scholarly journals Influence of Family History of Neurodegenerative Diseases on Outcome Following Pediatric Concussion

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S7.2-S8
Author(s):  
Colt Coffman ◽  
Jacob Kay ◽  
Adam Harrison ◽  
Jeffery Holloway ◽  
Robert Davis Moore
Keyword(s):  
Family History ◽  
Neurodegenerative Disease ◽  
Clinical Symptoms ◽  
Cognitive Outcomes ◽  
Group Differences ◽  
Post Injury ◽  
Pediatric Concussion ◽  
History Of ◽  
Concussion History ◽  
Data Group

ObjectiveTo longitudinally evaluate the relation between family history of neurodegenerative disease and clinical symptoms, as well as vestibular-ocular and cognitive outcomes following concussion in children.BackgroundResearch indicates that pediatric concussion may lead to chronic alterations in neuropsychological health that can adversely affect neurodevelopment. Therefore, it is critical to identify risk factors that may moderate recovery to improve concussion outcomes in children. Evidence suggests that one such moderator may be a family history of neurodegenerative disease (FHND).Design/MethodsData were collected from a local pediatric concussion clinic. Patients were examined at 2- and 5-weeks post-injury. Clinical symptoms were measured using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Vestibular-ocular function was assessed using the Vestibular/Ocular Motor Screening (VOMS) tool. Cognition was measured using a modified CogState Brain Injury Test Battery. Log-transformations were applied to normalize data. Group differences between those with (n = 13) and without (n = 26) a family history of neurodegenerative disease (Alzheimer’s, Non-Alzheimer’s Dementias, Parkinson’s, and/or Multiple Sclerosis) were analyzed. Children without FHND were double-matched based on sex, age, and concussion history.ResultsAcross timepoints, children with FHND reported more severe clinical symptoms on the RPQ (p’s < 0.05). Additionally, those with FHND showed higher VOMS saccades scores across timepoints compared to those without FHND (p’s < 0.05). Further, children with FHND reported greater dizziness following VOMS saccades and convergence tests at 5-weeks post-injury (p’s < 0.01). No group differences at any timepoint were observed for any measure of cognition.ConclusionsOur findings indicate that a family history of neurodegenerative disease is associated with more severe clinical symptoms and greater vestibular-ocular dysfunction following pediatric concussion.

scholarly journals Recovery Profiles Following Concussion Among Male Athletes with a Family History of Neurodegenerative Disease: Data from the NCAA-DOD CARE Consortium

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S13.2-S14
Author(s):  
Adam Harrison ◽  
Steven Broglio ◽  
R. Davis Moore ◽  
Andrew Lapointe ◽  
Michael McCrea
Keyword(s):  
Family History ◽  
Neurodegenerative Disease ◽  
Repeated Measures ◽  
Visual Memory ◽  
Memory Performance ◽  
Return To Play ◽  
Post Injury ◽  
Male Athletes ◽  
Time Interaction ◽  
History Of

ObjectiveLongitudinally assess recovery following concussion in male athletes with fhNDD.BackgroundResearch suggests that a family history of neurodegenerative disease (fhNDD) may predispose an athlete to abnormal recovery following brain injury. However, no one has longitudinally assessed recovery following concussion in male athletes with fhNDD.Design/MethodsData from the NCAA-DOD Grand Alliance: Concussion Assessment, Research, and Education (CARE) Consortium were used to compared male athletes with (n = 51) and without (n = 102) a family history of neurodegenerative disease (Parkinson’s, Alzheimer’s, Non-Alzheimer’s Dementia, and Mild Cognitive Impairment). All athletes completed baseline ImPACT assessments prior to the beginning of their sporting season. Athletes that sustained a concussion were then re-evaluated 24-48 hours post-injury, prior to un-restricted return to play (RTP), and again 6 months post-injury. Athletes without fhNDD were double matched based on age, body mass index, sport category, and concussion history.ResultsRepeated measures ANCOVA models were used to evaluate performance at each post-injury timepoint, while controlling for baseline performance. A group × time interaction was observed for visual memory performance. Post-hoc univariate analyses revealed that male athletes with fhNDD demonstrated significantly poorer visual memory performance 24–48 hours post-injury compared to controls (p ≤ 0.005). Additionally, we found a main effect of group for impulse control, indicating that male athletes with fhNDD demonstrated an increase number of impulse errors at all three post-injury evaluations (p ≤ 0.004). We did not to observe any other group differences (p’s > 0.05).ConclusionsOur results suggest that male athletes with a family history of neurodegenerative disease may exhibit greater post-injury cognitive deficits compared to controls. Additionally, some deficits may persist for at least 6 months post-injury. Further research is warranted to investigate the interaction between family history of neurodegenerative disease and concussion.

scholarly journals The Influence of Family History of Neurodegenerative Disease on Adolescent Concussion Outcomes

2021 ◽  
Vol 10 (3) ◽  
pp. 528
Author(s):  
Colt A. Coffman ◽  
Adam T. Harrison ◽  
Jacob J. M. Kay ◽  
Jeffrey P. Holloway ◽  
Michael F. LaFountaine ◽  
...  
Keyword(s):  
Family History ◽  
Neurodegenerative Disease ◽  
Cognitive Performance ◽  
Autonomic Function ◽  
Emotional Health ◽  
Autonomic Reactivity ◽  
Isometric Handgrip ◽  
Post Injury ◽  
Significant Group ◽  
History Of

Evidence suggests that factors associated with a family history of neurodegenerative disease (fhNDD) may influence outcomes following a concussion. However, the relevance of these findings in adolescent populations has not been fully explored. Therefore, the present study sought to evaluate the relationship between fhNDD and neurological outcomes following an adolescent concussion. Data from a local pediatric concussion clinic were used to compare adolescents with (n = 22) and without (n = 44) an fhNDD. Clinical symptom burden, emotional health, cardio-autonomic function, and cognitive performance were assessed at initial (~2 weeks) and follow-up (~5 weeks) post-injury evaluations. Cardio-autonomic function was assessed at rest and during isometric handgrip contraction (IHGC). Results indicated no significant group differences in emotional health or cognitive performance. Across evaluations, those with an fhNDD exhibited greater somatic symptom severity, alterations in HRV at rest, and early blunted cardio-autonomic reactivity during IHGC compared to those without an fhNDD. These findings suggest that positive fhNDD is negatively associated with clinical symptomology and cardio-autonomic functioning following an adolescent concussion. Further, these findings encourage clinicians to utilize a comprehensive neurological evaluation to monitor concussion recovery. Future studies should look into exploring the role of specific neurodegenerative processes and conditions on concussion outcomes in adolescents.

scholarly journals Behavioural Measures of Infant Activity but Not Attention Associate with Later Preschool ADHD Traits

2021 ◽  
Vol 11 (5) ◽  
pp. 524
Author(s):  
Amy Goodwin ◽  
Alexandra Hendry ◽  
Luke Mason ◽  
Tessel Bazelmans ◽  
Jannath Begum Ali ◽  
...  
Keyword(s):  
Family History ◽  
Child Behaviour ◽  
Activity Level ◽  
Group Differences ◽  
Early Interventions ◽  
Significant Group ◽  
Assessment Protocol ◽  
History Of ◽  
Observer Ratings ◽  
Infant Attention

Mapping infant neurocognitive differences that precede later ADHD-related behaviours is critical for designing early interventions. In this study, we investigated (1) group differences in a battery of measures assessing aspects of attention and activity level in infants with and without a family history of ADHD or related conditions (ASD), and (2) longitudinal associations between the infant measures and preschool ADHD traits at 3 years. Participants (N = 151) were infants with or without an elevated likelihood for ADHD (due to a family history of ADHD and/or ASD). A multi-method assessment protocol was used to assess infant attention and activity level at 10 months of age that included behavioural, cognitive, physiological and neural measures. Preschool ADHD traits were measured at 3 years of age using the Child Behaviour Checklist (CBCL) and the Child Behaviour Questionnaire (CBQ). Across a broad range of measures, we found no significant group differences in attention or activity level at 10 months between infants with and without a family history of ADHD or ASD. However, parent and observer ratings of infant activity level at 10 months were positively associated with later preschool ADHD traits at 3 years. Observable behavioural differences in activity level (but not attention) may be apparent from infancy in children who later develop elevated preschool ADHD traits.

scholarly journals Family history of FXTAS is associated with age-related cognitive-linguistic decline among mothers with the FMR1 premutation

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Jessica Klusek ◽  
Amanda Fairchild ◽  
Carly Moser ◽  
Marsha R. Mailick ◽  
Angela John Thurman ◽  
...  
Keyword(s):  
Family History ◽  
Neurodegenerative Disease ◽  
Cognitive Skills ◽  
Fragile X ◽  
Repeat Length ◽  
Syntactic Complexity ◽  
Cgg Repeat ◽  
Age Related ◽  
Increased Risk ◽  
History Of

Abstract Background Women who carry a premutation allele of the FMR1 gene are at increased vulnerability to an array of age-related symptoms and disorders, including age-related decline in select cognitive skills. However, the risk factors for age-related decline are poorly understood, including the potential role of family history and genetic factors. In other forms of pathological aging, early decline in syntactic complexity is observed and predicts the later onset of neurodegenerative disease. To shed light on the earliest signs of degeneration, the present study characterized longitudinal changes in the syntactic complexity of women with the FMR1 premutation across midlife, and associations with family history of fragile X-associated tremor/ataxia syndrome (FXTAS) and CGG repeat length. Methods Forty-five women with the FMR1 premutation aged 35–64 years at study entry participated in 1–5 longitudinal assessments spaced approximately a year apart (130 observations total). All participants were mothers of children with confirmed fragile X syndrome. Language samples were analyzed for syntactic complexity and participants provided information on family history of FXTAS. CGG repeat length was determined via molecular genetic testing. Results Hierarchical linear models indicated that women who reported a family history of FXTAS exhibited faster age-related decline in syntactic complexity than those without a family history, with that difference emerging as the women reached their mid-50 s. CGG repeat length was not a significant predictor of age-related change. Conclusions Results suggest that women with the FMR1 premutation who have a family history of FXTAS may be at increased risk for neurodegenerative disease, as indicated by age-related loss of syntactic complexity. Thus, family history of FXTAS may represent a personalized risk factor for age-related disease. Follow-up study is needed to determine whether syntactic decline is an early indicator of FXTAS specifically, as opposed to being a more general age-related cognitive decline associated with the FMR1 premutation.

scholarly journals Examining the Relationship between Biopsychosocial History and Clinical Profiles Following Concussion

2019 ◽  
Vol 34 (5) ◽  
pp. 765-765
Author(s):  
K Emami ◽  
A M Sufrinko ◽  
M W Collins ◽  
A P Kontos ◽  
E A Rossi
Keyword(s):  
Risk Factors ◽  
Motion Sickness ◽  
Clinical Profile ◽  
Clinical Risk Factors ◽  
Post Injury ◽  
Chi Square ◽  
Clinical Risk ◽  
History Of ◽  
Concussion History ◽  
Clinical Profiles

Abstract Purpose To determine if clinical risk factors (e.g., migraine history, motion sickness, concussion history) place an individual at risk for specific clinical profiles (e.g., posttraumatic migraine, vestibular) designated by a clinician following concussion. Methods Fifty (22M; 28F) symptomatic, concussed patients (17.02±3.14 years old) were evaluated within 21days post-injury. Demographics and medical history were obtained, including history of migraine, motion sickness, ADHD, learning disability (LD), oculomotor disorder, psychiatric diagnoses, and prior concussion. The presence of each clinical profile was determined by a clinician, based on synthesis of evaluation findings, including neurocognitive testing, symptom report, and vestibular/oculomotor screening results. Chi-square analyses were used to explore associations between risk factors and clinical profile post-injury. Results Chi-square analyses found that female sex was associated with increased odds (OR=5.25,95% CI[1.55, 17.77]) of vestibular clinical profile, X2(1, n=50)=7.55, p=.006. History of concussion was associated with increased odds (OR=7.10,95%CI[1.39,35.87]) of the PTM profile (X2[1, n=50]=6.56, p=.01) and increased odds (OR=9.85,95%CI[1.00,96.67]) of anxiety/mood profile (X2 1, n=50]=5.24, p=.022. Further, history of motion sickness was associated with increased odds OR=10.2,95%CI[1.2,86.69] of the PTM profile (X2[1, n=50]=6.11, p=.013). No other relationships were found. Conclusion Some clinical risk factors were associated with post-injury clinical profiles consistent with prior literature, while others were not. For example, females were more likely to have a vestibular profile. While motion sickness was associated with PTM, history of migraine was not. Concussion history, which has inconsistent findings for re-injury outcomes, was associated with increased likelihood of PTM and anxiety/mood profiles. Findings add to the literature supporting relationships among risk factors and clinical outcomes.

Variant acute intermittent porphyria in a child

1990 ◽  
Vol 36 (5) ◽  
pp. 812-814 ◽  
Author(s):  
N R Badcock ◽  
G D Zoanetti ◽  
D A O'Reilly ◽  
E F Robertson
Keyword(s):  
Family History ◽  
Parenteral Nutrition ◽  
Enzyme Activities ◽  
Clinical Symptoms ◽  
Acute Intermittent Porphyria ◽  
Normal Activity ◽  
Porphobilinogen Deaminase ◽  
Acute Porphyria ◽  
Protoporphyrinogen Oxidase ◽  
History Of

Abstract A child who was grossly malnourished and who showed increased excretion of porphyrin and porphyrin precursor had normal activity of erythrocyte porphobilinogen deaminase (EC 4.3.1.8) and leukocyte protoporphyrinogen oxidase (EC 1.3.3.4). Clinical symptoms, coincident with the excretion of rose-colored urine, were consistent with the diagnosis of an acute porphyria. The disease resolved spontaneously after the withdrawal of carbamazepine and sodium valproate and the commencement of parenteral nutrition with subsequent carbohydrate loading. In addition to normal concentrations of enzyme activities, the patient is unusual in presenting before puberty and in having no family history of porphyria.

scholarly journals A-209 The Relationship Between Performance on the Test of Memory Malingering (TOMM) Trial 1 and Neurocognitive, Emotional, and Behavioral Functioning in a Pediatric Concussion Population

2020 ◽  
Vol 35 (6) ◽  
pp. 1004-1004
Author(s):  
Smith A ◽  
Thomas J ◽  
Friedhoff C ◽  
Chin E
Keyword(s):  
Rating Scales ◽  
Pass Rate ◽  
Prior History ◽  
Performance Validity ◽  
Post Injury ◽  
Pediatric Concussion ◽  
History Of ◽  
Concussion Recovery ◽  
Validity Tests ◽  
Performance Validity Tests

Abstract Objective In concussion populations, suboptimal effort on performance validity tests (PVTs) has been associated with poorer neuropsychological scores and greater post-concussive complaints. This study examined if performance on TOMM Trial 1 was associated with increased cognitive deficits, post-concussive symptoms, and emotional concerns in a pediatric concussion population. Method This study utilized archival data from 93 patients (mean age = 14.56, SD = 2.01) with a history of concussion who were assessed at approximately 40 days post-injury. Individuals were divided into “Pass” and “Fail” groups based on their TOMM Trial 1 performance using the established cut-off. The testing battery included Auditory Consonant Trigrams, CPT-II and III, HVLT-R, WJ-III and IV, ImPACT, BASC-2, and BRIEF. Results The overall pass rate on Trial 1 was 70% (mean = 46.04, SD = 4.55). There were no significant correlations with Trial 1 and age, grade, gender, prior history of concussion, or mechanism of injury. The Fail group scored lower across domains of attention, memory, and processing speed when compared to the Pass group (p &lt; .05), though their performances were largely average. On rating scales, more concerns were endorsed with the Fail group for attention and executive functioning relative to the Pass group (p &lt; .05), though their scores were below clinical levels. The Fail group reported more post-concussive complaints (p &lt; .05) but they did not significantly differ from the Pass group in terms of depressive symptoms, anxiety, or somatization. Conclusions This study highlights the importance of utilizing PVTs when evaluating concussion recovery in pediatric patients.

Persistent visual and vestibular impairments for Postural control following concussion

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S14.3-S15
Author(s):  
Jaclyn B. Caccese ◽  
Fernando Vanderlinde Santos ◽  
Felipe Yamaguchi ◽  
John J. Jeka
Keyword(s):  
Confidence Interval ◽  
Visual Stimulus ◽  
Group Differences ◽  
Control Group ◽  
Upright Stance ◽  
Post Injury ◽  
Sensory Reweighting ◽  
Vestibular Stimulus ◽  
Concussion History ◽  
Proprioceptive Stimulus

ObjectiveThe purpose of this study was to examine sensory reweighting for upright stance in three groups (i.e., sub-acute concussion, concussion history, control).BackgroundBalance impairments are common following concussion; however, the physiologic mechanisms underlying these impairments are not well understood.Design/methodsThere were 13 participants (8 women, 21 ± 3 years) between 2 weeks and 6 months post-injury who reported being asymptomatic at the time of testing (i.e., sub-acute concussion group), 13 participants (8 women, 21 ± 1 year) with a history of concussion (i.e., concussion history group, >1 year following concussion), and 26 participants (8 women, 22 ± 3 years) with no concussion history (i.e., control group). We assessed sensory reweighting by simultaneously perturbing participants' visual, vestibular, and proprioceptive systems. The visual stimulus was a sinusoidal translation of the visual scene at 0.2Hz, the vestibular stimulus was ±1 mA binaural monopolar galvanic vestibular stimulation (GVS) at 0.36Hz, and the proprioceptive stimulus was Achilles' tendon vibration at 0.28Hz. The visual stimulus was presented at two different amplitudes (low vision = 0.2m, high vision = 0.8m). We computed center of mass gain to each modality.ResultsThe sub-acute concussion group (95% confidence interval = 0.078-0.115, p = 0.001) and the concussion history group (95% confidence interval = 0.056-0.094, p = 0.038) had higher gains to the visual stimulus than the control group (95% confidence interval = 0.040-0.066). The sub-acute concussion group (95% confidence interval = 0.795–1.159, p = 0.002) and the concussion history group (95% confidence interval = 0.633–1.012, p = 0.018) had higher gains to the vestibular stimulus than the control group (95% confidence interval = 0.494-0.752). There were no group differences in gains to the proprioceptive stimulus and there were no group differences in sensory reweighting.ConclusionsFollowing concussion, participants responded more strongly to visual and vestibular stimuli during upright stance, suggesting they may have abnormal dependence on visual and vestibular feedback. These findings may indicate an area for targeted rehabilitation interventions.

Association of Exercise-Induced Bronchospasm with Obesity

1992 ◽  
Vol 4 (4) ◽  
pp. 351-359 ◽  
Author(s):  
Ted A. Kaplan ◽  
Mary Helen Campbell-Shaw ◽  
Gina Moccia
Keyword(s):  
Family History ◽  
Positive Result ◽  
Clinical Symptoms ◽  
Atopic Disease ◽  
Select Group ◽  
High Incidence ◽  
History Of ◽  
Total Pool ◽  
Provocation Testing ◽  
Exercise Induced

Exercise-induced bronchospasm (EIB) is present in many patients with asthma or with a family history of atopy. A review was made of exercise provocation testing performed on 37 children ages 5 to 17 years. Maximal forced expiratory maneuvers were performed before and serially every 3 minutes after a 7-min run/walk. A positive result was defined as a fall of at least 15% in FEV, or PEFR or 25% in FEF25-75 at some point within 20 min postexercise. A total of 27 out of 37 patients in this select group had positive tests (73%), with a mean fall in FEF25-75 of 31.9%. Of these 27 children with EIB, 16 had a history of atopy, 23 had clinical symptoms of EIB, and 21 were overweight. Of the 12 nonatopic children with EIB, 9 were overweight, with a mean fall in FEF25-75 of 32.1%. These 9 came from a total pool of 10 overweight, nonatopic children (90%). Being overweight was associated with a high incidence of EIB independent of a history of atopic disease.

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