe AP, Broglio SP. Evaluation Of The Rate Of Orthopedic Injuries Of Concussed And Non-concussed Players In The NFL. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562789.25578.b4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sayre HD, Bradney DA, Breedlove KM, Bowman TG. Concussive Head Impact Biomechanics in Women's Lacrosse and Soccer Athletes: A Case Series. ACTA ACUST UNITED AC 2019. [DOI: 10.3928/19425864-20190228-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Le RK, Saunders TD, Breedlove KM, Bradney DA, Lucas JM, Bowman TG. Differences in the Mechanism of Head Impacts Measured Between Men's and Women's Intercollegiate Lacrosse Athletes. Orthop J Sports Med 2018; 6:2325967118807678. [PMID: 30480018 PMCID: PMC6249660 DOI: 10.1177/2325967118807678] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Lacrosse is a rapidly growing sport in the United States. Comparing the magnitude and frequency of head impact mechanisms between sexes will provide data for injury prevention techniques and risk reduction of head injuries. Purpose To compare sex-specific differences in the magnitude and frequency of head impact mechanisms in National Collegiate Athletic Association (NCAA) Division III intercollegiate lacrosse athletes. Study Design Cohort study; Level of evidence, 2. Methods A total of 31 NCAA Division III intercollegiate lacrosse athletes (16 men [mean age, 21 ± 1 years; mean height, 179.70 ± 5.82 cm; mean weight, 80.71 ± 6.33 kg] and 15 women [mean age, 20 ± 1 years; mean height, 165.43 ± 5.25 cm; mean weight, 64.08 ± 7.59 kg]) voluntarily participated in this study. Participants wore xPatch sensors at every event during the 2015 spring season. Sensors recorded the magnitude, frequency, and location of head impacts over 10g. Linear (g) and rotational (deg/s2) acceleration determined impact magnitudes. We calculated incidence rates (IRs; per 1000 athlete-exposures [AEs]) and incidence rate ratios (IRRs) with 95% CIs to determine frequency differences. Film footage from each event was synchronized with the time of each head impact for verification and mechanism coding. Sex and impact mechanism served as the independent variables. Results A significant interaction was found between impact mechanism and sex (P < .001) and main effects for impact mechanism (P < .001) and sex (P < .001). The most common mechanism in men's lacrosse was head to body (IR, 970.55/1000 AEs [95% CI, 266.14-331.98]), and in women's lacrosse, stick to head (IR, 289.87/1000 AEs [95% CI, 124.32-184.55]) was most common. Only 9 of 419 impermissible head impacts in men's lacrosse games were classed as penalties (2%); 7 of 25 impermissible head impacts in women's lacrosse games were called as penalties (28%). Conclusion The impact mechanisms of head to body in men's lacrosse and stick to head in women's lacrosse are penalties but occur frequently, suggesting that a focus on stressing rule enforcement is warranted. Because mechanism and sex affect the magnitude of head impacts, proper offensive and defensive techniques against opponents should be encouraged to reduce head impacts.
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Affiliation(s)
- Rachel K Le
- Department of Athletic Training, University of Lynchburg, Lynchburg, Virginia, USA
| | - Tabitha D Saunders
- Department of Athletic Training, University of Lynchburg, Lynchburg, Virginia, USA
| | | | - Debbie A Bradney
- Department of Athletic Training, University of Lynchburg, Lynchburg, Virginia, USA
| | - Jill M Lucas
- Department of Athletic Training, University of Lynchburg, Lynchburg, Virginia, USA
| | - Thomas G Bowman
- Department of Athletic Training, University of Lynchburg, Lynchburg, Virginia, USA
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Breedlove KM, Breedlove EL, Bowman TG, Arruda EM, Nauman EA. The effect of football helmet facemasks on impact behavior during linear drop tests. J Biomech 2018; 79:227-231. [DOI: 10.1016/j.jbiomech.2018.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/27/2018] [Accepted: 08/10/2018] [Indexed: 10/28/2022]
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Buckley TA, Breedlove KM, DiFabio MS, Oldham JR. No Relationship Between Head Impact Kinematics and Concussion Clinical Assessment Performance. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536645.03929.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Breedlove KM, Breedlove E, Nauman E, Bowman TG, Lininger MR. The Ability of an Aftermarket Helmet Add-On Device to Reduce Impact-Force Accelerations During Drop Tests. J Athl Train 2017; 52:802-808. [PMID: 28771033 DOI: 10.4085/1062-6050-52.6.01] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The Guardian Cap provides a soft covering intended to mitigate energy transfer to the head during football contact. Yet how well it attenuates impacts remains unknown. OBJECTIVE To evaluate the changes in the Gadd Severity Index (GSI) and linear acceleration during drop tests on helmeted headforms with or without Guardian Caps. DESIGN Crossover study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS Nine new football helmets sent directly from the manufacturer. INTERVENTION(S) We dropped the helmets at 3 velocities on 6 helmet locations (front, side, right front boss, top, rear right boss, and rear) as prescribed by the National Operating Committee on Standards for Athletic Equipment. Helmets were tested with facemasks in place but no Guardian Cap and then retested with the facemasks in place and the Guardian Cap affixed. MAIN OUTCOME MEASURE(S) The GSI scores and linear accelerations measured in g forces. RESULTS For the GSI, we found a significant interaction among drop location, Guardian Cap presence, and helmet brand at the high velocity (F10,50 = 3.01, P = .005) but not at the low (F3.23,16.15 = 0.84, P = .50) or medium (F10,50 = 1.29, P = .26) velocities. Similarly for linear accelerations, we found a significant interaction among drop location, Guardian Cap presence, and helmet brand at the high velocity (F10,50 = 3.01, P = .002, ω2 = 0.05) but not at the low (F10,50 = 0.49, P = .89, ω2 < 0.01, 1-β = 0.16) or medium (F5.20,26.01 = 2.43, P = .06, ω2 < 0.01, 1-β = 0.68) velocities. CONCLUSIONS The Guardian Cap failed to significantly improve the helmets' ability to mitigate impact forces at most locations. Limited evidence indicates how a reduction in GSI would provide clinically relevant benefits beyond reducing the risk of skull fracture or a similar catastrophic event.
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Talavage TM, Breedlove KM, Breedlove EL, Abbas K, Shenk T, Bowman TG, Nauman EA, Leverenz LJ. Improved prediction of subconcussive neurophysiological changes by kinematic impulse. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097270.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bowman TG, Breedlove KM, Leahy TE. Neurocognitive changes as measured by impact and the scat3 in women’s soccer players without diagnosed concussion. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097270.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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O'Day KM, Koehling EM, Vollavanh LR, Bradney D, May JM, Breedlove KM, Breedlove EL, Blair P, Nauman EA, Bowman TG. Comparison of head impact location during games and practices in Division III men's lacrosse players. Clin Biomech (Bristol, Avon) 2017; 43:23-27. [PMID: 28178579 DOI: 10.1016/j.clinbiomech.2017.01.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Head impacts have been studied extensively in football, but little similar research has been conducted in men's lacrosse. It is important to understand the location and magnitude of head impacts during men's lacrosse to recognize the risk of head injury. METHODS Descriptive epidemiology study set on collegiate lacrosse fields. Eleven men's lacrosse players (age=20.9±1.13years, mass=83.91±9.04kg, height=179.88±5.99cm) volunteered to participate. We applied X2 sensors behind the right ear of participants for games and practices. Sensors recorded data on linear and rotational accelerations and the location of head impacts. We calculated incidence rates per 1000 exposures with 95% confidence intervals for impact locations and compared the effect of impact location on linear and rotational accelerations with Kruskal-Wallis tests. FINDINGS We verified 167 head impacts (games=112; practices=55). During games, the incidence rate was 651.16 (95% confidence interval=530.57-771.76). The high and low incidence rates for head impact locations during games were: side=410.7 (95% confidence interval=292.02-529.41) and top=26.79 (95% confidence interval=3.53-57.10). For games and practices combined, the impact locations did not significantly affect linear (χ23=6.69, P=0.08) or rotational acceleration (χ23=6.34, P=0.10). INTERPRETATION We suggest further research into the location of head impacts during games and practices. We also suggest player and coach education on head impacts as well as behavior modification in men's lacrosse athletes to reduce the incidence of impacts to the side of the head in an effort to reduce potential injury.
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Bowman TG, Breedlove KM, Breedlove EL, Dodge TM, Nauman EA. Corrigendum to: “Impact attenuation properties of new and used lacrosse helmets” [J. Biomech. 48 (2015) 3782–3787]. J Biomech 2016. [DOI: 10.1016/j.jbiomech.2016.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bowman TG, Breedlove KM, Breedlove EL, Dodge TM, Nauman EA. Impact attenuation properties of new and used lacrosse helmets. J Biomech 2015; 48:3782-7. [DOI: 10.1016/j.jbiomech.2015.08.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 08/27/2015] [Accepted: 08/29/2015] [Indexed: 11/29/2022]
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Nauman EA, Breedlove KM, Breedlove EL, Talavage TM, Robinson ME, Leverenz LJ. Post-Season Neurophysiological Deficits Assessed by ImPACT and fMRI in Athletes Competing in American Football. Dev Neuropsychol 2015; 40:85-91. [PMID: 25961591 DOI: 10.1080/87565641.2015.1016161] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Neurocognitive assessment, functional magnetic resonance imaging, and head impact monitoring were used to evaluate neurological changes in high school football players throughout competitive seasons. A substantial number of asymptomatic athletes exhibited neurophysiological changes that persisted post-season, with abnormal measures significantly more common in athletes receiving 50 or more hits per week during the season.
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Affiliation(s)
- Eric A Nauman
- a School of Mechanical Engineering, Weldon School of Biomedical Engineering, Department of Basic Medical Sciences , Purdue University , West Lafayette , Indiana
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Shenk TE, Robinson ME, Svaldi DO, Abbas K, Breedlove KM, Leverenz LJ, Nauman EA, Talavage TM. fMRI of Visual Working Memory in High School Football Players. Dev Neuropsychol 2015; 40:63-8. [DOI: 10.1080/87565641.2015.1014088] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Poole VN, Abbas K, Shenk TE, Breedlove EL, Breedlove KM, Robinson ME, Leverenz LJ, Nauman EA, Talavage TM, Dydak U. MR Spectroscopic Evidence of Brain Injury in the Non-Diagnosed Collision Sport Athlete. Dev Neuropsychol 2014; 39:459-73. [DOI: 10.1080/87565641.2014.940619] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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