- Impaired local dynamic stability during treadmill walking predicts future falls in patients with multiple sclerosis: A prospective cohort study. [Journal Article]
- CBClin Biomech (Bristol, Avon) 2019 May 09; 67:197-201
- CONCLUSIONS: The results may indicate that the assessment of local stability of walking can identify patients who would benefit from gait retraining and fall prevention programs.
- Mild traumatic brain injury: The effect of age at trauma onset on brain structure integrity. [Journal Article]
- NCNeuroimage Clin 2019 Jun 19; 23:101907
- Mounting evidence suggests that mild traumatic brain injuries (mTBI) have long-term effects that interact with the aging process to precipitate cognitive decline. This line of research predicts that …
Mounting evidence suggests that mild traumatic brain injuries (mTBI) have long-term effects that interact with the aging process to precipitate cognitive decline. This line of research predicts that early exposure to brain trauma is particularly detrimental to long-term brain integrity. However, a second line of research into the effects of age at trauma onset predict that older brains are more vulnerable to the effects of mTBI than younger brains. We sought to determine whether patients who sustain a mTBI earlier in life fare better than patients who sustain a mTBI at an older age. We conducted a multi-cohort, case-control study, with participants randomly sampled from a population of patients with a history of mTBI. We recruited two cohorts of aging participants (N = 74, mean [SD] = 61.16 [6.41]) matched in age and education levels that differed in only one respect: age at mTBI onset. One cohort sustained their concussion in their early twenties (24.60 [6.34] y/o), the other in their early sixties (61.05 [4.90] y/o). Each mTBI cohort had its own matched control group. Participants underwent high-resolution MRI at 3 Tesla for T1 and diffusion-weighted images (DWI) acquisition. Images were processed and analyzed using Deformation-Based Morphometry and DWI Tract-Based Spatial Statistics to identify group differences in a 2 × 2 ANOVA design. Results showed a significant interaction on DWI measures of white matter integrity indicating larger anomalies in participants who sustained a mTBI at a younger age (F1,70, P < .05, FDR corrected). These findings suggest that mTBI initiates a lifelong neurodegeneration process that outweighs the risks associated with sustaining a mTBI at an older age. Implications are important for young athletes' populations exposed to the risk of mTBI in the practice of their sports and for retired athletes aging with a history of concussions sustained at a younger age.
- The Flooring for Injury Prevention (FLIP) Study of compliant flooring for the prevention of fall-related injuries in long-term care: A randomized trial. [Journal Article]
- PMPLoS Med 2019; 16(6):e1002843
- CONCLUSIONS: In contrast to results from previous retrospective and nonrandomized studies, this study found that compliant flooring underneath hospital-grade vinyl was not effective at preventing serious fall-related injuries in LTC. Future studies are needed to identify effective methods for preventing fall-related injuries in LTC.
- Preseason Vestibular Ocular Motor Screening in Children and Adolescents. [Journal Article]
- CJClin J Sport Med 2019 Jun 19
- CONCLUSIONS: There was a low rate of abnormal findings for the individual VOMS subtests, with the exception of NPC distance, among male youth hockey players during preseason assessment.
- Survey of Child Neurologists on Management of Pediatric Post-traumatic Headache. [Journal Article]
- JCJ Child Neurol 2019 Jun 24; :883073819856837
- Traumatic brain injury causes significant morbidity in youth, and headache is the most common postconcussive symptom. No established guidelines exist for pediatric post-traumatic headache management.…
Traumatic brain injury causes significant morbidity in youth, and headache is the most common postconcussive symptom. No established guidelines exist for pediatric post-traumatic headache management. We aimed to characterize common clinical practices of child neurologists. Of 95 practitioners who completed our survey, most evaluate <50 pediatric concussion patients per year, and 38.9% of practitioners consistently use International Classification of Headache Disorders criteria to diagnose post-traumatic headache. Most recommend nonsteroidal anti-inflammatory drugs as abortive therapy, though timing after injury and frequency of use varies, as does the time when providers begin prophylactic medications. Amitriptyline, topiramate, and vitamins/supplements are most commonly used for prophylaxis. Approach to rest and return to activities varies; one-third recommend rest for 1 to 3 days and then progressive return, consistent with current best practice. With no established guidelines for pediatric post-traumatic headache management, it is not surprising that practices vary considerably. Further studies are needed to define the best, evidence-based management for pediatric post-traumatic headache.
- Longitudinal Changes in Magnetic Resonance Spectroscopy in Pediatric Concussion: A Pilot Study. [Journal Article]
- FNFront Neurol 2019; 10:556
- CONCLUSIONS: There are no differences in 1H MRS measurements in the acute concussive period; however, changes in glutamate+glutamine and myo-inositol concentrations detectable by 1H MRS may develop beyond the acute period.
- Case report of sudden death after a gunshot wound to the C2 vertebral bone without direct spinal cord injury: Histopathological analysis of spinal-medullary junction. [Journal Article]
- FSForensic Sci Int 2019 Jun 14
- Gunshot wounds (GSW) are one of the most common causes of penetrating spinal injury, however few data are available regarding GSW causing an indirect fatal nervous tissue injury, such as that induced…
Gunshot wounds (GSW) are one of the most common causes of penetrating spinal injury, however few data are available regarding GSW causing an indirect fatal nervous tissue injury, such as that induced by the concussive force secondary to the bullet penetration. This report describes a rare case of a death following a GSW spine injury at the level of C2 vertebral body, without direct contact with the spinal cord, as seen with computed tomography scan performed soon after the death. At autopsy, vertebral canal and dura mater, as well as spinal cord and medulla oblongata, appeared devoid of pathologies and/or lesions, major viscera were unaltered. The cause of death was attributed to a cardiorespiratory arrest subsequent to the GSW injury of the C2 vertebral bone. Histopathological analysis of spinal cord and medulla oblongata was performed by means of conventional stainings, and glial fibrillary acidic protein (GFAP) and Neurofilaments 200kD (NF) immunohistochemistry. Histological alterations stood out against a tissue with no other evident sign of neuropathology, and could be observed from the caudalmost part of the medulla oblongata to the level of the inferior olivary nucleus. Main structural changes were found in the white matter, involving often the adjacent gray matter, where they appeared as multiple scattered areas of degeneration, lacking the usual staining affinity, and showing a disrupted fibrillary pattern as evidenced by myelin staining, and GFAP- and NF-immunolabelling. The shock wave secondary to the impact on the C2 vertebral bone is likely to have been the cause of a widespread neuronal-axonal histopathological damage at the spinal-medullary junction and caudal medulla oblongata that is compatible with a severe fatal respiratory dysfunction and dysregulation of the autonomic pathways subserving the control of blood pressure and cardiac activity.
- Satisfaction of basic psychological needs following a mild traumatic brain injury and relationships with post-concussion symptoms, anxiety, and depression. [Journal Article]
- DRDisabil Rehabil 2019 Jun 22; :1-9
- CONCLUSIONS: These results suggest that sustaining a mild traumatic brain injury may have a negative impact on the satisfaction of competence, autonomy, and relatedness needs. To conclude, it is recommended that these concepts be included in psychological intervention programs following mild traumatic brain injury. Implications for rehabilitation A significant decrease in psychological need satisfaction is highlighted following mild traumatic brain injury. It is recommended that the needs of autonomy, competence, and relatedness in intervention programs following mild traumatic brain injury needs to be addressed. The more mild traumatic brain injury patients are anxious and depressed the more likely it is that they will present a diminished satisfaction of needs, expressed by a lower level of perception of their autonomy, competence, and relatedness. Thus, integrative intervention for anxiety as well as depression following mild traumatic brain injury is also recommended.
- Increased Risk of Musculoskeletal Injury Following Sport-Related Concussion: A Perception-Action Coupling Approach. [Journal Article]
- SMSports Med 2019 Jun 21
- Recent studies have concluded that athletes have increased risk of musculoskeletal injury following sport-related concussion. While an underlying explanation is still unknown, perceptual-motor contro…
Recent studies have concluded that athletes have increased risk of musculoskeletal injury following sport-related concussion. While an underlying explanation is still unknown, perceptual-motor control may be implicated in this increased risk. Some authors have purported that indirect perception (i.e., a "top-down" view of neuromuscular control) may be disrupted following sport-related concussion. Direct perception theory states that the athlete and environment are inextricably linked in a continuous perception-action coupling loop. That is, the athlete is able to directly perceive opportunities for action (e.g., "affordances") in the environment. Based on these notions, the aim of the current paper was to introduce a theoretical model that argues that sport-related concussion may dysregulate the direct perception process, potentially increasing behavioral risk of musculoskeletal injury during sport. Our model is integrated with a sport-related concussion clinical treatment model, which highlights individualized profiles that characterize the heterogeneous response to sport-related concussion. These profiles have a typical constellation of symptoms (e.g., anxiety, fatigue, ocular dysfunction, etc.), which themselves have been associated with disrupted perception-action coupling, independent of sport-related concussion. Therefore, we argue that athletes who have not re-established perception-action coupling loops following sport-related concussion may be at increased risk of subsequent musculoskeletal injury.
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- Slow Processing Speed and Sluggish Cognitive Tempo in Pediatric Attention-Deficit/Hyperactivity Disorder: Evidence for Differentiation of Functional Correlates. [Journal Article]
- CPChild Psychiatry Hum Dev 2019 Jun 21
- The association between slow processing speed and sluggish cognitive tempo (SCT), a phenotype described within attention-deficit/hyperactivity disorder (ADHD) samples over the past decade, remains un…
The association between slow processing speed and sluggish cognitive tempo (SCT), a phenotype described within attention-deficit/hyperactivity disorder (ADHD) samples over the past decade, remains unclear. We examined whether SCT and processing speed predict different functional correlates within children and adolescents with ADHD. Participants were 193 clinically-referred youth meeting DSM ADHD criteria without comorbid conditions (mean age = 9.9 years, SD = 2.5; age range 6-16). The incremental utility of SCT and processing speed to predict (1) adaptive functioning and (2) academic achievement, after controlling for age, sex, medication status, and ADHD symptom burden, was assessed using hierarchical multiple regressions. SCT symptoms significantly predicted adaptive functioning, accounting for 6% of the variance, but did not predict academic achievement. Processing speed did not add incrementally to the prediction of adaptive functioning, but did predict academic achievement, accounting for 4% of the variance. Results suggest that SCT and processing speed differentially predict functional abilities not accounted for by ADHD symptom burden.