The Journal of head trauma rehabilitation
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J Head Trauma Rehabil · May 2012
Review Comparative StudyEthical implications of neuroimaging in sports concussion.
The Centers for Disease Control and Prevention estimates that 1.6 to 3.8 million traumatic brain injuries that occur each year are related to sports injuries. New research has broadened the understanding of the acute and chronic pathophysiology of concussion associated with brain injury, and recent advances in diagnostic capabilities with neuroimaging are leading to new ethical questions around sport and care of the head-injured athlete. In this review, we synthesize the current literature on neuroimaging for assessing concussed athletes and explore ethical issues in the context of return to play, short- and long-term neurologic health effects following concussion and resource allocation that are emerging with new implications as neurotechnology becomes an increasingly powerful tool on the playing field of health.
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J Head Trauma Rehabil · May 2012
ReviewTraumatic brain injury, shell shock, and posttraumatic stress disorder in the military--past, present, and future.
With preferential use of high explosives in modern warfare, traumatic brain injury (TBI) has become a common injury for troops. Most TBIs are classified as "mild," although military personnel with these injuries can have persistent symptoms such as headache, memory impairment, and behavioral changes. During World War I, soldiers in the trenches, undergoing unrelenting artillery bombardment, suffered from similar symptoms, designated at the time as "shell shock." Dr Frederick Mott proposed studying the brains of deceased soldiers to elucidate the neuropathology of this clinical entity. ⋯ To this day, there exists a paucity of neuropathology studies investigating the effects of high explosives on the human brain. By analogy, studies have recently revealed that athletes with repeated head trauma can develop a neurodegenerative disease, chronic traumatic encephalopathy, who present with similar clinical features. Given current circumstance, we propose completing the work envisioned by Dr Mott almost 100 years ago.
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J Head Trauma Rehabil · May 2012
ReviewFatigue and sleep disturbance following traumatic brain injury--their nature, causes, and potential treatments.
Although fatigue and sleep disturbance are commonly reported following traumatic brain injury (TBI), understanding of their nature and treatment remains limited. ⋯ These findings suggest potential treatments including cognitive behavior therapy supporting lifestyle modifications, pharmacologic treatments with modafinil and melatonin, and light therapy to enhance alertness, vigilance, and mood. Controlled trials of these interventions are needed.
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J Head Trauma Rehabil · May 2012
Comparative StudyNeuronal loss in the medial cholinergic pathway from the nucleus basalis of Meynert in patients with traumatic axonal injury: a preliminary diffusion tensor imaging study.
The recent development of diffusion tensor imaging (DTI) allows visualization and estimation of the medial cholinergic pathway (MCP), which originates from the nucleus basalis of Meynert and provides cortical cholinergic innervation to the cerebral cortex. We investigated the injury to the MCP in patients with traumatic axonal injury (TAI), using DTI. ⋯ Changes in DTI parameters of the TAI group appear to be due to neuronal loss of the MCP. We believe that DTI would be useful for the evaluation of the MCP in patients with TAI.
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J Head Trauma Rehabil · May 2012
Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth.
To determine the prevalence rate of traumatic brain injury (TBI) in incarcerated youth and whether frequency and severity of TBI are associated with postconcussion symptoms (PCS), violent offending behaviors, age of first conviction, and substance abuse. ⋯ Findings indicate a need to account for TBI in offender populations in managing care needs, which may contribute to reduction in offending behaviors.