Journal of neurotrauma
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Journal of neurotrauma · Apr 2016
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes.
Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). ⋯ The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single- and additional-impact injuries on symptom burden and LOR.
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Journal of neurotrauma · Apr 2016
Traumatic Brain Injury Severity Affects Neurogenesis in Adult Mouse Hippocampus.
Traumatic brain injury (TBI) has been proven to enhance neural stem cell (NSC) proliferation in the hippocampal dentate gyrus. However, various groups have reported contradictory results on whether TBI increases neurogenesis, partially due to a wide range in the severities of injuries seen with different TBI models. To address whether the severity of TBI affects neurogenesis in the injured brain, we assessed neurogenesis in mouse brains receiving different severities of controlled cortical impact (CCI) with the same injury device. ⋯ Severe TBI increased neurogenesis at all three stages. Our data suggest that the severity of injury affects adult neurogenesis in the hippocampus, and thus it may partially explain the inconsistent results of different groups regarding neurogenesis following TBI. Further understanding the mechanism of TBI-induced neurogenesis may provide a potential approach for using endogenous NSCs to protect against neuronal loss after trauma.
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Journal of neurotrauma · Apr 2016
Recovery from Mild Traumatic Brain Injury in Previously Healthy Adults.
This prospective longitudinal study reports recovery from mild traumatic brain injury (MTBI) across multiple domains in a carefully selected consecutive sample of 74 previously healthy adults. The patients with MTBI and 40 orthopedic controls (i.e., ankle injuries) completed assessments at 1, 6, and 12 months after injury. Outcome measures included cognition, post-concussion symptoms, depression, traumatic stress, quality of life, satisfaction with life, resilience, and return to work. ⋯ A large percentage of the subgroup who had persistent symptoms had a modifiable psychological risk factor at 1 month (i.e., depression, traumatic stress, and/or low resilience), and at 6 months, they had greater post-concussion symptoms, fatigue, insomnia, traumatic stress, and depression, and worse quality of life. All of the control subjects who had mild post-concussion-like symptoms at 12 months also had a mental health problem (i.e., depression, traumatic stress, or both). This illustrates the importance of providing evidence-supported treatment and rehabilitation services early in the recovery period.
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Journal of neurotrauma · Apr 2016
Agreement between High School Athletes and their Parents on Reporting Athletic Events and Concussion Symptoms.
An enhanced understanding of agreement levels between adolescents and parents for reporting athletic events and symptoms can help inform surveillance systems as well as clinical and epidemiological investigations of sports-related concussions. We sought to quantify agreement levels between high school athletes and parents for reporting: (1) number of games; (2) number of practices; (3) occurrence of an injury resulting in any concussion symptoms; and (4) presence of each specific symptom on the date of that injury among high school boys' football and girls' soccer athletes playing in Autumn 2012 in Washington State. There was substantial agreement on reporting the number of athletic events. ⋯ Overall, athletes reported greater severity of symptoms than parents did; notably, no difference in mean symptom scores was found when the athlete had a history of concussion. Agreement levels were greater when information was ascertained within 1 week of injury than when it was obtained later than 1 week. Including both athletes' and parents' reports of sports-related events and ascertaining information as soon as possible after injury are important considerations in designing injury surveillance systems.
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Journal of neurotrauma · Apr 2016
Observational StudyRecovery of olfactory function following pediatric traumatic brain injury: A longitudinal follow-up.
There is increasing evidence that disruption of olfactory function after pediatric traumatic brain injury (TBI) is common. Olfactory dysfunction (OD) has been linked to significant functional implications in areas of health, safety, and quality of life, but longitudinal research investigating olfactory recovery is limited. This study aimed to investigate recovery trajectories for olfaction following pediatric TBI and explore predictors of early and late olfactory outcomes. ⋯ Predictors of early (0-3 month) and late (18 month) olfactory outcomes varied with site of impact, a significant predictor of later olfactory performance. In summary, while there was evidence of recovery of OD over time in pediatric TBI, the majority of children with severe OD did not show any recovery. In light of limited recovery of function for more severely affected children, the importance of appropriate education and implementation of rehabilitation management strategies is highlighted.