scholarly journals Flying may not affect symptom recovery after concussion in Athletes

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S23.1-S23
Author(s):  
Tara Sharma ◽  
Julia Kerrigan ◽  
David McArthur ◽  
Thomas McAllister ◽  
Michael McCrea ◽  
...  
Keyword(s):  
College Athletes ◽  
Assessment Tool ◽  
Symptom Burden ◽  
Collegiate Athletes ◽  
Group Differences ◽  
Post Injury ◽  
Significant Group ◽  
Time Zones ◽  
History Of ◽  
Chi Square Analysis

ObjectiveTo determine if there is a relationship between concussion recovery and airplane travel soon after injury in collegiate athletes and military cadets.BackgroundConcussions are a common occurrence in young athletes. Very few studies have examined how flying may influence the clinical progression of a concussive injury.Design/MethodsThis is a prospective cohort study comprised of 3480 college athletes and cadets with concussion obtained from the Concussion Assessment, Research and Education (CARE) Consortium and divided in two groups: those who flew and those who did not fly after concussion. Those with unknown flight status were excluded. Demographics between groups were compared using Chi Square analysis. Symptom burden was calculated by subtracting baseline Sports Concussion Assessment Tool (SCAT3) symptom scores from the post-injury score after flying. Significance between outcome measures and flight status were evaluated using a paired t-test. Analysis of Variance (ANOVA) was used to determine if number of time zones crossed during flight influenced outcomes.Results165 athletes flew 31.8 ± 52.3 [SD] hours after injury, 2235 athletes did not fly, and 1080 had unknown flight status. There were no significant study group differences for age, sex, sport, history of prior concussion, and history of headache. No significant group differences were found in days to return to unrestricted play (p = 0.11), days after injury to start graded exertion (p = 0.50), duration of concussion symptoms (p = 0.23), days until return to normal academic performance (p = 0.75), and symptom burden (p = 0.47). Number of time zones crossed did not affect any outcomes.ConclusionsAirplane travel early after concussion did not significantly affect recovery or severity of concussion symptoms in college athletes and cadets. Further studies need to investigate the possible effects of flying more acutely after injury. These data may help guide future recommendations on flight travel after concussion in athletes.

scholarly journals Effect of Diagnosed Sleep Disorders on Baseline Concussion Symptom, Cognitive, and Balance Assessments in Collegiate Athletes

2020 ◽  
Vol 48 (4) ◽  
pp. 991-999
Author(s):  
Jamie McAllister-Deitrick ◽  
Alicia M. Trbovich ◽  
Steven P. Broglio ◽  
Michael McCrea ◽  
Thomas W. McAllister ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Student Athletes ◽  
Assessment Tool ◽  
Collegiate Athletes ◽  
Brief Symptom Inventory ◽  
Group Differences ◽  
Level Of Evidence ◽  
Significant Group ◽  
History Of

Background: Symptoms, cognition, balance, and other domains are commonly assessed at baseline testing as part of comprehensive preseason evaluations among collegiate student-athletes. Although approximately 27% of college students have at least 1 sleep disorder, researchers have yet to examine the role of a preexisting sleep disorder on preinjury baseline performance. Purpose: To compare athletes with and without a reported history of diagnosed sleep disorders on commonly used baseline concussion assessments. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 666 National Collegiate Athletic Association student-athletes completed baseline measures including the Balance Error Scoring System (BESS), Brief Symptom Inventory–18 (BSI-18), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post-Concussion Symptom Scale (PCSS), Sport Concussion Assessment Tool–5th Edition (SCAT5), and Standardized Assessment of Concussion (SAC). There were 333 athletes with a history of diagnosed sleep disorders who were matched on age, sex, sport, and concussion history to 333 athletes with no history of diagnosed sleep disorders. Participants in both groups had a mean age of 19.89 ± 1.36 years and included 182 (54.7%) male athletes, and 126 (37.8%) reported a history of ≥1 concussions. Results: A series of 1-way analyses of covariance with Bonferroni corrections revealed significant group differences on the BESS (F1,559 = 8.88; P < .01); BSI-18 somatization (F1,640 = 18.48; P < .01), depression (F1,640 = 18.78; P < .01), anxiety (F1,640 = 19.42; P < .01), and global severity index (F1,640 = 27.18; P < .01); PCSS (F1,424 = 29.42; P < .01); SCAT5 symptom number (F1,634 = 28.79; P < .01) and symptom severity (F1,634 = 31.74; P < .01); and SAC (F1,578 = 4.36; P = .037). Specifically, while the sleep disorder group did perform better on the BESS, they also reported higher symptoms on the BSI-18, PCSS, and SCAT5 and performed worse on the SAC. There were no group differences on ImPACT performance. Conclusion: Collegiate student-athletes with diagnosed sleep disorders reported elevated affective and concussion symptoms at baseline that could affect the interpretation of postinjury impairments and symptoms. Based on the small effect sizes of our findings, however, the magnitude of these differences is of questionable clinical significance. Still, clinicians should consider diagnosed sleep disorders as reported during preparticipation sports physical examinations when interpreting baseline and postinjury concussion assessments.

scholarly journals Outcomes of Multidisciplinary Care for Pediatric Post-Concussive Symptoms

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S18.1-S18
Author(s):  
Jillian O’Neil ◽  
Sean Rose ◽  
Ashley Davidson ◽  
Kathleen Shiplett ◽  
Anthony Castillo ◽  
...  
Keyword(s):  
Aerobic Exercise ◽  
Psychological Intervention ◽  
Multidisciplinary Treatment ◽  
Symptom Burden ◽  
Multidisciplinary Care ◽  
Exercise Session ◽  
Symptom Improvement ◽  
Final Visit ◽  
Post Injury ◽  
History Of

ObjectiveTo evaluate the effectiveness of a multidisciplinary treatment approach for adolescents experiencing prolonged recovery from concussion.BackgroundAlthough most youth recover from a concussion within 2–4 weeks, an estimated 14% of those injured remain symptomatic at 3 months post-injury. For those experiencing protracted recovery, the 2017 Berlin Concussion in Sport Group Consensus Statement recommends multidisciplinary collaborative care. While recent research utilizing progressive aerobic exercise among adolescents with concussion has shown promise for reduction in symptom burden, limited evidence exists for multidisciplinary care.Design/MethodsParticipants included 39 adolescents (77% female, 87% Caucasian) referred to the Nationwide Children’s Hospital Complex Concussion Clinic. All patients included had persistent (≥30 days post-injury) post-concussion symptoms (SCAT-5 symptom score ≥10). The sample ranged in age from 11-20 years (mean = 15.0, SD = 2.0) and median days since injury was 60 (range = 30–161). 31% of participants had a history of one or more previous concussions, 54% had a history of anxiety or depression, and 26% had a history of ADHD or a learning disorder. The multidisciplinary treatment included sessions with Neurology (mean number of sessions = 2.5), Neuropsychology (mean = 2.1), Physical Therapy (mean = 3.6), and Athletic Training sessions involving graded physical exercise (mean = 4.0), with an average treatment duration of 57.4 days. SCAT-5 symptom rating scales were completed at each visit.ResultsSymptom burden among participants significantly decreased between their initial visit (mean = 49.6, SD = 19.2) and final exercise session (mean = 12.8, SD = 14.1); p < 0.001. Gender did not predict symptom ratings at treatment onset, though males (mean = 5.6) had significantly lower symptom scores than females (mean = 15.0) at their final visit (p < 0.05). Demographic factors and premorbid psychological history did not predict rate of symptom improvement.ConclusionsHigh rates of premorbid psychological problems are evident in children referred for treatment of PCS. Multidisciplinary care involving graded aerobic exercise and psychological intervention shows promise, though specific factors associated with treatment response remain to be elucidated.

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 How Accurate are Concussed College Athlete’s Self-reported Balance Problems?

2019 ◽  
Vol 34 (5) ◽  
pp. 793-793
Author(s):  
A DaCosta ◽  
M Fasciana ◽  
A Crane ◽  
A LoGalbo
Keyword(s):  
Assessment Tool ◽  
Collegiate Athletes ◽  
Self Report ◽  
Balance Performance ◽  
Post Injury ◽  
Sports Concussion ◽  
Baseline Testing ◽  
Balance Problems ◽  
Balance Error

Abstract Purpose The Balance Error Scoring System (BESS) has been determined to be a reliable and valid measure of balance performance (Bell et al., 2011). Previous research indicates self-reported balance difficulties and postural stability are positively correlated (Broglio et al., 2009). Furthermore, athletes exhibit an increase in errors on the BESS following a concussion (McCrea et al., 2004). Methods 68 collegiate athletes (age 18-23; M=19.62, SD=1.44) received baseline, post-concussion, and follow-up evaluations. Balance performance was measured via the BESS on the Sports Concussion Assessment Tool-5th edition (SCAT5), while symptom reporting was measured by the SCAT5 and ImPACT neurocognitive testing. Results Multiple simple linear regressions were conducted, suggesting that changes in BESS performance from baseline to post-trauma significantly predicted self-report of “balance problems” at post-trauma on ImPACT (F(1, 66)=11.94, p=.001; R2=.15) and SCAT5 (F(1, 66)=5.73, p=.02; R2=.08). While baseline BESS errors were significantly correlated with post-trauma BESS errors (r=.29, p=.02), BESS errors at post-trauma did not significantly predict self-reporting of balance problems on either assessment. Conclusion Results suggest that self-reported balance difficulties following a concussion are an indicator of change in intraindividual balance performance, but not post-trauma balance performance alone. Furthermore, it provides clinical context as the individuals’ perception of change may be greater, impacting the likelihood of self-reporting of balance problems at post-trauma. These results support the clinical utility of examining pre- and post-injury changes in balance by including balance measurements in pre-participation baseline testing.

scholarly journals Y-Balance test asymmetry is greater in collegiate athletes with a history of concussion

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S26.1-S26
Author(s):  
Hoch Matthew ◽  
Curry Nicole ◽  
Hartley-Gabriel Emily ◽  
Heebner Nicholas ◽  
Hoch Johanna
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Collegiate Athletes ◽  
Lower Extremity Injury ◽  
Absolute Difference ◽  
Group Differences ◽  
Extremity Injury ◽  
Balance Test ◽  
Increased Risk ◽  
History Of

Athletes with a history of concussion (HC) are at an increased risk of sustaining lower extremity injuries. It is unclear if these individuals exhibit dynamic postural control deficits associated with lower extremity injury risk. The purpose of this study was to determine if collegiate athletes with a HC demonstrate differences in Y-Balance Test (YBT) performance compared to athletes with no history of concussion (NHC). A total of 116 varsity and club athletes from a Division-I university participated. Forty participants reported a HC (female/male: 31/9, age: 20.0 ± 1.4 years, height: 169.3 ± 13.1 cm, mass: 68.4 ± 14.0 kg) while 76 reported NHC (female/male: 60/16, age: 20.0 ± 1.7 years, height: 168.5 ± 12.9 cm, mass: 68.7 ± 14.6 kg). Individuals with a current concussion or lower extremity injury, or a history of lower extremity surgery were excluded. Participants completed the YBT anterior reach direction barefoot on both limbs. The YBT was completed by maximally reaching anteriorly, maintaining balance, and returning to the starting position without errors. Participants completed 4 practice trials and 3 test trials. Reach distances were averaged and normalized to leg length. Between-limb asymmetry was calculated as the absolute difference between the left and right limbs. Separate independent t-tests examined group differences in normalized reach distances and asymmetry. The proportion of participants in each group with >4 cm of asymmetry was compared using a χ2 test. Alpha was set at 0.05 for all analyses. No group differences were identified in normalized reach distances for the left (HC: 61.4% ± 9.2%, NHC: 60.8% ± 6.2%, p = 0.88, ES = 0.08) or right (HC: 61.4% ± 6.2%, NHC: 60.2% ± 6.8%, p = 0.51, ES = 0.17) limbs. However, a greater proportion of HC participants demonstrated >4 cm asymmetry (HC: 40.0%, NHC: 19.7%; p = 0.02) and these participants exhibited greater asymmetry (HC: 3.87 ± 3.69 cm, NHC: 2.40 ± 2.13 cm, p = 0.03; ES = 0.53). Athletes with a HC exhibited greater asymmetry compared to athletes with NHC. Anterior reach asymmetries of >4 cm are associated with greater lower extremity injury risk. The YBT may provide a clinical technique to further explore the relationship between concussion and lower extremity injury.

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 Peripheral blood neuroendocrine hormones are associated with clinical indices of sport-related concussion

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alex P. Di Battista ◽  
Shawn G. Rhind ◽  
Nathan Churchill ◽  
Doug Richards ◽  
David W. Lawrence ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Solid Phase ◽  
Negative Relationship ◽  
Symptom Burden ◽  
Dehydroepiandrosterone Sulfate ◽  
Initial Symptom ◽  
Post Injury ◽  
Medical Clearance ◽  
Sport Teams ◽  
The Relationship

AbstractThe purpose of this study was to evaluate the relationship between neuroendocrine hormones and clinical recovery following sport-related concussion (SRC). Ninety-five athletes (n = 56 male, n = 39 female) from a cohort of 11 interuniversity sport teams at a single institution provided blood samples; twenty six athletes with SRC were recruited 2–7 days post-injury, and 69 uninjured athletes recruited prior to the start of their competitive season. Concentrations of seven neuroendocrine hormones were quantitated in either plasma or serum by solid-phase chemiluminescent immunoassay. The Sport Concussion Assessment Tool version 5 (SCAT-5) was used to evaluate symptoms at the time of blood sampling in all athletes. Multivariate partial least squares (PLS) analyses were used to evaluate the relationship between blood hormone concentrations and both (1) time to physician medical clearance and (2) initial symptom burden. A negative relationship was observed between time to medical clearance and both dehydroepiandrosterone sulfate (DHEA-S) and progesterone; a positive relationship was found between time to medical clearance and prolactin. Cognitive, somatic, fatigue and emotion symptom clusters were associated with distinct neuroendocrine signatures. Perturbations to the neuroendocrine system in athletes following SRC may contribute to initial symptom burden and longer recovery times.

An Examination of Feedback Seeking in Individuals With Social Anxiety Disorder, Generalized Anxiety Disorder, or No History of Mental Disorder Using a Daily Diary Method

2018 ◽  
Vol 32 (1) ◽  
pp. 15-37 ◽  
Author(s):  
Gillian A. Wilson ◽  
Naomi Koerner ◽  
Martin M. Antony
Keyword(s):  
Anxiety Disorder ◽  
Daily Diary ◽  
Group Differences ◽  
Generalized Anxiety ◽  
Feedback Seeking ◽  
Significant Group ◽  
Diary Data ◽  
Diary Method ◽  
History Of ◽  
Daily Diary Method

This study examined excessive reassurance seeking (or positive feedback seeking; PFS) and negative feedback seeking (NFS) in individuals with social anxiety disorder (SAD), generalized anxiety disorder (GAD), or no history of mental health difficulties. A 2-week daily diary method was used to examine potential group differences in the frequency, topics, and targets of PFS and NFS. The SAD and GAD groups reported significantly higher feedback seeking (FS) than the healthy group on self-report questionnaires. The most common targets of FS in each group were other people (e.g., romantic partner, family members). According to diary data, there were no significant group differences in the frequency of PFS, NFS, overall FS, or overall FS adjusted for self-reported compliance with diary completion (after applying Bonferroni correction). There were also no significant group differences in FS topics according to diary data. Future research directions and potential implications of these findings are discussed.

Interactions among Variables in the P300 Response to a Continuous Performance Task in Normal and ADHD Adults

2004 ◽  
Vol 15 (10) ◽  
pp. 666-677 ◽  
Author(s):  
David L. McPherson ◽  
Mimi T. Salamat
Keyword(s):  
Event Related Potential ◽  
Group Differences ◽  
False Alarms ◽  
Continuous Performance Task ◽  
Significant Group ◽  
Hyperactivity Disorder ◽  
Number Of False Alarms ◽  
Auditory P300 ◽  
History Of ◽  
The Common

This study investigated the effect of variable interstimulus intervals (ISIs) in a group of normal and ADHD (attention deficit hyperactivity disorder) adults on behavioral reaction time and the auditory P300 event-related potential. This study involved 20 adult subjects with no history of ADHD and 11 adult subjects diagnosed with ADHD. The subjects were instructed to respond to the common stimuli and ignore the rare stimulus. Significant differences in the latency of the P300a, P300b, the amplitude of the P300b, and in the number of false alarms and correct rejections between ISIs were observed in the normal group. The group with ADHD failed to show any significant differences between ISIs. Psychophysical measures of hits showed significant differences for the number of hits for ISI 2 (2 sec) between the two groups. False alarms and correct rejections for all ISIs showed significant differences between groups. Significant group differences were seen for latency of the P300a and P300b at each of the three ISIs, for amplitude of the P300a and P300b for ISI 1 and ISI 3, and for the amplitude of the P300b for ISI 2. There was a greater separation in the group with ADHD between the P300a and P300b suggesting a processing lag in that group.

scholarly journals Acute and Chronic Effects of Multiple Concussions on Midline Brain Structures

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012580
Author(s):  
Nathan W Churchill ◽  
Michael G Hutchison ◽  
Simon J Graham ◽  
Tom A Schweizer
Keyword(s):  
Assessment Tool ◽  
Mean Diffusivity ◽  
Brain Structures ◽  
Return To Play ◽  
Post Injury ◽  
Chronic Effects ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
One Year ◽  
Mri Study

Objective:To test the hypothesis that a history of concussion (HOC) causes greater disturbances in cerebral blood flow (CBF) and white matter microstructure of midline brain structures after subsequent concussions, during the acute and chronic phases of recovery.Methods:In this longitudinal magnetic resonance imaging (MRI) study, 61 athletes with uncomplicated concussion (36 with HOC) were imaged at the acute phase of injury (1 to 7 days post-injury), the subacute phase (8 to 14 days), medical clearance to return to play (RTP), one month post-RTP and one year post-RTP. A normative group of 167 controls (73 with HOC) were also imaged. Each session assessed CBF of the cingulate cortex, along with fractional anisotropy (FA) and mean diffusivity (MD) of the corpus callosum. Linear mixed models tested for interactions of HOC with time post-injury. The sport concussion assessment tool (SCAT) was also used to evaluate effects of HOC on symptoms, cognition and balance.Results:Athletes with HOC had greater declines in midcingulate CBF subacutely (z=-3.29, p=0.002) and greater declines in posterior cingulate CBF at one year post-RTP (z=-2.42, p=0.007). No significant effects of HOC were seen for FA, whereas athletes with HOC had higher MD of the splenium at RTP (z=2.54, p=0.008). These effects were seen in the absence of differences in SCAT domains (|z|<1.14, p>0.256) or time to RTP (z=0.23, p=0.818).Conclusions:Results indicate subacute and chronic effects of HOC on cingulate CBF and callosal microstructure, in the absence of differences in clinical indices. These findings provide new insights into physiological brain recovery after concussion, with cumulative effects of repeated injury detected among young, healthy athletes.

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