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Headache 2022 May;62(5):566-576

Mayo Clinic, Phoenix, Arizona, USA.

Objective: To investigate the impact of having headaches prior to traumatic brain injury (TBI) on headache features and long-term patient health outcomes.

Background And Methods: This was an exploratory analysis of patients with TBI who were enrolled in the American Registry for Migraine Research (ARMR), a multicenter, prospective, longitudinal patient registry composed of patients with International Classification of Headache Disorders, 3rd edition (ICHD-3)-defined headache diagnoses. The ARMR study enrolled 2,707 patients between February 1, 2016 and May 6, 2020, 565 of whom qualified for this analysis. Read More

Front Neurol 2022 11;13:704844. Epub 2022 Apr 11.

Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Background: Following mild traumatic brain injury (mTBI), also known as concussion, many patients with chronic symptoms (>3 months post injury) receive conventional imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). However, these modalities often do not show changes after mTBI. We studied the benefit of triaging patients with ongoing symptoms >3 months post injury by quantitative electroencephalography (qEEG) and then completing a brain single positron emission computed tomography (SPECT) to aid in diagnosis and early detection of brain changes. Read More

NeuroRehabilitation 2022 May 6. Epub 2022 May 6.

College of Nursing and Health Sciences, Flinders University, Flinders University, Adelaide, SA, Australia.

Background: Recent research recommends physical exercise rather than rest following a mild traumatic brain injury (mTBI).

Objective: To determine the effect of physical exercise on persistent symptoms in people with mTBI.

Methods: A search of randomized controlled trials was conducted in CINAHL, Cochrane Library, EMBASE, MEDLINE, SportDiscus and Web of Science, from 2010 to January 2021. Read More

Reumatismo 2022 May 3;74(1). Epub 2022 May 3.

Division of Rheumatology, Department of Physical Medicine and Rehabilitation Faculty of Medicine, Gazi University, Ankara.

Post-coronavirus disease (COVID) syndrome (PCS) is a term used to describe the clinical condition of patients who have recovered from COVID-19 but are still experiencing prolonged effects of infection or persistent symptoms for longer than expected. Although PCS has been previously studied in the general population, it has not been investigated in a specific population of patients with inflammatory rheumatic disease (IRD). This study aims to evaluate the presence and frequency of PCS among our rheumatology outpatients. Read More

Trials 2022 Apr 26;23(1):355. Epub 2022 Apr 26.

Center for Child Health, Behavior and Development, Seattle Children's Research Institute, PO Box 5371, CURE-03, Seattle, WA, 98145, USA.

Background: Subthreshold exercise, defined as aerobic exercise below the level that causes symptoms, has been utilized as a treatment for youth with persistent postconcussive symptoms (PPCS), but there is currently little evidence to guide use. In addition, prior studies of exercise for PPCS have all required multiple in-person visits. We developed a virtual approach for delivering subthreshold exercise to youth with PPCS called the Mobile Subthreshold Exercise Program (MSTEP), and we have now been funded to conduct a large national randomized controlled trial (RCT) to test its efficacy for reducing concussive symptoms and improving health-related quality of life. Read More

Front Hum Neurosci 2022 8;16:715807. Epub 2022 Apr 8.

Virginia Institute of Neuropsychiatry, Midlothian, VA, United States.

Over 40 years of research have shown that traumatic brain injury affects brain volume. However, technical and practical limitations made it difficult to detect brain volume abnormalities in patients suffering from chronic effects of mild or moderate traumatic brain injury. This situation improved in 2006 with the FDA clearance of NeuroQuant, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. Read More

Int J Environ Res Public Health 2022 04 4;19(7). Epub 2022 Apr 4.

Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, UK.

Introduction: Concussion is a common yet complex condition, with each new case requiring assessment by a medical doctor. Recent research has shown that doctors working in the UK have significant knowledge deficits regarding concussion diagnosis and management.

Aim: The aim of this scoping review was to map out the evidence about how undergraduate medical students are being educated about concussion. Read More

NeuroRehabilitation 2022 ;50(3):297-308

Ophthalmology & Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.

Background: Post-traumatic headache is the most common sequela of brain injury and can last months or years after the damaging event. Many headache types are associated with visual concerns also known to stem from concussion.

Objectives: To describe the various headache types seen after head injury and demonstrate how they impact or are impacted by the visual system. Read More

J Neurotrauma 2022 Apr;39(7-8):435

Diagnostics (Basel) 2022 Mar 18;12(3). Epub 2022 Mar 18.

Laboratory of Neuropathology and Electron Microscopy, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece.

Traumatic brain injury is a significant public health issue and represents the main contributor to death and disability globally among all trauma-related injuries. Martial arts practitioners, military veterans, athletes, victims of physical abuse, and epileptic patients could be affected by the consequences of repetitive mild head injuries (RMHI) that do not resume only to short-termed traumatic brain injuries (TBI) effects but also to more complex and time-extended outcomes, such as post-concussive syndrome (PCS) and chronic traumatic encephalopathy (CTE). These effects in later life are not yet well understood; however, recent studies suggested that even mild head injuries can lead to an elevated risk of later-life cognitive impairment and neurodegenerative disease. Read More

NeuroRehabilitation 2022 ;50(3):279-296

Herbert Wertheim School of Optometry & Vision Science at the University of California, Berkeley, CA, USA.

Background: Individuals who have suffered a concussion/mild traumatic brain injury (mTBI) frequently report symptoms associated with vestibular and/or oculomotor dysfunction (VOD) like dizziness, nausea, fatigue, brain fog, headache, gait and neurocognitive impairments which are associated with the development of chronic symptoms. The Vestibular/Ocular Motor Screening (VOMS) tool has been established as a reliable and clinically relevant complement to use alongside a battery of post-concussion tests to improve screening and referral for further evaluation and treatment of VOD.

Objectives: This paper will review the pathoanatomy and symptomatology of common vestibular and oculomotor disorders after concussion, as well as the utility of the VOMS to assist in diagnosis, referral, and management. Read More

Sci Rep 2022 03 14;12(1):4364. Epub 2022 Mar 14.

The Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, 70300, Zerifin, Israel.

Data on epidemiology and prognosticators of persistent post-concussion syndrome (PPCS) after mild traumatic brain injury (mTBI) in the pediatric population is scarce. The aim of this study was to evaluate the prevalence of PPCS in children after mTBI and to identify clinical variables in children who are at high risk for developing PPCS. A multicenter, retrospective matched cohort in which PPCS symptoms were evaluated in children 8-15-year-old, 6-60 months after being admitted to the emergency department because of mTBI. Read More

Neuroophthalmology 2022 13;46(2):85-90. Epub 2021 Oct 13.

Department of Ophthalmology, Amman Eye Clinic, Amman, Jordan.

Photophobia is considered the second most common symptom of both concussion and post-concussion syndrome. Soldiers on duty experience photophobia after blast-related concussions or mild traumatic brain injury in 60-75% of instances. In addition, soldiers report other symptoms, such as asthenopia, squinting, dry eyes and headaches, for which they are considered to be at high risk. Read More

Arch Clin Neuropsychol 2022 Feb;37(3):568-582

Centre de formation médicale du Nouveau-Brunswick, Université de Sherbrooke, Moncton, New Brunswick, Canada; Faculté Saint-Jean, University of Alberta, Edmonton, Alberta, Canada.

Objective: The purpose of this rapid systematic review was to identify and synthesize results of empirical studies that have examined psychoeducational interventions provided to children and adolescents aged 5-19 recovering from a concussion and their families.

Methods: This study followed the PRISMA guidelines adjusted for a rapid systematic review. We searched three databases (EMBASE, PsycInfo and MEDLINE) with key terms for concussion (or mild traumatic brain injury - mTBI), the intervention (psychoeducation, instructions, and reassurance) and the target population (children and adolescents aged 5 to 19). Read More

Sci Rep 2022 03 7;12(1):4002. Epub 2022 Mar 7.

National Institutes of Health, National Institute of Nursing Research, Bethesda, MD, 20814, USA.

Traumatic brain injury (TBI) can be associated with long-term neurobehavioral symptoms. Here, we examined levels of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in extracellular vesicles isolated from blood, and their relationship with TBI severity and neurobehavioral symptom reporting. Participants were 218 service members and veterans who sustained uncomplicated mild TBIs (mTBI, n = 107); complicated mild, moderate, or severe TBIs (smcTBI, n = 66); or Injured controls (IC, orthopedic injury without TBI, n = 45). Read More

Brain Inj 2022 Jan 28;36(2):175-182. Epub 2022 Feb 28.

Department of Psychology, National Chengchi University, Taipei, Taiwan.

Primary Objective: Headache, both before and after injury, has been associated with worse outcome following mild traumatic brain injury (MTBI). This study examined whether three MTBI patient groups - no headache (reported no pre-/post-injury headache), pre-injury headache (reported pre-injury headache, nearly all of whom also reported post-injury headache), and post-traumatic headache only (denied pre-injury headache and reported post-injury headache) - differed in acute-to-subacute outcomes.

Research Design: Cross-sectional observational study. Read More

Fa Yi Xue Za Zhi 2021 Oct;37(5):661-665

Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China.

Objectives: To understand the current status of appraisal of post-concussion syndrome disability and the reasons for the changes in re-appraisal opinions.

Methods: The cases that were judged as "post-concussion syndrome and ten-level disability" in the first appraisal and re-appraised for psychiatric impairment by the Academy of Forensic Science in 2019 were analyzed retrospectively.

Results: There were 75 cases, including 58 cases with pre-hospital emergency medical records, among which 39 cases were clearly recorded to be without a history of coma; 74 cases had emergency medical records, among which 44 cases were recorded of having a history of coma; 43 cases had follow-up medical records, among which 24 cases had a history of psychiatric follow-up. Read More

Curr Neurol Neurosci Rep 2022 03 17;22(3):171-181. Epub 2022 Feb 17.

Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, FG26, Toronto, ON, M4N 3M5, Canada.

Purpose Of Review: Mild traumatic brain injury (mTBI) can result in prolonged post-concussive symptoms (e.g., depression, headaches, cognitive impairment) that are debilitating and difficult to treat. Read More

Brain Inj 2022 Jan 14;36(1):39-51. Epub 2022 Feb 14.

Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, M4G 1R8, Toronto, Canada.

Objective: Explore the feasibility, tolerability, and early efficacy of transcranial direct current stimulation (tDCS) as a therapeutic intervention for youth with cognitive persistent post-concussion symptoms (PPCS).

Hypothesis: tDCS improves performance on a dual task working memory (WM) paradigm in youth with cognitive PPCS.

Participants: Twelve youth experiencing cognitive PPCS. Read More

J Alzheimers Dis 2022 ;86(3):943-959

Department of Psychiatry, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.

Mild traumatic brain injury (mTBI) is the most prevalent type of TBI (80-90%). It is characterized by a loss consciousness for less than 30 minutes, post-traumatic amnesia for less than 24 hours, and Glasgow Coma Score of 13-15. Accurately diagnosing mTBIs can be a challenge because the majority of these injuries do not show noticeable or visible changes on neuroimaging studies. Read More

Brain Inj 2022 Jan 10;36(1):59-71. Epub 2022 Feb 10.

Department of Neurology, University of California Davis, Sacramento, California, USA.

Objective: Identification of patients with mTBI at risk for developing persistent-post concussive syndromes should begin during the ED/inpatient evaluation due to frequent lack of post-discharge follow-up. The best method for evaluating cognitive deficits in these acute settings and how to utilize this information to optimize follow-up care is a matter of ongoing research. In this descriptive study, we present the cognitive profile of 214 hospitalized patients with mTBI using a novel cognitive and behavioral screener, the UCD-Cog. Read More

J Neurotrauma 2022 Apr;39(7-8):487-496

Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, Québec, Canada.

The objective of this study was to compare the effects of a cervicovestibular rehabilitation program combined with symptom-limited aerobic exercise (SLAE) program to a SLAE program alone in adults with persistent symptoms after mild traumatic brain injury (mTBI) on severity of symptoms and other indicators of clinical recovery. In this single-blind, parallel-group randomized controlled trial, 60 adults with persistent symptoms after mTBI were randomly assigned to: (1) a 6-week SLAE program or (2) a 6-week cervicovestibular rehabilitation program combined with a SLAE program. All participants took part in four evaluation sessions (baseline, week 6, 12, and 26) performed by a blinded evaluator. Read More

Front Neurol 2021 10;12:734329. Epub 2022 Jan 10.

UR Imaging-UMI, University of Rochester Medical Center, University of Rochester, Rochester, NY, United States.

To determine and characterize the radiomics features from structural MRI (MPRAGE) and Diffusion Tensor Imaging (DTI) associated with the presence of mild traumatic brain injuries on student athletes with post-concussive syndrome (PCS). 122 student athletes (65 M, 57 F), median (IQR) age 18.8 (15-20) years, with a mixed level of play and sports activities, with a known history of concussion and clinical PCS, and 27 (15 M, 12 F), median (IQR) age 20 (19, 21) years, concussion free athlete subjects were MRI imaged in a clinical MR machine. Read More

Med Sci Sports Exerc 2022 Jun 25;54(6):905-911. Epub 2022 Jan 25.

Sports Medicine Center, Children's Hospital of Colorado, Aurora, CO.

Purpose: Physical activity (PA) after concussion is an important aspect of appropriate clinical management. However, symptoms or functional deficits may reduce patient propensity toward PA, thereby negatively affecting recovery. Our purpose was to examine whether postconcussion dizziness, total symptom severity, or postural stability predicts PA level in the 2 wk after initial evaluation. Read More

J Neurotrauma 2022 03 9;39(5-6):358-370. Epub 2022 Feb 9.

Brain and Spinal Injury Center, San Francisco, California, USA.

Symptom endorsement after traumatic brain injury (TBI) is common acutely post-injury and is associated with other adverse outcomes. Prevalence of persistent symptoms has been debated, especially in mild TBI (mTBI). A cohort of participants ≥17 years with TBI ( = 2039), 257 orthopedic trauma controls (OTCs), and 300 friend controls (FCs) were enrolled in the TRACK-TBI study and evaluated at 2 weeks and 3, 6, and 12 months post-injury using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Read More

Am J Audiol 2022 Mar 25;31(1):228-242. Epub 2022 Jan 25.

Department of Audiology, Nova Southeastern University, Fort Lauderdale, FL.

Objective: Millions of people suffer from traumatic brain injuries every year with common sequelae, including dizziness, disequilibrium, compromised vision, and gait abnormalities. Individuals suffering a mild traumatic brain injury (mTBI) or concussion may be prescribed bed rest, but for some, symptoms may persist and require different treatment options. The aim of this mini-systematic review was to synthesize the best available evidence regarding the effectiveness of vestibular rehabilitation therapy (VRT) as a treatment option for adults with mTBIs. Read More

Front Neurol 2021 4;12:718318. Epub 2022 Jan 4.

The Ear and Balance Institute, Covington, LA, United States.

Dizziness is a frequent complaint after head trauma. Among patients who suffer a concussion (mild traumatic brain injury or mTBI), dizziness is second only to headache in symptom frequency. The differential diagnosis of post-concussive dizziness (PCD) can be divided into non-vestibular, central vestibular and peripheral vestibular causes with growing recognition that patients frequently exhibit both central and peripheral findings on vestibular testing. Read More

Diagnostics (Basel) 2021 Dec 30;12(1). Epub 2021 Dec 30.

Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15217, USA.

Neuroelectric measures derived from human magnetoencephalographic (MEG) recordings hold promise as aides to diagnosis and treatment monitoring and targeting for chronic sequelae of traumatic brain injury (TBI). This study tests novel MEG-derived regional brain measures of tonic neuroelectric activation for long-term test-retest reliability and sensitivity to symptoms. Resting state MEG recordings were obtained from a normative cohort (CamCAN, baseline: = 613; 16-month follow-up: = 245) and a chronic symptomatic TBI cohort (TEAM-TBI, baseline: = 62; 6-month follow-up: = 40). Read More

Korean J Radiol 2022 02 4;23(2):226-236. Epub 2022 Jan 4.

Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Objective: This study aimed to explore the myelin volume change in patients with mild traumatic brain injury (mTBI) with post-concussion syndrome (PCS) using a multidynamic multiecho (MDME) sequence and automatic whole-brain segmentation.

Materials And Methods: Forty-one consecutive mTBI patients with PCS and 29 controls, who had undergone MRI including the MDME sequence between October 2016 and April 2018, were included. Myelin volume fraction (MVF) maps were derived from the MDME sequence. Read More

Curr Sports Med Rep 2022 Jan;21(1):12-14

David L. MacIntosh Sport Medicine Clinic, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada; and Dovigi Orthopaedic and Sports Medicine Clinic, Mount Sinai Hospital, Toronto, Canada.