Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022

British Journal of Sports Medicine, Год журнала: 2023, Номер 57(11), С. 695 - 711

Опубликована: Июнь 1, 2023

For over two decades, the Concussion in Sport Group has held meetings and developed five international statements on concussion sport. This 6th statement summarises processes outcomes of International Conference Amsterdam 27-30 October 2022 should be read conjunction with (1) methodology paper that outlines consensus process detail (2) 10 systematic reviews informed conference outcomes. Over 3½ years, author groups conducted predetermined priority topics relevant to The format conference, expert panel workshops revise or develop new clinical assessment tools, as described paper, evolved from previous several components. Apart this statement, yielded revised tools including Recognition Tool-6 (CRT6) Assessment (SCAT6, Child SCAT6), well a tool, Office (SCOAT6, SCOAT6). also integrated features focus para athlete, athlete's perspective, concussion-specific medical ethics matters related both athlete retirement potential long-term effects SRC, neurodegenerative disease. evidence-informed principles prevention, management, emphasises those areas requiring more research.

Язык: Английский

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Invalid Response Set and Malingering in the Field of Psychological Injury and Law I: Basics

Опубликована: Янв. 1, 2025

Язык: Английский

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Prospective Harmonization, Common Data Elements, and Sharing Strategies for Multicenter Pre-Clinical Traumatic Brain Injury Research in the Translational Outcomes Project in Neurotrauma Consortium

Journal of Neurotrauma, Год журнала: 2025, Номер unknown

Опубликована: Янв. 20, 2025

Effective team science requires procedural harmonization for rigor and reproducibility. Multicenter studies across experimental modalities (domains) can help accelerate translation. The Translational Outcomes Project in NeuroTrauma (TOP-NT) is a pre-clinical traumatic brain injury (TBI) consortium charged with establishing validating noninvasive TBI assessment tools through science. Here, we present practical approaches of research five centers providing needed vocabulary structure to achieve centralized data organization use. This includes sharing as an essential step that enables between domains, evaluating reproducibility sites, performing multimodal analyses. As part this process, TOP-NT (1) produced library TBI-relevant standard operating procedures coordinate workflow, (2) aligned 481 clinical common elements (CDEs), (3) generated 272 new CDEs. then (4) connected diverse types validate assessments domains allow multivariable phenotyping. Lastly, (5) specified technical quality controls studies. These facilitate science, distinguish wide spectrum from variability, apply quality-controls, ease higher level uses three rat models four sites. Each site collects primary outcome measures, including magnetic resonance imaging (MRI) protocols blood biomarkers neuronal glial injury, validated by histopathology behavioral outcomes. Collected are organized using the CDEs, covering surgical, behavioral, biomarker, MRI, quantitative histopathological methods. We report curation steps suited storage Open Data Commons repository, allowing unbiased cross-site analysis. approach leads introducing level, syndromic understanding signatures. authors outline semantic structural framework suggesting strategies robust multicenter trials improve translatability assessments.

Язык: Английский

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Next-Day Serum Glial Fibrillary Acidic Protein Levels to Aid Diagnosis of Sport-Related Concussion

Neurology, Год журнала: 2025, Номер 104(5)

Опубликована: Фев. 7, 2025

Previous studies on sport-related concussion (SRC) may have measured brain injury blood-based biomarker, glial fibrillary acidic protein (GFAP), either before or after its peak, potentially underestimating the diagnostic value. The primary aim of this study was to evaluate performance serum GFAP at 24 hours post-SRC. Secondary objectives included assessing whether timing sample collection relative an Australian football match (with without SRC) affected levels, evaluating if combining with symptoms improved discrimination SRC compared alone, and determining utility neurofilament light (NfL) levels In a prospective cohort study, adult male female players Victorian Amateur Football Association (Melbourne, Australia) had blood sampled around postinjury/postmatch. NfL were quantified using Simoa assays, area under curve (AUC) values calculated for time bins 16-24 hours, 24-32 36-52 hours. Symptom severity assessed Sport Concussion Assessment Tool 5 (SCAT). A total 151 athletes (median age 22.5 years; 85% male) 97 controls 24.3 86% median 24.5 (interquartile range [IQR] 21.7-28.0; min-max 16-51.5). Time postmatch did not affect in controls; however, higher correlated shorter post-SRC (Spearman r = -0.25, 95% CI -0.40 -0.09). Median concentrations 65.9 pg/mL (IQR 49.1-81.3) controls, SRC, 124.6 86.7-190.7) 94.5 61.6-163.9) 59.9 49.1-94.7) AUC 0.83 (95% 0.76-0.90) 0.72 0.64-0.80), respectively. Furthermore, SCAT enhanced discriminatory capability alone (AUC increased from 0.91 0.97; z 2.48, p 0.01). Serum limited value ≤0.60). following potential suspected be useful objective aid diagnosis.

Язык: Английский

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Gaze Stability Test Asymmetry Before and After Individualized Rehabilitation in Youth Athletes With Concussion

Journal of Sport Rehabilitation, Год журнала: 2025, Номер unknown, С. 1 - 9

Опубликована: Янв. 1, 2025

Context : Concussion causes physiological disruptions, including disruptions to the vestibular and visual systems, which can cause dizziness, imbalance, blurry vision. The ocular reflex functions maintain a stable field, be measured using gaze stability test (GST). Design This preliminary study used retrospective chart review examine changes in GST performance asymmetry sample of 117 youth athletes with concussion (mean age = 14.51, SD 2.08) before (T1) after (T2) they completed therapy program that included in-office treatment by physical therapist customized home exercise program. Examples exercises may assigned during are provided. Methods After examining descriptive information, scores percentage between time points were compared via Wilcoxon signed-rank tests. Results also descriptively previously published findings. revealed significant improvements median leftward rightward direction head movements from T1 T2 reduction ( P < .001). Both improved 145.00 210.00°/s, is above 50th percentile literature uninjured athletes. Asymmetry decreased an average 10.07% (SD 7.89) 4.11% 3.88), lower than literature. Conclusions produces symptoms vary among individuals injuries. velocity values provide objective data about athlete’s impairment progress recovery within domain. aid making clinical decisions on return play progression promote successful safe sport.

Язык: Английский

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Mild and Moderate Traumatic Brain Injury in the Legal Context

Опубликована: Янв. 1, 2025

Язык: Английский

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Neuropsychological review of records in forensic cases: An AACN best practices paper with international perspectives

The Clinical Neuropsychologist, Год журнала: 2025, Номер unknown, С. 1 - 31

Опубликована: Фев. 4, 2025

Objective: The purpose of this American Academy Clinical Neuropsychology (AACN) best practices paper is to provide the neuropsychological community with fundamentals a competent forensic review records. Method: Narrative addressing fundamental factors related Examples highlighted information necessary for determination traumatic brain injury (TBI), and data from records that can be used address questions regarding validity presentation. International intra-jurisdictional perspectives within US were illustrate necessity adhering rules. Results: Factors identified involve ethical responsibilities, completeness in obtaining reviewing relevant records, evaluation credibility considerations examinee self-reporting, grounding opinions peer-reviewed science, causation context litigation, avoiding bias reporting, as well consideration cultural language factors. Different jurisdictional rules require close attention. Conclusions: Neuropsychologists need aware obtain basic facts, maintain objectivity, conclusions examination report. In litigation cases, based solely on may challenged reasons might include not having personally evaluated plaintiff, whether meet Daubert criteria pertaining sufficient scientific bases facts. A thorough helps deal litigant/claimant subjectivity malleability self-report, it critical reasoning about other causation.

Язык: Английский

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Scoping review: Intervention for ocular motor disorders in children and adults with mild traumatic brain injury

Optometry and Vision Science, Год журнала: 2025, Номер unknown

Опубликована: Фев. 14, 2025

SIGNIFICANCE Intervention strategies for post–mild traumatic brain injury (mTBI) ocular motor disorders vary across disciplines and include watchful waiting, vestibular rehabilitation, vision rehabilitation/vision therapy, optical intervention. However, evidence supporting their effectiveness is limited, highlighting the need high-quality randomized controlled trials with standardized testing, diagnostic criteria, reassessment of function after BACKGROUND Ocular occur frequently mTBI. OBJECTIVES This study aimed to conduct a scoping review interventions mTBI-related in children adults. DATA SOURCES The following electronic bibliographic databases were searched: PubMed, Embase, PEDro, OVID, Clinical Key, Google Scholar, REHABDATA. STUDY SELECTION studies published English between 2003 2024 involving mTBI participants who had an assessment prior intervention included this study. EXTRACTION AND SYNTHESIS Preferred Reporting Items Systematic reviews Meta-Analyses extension Scoping Reviews guidelines followed reporting. Study population, intervention, outcomes extracted synthesized tabular graphical formats. RESULTS Sixty-seven eligible included, only three (4%) judged as low risk bias. waiting (n = 31, 46%), rehabilitation 13, 19%), therapy 10, 15%), 4, 6%), alternative or multifaceted 9, 14%). Among providing statistically supported results, improvements one more outcome domains reported nearly 80% on (19/24) 100% (4/4), (7/7), (1/1). CONCLUSIONS IMPLICATIONS Although post-mTBI deficits improved strategy, interventions, most significant emphasizes necessity testing protocols criteria functions evaluate these different age groups recovery stages.

Язык: Английский

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Brain Network Functional Connectivity in Children With a Concussion

Neurology, Год журнала: 2025, Номер 104(8)

Опубликована: Апрель 3, 2025

Pediatric concussion can disrupt functional brain network connectivity, but prospective longitudinal research is needed to clarify recovery and identify moderators of change. This study investigated connectivity (FC) up 6 months after pediatric concussion. concurrent cohort observational consecutively recruited children (aged 8 17 years) at 5 Canadian hospital emergency departments within 48 hours sustaining a or mild orthopaedic injury (OI). Children completed 3T MRI scanning postacutely (2 33 days) either 3 (randomly assigned the postacute visit). Reliable change between retrospective preinjury (based on parent report) 1-month postinjury symptom ratings based child report was used classify with without persisting symptoms. Within-network between-network FC computed for networks from resting-state fMRI scans analyzed using linear mixed-effects models, multiple comparison correction. Groups (385 concussion/198 OI; 59% male; 69% White; age 12.42 ± 2.29 did not differ in within-network FC. Relative OI, visual ventral attention lower concussion, d (95% CI) = -0.46 (-0.79 -0.14), across time. Connectivity default mode -0.60 (-0.92 -0.27). At frontoparietal younger children, -0.98 (-1.58 -0.37), higher older 0.81 (0.20 1.42). For groups report, dorsal female symptoms relative symptoms, 1.25 (2.05 0.46), 0.87 (0.25 1.49). Time injury, biological sex, persistent status are important seen department settings. Postacute may enhance clinical diagnosis. Although preserved, differences emerge most clinically recover persist providing potential objective biomarker lasting changes function.

Язык: Английский

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Mild and moderate traumatic brain injury: Screening, documentation, and referral to concussion services

Australasian Emergency Care, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Screening of traumatic brain injuries (TBI) using different clinical assessment tools would facilitate diagnosis and effective inpatient follow-up. We aimed to describe rates diagnosis, classification, documentation, referral practices for TBI inpatients. In a retrospective cohort study, we reviewed electronic records adult patients admitted hospital ward with head trauma from an emergency department (ED) in 2021. Data included demographics, injury, diagnoses, concussion services. Factors predicting ED physician documentation services were identified. Of approximately 34,000 adults the ED, 1059 presented trauma, 609 (57.5 %) diagnosed TBI. There 553 mild/moderate cases incidence rate 103.4 per 100,000 population Canterbury. 14 % (n = 77) referred service. Predictors ED-documented non-isolated injury (OR:0.60), CT request (OR:9.12), injured street/public areas (OR:2.03). Older age decreased odds service (0.96 0.46, respectively), while female increased (5.8 28, respectively). Better might health care access, efficient decision making.

Язык: Английский

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