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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Serum calcitonin gene-related peptide in patients with persistent post-concussion symptoms, including headache: a cohort study

Journal of Neurology, Год журнала: 2024, Номер 271(5), С. 2458 - 2472

Опубликована: Янв. 17, 2024

Abstract Background Calcitonin gene-related peptide (CGRP) plays an important role in migraine pathophysiology, and post-traumatic headache (PTH) frequently presents with migraine-like features. Despite several clinical similarities, few studies have explored CGRP PTH concussion. This study investigates serum levels patients persistent post-concussion symptoms (PPCS), including PTH. Methods cohort was based on samples from individuals aged 18–30 years PPCS who participated a previously published randomized controlled trial of non-pharmacological intervention. The primary outcome concentrations, determined at baseline before randomization follow-up 7 months later, using enzyme-linked immunosorbent assay (ELISA). were compared healthy anonymous blood donors the same age group. Results Baseline collected 86 participants PPCS. most often female (78%) frequent phenotype (74%). Serum higher than 120 (median: 158.5 pg/mL vs. 76.3 pg/mL, p = 0.050). A stratified analysis revealed that females had fivefold median (166.3 32.1 0.0006), while no differences observed males (p 0.83). At follow-up, decreased change – 1.3 (95% confidence interval: 17.6–0, 0.024). Discussion Elevated decrease over time suggest involvement PTH/PPCS. If confirmed other studies, it could pave way for CGRP-targeted therapies, which significance.

Язык: Английский

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Emergency Department Risk Factors for Post-Concussion Syndrome After Mild Traumatic Brain Injury: A Systematic Review

Journal of Neurotrauma, Год журнала: 2024, Номер 41(11-12), С. 1253 - 1270

Опубликована: Фев. 23, 2024

Approximately 16% of patients with mild traumatic brain injury (mTBI) develop a post-concussion syndrome (PCS) persistent physical, neurological, and behavioral complaints. PCS has great impact on patient's quality life, often decreases the ability to return work, henceforth economic impact. Recent studies suggest that early treatment can greatly improve prognosis prevent long-term effects in these patients. However, recognition at high risk remains difficult. The objective this systematic review is assess factors associated development PCS, primarily aimed group non-hospitalized who were seen mTBI emergency department (ED). We searched PubMed/MEDLINE, Cochrane Library EMBASE September 23, 2022, for prospective assessed PCS. Exclusion criteria were: retrospective studies; > 20% computed tomography (CT) abnormalities, <18 years age, follow-up <4 weeks, severe trauma, study population <100 search strategy identified 1628 articles, which 17 met eligibility criteria. Risk found are pre-existing psychiatric history, headache ED, neurological symptoms female sex, CT pre-existent sleeping problems, neck pain ED. This seven mTBI. Future research should if implementation into stratification tool will assist physician identification

Язык: Английский

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Consensus paper on the assessment of adult patients with traumatic brain injury with Glasgow Coma Scale 13–15 at the emergency department: A multidisciplinary overview

European Journal of Emergency Medicine, Год журнала: 2024, Номер 31(4), С. 240 - 249

Опубликована: Май 14, 2024

Traumatic brain injury (TBI) is a common reason for presenting to emergency departments (EDs). The assessment of these patients frequently hampered by various confounders, and diagnostics still often based on nonspecific clinical signs. Throughout Europe, there wide variation in practices, including the follow-up those discharged from ED. objective present practical recommendation adult with an acute TBI, focusing milder cases not requiring in-hospital care. aim advise harmonize practices European settings. A multiprofessional expert panel, giving consensus recommendations recent scientific literature employed. focus preserved consciousness (Glasgow Coma Scale 13–15) care after ED assessment. main results this paper contain practical, clinically usable assessment, decision-making head computerized tomography (CT), use biomarkers, discharge options, needs follow-up, as well discussion features risk factors prolonged recovery. In conclusion, provides stepwise approach TBI at Recommendations are given performance CT, biomarkers disposition careful patient information organization discharged.

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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Experience of Acceptance and Commitment Therapy for those with mild traumatic brain injury (ACTion mTBI): A qualitative descriptive study

PLoS ONE, Год журнала: 2025, Номер 20(1), С. e0312940 - e0312940

Опубликована: Янв. 30, 2025

Psychological interventions may make a valuable contribution to recovery following mild traumatic brain injury (mTBI) and have been advocated for in treatment consensus guidelines. Acceptance Commitment Therapy (ACT) is more recently developed therapeutic option that offer an effective approach. Consequently, we ACTion mTBI, 5-session ACT-informed intervention protocol. To establish the feasibility of this intervention, wanted understand participants’ experiences determine acceptability identify any refinements needed inform full-scale effectiveness trial. We recruited adults (≥16 years age) diagnosed with mTBI who were engaged community-based multidisciplinary rehabilitation. After completing sessions, 23/27 (85.2%) participants (mean time post-injury: 28.0 weeks) completed semi-structured interview about their experience intervention. Interviews audio-recorded, transcribed verbatim analysed using qualitative description There two overarching themes 1) attacking concussion from different direction 2) positive impact on which depicted overall Within these themes, our analysis also identified subthemes: helpful aspects included education ACT processes (i.e., being present able step back) “ contextual factors enabled ” equipped tools, cultural spiritual responsiveness, connection, having structured yet flexible approach order delivery meet individual needs. Participants’ support acceptability, responsibility mTBI. Suggested enabling access over time, not just at one point during addition brief check-in follow-up.

Язык: Английский

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