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Behav Brain Res 2019 Apr 15:111913. Epub 2019 Apr 15.

NeuroBehavioral Research Lab, Department of Veteran Affairs Medical Center, New Jersey Health Care System, East Orange, New Jersey, USA; Department of Pharmacology, Physiology and Neurosciences, New Jersey Medical School - Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA; Graduate School of Biomedical Sciences, New Jersey Medical School-Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA. Electronic address:

Psychiatric disorders affect nearly 50% of individuals who have experienced a traumatic brain injury (TBI). Anhedonia is a major symptom of numerous psychiatric disorders and is a diagnostic criterion for depression. It has recently been appreciated that reinforcement may be separated into consummatory (hedonic), motivational and decisional components, all of which may be affected differently in disease. Read More

Int J Sports Phys Ther 2019 Apr;14(2):296-307

UHealth Sports Medicine Institute, University of Miami Miller School of Medicine, Miami, FL.

Introduction: Impairments in postural stability have been identified following sports-related concussion. CaneSense™ is a recently developed mobile lower limb motion capture system and mobile application for movement assessment which provides an objective measure of postural stability. One of the components within CaneSense™ is the Post-Concussive Excursion Index (PCEI), a measure of postural stability expressed as a percentage of symmetry between lower limbs. Read More

Int J Sports Phys Ther 2019 Apr;14(2):282-295

University of Michigan-Flint, Flint, MI, USA.

Background: Patients with concussion may present with cervical spine impairments, therefore accurate characterization of cervical post-concussion impairments is needed to develop targeted physical therapy interventions.

Purpose: To characterize the type, frequency and severity of cervical impairments in children and adolescents referred for physical therapy after concussion.Study design: Retrospective, descriptive study. Read More

Trends Hear 2019 Jan-Dec;23:2331216519840094

3 Department of Communication Sciences and Disorders, University of North Carolina at Greensboro, NC, USA.

Around 75% to 90% of people who experience a traumatic brain injury (TBI) are classified as having a mild TBI (mTBI). The term mTBI is synonymous with concussion or mild head injury (MHI) and is characterized by symptoms of headache, nausea, dizziness, and blurred vision. Problems in cognitive abilities such as deficits in memory, processing speed, executive functioning, and attention are also considered symptoms of mTBI. Read More

J Neurosurg Pediatr 2019 Apr 16:1-8. Epub 2019 Apr 16.

1Sports Medicine Center and.

OBJECTIVEThe goal of this study was to determine which variables assessed during an initial clinical evaluation for concussion are independently associated with time until symptom resolution among pediatric patients.METHODSData collected from a prospective clinical registry of pediatric patients with concussion were analyzed. The primary outcome variable was time from injury until symptom resolution. Read More

Pediatr Ann 2019 Apr;48(4):e182-e185

Concussions are common in pediatric athletes, but they often go underreported. The topic of concussions has garnered much attention from the media recently, and this attention has resulted in the development of stricter guidelines for management of concussion by professional sporting leagues such as the National Football League and the National Hockey League. It is important to establish a clear understanding of the definitions, signs, and symptoms of concussion so that teachers, families, coaches, and physicians can better recognize it when it occurs. Read More

Brain Connect 2019 Apr 15. Epub 2019 Apr 15.

University of Maryland School of Medicine, Diagnostic Radiology & Nuclear Medicine , 22 S Greene St , Baltimore, United States , 21043 ;

Mild traumatic brain Injury (mTBI) is one of the most common neurological disorders for which a subset of patients develops persistent post concussive symptoms. Previous studies discovered abnormalities and disruptions in the brain functional networks of mTBI patients principally using static functional connectivity measures which assume that neural communication across the brain is static during resting state conditions. In this study, we examine the differences in dynamic neural communication between mTBI and control participants through the application of a combination of dynamic functional analysis and graph theoretic algorithms. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Apr 13. Epub 2019 Apr 13.

Division of Physiotherapy, Department of Medical and Health Science, Linköping University, Linköping, Sweden.

Purpose: Describe the motivation for floorball participation, injury prevention expectations, injury risk perceptions and prevalence of health problems in youth floorball players at the start of the season.

Methods: This cross-sectional survey is part of a larger Sport Without Injury ProgrammE (SWIPE) project and provides baseline data before a cluster randomised controlled trial of an injury prevention program (Knee Control). A baseline survey (online and paper based) was collected from 47 teams with 471 youth floorball players from two provinces of Sweden before the start of the 2017 season. Read More

Disabil Rehabil 2019 Apr 12:1-7. Epub 2019 Apr 12.

a Center on Brain Injury Research and Training, University of Oregon , Eugene , OR , USA.

Background: Each year ∼700 000 U.S. children ages 0-19 years sustain a traumatic brain injury. Read More

BMJ Open 2019 Apr 11;9(4):e026104. Epub 2019 Apr 11.

Department of Psychology, University of Copenhagen, Copenhagen, Denmark.

Objectives: Sickness absence after mild traumatic brain injury (mTBI) is frequent due to postconcussive symptoms. We examined labour market attachment following mTBI up to 5 years postinjury.

Design And Setting: Nationwide cohort study with register follow-up. Read More

J Med Imaging Radiat Oncol 2019 Apr 11. Epub 2019 Apr 11.

FMHS University of Auckland, Auckland, New Zealand.

Introduction: Since the introduction of a shared e-scooter service to Auckland in October there have been multiple media reports of associated injuries, but no quantitation of the number or severity of these injuries, or the impact on hospital emergency department services in Auckland.

Methods: We performed a retrospective chart review on all patients referred to Auckland hospital ED radiology with the indication containing 'e-scooter' between 15 August 2018 and 15 December 2018. All requests were screened to ensure that the injury was caused by an e-scooter. Read More

Clin J Sport Med 2019 Apr 5. Epub 2019 Apr 5.

School of Kinesiology, Western University, London, ON, Canada.

Objective: To assess the predictive capability of the postconcussion symptom scale (PCSS) of the sport concussion assessment tool (SCAT) III to differentiate concussed and nonconcussed adolescents.

Design: Retrospective.

Setting: Tertiary. Read More

Br J Neurosurg 2019 Apr 9:1-9. Epub 2019 Apr 9.

a Sheffield Institute for Translational Neuroscience , University of Sheffield , Sheffield , UK.

Introduction: Several patients who suffer Mild Traumatic Brain Injury (mTBI) develop Persistent Post-Concussion Symptoms (PPCS) and long-term disability. Current prognostic models for mTBI have a large unexplained variance, which limits their use in a clinical setting.

Aim: This study aimed to identify background demographics and mTBI details that are associated with PPCS and long-term disability. Read More

J Neurotrauma 2019 Apr 9. Epub 2019 Apr 9.

German Sports University, Department of Neurology, Psychosomatic Medicine, and Psychiatry, Cologne, Germany ;

Methods of post-concussion diagnosis are still of debate, regarding sensitivity, objectivity, reliability, and costs. Spontaneous displays of nonverbal hand movement behavior during interaction are indicative of psychopathology and relatively simple to record and analyze. Increased continuous (/irregular) body-focused hand movement activity in particular indicates psychopathologies that overlap in symptomatology with those of sport related concussions (SRC). Read More

Arch Clin Neuropsychol 2019 Apr 8. Epub 2019 Apr 8.

Butler University, Department of Health Sciences, Indianapolis, IN 46208, USA.

Objective: The main objectives of this study were to determine how accurately the embedded invalidity indicators (EIIs) identify purposeful underperformers on the baseline Immediate Post-concussion Assessment and Cognitive Test (ImPACT); and to assess the effectiveness of each individual EII.

Methods: A randomized controlled trial was conducted in which all participants completed a baseline ImPACT assessment. Participants were randomized into a control or purposeful underperformance (sandbagging) group. Read More

J Pediatr 2019 Apr 4. Epub 2019 Apr 4.

Department of Pediatrics, Division of Pediatric Emergency Medicine, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address:

Objective: To estimate the proportion of pediatric patients with a concussion who received analgesia when presenting with pain to US emergency departments, and to describe the analgesics used.

Study Design: This was a repeated cross-sectional analysis study using the National Hospital Ambulatory Medical Care Survey database of nationally representative emergency department visits from 2007 to 2015. We included children under 18 years old with isolated concussions. Read More

Pediatr Exerc Sci 2019 Apr 7:1-8. Epub 2019 Apr 7.

1 McMaster University.

The multidisciplinary field of pediatric traumatic brain injury (TBI) and exercise medicine is of growing importance. There is active study into the diagnostic and therapeutic potential of exercise in pediatric TBI as well as the effects of TBI on postinjury fitness. With the evidence-based growing, a literature review can help establish the state of the science and inform future research. Read More

Br J Sports Med 2019 Apr 6. Epub 2019 Apr 6.

Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia.

Background: The use of video to assist professional sporting bodies with the diagnosis of sport-related concussion (SRC) has been well established; however, there has been little consistency across sporting codes with regards to which video signs should be used, and the definitions of each of these signs.

Aim: The aims of this study were to develop a consensus for the video signs considered to be most useful in the identification of a possible SRC and to develop a consensus definition for each of these video signs across the sporting codes.

Methods: A brief questionnaire was used to assess which video signs were considered to be most useful in the identification of a possible concussion. Read More

Br J Sports Med 2019 Apr 5. Epub 2019 Apr 5.

Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.

Am J Emerg Med 2019 Mar 30. Epub 2019 Mar 30.

Emory University School of Medicine, Department of Orthopaedics, Atlanta, GA, United States of America. Electronic address:

Introduction: There has been a spike in recent news regarding motorized scooter injuries due to the expansion of scooter sharing companies. Given the paucity of literature on this topic, the purpose of our study was to describe and quantify emergency department encounters associated with motorized scooter related injuries.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for motorized scooter related injuries from 2013 to 2017. Read More

Med Gas Res 2019 Jan-Mar;9(1):1-12

Hyperbaric Oxygen Therapy San Francisco, American College of Hyperbaric Medicine, San Francisco, CA, USA.

The National Brain Injury Rescue and Rehabilitation Project was established as a preliminary study to test the safety and practicality of multi-center hyperbaric oxygen administration for the post-concussive symptoms of chronic mild traumatic brain injury as a precursor to a pivotal, independent, multi-center, controlled clinical trial. This report presents the results for 32 subjects who completed a preliminary trial of hyperbaric oxygen several years before the passage of the 21 Century Cures Act. This study anticipated the Act and its reassessment of clinical research. Read More

CJEM 2019 Apr 5:1-5. Epub 2019 Apr 5.

‡Division of Emergency Medicine, Department of Medicine,McMaster University,Hamilton,ON.

Objectives: The purpose of this study was to identify 1) the proportion of patients discharged from the emergency department (ED) with a diagnosis of concussion and return within 14 days, and 2) the characteristics that prompt a return.

Methods: A health records review was conducted on adult patients with a discharge diagnosis of a concussion who accessed care through Hamilton Health Sciences EDs and Urgent Care Centre in 2016. Subsequent data were collected from those who returned to the ED within 14 days. Read More

Medicine (Baltimore) 2019 Apr;98(14):e14948

Department of Biomedical Engineering.

Despite the widespread awareness of concussion across all levels of sport, the management of concussion from youth to college is inconsistent and fragmented. A fundamental gap contributing to inconsistent care is the lack of a scalable, systematic approach to document initial injury characteristics following concussion. The purpose of this study was to determine differences in injury profiles and management of youth, high school, and college athletes using a mobile application for incident report documentation. Read More

J Strength Cond Res 2019 Apr 1. Epub 2019 Apr 1.

School of Physical Therapy, Western University, London, Ontario, Canada.

Versteegh, TH, Dickey, JP, Emery, CA, Fischer, LK, MacDermid, JC, and Walton, DM. Evaluating the effects of a novel neuromuscular neck training device on multiplanar static and dynamic neck strength: A pilot study. J Strength Cond Res XX(X): 000-000, 2019-The neck serves an important function in damping the transference of acceleration forces between the head and the trunk, such as that occurring during contact sports or motor vehicle collisions. Read More

Can J Neurol Sci 2019 Apr 4:1-4. Epub 2019 Apr 4.

Faculty of Medicine,University of Ottawa,Ottawa, Ontario,Canada.

Second impact syndrome (SIS) is associated with malignant brain swelling and usually occurs in young athletes with one or more prior, recent concussions. SIS is rare and some dispute its existence. We report a case of SIS in Rowan Stringer, age 17, a rugby player who sustained a fatal brain injury despite prompt medical therapy including decompression surgery. Read More

Can J Neurol Sci 2019 Apr 4:1-3. Epub 2019 Apr 4.

University of Ottawa Faculty of Medicine,Ottawa, Ontario,Canada.

Am J Sports Med 2019 Apr;47(5):1236-1247

Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Background:: Little is known about the nature of concussion injury among university student-athletes, including concussion incidence and rates across sports, the mechanisms of injury, the type of activity during competition or practice, and the time to return to academics, return to sport, and symptom resolution.

Purpose:: To describe methods of the Ivy League-Big Ten Epidemiology of Concussion Study and first epidemiologic findings.

Study Design:: Descriptive epidemiology study. Read More

Sci Rep 2019 Apr 2;9(1):5498. Epub 2019 Apr 2.

Biomedical Engineering, University of Manitoba, Winnipeg, Canada.

This study investigates the effect of Repetitive Transcranial Magnetic Stimulation (rTMS) on persistent post-concussion syndrome (PCS). The study design was a randomized (coin toss), placebo controlled, and double-blind study. Thirty-seven participants with PCS were assessed for eligibility; 22 were randomised and 18 completed the study requirements. Read More

PLoS One 2019 2;14(4):e0214525. Epub 2019 Apr 2.

Department of Neurology, Interdisciplinary Center for Vertigo and Neurological Visual Disorders, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Objectives: We propose a bottom-up, machine-learning approach, for the objective vestibular and balance diagnostic data of concussion patients, to provide insight into the differences in patients' phenotypes, independent of existing diagnoses (unsupervised learning).

Methods: Diagnostic data from a battery of validated balance and vestibular assessments were extracted from the database of the Swiss Concussion Center. The desired number of clusters within the patient database was estimated using Calinski-Harabasz criteria. Read More

Cureus 2019 Jan 22;11(1):e3937. Epub 2019 Jan 22.

Pediatrics, Pontifical Catholic University of Ecuador, Quito, ECU.

Aim: To evaluate the utility of magnetic resonance imaging (MRI) in children with mild traumatic brain injury (mTBI), persistent post-concussive syndrome (PPCS), and normal neurologic examination.

Materials And Methods: This was a retrospective review of pediatric patients, who were evaluated in a Pediatric Concussion Clinic between August 2013 and November 2018, with documented persistent post-concussive symptoms, normal neurological examination, and available brain MRI.

Results: In our analysis of 86 cases we found seven MRI studies with abnormal findings, but none were clinically significant. Read More

Front Neuroinform 2019 18;13. Epub 2019 Mar 18.

Department of Radiology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States.

When properly implemented and processed, anatomic -weighted magnetic resonance imaging (MRI) can be ideal for the noninvasive quantification of white matter (WM) and gray matter (GM) in the living human brain. Although MRI is more suitable for distinguishing GM from WM than computed tomography (CT), the growing clinical use of the latter technique has renewed interest in head CT segmentation. Such interest is particularly strong in settings where MRI is unavailable, logistically unfeasible or prohibitively expensive. Read More

Pediatrics 2019 Apr 1. Epub 2019 Apr 1.

Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; Departments of.

Background: In ice hockey and soccer, age restrictions exist for body checking and heading because of injury risk. There are currently no age restrictions for tackling in youth football.

Methods: We surveyed a nationally representative sample of US parents regarding their support for age restrictions on tackling in football with responses of "yes," "no," and "maybe. Read More

J Athl Train 2019 Apr 1. Epub 2019 Apr 1.

Vanderbilt Sports Concussion Center, Vanderbilt University School of Medicine, Nashville, TN.

Context: Postconcussion deficits in neurocognitive performance and postural control may persist at the time of return to sport participation. How these deficits, if present, affect athletic performance is largely unknown, with prior studies showing mixed results.

Objective: To evaluate postconcussion National Hockey League player performance using advanced hockey metrics over short- (5 games), medium- (10 games), and long-term (remainder of the season) seasonal performance. Read More

J Athl Train 2019 Apr 1. Epub 2019 Apr 1.

Department of Neurology, Oregon Health & Science University, Portland.

Context: In longitudinal studies tracking recovery after concussion, researchers often have not considered the timing of return to play (RTP) as a factor in their designs, which can limit the understanding of how RTP may affect the analysis and resulting conclusions.

Objective: To evaluate the recovery of balance and gait in concussed athletes using a novel linear mixed-model design that allows an inflection point to account for changes in trend that may occur after RTP.

Design: Cohort study. Read More

Am Fam Physician 2019 Apr;99(7):426-434

Womack Army Medical Center, Ft. Bragg, NC, USA.

Mild traumatic brain injury, also known as concussion, is common in adults and youth and is a major health concern. Concussion is caused by direct or indirect external trauma to the head resulting in shear stress to brain tissue from rotational or angular forces. Concussion can affect a variety of clinical domains: physical, cognitive, and emotional or behavioral. Read More

Clin Pediatr (Phila) 2019 Mar 31:9922819839230. Epub 2019 Mar 31.

1 Children's National Health System, Washington, DC, USA.

Emerging evidence supports an active approach for acute pediatric concussion management. The current practices of pediatric emergency providers following acute concussions has not been well studied. We prospectively enrolled 134 pediatric patients with an acute concussion. Read More

Phys Ther Sport 2019 Mar 23;37:105-112. Epub 2019 Mar 23.

New Zealand Rugby, New Zealand.

Objectives: The objective of this study is to explore the effect of concussion history on head control during front on rugby tackles in non-professional male and female Rugby Union players.

Design: An observational cross-sectional design.

Setting: A laboratory-based study of simulated front on rugby tackles with a dynamic relatively-weighted (∼50% body-mass) tackle bag. Read More

World Neurosurg 2019 Mar 27. Epub 2019 Mar 27.

Vanderbilt Sports Concussion Center Vanderbilt University School of Medicine Nashville, TN, USA; Department of Neurological Surgery Vanderbilt University Medical Center Nashville, TN, USA. Electronic address:

Background: Sport-related structural brain injury (SRSBI) is a rare but potentially catastrophic injury. Limited data exists outlining its epidemiology, pathophysiology, and outcomes. We present the case of an epidural hematoma (EDH) suffered during a high school soccer game. Read More

Arch Clin Neuropsychol 2019 Mar 30. Epub 2019 Mar 30.

Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA.

Objective: To determine if concussion history and career status is associated with neurocognitive performance in elite football players.

Methods: The study design was a cross-sectional single assessment. Fifty-seven elite football players (age 29. Read More

J Appl Behav Anal 2019 Mar 29. Epub 2019 Mar 29.

The University of Southern Mississippi.

Recently, concerns regarding sport-related concussions have increased within the research literature, the media, and popular culture. One potential source of soccer-related concussions involves the purposeful striking of the ball with one's head (i.e. Read More

Occup Ther Int 2019 24;2019:9245153. Epub 2019 Feb 24.

New York Institute of Technology, Northern Boulevard, P.O. Box 8000, Old Westbury, NY 11568-8000, USA.

The purposes of this study were to examine occupational therapists' perceived confidence in the treatment and assessment of patients who have sustained concussion, to determine what factors are associated with higher versus lower levels of confidence, and to determine if concussion was a topic covered in occupational therapy curricula. This study utilized an electronic questionnaire sent out to occupational therapists in all areas of practice through social media, AOTA discussion forums, and through a continuing education company. Results indicate that there is variability in occupational therapists' perceived confidence in evaluation and treatment for individuals who have sustained concussion. Read More

Neuropsychology 2019 Mar 28. Epub 2019 Mar 28.

National Institute for Stroke and Applied Neuroscience, Auckland University of Technology.

Objective: To assess longer-term social cognition after mild traumatic brain injury (mTBI) and to identify the sociodemographic and acute factors (mood, cognitive functioning, and symptoms) influencing social cognition.

Method: Data were extracted for 121 adults who experienced a mTBI and completed the Emotion Evaluation and Social Inference Enriched tests of The Awareness of Social Inference Test (TASIT) 4 years postinjury. To identify early indicators of outcome, responses to the Hospital Anxiety and Depression Scale, Rivermead Post-Concussion Symptom Questionnaire, and CNS Vital Signs neurocognitive assessment conducted 1 month postinjury were also extracted. Read More

BMC Psychiatry 2019 Mar 27;19(1):100. Epub 2019 Mar 27.

Division of Physical Medicine and Rehabilitation, University of British Columbia, 4255 Laurel St, Vancouver, BC, V5Z 2G9, Canada.

Background: Depression is a common complication of traumatic brain injury (TBI). New evidence suggests that antidepressant medication may be no more effective than placebo in this population.

Main Body: Selective serotonin reuptake inhibitors are recommended as first-line treatment for depression in contemporary expert consensus clinical practice guidelines for management of TBI. Read More

Cephalalgia 2019 Mar 26:333102418815650. Epub 2019 Mar 26.

1 Mayo Clinic Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.

Objectives: Often, persistent post-traumatic headache and migraine are phenotypically similar. However, the similarities and differences in the neuropathological underpinnings of persistent post-traumatic headache and migraine require further understanding. We used diffusion tensor imaging (DTI) and a novel method for detecting subtle changes in fibertract integrity by measuring node-by-node parameters along each tract to compare fibertract profiles between those with migraine and those with persistent post-traumatic headache, and compared both cohorts to a group of controls. Read More

Injury 2019 Mar 19. Epub 2019 Mar 19.

Department of Orthopaedics and Traumatology, University Hospital of Siena, V.le Bracci, n°14-16, 53100 Siena, Italy. Electronic address:

Introduction: Horse racing is a hazardous sport. We analyzed the incidence and characteristics of jockey injuries in a typical horse race.

Methods: We analyzed all injuries sustained by 224 jockeys in the last 72 years. Read More

Dis Mon 2019 Mar 22. Epub 2019 Mar 22.

PGY-3 University of Chicago, Department of Neurology, Chicago, Illinois, United States.

Clin J Sport Med 2019 Mar 18. Epub 2019 Mar 18.

UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Objective: The purpose of this study was to determine which assessments best identify athletes with sport-related concussion (SRC) from healthy controls in the acute/early subacute phase (within 10 days of SRC) of injury.

Design: Prospective, cohort study.

Setting: Specialty concussion clinic. Read More

Clin J Sport Med 2019 Mar 18. Epub 2019 Mar 18.

Center for Effectiveness Research in Orthopedics, SmartState Centers, University of South Carolina, Greenville, South Carolina.

Objective: The objective of this study was to determine whether football players receiving heads up (HU) training would display a lower rate of sport-related concussion (SRC) compared to those without HU training.

Design: Prospective cohort.

Setting: Scholastic football fields. Read More

Clin J Sport Med 2019 Mar 15. Epub 2019 Mar 15.

School of Kinesiology, Faculty of Health Sciences, London, ON, Canada.

Objective: To study autonomic responses to postural changes in concussed adolescents. The influence of sex was also studied.

Design: Longitudinal cohort observational study. Read More

J Am Coll Health 2019 Mar 25:1-6. Epub 2019 Mar 25.

b Department of Psychological Sciences , WA Franke College of Businesss, Northern Arizona University , Flagstaff , AZ , USA.

Objective: Understand from whom concussed football players seek and receive emotional support, and whether this support is associated with injury perceptions.

Participants: Football players (N = 26) from three NCAA Division I programs.

Methods: With approval from the head athletic trainer, concussed athletes (2017 season) completed short surveys within 4-6 days of diagnosis and when cleared to return. Read More