Brain injury : [BI]
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Brain injury : [BI] · Jan 2015
ReviewChronic traumatic encephalopathy: contributions from the Boston University Center for the Study of Traumatic Encephalopathy.
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease associated with repetitive brain trauma (RBT). Initially described in boxers, CTE has now been found in other contact sport athletes with a history of RBT. In recent years, there has been tremendous media attention regarding CTE, primarily because of the deaths of high profile American football players who were found to have CTE upon neuropathological examination. However, the study of CTE remains in its infancy. This review focuses on research from the Centre for the Study of Traumatic Encephalopathy (CSTE) at Boston University. ⋯ Current research at the BU CSTE is aimed at increasing understanding of the long-term consequences of repetitive head impacts and attempting to begin to answer several of the unanswered questions regarding CTE.
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The aim of this literature review was to systematically describe the sequential metabolic changes that occur following concussive injury, as well as identify and characterize the major concepts associated with the neurochemical cascade. ⋯ Concussive injury initiates a complex cascade of pathophysiological changes that include hyper-acute ionic flux, indiscriminant excitatory neurotransmitter release, acute hyperglycolysis and sub-acute metabolic depression. Additionally, these metabolic changes can subsequently lead to impaired neurotransmission, alternate fuel usage and modifications in synaptic plasticity and protein expression. The combination of these metabolic alterations has been proposed to cause the transient and prolonged neurological deficits that typically characterize concussion. Consequently, understanding the implications of the neurochemical cascade may lead to treatment and return-to-play guidelines that can minimize the chronic effects of concussive injury.
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Brain injury : [BI] · Jan 2015
ReviewIn search of evidence-based treatment for concussion: characteristics of current clinical trials.
Abstract Objective: To assess the characteristics of current clinical trials investigating the treatment of concussion. ⋯ Diverse, potentially promising therapeutics are currently being studied for the treatment of concussion. However, several deficiencies were identified including a paucity of trials addressing return-to-activity principles. Also, small sample size and trial heterogeneity may threaten scientific evaluation and subsequent clinical application.
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Brain injury : [BI] · Jan 2015
Review Historical ArticleChronic traumatic encephalopathy in professional sports: retrospective and prospective views.
The purposes of this paper are to review: (1) the history of chronic traumatic encephalopathy (CTE) in sports, (2) the similarities and differences between historic and current definitions of CTE, (3) recent epidemiology and cohort studies of CTE and (4) controversies regarding the current CTE positions. ⋯ There are multiple causes of abnormal tau protein deposition in the human brain and the pathogenesis of CTE may not be related solely to concussion and/or sub-concussive injury. In all likelihood, the causes of CTE are a multivariate, as opposed to a univariate, phenomenon.
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Brain injury : [BI] · Jan 2015
ReviewThe role of apolipoprotein E episilon (ε)-4 allele on outcome following traumatic brain injury: A systematic review.
The apolipoprotein E gene (APOE) has emerged as a candidate for prognosticating traumatic brain injury (TBI) recovery, with APOEε4 identified as a susceptibility marker for poor outcome, despite large discrepancy in its reported influence post-TBI. ⋯ The influence of APOEε4 on neuropsychological testing, functional outcome and in paediatric populations was incongruous. This review supports the majority of research indicating APOEε4 adversely influences recovery following TBI, particularly with respect to dementia-related outcomes and outcomes following sTBI.