Loss of Consciousness is Associated with Elevated Cognitive Intra-Individual Variability Following Sports-Related Concussion

2020 ◽  
pp. 1-7
Author(s):  
Victoria C. Merritt ◽  
Liora S. Greenberg ◽  
Jessica E. Meyer ◽  
Peter A. Arnett
Keyword(s):  
Risk Factor ◽  
Cognitive Functioning ◽  
Anterograde Amnesia ◽  
Individual Variability ◽  
Loss Of Consciousness ◽  
Post Injury ◽  
Future Studies ◽  
Two Measures ◽  
Time Since Injury ◽  
Maximum Discrepancy

Abstract Objective: The purpose of this study was to evaluate whether loss of consciousness (LOC), retrograde amnesia (RA), and anterograde amnesia (AA) independently influence a particular aspect of post-concussion cognitive functioning—across-test intra-individual variability (IIV), or cognitive dispersion. Method: Concussed athletes (N = 111) were evaluated, on average, 6.04 days post-injury (SD = 5.90; Mdn = 4 days; Range = 1–26 days) via clinical interview and neuropsychological assessment. Primary outcomes of interest included two measures of IIV—an intra-individual standard deviation (ISD) score and a maximum discrepancy (MD) score—computed from 18 norm-referenced variables. Results: Analyses of covariance (ANCOVAs) adjusting for time since injury and sex revealed a significant effect of LOC on the ISD (p = .018, η p 2 = .051) and MD (p = .034, η p 2 = .041) scores, such that athletes with LOC displayed significantly greater IIV than athletes without LOC. In contrast, measures of IIV did not significantly differ between athletes who did and did not experience RA or AA (all p > .05). Conclusions: LOC, but not RA or AA, was associated with greater variability, or inconsistencies, in cognitive performance acutely following concussion. Though future studies are needed to verify the clinical significance of these findings, our results suggest that LOC may contribute to post-concussion cognitive dysfunction and may be a risk factor for less efficient cognitive functioning.

scholarly journals Loss of Consciousness is Associated with Increased Neurocognitive Intra-Individual Variability Following Sports-Related Concussion

2019 ◽  
Vol 34 (5) ◽  
pp. 734-734
Author(s):  
V C Merritt ◽  
L S Greenberg ◽  
J E Meyer ◽  
P A Arnett
Keyword(s):  
Cognitive Functioning ◽  
Individual Variability ◽  
Clinical Samples ◽  
Loss Of Consciousness ◽  
Neurocognitive Performance ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Two Measures ◽  
Time Since Injury ◽  
Relevant Consideration

Abstract Purpose Traditional markers of concussion severity, including loss of consciousness (LOC), retrograde amnesia (RA), and post-traumatic amnesia (PTA), have been inconsistently associated with neurocognitive performance following sports-related concussion. The purpose of this study was to evaluate whether LOC, RA, and PTA influence a particular aspect of post-concussion cognitive functioning—across-test intra-individual variability (IIV). Methods Concussed athletes (N=119; 77.3% male) were evaluated, on average, 8.55 days post-concussion (SD=11.27; Mdn=4 days) via clinical interview and neuropsychological assessment. Primary outcomes of interest included two measures of IIV-an average standard deviation (ASD) score and a maximum discrepancy (MD) score-computed from 18 norm-referenced variables. Results A one-way ANCOVA adjusting for time since injury revealed a significant effect of LOC on the ASD (F(1, 116)=6.78, p=.010, ηp2=.055) and MD (F(1, 116)=5.65, p=.019, ηp2=.046) scores, such that athletes with LOC displayed significantly greater IIV than athletes without LOC. In contrast, measures of IIV did not significantly differ between athletes who did and did not experience RA or PTA (all p>.05). Conclusion LOC, but not RA or PTA, was associated with greater variability, or inconsistencies, in cognitive performance following concussion. This suggests that LOC may be a relevant consideration when evaluating post-concussion cognitive dysfunction. IIV has recently been established as a sensitive measure of cognitive functioning in a variety of clinical samples and has been associated with underlying neurobiological integrity. Taken together, our results implicate LOC as a possible contributing factor of less efficient cognitive functioning following concussion and may help detect athletes at risk for poor clinical outcomes.

scholarly journals A-126 Clinical Utility of Risk Factors to Predict Self-reported Neurobehavioral Outcome Following Traumatic Brain Injury: PTSD, Sleep, Resilience, and Lifetime Blast Exposure

2020 ◽  
Vol 35 (6) ◽  
pp. 919-919
Author(s):  
Lange R ◽  
Lippa S ◽  
Hungerford L ◽  
Bailie J ◽  
French L ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Clinical Utility ◽  
Poor Sleep ◽  
Post Injury ◽  
Poor Outcome ◽  
Blast Exposure ◽  
Neurobehavioral Outcome

Abstract Objective To examine the clinical utility of PTSD, Sleep, Resilience, and Lifetime Blast Exposure as ‘Risk Factors’ for predicting poor neurobehavioral outcome following traumatic brain injury (TBI). Methods Participants were 993 service members/veterans evaluated following an uncomplicated mild TBI (MTBI), moderate–severe TBI (ModSevTBI), or injury without TBI (Injured Controls; IC); divided into three cohorts: (1) < 12 months post-injury, n = 237 [107 MTBI, 71 ModSevTBI, 59 IC]; (2) 3-years post-injury, n = 370 [162 MTBI, 80 ModSevTBI, 128 IC]; and (3) 10-years post-injury, n = 386 [182 MTBI, 85 ModSevTBI, 119 IC]. Participants completed a 2-hour neurobehavioral test battery. Odds Ratios (OR) were calculated to determine whether the ‘Risk Factors’ could predict ‘Poor Outcome’ in each cohort separately. Sixteen Risk Factors were examined using all possible combinations of the four risk factor variables. Poor Outcome was defined as three or more low scores (< 1SD) on five TBI-QOL scales (e.g., Fatigue, Depression). Results In all cohorts, the vast majority of risk factor combinations resulted in ORs that were ‘clinically meaningful’ (ORs > 3.00; range = 3.15 to 32.63, all p’s < .001). Risk factor combinations with the highest ORs in each cohort were PTSD (Cohort 1 & 2, ORs = 17.76 and 25.31), PTSD+Sleep (Cohort 1 & 2, ORs = 18.44 and 21.18), PTSD+Sleep+Resilience (Cohort 1, 2, & 3, ORs = 13.56, 14.04, and 20.08), Resilience (Cohort 3, OR = 32.63), and PTSD+Resilience (Cohort 3, OR = 24.74). Conclusions Singularly, or in combination, PTSD, Poor Sleep, and Low Resilience were strong predictors of poor outcome following TBI of all severities and injury without TBI. These variables may be valuable risk factors for targeted early interventions following injury.

Abstract TP197: Risk of Stroke in Women with use of Testosterone-Containing Hormone Replacement Therapy

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Haseeb A Rahman ◽  
Ahmed Malik ◽  
Aesha Rahman ◽  
Saqib Chaudhry ◽  
Malik M Adil ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Stroke Risk ◽  
Hormone Replacement ◽  
Future Studies ◽  
Baseline Visit ◽  
Using Data

Background: There has been debate in the role of exogenous testosterone as a risk factor for stroke. Hormone replacement therapy (HRT) is considered a risk factor for stroke. The risk of ischemic stroke may increase when using testosterone-containing HRT. Methods: Using data from the observational component of the Women’s Health Initiative (WHI) [WHI Observational Study (OS)], we analyzed the 93,676 women aged 50-79 years, who participated in the OS over a period of 12±1 years. We compared the outcome of stroke in participants with reported use of a combination of testosterone and estrogen, estrogen alone, progesterone alone, and a combination of estrogen and progesterone, as recorded at the baseline visit. A logistic regression analysis was run to determine the odds of developing stroke. Results: Of the 93, 676 participants, 1772 used a combination of testosterone and estrogen (Estratest) HRT, 11,282 used progesterone alone, 10,808 used a combination of estrogen and progesterone, and 31,673 used estrogen alone. A smaller proportion of participants who developed an outcome of stroke had used Estratest as compared to estrogen alone or a combination of estrogen and progesterone (1.9% vs. 96.3% p=0.62). In the logistic regression, participants who had used Estratest were 1.2 times as likely to develop stroke as users of other hormone replacement therapy (OR 1.2 95%CI (0.96-1.6)), while women who had used progesterone only were 0.87 times less likely to develop stroke than users of other hormone replacement therapy (OR 0.874 95%CI (0.77-0.99)). After adjusting for confounders, the risk of developing stroke increased in users of Estratest (OR 1.25 95%CI (0.96-1.6) p=0.04), and decreased in users of progesterone only (OR 0.873 95%CI (0.77-0.99) p=0.038). Conclusion: Use of testosterone-containing HRT slightly increased the risk of stroke in women when compared to progesterone alone HRT, although this was not found to be significant. Stroke risk with Estratest may be considered to be similar to estrogen only and combination of estrogen plus progesterone HRT. Future studies are required to investigate these correlations.

Intergenerational Transmission of Physical and Emotional Sibling Violence: A Potential Connection to Elder Abuse

2018 ◽  
Vol 99 (3) ◽  
pp. 256-268 ◽  
Author(s):  
Nathan H. Perkins ◽  
Marcia Spira ◽  
Julie Erin Key
Keyword(s):  
Risk Factor ◽  
Life Course ◽  
Family Violence ◽  
Intergenerational Transmission ◽  
Potential Risk ◽  
Elder Abuse ◽  
Potential Risk Factor ◽  
Sibling Violence ◽  
Future Studies ◽  
The Life Course

This article focuses on the persistence of physical and emotional sibling violence through the life course and its potential connection to elder abuse. Theories relevant to the linkage between sibling violence and elder abuse are presented and discussed. Highlighted is the need for future studies to examine the association between these forms of family violence in order for preventative and intervention mechanisms to be created and implemented. Implications for practice include the need to assess physical and emotional sibling violence as a potential risk factor for elder abuse.

scholarly journals Industrial Park and Welfare Effect: A Preliminary Evidence from Indonesia

2019 ◽  
Vol 4 (7) ◽  
pp. 77-86
Author(s):  
Afrimadona Afrimadona ◽  
Shanti Darmastuti ◽  
Andi Kurniawan
Keyword(s):  
Preliminary Evidence ◽  
Economic Consequences ◽  
Academic World ◽  
Future Studies ◽  
Household Spending ◽  
Positive Effects ◽  
Industrial Parks ◽  
The People ◽  
Two Measures ◽  
The Relationship

How can the presence of industrial parks affect the welfare of the people in the districts/city within which they operate? While studies about the socio-political and economic consequences of industrial parks abound in the academic world, industrial parks are still understudied in Indonesia. the paper is a preliminary observation on the relationship between the presence of industrial parks and the welfare conditions of the people in the districts. Using two measures of welfare, human development index and household spending, we find that the presence of industrial parks has some positive effects on these two measures. The two models of the bivariate relationships show that the relationships are statistically significant. Nevertheless, the study still suffers from some weaknesses that future studies can improve.

scholarly journals Predictors of proximity to others in colony housed shelter cats (Felis silvestris catus)

2016 ◽  
pp. 24 ◽  
Author(s):  
Malini Suchak ◽  
Michael Piombino ◽  
Kalina Bracco
Keyword(s):  
Past History ◽  
Individual Variability ◽  
Felis Silvestris Catus ◽  
Future Studies ◽  
The Past ◽  
Close Proximity ◽  
History Of ◽  
Adult Cats ◽  
Stress Behaviors ◽  
High Degree

Colony housing of cats allows shelters to maximize the number of cats housed in limited space. Most research on colony-housed cats examines stress in relation to group size or enclosure size.  While this is important for evaluating welfare, it is equally important to understand how cats are interacting socially in these colonies. We observed 259 adult cats housed in groups of two to eight individuals. Scan samples were used to assess how frequently individual cats were in close proximity to other cats. These data were used to measure individual differences in sociability and patterns of proximity to certain partners. We used information about the past history of the cat, which was collected upon admission to the shelter to identify predictors of time spent in proximity. There was a high degree of inter-individual variability in sociability. Strays tended to spend less time in proximity to other cats, and this effect was most pronounced in females.However, none of the information collected upon admission predicted patterns of proximity to certain partners, or which cats spent time in association witheach other. Future studies should explore the implications of differences in sociability by associating observations of social behavior and stress behaviors.

Abstract P441: Dental Caries a Risk Factor for Intracerebral Hemorrhage

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Elizabeth A La Valley ◽  
Souvik Sen ◽  
James Curtis ◽  
Rebecca F Gottesman ◽  
Wayne D Rosamond ◽  
...  
Keyword(s):  
Risk Factor ◽  
Dental Caries ◽  
Intracerebral Hemorrhage ◽  
Cox Regression ◽  
Collagen Binding ◽  
Future Studies ◽  
Kaplan Meier ◽  
Chart Abstraction ◽  
Metalloproteinase 9 ◽  
Prior Stroke

Introduction: Streptococcus mutans is a known cause of dental caries that contains a collagen-binding protein, Cnm, and shows inhibition of platelet aggregation and matrix metalloproteinase-9 activation. This strain has been linked to aggravation of experimental intracerebral hemorrhage (ICH) and may be a risk factor for intracerebral hemorrhage. Methods: Presence of dental caries was assessed in subjects from the Dental Atherosclerosis in Communities Study (DARIC) without prior stroke or intracerebral hemorrhage. This cohort was followed for a period of incident intracerebral hemorrhage, subsequently verified by chart abstraction. Cox regression with time-dependent covariate was used to compute crude and adjusted hazards ratio stratified as <15 years and ≥15 years from the initial dental assessment. Results: Among 6506 subjects, dental caries were recorded in 1227 (19%) subjects. 47 (1%) had ICH over a period of 30 years. Those with dental caries versus those without dental caries had a greater proportion of younger (mean age 61.8±5.6 vs. 62.5±5.6, p<0.001), male (24% vs. 16%, p<0.001), African-American (53% vs 12%, p<0.001) and hypertensive (24% vs. 16%, p<0.001) patients. The association between dental caries and ICH in the first 15 years was not higher (crude HR 1.0, 95% CI 0.4-2.3) and remained so after adjusting for age, gender, race, and hypertension (adj. HR 1.1, 95% CI 0.5-2.9). The association between caries and ICH in the second 15 years was higher (crude HR 3.7, 95% CI 1.1-12.0) and strengthened after adjustment (adjusted OR 4.5, 95% CI 1.3-15.5). This is depicted in the Kaplan-Meier curve below. Conclusion: We report a significant association between dental caries and ICH. Future studies are needed to determine if early treatment of dental caries can reduce the risk of ICH.

Is the Energy Expenditure Provided by Exergames Valid?

2019 ◽  
Vol 40 (09) ◽  
pp. 563-568
Author(s):  
Ricardo Borges Viana ◽  
Paulo Gentil ◽  
Marília Santos Andrade ◽  
Rodrigo Luiz Vancini ◽  
Claudio Andre Barbosa de Lira
Keyword(s):  
Energy Expenditure ◽  
Carbon Dioxide Production ◽  
Accurate Information ◽  
Large Effect Size ◽  
Metabolic System ◽  
Physically Active ◽  
Future Studies ◽  
Young Males ◽  
Need To Evaluate ◽  
Two Measures

AbstractTo assess energy expenditure (EE) estimated by a metabolic system during the exergame Hollywood Workout on Xbox 360Kinect® and to compare this measure with the EE estimated by the exergame (EEEx). thirty-four physically active young males performed the Sports Athlete protocol of the Hollywood Workout. Oxygen uptake (V̇O2) and carbon dioxide production (V̇CO2) were measured before and during the protocol using a metabolic system. The absolute means V̇O2 and V̇CO2 were used to calculate the EE during the exergame session (EEMS). The EEEx (kcal) provided by the exergame was collected, and the two measures were compared. Mean V̇CO2 and V̇O2 during the Sports Athlete protocol were 1.8±0.4 L·min−1 (22.9±3.2 mL·kg−1.min−1) and 2.0±0.4 L·m−1 (25.4±2.6 mL·kg−1·min−1), respectively. The EEMS (300.3±53.4 kcal) was 88.6±34.7% greater than the EEEx (160.3±16.5 kcal; p<0.0001; d=3.7 [large effect size]). The EEMS was almost double EEEx. Thus, it is necessary to use caution when using EE information provided by an exergame interface. Further, future studies need to evaluate EE provided by other exergames. The companies that produce the games must be more attentive and adopt more precise methods in order to provide more accurate information to the users.

scholarly journals M70. THE EFFICACY OF COMBINING COGNITIVE REMEDIATION AND NON-INVASIVE BRAIN STIMULATION. A SYSTEMATIC REVIEW

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S162-S162
Author(s):  
Anika Poppe ◽  
Leonie Bais ◽  
Franziska Ritter ◽  
Branislava Curčić-Blake ◽  
Gerdina (Marieke) Pijnenborg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Functioning ◽  
Brain Stimulation ◽  
Cognitive Remediation ◽  
Strategy Use ◽  
Daily Functioning ◽  
Positive Trend ◽  
Future Studies ◽  
Non Invasive ◽  
Clinical Populations

Abstract Background Cognitive deficits are commonly observed in people diagnosed with schizophrenia and have been found to be more predictive of future daily and community functioning than the severity of clinical symptoms (e.g., hallucinations and delusions). Cognitive remediation (CR) is a psychological treatment developed to improve cognitive functioning and thereby daily functioning. Despite the effectivity of CR programs, reduced neuroplasticity in brain networks underlying the cognitive tasks may impede the effectiveness of these treatment programs. Increasing the neuroplasticity in these networks by the use of non-invasive brain stimulation (NIBS) like transcranial direct current stimulation or transcranial magnetic stimulation might boost the effect of CR. In a systematic review, we will address the question whether the combination of non-invasive brain stimulation and cognitive remediation may be a promising treatment strategy. We will apply a transdiagnostic perspective in order to determine the potential benefit of combining CR and NIBS in general, and not specific to a diagnostic category. Methods A systematic review of literature was conducted by searching PsycINFO, Pubmed, Web of Science, and Medline databases for combined treatments of CR and NIBS. Included studies were assessed for cognitive, clinical and functional outcomes. Results 64 studies were identified, with 40 studies including clinical populations (e.g., schizophrenia, Alzheimer’s disease, HIV, MS). The cognitive outcomes showed mixed results. Most effects were found on complex attention and executive functioning. In these domains about 38% of the studies found an added positive treatment effect for combining interventions, in comparison to single interventions (i.e. CR, NIBS, or CR+sham-stimulation). Functional outcome measures were included in ten of the 40 studies with clinical populations. Eight studies found a positive trend towards greater improvements in daily functioning when CR and NIBS were combined. Discussion So far, findings indicate promising effects of combining CR and NIBS on cognitive functioning and daily functioning in healthy and various clinical populations. There is a lot of variety between studies (e.g., duration of treatment, number of total sessions, number of weekly sessions, cognitive domains targeted) which may explain the mixed results. Especially, the design of the CR varied widely. Strategy-use and targeting meta-cognition, which were identified as effective elements of CR as a stand-alone treatment were not included in many combined CR+NIBS designs. Future studies have to elucidate whether the combining CR (including strategy-use and meta-cognition) and NIBS has an additive effect on cognitive and/or daily functioning compared to non-combined treatment. Moreover, future studies should evaluate whether beneficial effects from the experimental studies translate into long-term improvement in activities of daily life.

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