Research project : dr jon patricios (Concussion in rugby playing children)
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Publication Type Journal Article. Research Support, U.S. Gov't, Non-P.H.S.. Result <49> Unique Identifier 18496184 Status
MEDLINE Authors
Greenwald RM. Gwin JT. Chu JJ. Crisco JJ. Authors Full Name Greenwald, Richard M. Gwin, Joseph T. Chu, Jeffrey J. Crisco, Joseph J. Institution Simbex, Lebanon, New Hampshire, USA. Title
Head impact severity measures for evaluating mild traumatic brain injury risk exposure. Source
Neurosurgery. 62(4):789-98; discussion 798, 2008 Apr. Abstract
OBJECTIVE: The aims of this study were to quantify the sensitivity of various biomechanical measures (linear acceleration, rotational acceleration, impact duration, and impact location) of head impact to the clinical diagnosis of concussion in United States football players and to develop a novel measure of head impact severity combining these measures into a single score that better predicts the incidence of concussion. METHODS: On-field head impact data were collected from 449 football players at 13 organizations (n = 289,916) using in-helmet systems of six single-axis accelerometers. Concussions were diagnosed by medical staff and later associated with impact data. Principal component analysis and a weighting coefficient based on impact location were used to transform correlated head impact measures into a new composite variable, weighted principal component score (wPCS). The predictive power of linear acceleration, rotational acceleration, head injury criterion, and wP! CS was quantified using receiver operating characteristic curves. The null hypothesis, that a measure was no more predictive than guessing, was tested (alpha = 0.05). In addition, receiver operating characteristic curves for wPCS and classical measures were directly compared to test the hypothesis that wPCS was more predictive of concussion than were classic measures (alpha = 0.05). RESULTS: When all of the impacts were considered, every biomechanical measure evaluated was statistically more predictive of concussion than guessing (P < 0.005). However, for the top 1 and 2% of impacts based on linear acceleration, a subset that consisted of 82% of all diagnosed concussions, only wPCS was significantly more predictive of concussion than guessing (P < 0.03); when compared with each other, wPCS was more predictive of concussion than were classical measures for the top 1 and 2% of all of the data (P < 0.04). CONCLUSION: A weighted combination of several biomechanical inputs, incl! uding impact location, is more predictive of concussion than a single biomechanical measure. This study is the first to the authors' knowledge to quantify improvements in the sensitivity of a biomechanical measure to incidence of concussion when impact location is considered. Publication Type Journal Article. Research Support, N.I.H., Extramural. Research Support, Non-U.S. Gov't. Result <50> Unique Identifier 17762745 Status
MEDLINE Authors
De Beaumont L. Lassonde M. Leclerc S. Theoret H. Authors Full Name De Beaumont, Louis. Lassonde, Maryse. Leclerc, Suzanne. Theoret, Hugo. Institution Centre de Recherche en Neuropsychologie et Cognition, Universite de Montreal, Montreal, Canada. louis.de.beaumont@umontreal.ca Title
Long-term and cumulative effects of sports concussion on motor cortex inhibition. Source
Neurosurgery. 61(2):329-36; discussion 336-7, 2007 Aug. Abstract
OBJECTIVE: Using transcranial magnetic stimulation paradigms, this study investigated motor cortex integrity as a function of an athlete's prior history of concussions. PATIENTS AND METHODS: Motor cortex excitatory and inhibitory mechanisms were studied in athletes using four different transcranial magnetic stimulation protocols, namely 1) resting motor threshold, 2) intracortical inhibition and intracortical facilitation in a paired-pulse paradigm, 3) excitability of the corticospinal system using an input-output curve, and 4) intracortical inhibition in a cortical silent-period paradigm. Motor-evoked potentials were recorded from the first dorsal interosseous muscle of the right hand. RESULTS: Cortical silent-period duration in athletes who have experienced multiple concussions was prolonged when compared to that of normal control participants. Linear regression suggested that concussion severity was the main factor explaining motor cortex dysfunction. Moreover, when we ! retested the athletes, the cortical silent period was more prolonged in those who sustained another concussion after baseline testing had occurred. CONCLUSION: Findings from this study indicate that sports-related concussions result in long-term motor system dysfunctions that seem to be attributable to subclinical intracortical inhibitory system abnormalities. This study also shows that sustaining subsequent concussions exacerbates this deficit, and thus provides additional support for the contention that the adverse effects of sports-related concussions on intracortical inhibitory systems are cumulative. Publication Type Journal Article. Research Support, Non-U.S. Gov't. Result <51> Unique Identifier 17327793 Status
MEDLINE Authors
Schnebel B. Gwin JT. Anderson S. Gatlin R. Authors Full Name Schnebel, Brock. Gwin, Joseph T. Anderson, Scott. Gatlin, Ron. Institution Department of Orthopedics, University of Oklahoma, Norman, Oklahoma, USA. bschnebel@mcbrideclinic.com Title
In vivo study of head impacts in football: a comparison of National Collegiate Athletic Association Division I versus high school impacts. Source
Neurosurgery. 60(3):490-5; discussion 495-6, 2007 Mar. Abstract
OBJECTIVE: To compare the frequency and magnitude of head impacts between National Collegiate Athletic Association Division I and American high school football players. The long-term goal is to correlate impact forces with injury patterns, leading to improvements in protective headgear. METHODS: The helmets of football players at the University of Oklahoma (n = 40) and Casady High School (n = 16) were instrumented with the Head Impact Telemetry System (Simbex, Lebanon, NH). Data were collected for practices and games for the 2005 football season and were analyzed by player position and school. Player positions were separated into two groups (skill and line) for analysis. Two case studies of athletes who sustained a concussion are also presented. RESULTS: A total of 54,154 impacts were recorded at the University of Oklahoma and 8326 at Casady High School. College players sustained high-level impacts greater than 98 g more frequently than high school players. The mean linear! accelerations for the top 1, 2, and 5% of all impacts were also higher for college players (P < 0.02). Skill position players received 24.6% of all impacts and sustained an impact greater than 98 g once every 70 impacts. In contrast, linemen sustained the highest number of impacts, but most were relatively low-magnitude (20-30 g). Linemen sustained an impact greater than 98 g once every 125 impacts. CONCLUSION: Differences in the frequency and magnitude of head acceleration after impact exist between a Division I college team and a high school team. Compared with linemen, skill position players typically sustain the highest-level impacts. Additional data collection and analysis are required to correlate concussion diagnosis with acceleration magnitude and impact location. Publication Type Comparative Study. Journal Article. Result <52> Unique Identifier 17143242 Status
MEDLINE Authors
Omalu BI. DeKosky ST. Hamilton RL. Minster RL. Kamboh MI. Shakir AM. Wecht CH. Authors Full Name Omalu, Bennet I. DeKosky, Steven T. Hamilton, Ronald L. Minster, Ryan L. Kamboh, M Ilyas. Shakir, Abdulrezak M. Wecht, Cyril H. Institution Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. bennet.omalu@verizon.net Title
Chronic traumatic encephalopathy in a national football league player: part II. Source
Neurosurgery. 59(5):1086-92; discussion 1092-3, 2006 Nov. Abstract
OBJECTIVE: We present the second reported case of autopsy-confirmed chronic traumatic encephalopathy in a retired professional football player, with neuropathological features that differ from those of the first reported case. These differing pathological features underscore the need for further empirical elucidation of the pathoetiology and pathological cascades of long-term neurodegenerative sequelae of professional football. METHODS: A psychological autopsy was performed with the next-of-kin and wife. Medical and hospital records were reviewed. A complete autopsy was accompanied by a comprehensive forensic neuropathological examination. Restriction fragment length polymorphism analysis was performed to determine apolipoprotein-E genotype. RESULTS: Pertinent premortem history included a 14-year span of play in organized football starting from the age of 18 years. The subject was diagnosed with severe major depressive disorder without psychotic features after retirement, ! attempted suicide multiple times and finally committed suicide 12 years after retirement by ingestion of ethylene glycol. Autopsy revealed cardiomegaly, mild to moderate coronary artery disease, and evidence of acute ethylene glycol overdose. The brain showed no atrophy, a cavum septi pellucidi was present, and the substantia nigra showed mild pallor. The hippocampus and cerebellum were not atrophic. Amyloid plaques, cerebral amyloid angiopathy, and Lewy bodies were completely absent. Sparse to frequent tau-positive neurofibrillary tangles and neuropil threads were present in all regions of the brain. Tufted and thorn astrocytes, as well as astrocytic plaques, were absent. The apolipoprotein-E genotype was E3/E4. CONCLUSION: Our first and second cases both had long careers without multiple recorded concussions. Both manifested Major Depressive Disorder after retirement. Amyloid plaques were present in the first case and completely absent in the second case. Both cases exhib! ited neurofibrillary tangles, neuropil threads, and coronary atheroscl erotic disease. Apolipoprotein-E4 genotypes were different. Reasons for the contrasting features in these two cases are not clear. Further studies are needed to identify and define the neuropathological cascades of chronic traumatic encephalopathy in football players, which may form the basis for prophylaxis and therapeutics. Publication Type Case Reports. Journal Article. Result <53> Unique Identifier 16462481 Status
MEDLINE Authors
Collins M. Lovell MR. Iverson GL. Ide T. Maroon J. Authors Full Name Collins, Micky. Lovell, Mark R. Iverson, Grant L. Ide, Thad. Maroon, Joseph. Institution University of Pittsburgh Medical Center Sports Concussion Program, Department of Orthopaedic Surgery/University of Pittsburgh Medical Center for Sports Medicine, Pennsylvania 15206, USA. collinsmw@upmc.edu Title
Examining concussion rates and return to play in high school football players wearing newer helmet technology: a three-year prospective cohort study. Source
Neurosurgery. 58(2):275-86; discussion 275-86, 2006 Feb. Abstract
OBJECTIVE: The purpose of this study was to compare concussion rates and recovery times for athletes wearing newer helmet technology compared to traditional helmet design. METHODS: This was a three-year, prospective, naturalistic, cohort study. Participants were 2,141 high school athletes from Western Pennsylvania. Approximately half of the sample wore the Revolution helmet manufactured by Riddell, Inc. (n = 1,173) and the remainder of the sample used standard helmets (n = 968). Athletes underwent computerized neurocognitive testing through the use of ImPACT at the beginning of the study. Following a concussion, players were reevaluated at various time intervals until recovery was complete. RESULTS: In the total sample, the concussion rate in athletes wearing the Revolution was 5.3% and in athletes wearing standard helmets was 7.6% [chi (1, 2, 141) = 4.96, P < 0.027]. The relative risk estimate was 0.69 (95% confidence interval = 0.499- 0.958). Wearing the Revolution helme! t was associated with approximately a 31% decreased relative risk and 2.3% decreased absolute risk for sustaining a concussion in this cohort study. The athletes wearing the Revolution did not differ from athletes wearing standard helmets on the mechanism of injury (e.g., head-to-head strike), on-field concussion markers (e.g., amnesia or loss of consciousness), or on-field presentation of symptoms (e.g., headaches, dizziness, or balance problems). CONCLUSION: Recent sophisticated laboratory research has better elucidated injury biomechanics associated with concussion in professional football players. This data has led to changes in helmet design and new helmet technology, which appears to have beneficial effects in reducing the incidence of cerebral concussion in high school football players. Publication Type Comparative Study. Journal Article. Research Support, Non-U.S. Gov't. Result <54> Unique Identifier 16462480 Status
MEDLINE Authors
Pellman EJ. Lovell MR. Viano DC. Casson IR. Authors Full Name Pellman, Elliot J. Lovell, Mark R. Viano, David C. Casson, Ira R. Institution ProHEALTH Care Associates, LLP, Lake Success, New York, USA. Title
Concussion in professional football: recovery of NFL and high school athletes assessed by computerized neuropsychological testing--Part 12. Source
Neurosurgery. 58(2):263-74; discussion 263-74, 2006 Feb. Abstract
OBJECTIVE: Acute recovery from concussion (mild traumatic brain injury) is assessed in samples of NFL and high school athletes evaluated within days of injury. METHODS: All athletes were evaluated within days of injury using a computer-based neuropsychological test and symptom inventory protocol. Test performance was compared to preinjury baseline levels of a similar but not identical group of athletes who had undergone preseason testing. Statistical analyses were completed using Multivariate Analysis of Variance (MANOVA). RESULTS: NFL athletes demonstrated a rapid neuropsychological recovery. As a group, NFL athletes returned to baseline performance in a week with the majority of athletes having normal performance two days after injury. High school athletes demonstrated a slower recovery than NFL athletes. CONCLUSION: Computer-based neuropsychological testing was used within the overall medical evaluation and care of NFL athletes. As found in a prior study using more trad! itional neuropsychological testing, NFL players did not demonstrate decrements in neuropsychological performance beyond one week of injury. High school players demonstrated more prolonged neuropsychological effects of concussion. Publication Type Comparative Study. Journal Article. Research Support, Non-U.S. Gov't. Result <55> Unique Identifier 16331164 Status
MEDLINE Authors
Viano DC. Casson IR. Pellman EJ. Bir CA. Zhang L. Sherman DC. Boitano MA. Authors Full Name Viano, David C. Casson, Ira R. Pellman, Elliot J. Bir, Cynthia A. Zhang, Liying. Sherman, Donald C. Boitano, Marilyn A. Institution Mild Traumatic Brain Injury Committee, National Football League, New York, New York, USA. dviano@comcast.net Title
Concussion in professional football: comparison with boxing head impacts--part 10. Source
Neurosurgery. 57(6):1154-72; discussion 1154-72, 2005 Dec. Abstract
OBJECTIVE: This study addresses impact biomechanics from boxing punches causing translational and rotational head acceleration. Olympic boxers threw four different punches at an instrumented Hybrid III dummy and responses were compared with laboratory-reconstructed NFL concussions. METHODS: Eleven Olympic boxers weighing 51 to 130 kg (112-285 lb) delivered 78 blows to the head of the Hybrid III dummy, including hooks, uppercuts and straight punches to the forehead and jaw. Instrumentation included translational and rotational head acceleration and neck loads in the dummy. Biaxial acceleration was measured in the boxer's hand to determine punch force. High-speed video recorded each blow. Hybrid III head responses and finite element (FE) brain modeling were compared to similarly determined responses from reconstructed NFL concussions. RESULTS: The hook produced the highest change in hand velocity (11.0 +/- 3.4 m/s) and greatest punch force (4405 +/- 2318 N) with average neck! load of 855 +/- 537 N. It caused head translational and rotational accelerations of 71.2 +/- 32.2 g and 9306 +/- 4485 r/s. These levels are consistent with those causing concussion in NFL impacts. However, the head injury criterion (HIC) for boxing punches was lower than for NFL concussions because of shorter duration acceleration. Boxers deliver punches with proportionately more rotational than translational acceleration than in football concussion. Boxing punches have a 65 mm effective radius from the head cg, which is almost double the 34 mm in football. A smaller radius in football prevents the helmets from sliding off each other in a tackle. CONCLUSION: Olympic boxers deliver punches with high impact velocity but lower HIC and translational acceleration than in football impacts because of a lower effective punch mass. They cause proportionately more rotational acceleration than in football. Modeling shows that the greatest strain is in the midbrain late in the exposur! e, after the primary impact acceleration in boxing and football. Publication Type Comparative Study. Journal Article. Research Support, Non-U.S. Gov't.
Unique Identifier 16239884 Status
MEDLINE Authors
Guskiewicz KM. Marshall SW. Bailes J. McCrea M. Cantu RC. Randolph C. Jordan BD. Authors Full Name Guskiewicz, Kevin M. Marshall, Stephen W. Bailes, Julian. McCrea, Michael. Cantu, Robert C. Randolph, Christopher. Jordan, Barry D. Institution Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina 27599-8700, USA. gus@email.unc.edu Title
Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Source
Neurosurgery. 57(4):719-26; discussion 719-26, 2005 Oct. Abstract
OBJECTIVE: Cerebral concussion is common in collision sports such as football, yet the chronic neurological effects of recurrent concussion are not well understood. The purpose of our study was to investigate the association between previous head injury and the likelihood of developing mild cognitive impairment (MCI) and Alzheimer's disease in a unique group of retired professional football players with previous head injury exposure. METHODS: A general health questionnaire was completed by 2552 retired professional football players with an average age of 53.8 (+/-13.4) years and an average professional football playing career of 6.6 (+/- 3.6) years. A second questionnaire focusing on memory and issues related to MCI was then completed by a subset of 758 retired professional football players (> or = 50 yr of age). Results on MCI were then cross-tabulated with results from the original health questionnaire for this subset of older retirees. RESULTS: Of the former players, 61! % sustained at least one concussion during their professional football career, and 24% sustained three or more concussions. Statistical analysis of the data identified an association between recurrent concussion and clinically diagnosed MCI (chi = 7.82, df = 2, P = 0.02) and self-reported significant memory impairments (chi = 19.75, df = 2, P = 0.001). Retired players with three or more reported concussions had a fivefold prevalence of MCI diagnosis and a threefold prevalence of reported significant memory problems compared with retirees without a history of concussion. Although there was not an association between recurrent concussion and Alzheimer's disease, we observed an earlier onset of Alzheimer's disease in the retirees than in the general American male population. CONCLUSION: Our findings suggest that the onset of dementia-related syndromes may be initiated by repetitive cerebral concussions in professional football players. Publication Type Comparative Study. Journal Article. Result <57> Unique Identifier 15987548 Status
MEDLINE Authors
Omalu BI. DeKosky ST. Minster RL. Kamboh MI. Hamilton RL. Wecht CH. Authors Full Name Omalu, Bennet I. DeKosky, Steven T. Minster, Ryan L. Kamboh, M Ilyas. Hamilton, Ronald L. Wecht, Cyril H. Institution Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania 15221, USA. bennet.omalu@verizon.net Title
Chronic traumatic encephalopathy in a National Football League player.[see comment]. Comments
Comment in: Neurosurgery. 2006 May;58(5):E1003; author reply E1003; discussion E1003; PMID: 16639303 Source
Neurosurgery. 57(1):128-34; discussion 128-34, 2005 Jul. Abstract
OBJECTIVE: We present the results of the autopsy of a retired professional football player that revealed neuropathological changes consistent with long-term repetitive concussive brain injury. This case draws attention to the need for further studies in the cohort of retired National Football League players to elucidate the neuropathological sequelae of repeated mild traumatic brain injury in professional football. METHODS: The patient's premortem medical history included symptoms of cognitive impairment, a mood disorder, and parkinsonian symptoms. There was no family history of Alzheimer's disease or any other head trauma outside football. A complete autopsy with a comprehensive neuropathological examination was performed on the retired National Football League player approximately 12 years after retirement. He died suddenly as a result of coronary atherosclerotic disease. Studies included determination of apolipoprotein E genotype. RESULTS: Autopsy confirmed the presence! of coronary atherosclerotic disease with dilated cardiomyopathy. The brain demonstrated no cortical atrophy, cortical contusion, hemorrhage, or infarcts. The substantia nigra revealed mild pallor with mild dropout of pigmented neurons. There was mild neuronal dropout in the frontal, parietal, and temporal neocortex. Chronic traumatic encephalopathy was evident with many diffuse amyloid plaques as well as sparse neurofibrillary tangles and tau-positive neuritic threads in neocortical areas. There were no neurofibrillary tangles or neuropil threads in the hippocampus or entorhinal cortex. Lewy bodies were absent. The apolipoprotein E genotype was E3/E3. CONCLUSION: This case highlights potential long-term neurodegenerative outcomes in retired professional National Football League players subjected to repeated mild traumatic brain injury. The prevalence and pathoetiological mechanisms of these possible adverse long-term outcomes and their relation to duration of years of play! ing football have not been sufficiently studied. We recommend comprehe nsive clinical and forensic approaches to understand and further elucidate this emergent professional sport hazard. Directory: health health -> A model didactic and clinical substance abuse curriculum developed for schools of nurse anesthesia health -> Curriculum Vitae Tonya Butler-Collins health -> By Health Educator Sylvester Johnson, Ph. D. Applied Physics For personal consultation service, please see health -> Purpose of this report health -> Cause for concern 2015/16 Supplement for wardens and sub-wardens Contents health -> Child sexual exploitation health -> Affordable care act health -> Section 5 Select Hardware and Mobile Device Selection and Security Download 358.25 Kb. Share with your friends:
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