International journal of psychophysiology : official journal of the International Organization of Psychophysiology
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Int J Psychophysiol · Oct 2018
Cortical thickness in pediatric mild traumatic brain injury including sports-related concussion.
This investigation explored whether differences in cortical thickness could be detected in children who sustained a mild traumatic brain injury (mTBI) compared to those with orthopedic injury (OI) and whether cortical thickness related parental reporting of symptoms. To achieve this objective, FreeSurfer®-based cortical thickness measures were obtained in 330 children, 8 to 15 years of age, with either a history of mTBI or OI. Imaging was performed in all participants with the same 3 Tesla MRI scanner at six-months post-injury, where a parent-rated Post-Concussion Symptom Inventory (PCSI) was also obtained. ⋯ Injuries associated with any type of abuse were excluded and children with OI could not have experienced a MVA. Mechanism of injury did not differentially relate to cortical thickness, although in the fall group, parental rating using the PCSI showed increased symptom reporting to be associated with reduced cortical thickness in the left interior frontal, temporal pole and lateral temporal lobe as well as in the right temporal pole. Results from these preliminary findings are discussed in terms of injury variables and developmental factors associated with mTBI in childhood.
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Int J Psychophysiol · Oct 2018
Sub-concussive trauma, acute concussion, and history of multiple concussions: Effects on quiet stance postural control stability.
Although balance control has been studied extensively following acute concussion, little is known regarding repetitive sub-concussive head impacts or chronic exposure to multiple concussive events. Quiet stance postural control was characterized in contact sport athletes at pre-season (n = 135) and post-season (n = 48) to evaluate the effects of subconcussive trauma to the head. To determine the impact of acute concussion on postural control, athletes diagnosed with a concussion during the season (n = 12) were tested at 72-h, 2-weeks, and 1-month post-injury. ⋯ Additionally, head-impact exposure metrics were not correlated with COP metrics. Taken together, the data suggests alterations in COP sway during quiet stance persist in the acute 2-week period after injury. These findings were not present with either a history of multiple concussions or exposure to sub-concussive head impacts indicating acute concussion does not have appear to have long term effects for these measures.
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Structural neuroimaging of athletes who have sustained a sports-related concussion (SRC) can be viewed as either standard clinical imaging or with advanced neuroimaging methods that quantitatively assess brain structure. Negative findings from conventional computed tomography (CT) or magnetic resonance imaging (MRI) are the norm in SRC. Nonetheless, these conventional measures remain the first line of neuroimaging of the athlete as they do detect clinically significant pathologies, when present, such as hemorrhagic abnormalities in the form of hematomas, contusions and mircobleeds along with regions of focal encephalomalacia or other signal abnormalities, with CT best capable of detecting skull fractures. ⋯ With advancements in image analysis, multiple quantitative neuroimaging metrics now can be utilized in assessing SRC. Such multimodality approaches are particularly relevant and important for assessing white matter and network integrity of the brain following injury, including SRC. This review focuses just on the structural side of neuroimaging in SRC, but these techniques also are being integrated with functional neuroimaging, where the combination of the two approaches may provide superior methods in assessing the pathological effects of SRC.
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Int J Psychophysiol · Oct 2018
Subconcussive head impacts in sport: A systematic review of the evidence.
To identify and evaluate the evidence that examines subconcussive impacts in sport-specific settings, and address two objectives: a) to determine how 'subconcussion' is characterized in the current literature, and b) to identify directions for future research. ⋯ Evidence reviewed predominantly from studies of male athletes in contact and collision sports identifies that repetitive hits to the head are associated with microstructural and functional changes in the brain. Whether these changes represent injury is unclear. We determined the term 'subconcussion' to be inconsistently used, poorly defined, and misleading. Future research is needed to characterize the phenomenon in question.