The Role of Neck Muscle Activities on the Risk of Mild Traumatic Brain Injury in American Football

2017 ◽  
Vol 139 (10) ◽  
Author(s):  
Xin Jin ◽  
Zhaoying Feng ◽  
Valerie Mika ◽  
Haiyan Li ◽  
David C. Viano ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Muscle Activation ◽  
Neck Muscles ◽  
American Football ◽  
Preventive Strategy ◽  
Muscle Response ◽  
Neck Strength ◽  
The Impact

Concussion, or mild traumatic brain injury (mTBI), is frequently associated with sports activities. It has generally been accepted that neck strengthening exercises are effective as a preventive strategy for reducing sports-related concussion risks. However, the interpretation of the link between neck strength and concussion risks remains unclear. In this study, a typical helmeted head-to-head impact in American football was simulated using the head and neck complex finite element (FE) model. The impact scenario selected was previously reported in lab-controlled incident reconstructions from high-speed video footages of the National Football League using two head-neck complexes taken from Hybrid III dummies. Four different muscle activation strategies were designed to represent no muscle response, a reactive muscle response, a pre-activation response, and response due to stronger muscle strength. Head kinematics and various head/brain injury risk predictors were selected as response variables to compare the effects of neck muscles on the risk of sustaining the concussion. Simulation results indicated that active responses of neck muscles could effectively reduce the risk of brain injury. Also, anticipatory muscle activation played a dominant role on impact outcomes. Increased neck strength can decrease the time to compress the neck and its effects on reducing brain injury risks need to be further studied.

Impact of routine S100B protein assay on CT scan use in children with mild traumatic brain injury

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fleur Lorton ◽  
Jeanne Simon-Pimmel ◽  
Damien Masson ◽  
Elise Launay ◽  
Christèle Gras-Le Guen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
University Hospital ◽  
S100b Protein ◽  
Research Network ◽  
Ct Scans ◽  
Intermediate Risk ◽  
Protein Assay ◽  
The Impact

AbstractObjectivesTo evaluate the impact of implementing a modified Pediatric Emergency Care Applied Research Network (PECARN) rule including the S100B protein assay for managing mild traumatic brain injury (mTBI) in children.MethodsA before-and-after study was conducted in a paediatric emergency department of a French University Hospital from 2013 to 2015. We retrospectively included all consecutive children aged 4 months to 15 years who presented mTBI and were at intermediate risk for clinically important traumatic brain injury (ciTBI). We compared the proportions of CT scans performed and of in-hospital observations before (2013–2014) and after (2014–2015) implementation of a modified PECARN rule including the S100B protein assay.ResultsWe included 1,062 children with mTBI (median age 4.5 years, sex ratio [F/M] 0.73) who were at intermediate risk for ciTBI: 494 (46.5%) during 2013–2014 and 568 (53.5%) during 2014–2015. During 2014–2015, S100B protein was measured in 451 (79.4%) children within 6 h after mTBI. The proportion of CT scans and in-hospital observations significantly decreased between the two periods, from 14.4 to 9.5% (p=0.02) and 73.9–40.5% (p<0.01), respectively. The number of CT scans performed to identify a single ciTBI was reduced by two-thirds, from 18 to 6 CT scans, between 2013–2014 and 2014–2015. All children with ciTBI were identified by the rules.ConclusionsThe implementation of a modified PECARN rule including the S100B protein assay significantly decreased the proportion of CT scans and in-hospital observations for children with mTBI who were at intermediate risk for ciTBI.

Mild Traumatic Brain Injury and Postconcussive Symptom Endorsement: A Parallel Comparison Between Two Nonclinical Cohorts

2020 ◽  
Author(s):  
R Elisabeth Cornwell ◽  
Jorge I Arango ◽  
C B Eagye ◽  
Candace Hill-Pearson ◽  
Karen Schwab ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Epidemiological Studies ◽  
Emergency Department Visits ◽  
Survey Study ◽  
Military Health ◽  
History Of ◽  
The Military ◽  
The Impact

ABSTRACT Introduction The prevalence of mild traumatic brain injury (mTBI) is commonly estimated based on indirect metrics such as emergency department visits and self-reporting tools. The study of postconcussive symptoms faces similar challenges because of their unspecific character and indistinct causality. In this article, we compare two nonclinical, epidemiological studies that addressed these two elements and were performed within a relatively narrow period in the state of Colorado. Materials and Methods De-identified datasets were obtained from a random digit-dialed survey study conducted by the Craig Hospital and a study surveying soldiers returning from deployment by Defense and Veteran Traumatic Brain Injury Center. Information pertinent to participants’ demographics, a history of mTBI, and symptom endorsement was extracted and homogenized in order to establish a parallel comparison between the populations of the two studies. Results From the 1,558 (Warrior Strong, 679; Craig Hospital, 879) records selected for analysis, 43% reported a history of at least one mTBI. The prevalence was significantly higher among individuals from the Defense and Veteran Traumatic Brain Injury Center study independent of gender or race. Repetitive injuries were reported by 15% of the total combined cohort and were more prevalent among males. Symptom endorsement was significantly higher in individuals with a positive history of mTBI, but over 80% of those with a negative history of mTBI endorsed at least one of the symptoms interrogated. Significant differences were observed between the military and the civilian populations in terms of the types and frequencies of the symptoms endorsed. Conclusions The prevalence of mTBI and associated symptoms identified in the two study populations is higher than that of previously reported. This suggests that not all individuals sustaining concussion seek medical care and highlights the limitations of using clinical reports to assess such estimates. The lack of appropriate mechanisms to determine symptom presence and causality remains a challenge. However, the differences observed in symptom reporting between cohorts raise questions about the nature of the symptoms, the impact on the quality of life for different individuals, and the effects on military health and force readiness.

scholarly journals Mild Traumatic Brain Injury is Associated With Effect of Inflammation on Structural Changes of Default Mode Network in Those Developing Chronic Pain 

2020 ◽  
Author(s):  
Xuan Niu ◽  
Lijun Bai ◽  
Yingxiang Sun ◽  
Yuan Wang ◽  
Guanghui Bai ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Structural Changes ◽  
Cingulate Cortex ◽  
Pain Modulation ◽  
Anterior Cingulate ◽  
Dorsal Anterior Cingulate Cortex ◽  
The Impact

Abstract Background：Mild traumatic brain injury (mTBI) is higher prevalence (more than 50%) to develop chronic posttraumatic headache (CPTH) compared with moderate or severe TBI. However, the underlying neural mechanism for CPTH remains unclear. This study aimed to investigate the inflammation level and cortical volume changes in patients with acute PTH (APTH) and further examine their potential in identifying patients who finally developing CPTH at follow-up.Methods：77 mTBI patients initially underwent neuropsychological measurements, 9-plex panel of serum cytokines and MRI scans within 7 days post-injury (T-1) and 54 (70.1%) of patients follow-up at 3-month (T-2). 42 matched healthy controls completed the same protocol at T-1 once. Results：MTBI patients with APTH presented significantly increased GM volume mainly in the right dorsal anterior cingulate cortex (dACC) and dorsal posterior cingulate cortex (dPCC), of which the dPCC volume can predict much worse impact of headache on patients’ lives by HIT-6 (β = 0.389, P = 0.007). Serum levels of C-C motif chemokine ligand 2 (CCL2) were also elevated in these patients, and its effect on the impact of headache on quality of life was partially mediated by the dPCC volume (mean [SE] indirect effect, 0.088 [0.0462], 95% CI, 0.01-0.164). Longitudinal analysis showed that the dACC and dPCC volumes as well as CCL2 levels persistently increased in patients developing CPTH 3 month postinjury. Conclusion：The findings suggested that structural remodelling of DMN brain regions were involved in the progression from acute to chronic PTH following mTBI, which also mediated the effect of inflammation processes on pain modulation.Trial registration: ClinicalTrial.gov ID: NCT02868684; registered 16 August 2016.

scholarly journals Slow blood-to-brain transport underlies enduring barrier dysfunction in American football players

Brain ◽  
2020 ◽  
Vol 143 (6) ◽  
pp. 1826-1842 ◽  
Author(s):  
Ronel Veksler ◽  
Udi Vazana ◽  
Yonatan Serlin ◽  
Ofer Prager ◽  
Jonathan Ofer ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Mild Traumatic Brain Injury ◽  
American Football ◽  
Football Players ◽  
Barrier Dysfunction ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

Abstract Repetitive mild traumatic brain injury in American football players has garnered increasing public attention following reports of chronic traumatic encephalopathy, a progressive tauopathy. While the mechanisms underlying repetitive mild traumatic brain injury-induced neurodegeneration are unknown and antemortem diagnostic tests are not available, neuropathology studies suggest a pathogenic role for microvascular injury, specifically blood–brain barrier dysfunction. Thus, our main objective was to demonstrate the effectiveness of a modified dynamic contrast-enhanced MRI approach we have developed to detect impairments in brain microvascular function. To this end, we scanned 42 adult male amateur American football players and a control group comprising 27 athletes practicing a non-contact sport and 26 non-athletes. MRI scans were also performed in 51 patients with brain pathologies involving the blood–brain barrier, namely malignant brain tumours, ischaemic stroke and haemorrhagic traumatic contusion. Based on data from prolonged scans, we generated maps that visualized the permeability value for each brain voxel. Our permeability maps revealed an increase in slow blood-to-brain transport in a subset of amateur American football players, but not in sex- and age-matched controls. The increase in permeability was region specific (white matter, midbrain peduncles, red nucleus, temporal cortex) and correlated with changes in white matter, which were confirmed by diffusion tensor imaging. Additionally, increased permeability persisted for months, as seen in players who were scanned both on- and off-season. Examination of patients with brain pathologies revealed that slow tracer accumulation characterizes areas surrounding the core of injury, which frequently shows fast blood-to-brain transport. Next, we verified our method in two rodent models: rats and mice subjected to repeated mild closed-head impact injury, and rats with vascular injury inflicted by photothrombosis. In both models, slow blood-to-brain transport was observed, which correlated with neuropathological changes. Lastly, computational simulations and direct imaging of the transport of Evans blue-albumin complex in brains of rats subjected to recurrent seizures or focal cerebrovascular injury suggest that increased cellular transport underlies the observed slow blood-to-brain transport. Taken together, our findings suggest dynamic contrast-enhanced-MRI can be used to diagnose specific microvascular pathology after traumatic brain injury and other brain pathologies.

scholarly journals Improving the translational potential of rodent models to study the behavioral and pathophysiological effects of repetitive mild traumatic brain injury

2018 ◽  
Vol 120 (1) ◽  
pp. 1-3
Author(s):  
Megan E. Huibregtse
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Outcome Measures ◽  
Mild Traumatic Brain Injury ◽  
Chronic Traumatic Encephalopathy ◽  
Rodent Models ◽  
Head Impacts ◽  
Repetitive Head Impacts ◽  
The Impact

Chronic traumatic encephalopathy (CTE) is thought to be caused by repetitive head impacts. Consequently, there is a need to develop rodent models to better understand the behavioral and pathophysiological changes of repetitive mild traumatic brain injury (rmTBI) and to determine the link between rmTBI and CTE. This Neuro Forum article reviews recent rodent rmTBI models, comparing the impact methods and outcome measures in terms of translational potential.

More Helmets Fewer Deaths: Motorcycle Helmet Legislation Impacts Traumatic Brain Injury-Related Mortality in Young Adults

2017 ◽  
Vol 83 (6) ◽  
pp. 541-546 ◽  
Author(s):  
Ahmed Hassan ◽  
Tahereh Orouji Jokar ◽  
Peter Rhee ◽  
Kareem Ibraheem ◽  
Narong Kulvatunyou ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Linear Regression Analysis ◽  
Preventive Strategy ◽  
Trauma Patients ◽  
Patient Admissions ◽  
Nationwide Inpatient Sample Database ◽  
Motorcycle Helmet ◽  
The Impact ◽  
Related Mortality

The aim of our study was to assess the impact of helmet legislations on the incidence and the mortality rate of motorcycle collision (MCC)-related traumatic brain injury (TBI) in young adult trauma patients. A 1-year (2011) retrospective analysis was performed of all patients under 21 years old with trauma-related hospitalization using the Nationwide Inpatient Sample database (representing 20% of all in-patient admissions). Patients with MCC were identified using E-codes. States were classified into three groups based on helmet legislations: universal age helmet legislation, <18 years helmet legislation, and <21 years helmet legislation. Outcome measures were the rates of TBI and mortality. Linear regression analysis was used to assess outcomes among the states. A total of 1,165,150 patients with trauma-related hospitalizations across 29 states were reviewed of which, 587 patients with MCC were included. Ten states had universal age legislation; 13 states had age <18 years legislation, and 6 states had age <21 years legislation. There was a lower incidence in the rate of TBI (P = 0.03) in states with universal helmet legislations compared with states with age-restricted helmet legislation. Universal helmet legislations lowered the rate of MCC-related TBI injures by a factor of 2.15 (β coefficient: 2.15; 95% confidence interval: 0.91–10.18; P = 0.04). States with age-restricted helmet legislations have a higher rate of traumatic brain injury and mortality compared with states with universal helmet legislations. Establishing universal helmet legislations across the states may provide a potential preventive strategy against traumatic brain injury.

scholarly journals Diffusion imaging of mild traumatic brain injury in the impact accelerated rodent model: A pilot study

Brain Injury ◽  
2017 ◽  
Vol 31 (10) ◽  
pp. 1376-1381 ◽  
Author(s):  
Zora Kikinis ◽  
Marc Muehlmann ◽  
Ofer Pasternak ◽  
Sharon Peled ◽  
Praveen Kulkarni ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pilot Study ◽  
Mild Traumatic Brain Injury ◽  
Diffusion Imaging ◽  
Rodent Model ◽  
The Impact

Understanding the impact of mild traumatic brain injury on veteran service-connected disability: results from Chronic Effects of Neurotrauma Consortium

Brain Injury ◽  
2018 ◽  
Vol 32 (10) ◽  
pp. 1178-1187 ◽  
Author(s):  
Clara Elizabeth Dismuke-Greer ◽  
Tracy L. Nolen ◽  
Kayla Nowak ◽  
Shawn Hirsch ◽  
Terri K. Pogoda ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Chronic Effects ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document