Name: a neuroscientific approach to the examination of concussions in student-athletes
Uploaded: 2014-12-08T14:00:00.000+00:00
Duration: 11 min 32 s
Description: Watch this Scientific Journal Video about A Neuroscientific Approach to the Examination of Concussions in Student-Athletes at JoVE.com

This study was supported by grants from the American Medical Society for Sports Medicine. The authors would like to acknowledge and show our appreciation for our undergraduate research students including David Lawton, Drew Gardner, Mark Sundman, Kelsey Evans, Graham Cochrane, Jordan Cottle and Jack Halligan for their assistance in data collection over the past four years.

下面描述的所有程序已经批准伊隆的机构审查委员会。 1.电脑神经认知测试<ol><li>要求参与者在电脑前坐下。登录到系统的参与者和指导他们完成电脑神经心理测试，由人口和背景信息部分，自报症状自评量表，以及6个模块（字歧视，设计内存，X和O的，符号匹配，色彩搭配，以及三个字母）。 </li><li>下载总结报告，并进入四复合分数言语记忆，视觉记忆，反应时间和电机的处理速度。 </li></ol> 2.事件相关电位<ol><li>测量头围使用卷尺，以确定要使用的脑电图净的大小。通过测量解剖标志确定EEG网布局。 </li><li>浸泡EEG网等lution氯化钠和婴儿洗发水5分钟。 </li><li>将EEG网对参与者的头上。我们使用的系统包括32个频道。 </li><li>检查电脑上的网站阻抗水平。对于我们的系统，低于100欧姆的阻抗被认为是可以接受的。 </li><li>解释认知任务，让参与者练习每一个任务。 <ol><li>听觉穿着或行为古怪任务:指示参与者戴上耳机，坐在舒适的桌子。告诉他们，他们会听到一连串的低音和高音，并通过点击一个按钮，高频听觉语气快速而准确地做出反应。 </li><li>侧卫任务:指导参与者坐在电脑屏幕前，他们将获得一系列的箭头投射到屏幕上的。指导参与者通过点击鼠标左键，如果它是指向左边或单击如果它是指向钻机鼠标右键来应对中间箭头方向HT迅速和准确地。 </li></ol></li><li>指导学员完成这两个听觉古怪的任务和侧卫任务两项试验。 </li><li>去除EEG净额参与者和浸泡在消毒液杀菌10分钟清洁EEG网。 </li></ol> 3.体感知觉回应<ol><li>舒适座位参与者的人用左手以俯卧位休息感官刺激的设备上和他们的手指沿着装置具有放置成与刺激探针接触位数2和3的衬垫尖端的轮廓位置23 </li><li>请参与者查看计算机显示器上的任务相关的说明和提示，并采用两键鼠标进入应答。项目5个不同的测试:2简单单活性中心反应时间的任务，一个双位点幅度鉴别，24与单个站点适配刺激，24和一个双位点振幅任务一时间顺序判断的任务。25 </li><li>前每个测试运行开始时，在计算机上的线索将指示参与者完成练习试验，以与任务熟习。电脑会给出每个测试后，学员表现的意见（ 如正确的，不正确的）。 </li></ol> 4.平衡协议<ol><li>指导参与者穿上防滑袜，然后站在平衡系统上，成为熟悉的工具。 </li><li>指示参与者站立在一个舒适的位置，与屏幕上的中央点相匹配的压力点的中心。研究人员记录下这舒适的起始位置，这样所有的测试发生在同一只脚的位置，而站在设备上。 </li><li>请参与者静置30秒，每四个条件（睁眼/坚硬的表面，闭着眼睛/坚硬的表面，睁眼/泡沫表面，闭眼/泡沫表面）。提供参与者每个条件和每个记录开始前3秒倒计时之间的10秒休息。 </li><li>同时完成次要任务重复各条件。指导他们向后7开始从给他们（ 例如 843）随机3位数字计算。 </li><li>记录一个摇摆指数得分，摇摆的每个条件和压力数据中心后用于进一步分析的量的标准偏差的量度。 </li></ol> 5.步态评估<ol><li> &#39;使用便携式15步态&#39;长地毯仪表步态分析系统在整个地毯的长度存在来检测参与者的脚步声的压力传感器评估的参与者。 </li><li>要求参与者在整个垫赤脚走在一个舒适的速度五倍离开垫后"垫子和3开始前&#39;的距离为3起。 </li><li>指示PARTICIPANTS完成五个附加步行试验，而从随机3位数字倒数七的并发认知双重任务。 </li><li>获得从步态分析输出的因变量包括几个时空参数，如速度，节奏和步长绝对值和变化的措施。 </li></ol> 6.遗传学<ol><li>请参与者谨慎从无菌容器中取出棉签棒（小心只触摸棉签棒的棒结束），将拭子放入嘴里，大力搓拭双颊内总共20秒。 </li><li>手棉签粘谁是戴乳胶或丁腈手套的技师。仅握住棒端，然后将拭子末端放入无菌1.7毫升管（标记有唯一的识别号码），它被立即置于冰上。 </li><li>在24小时内转移样品到-20℃的冰箱中。 </li><li> DNA提取使用根据制造商的协议的标准的DNA纯化试剂盒。为了获得更浓缩的样品，萃取后，执行一个异丙醇沉淀步骤和在20μl的EDTA缓冲液（pH 8.0）中再水化的DNA。 </li><li>储存在-80℃下提取的DNA，直至使用标准聚合酶链反应（PCR）测定用荧光标记的基因分型分析。 </li><li> "呼"的基因型PCR软件，然后通过观察PCR扩增曲线手动验证。 </li></ol>

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The authors declare that they have no competing financial interests.

这种多层面的方式来基准测试震荡的目标是双重的:1），以更好地了解神经肌肉系统的脑震荡（急性和长期）的影响; 2）帮助运动医学人员对回波发挥决定（他们主要使用神经认知测试，已建议由麦克罗伊）。26这个多面的方法来评价震荡提供相关的病因，功能的变化，并从震荡恢复有价值的信息。很少了解有关脑震荡的系统的综合影响，作为一个整体，该协议允许从多个学科的科学家不?...

脑震荡是发生在美国惊人的速度，并囊括了不少关注的公共健康问题。1-3美国疾病控制和预防中心（CDC）的估计，1.6至380万的脑震荡发生在体育和娱乐活动每年，由2013年的震荡共识声明2定义4,5震荡"可能造成或者通过直接打击对身体的头部，面部，颈部或其他与传送到头上的&#39;冲动&#39;的力量。"震荡可能导致神经病理学和/或子结构的变化可能会导致功能障碍的。2，这些缺陷可能会持续数周。这种情况并不少见。运动员遇到增加自我报告的症状，递减在姿势控制，降低神经认知功能甚至后14天的初始损伤6症状的长期性质，在一致的鉴定脑震荡，并在受伤前的能力的可变性常常导致复杂的和非标准化的返回到播放决定由医师，不确定的恢复时间，并有可能长期后遗症。7-9 经过震荡，个人可能会遇到的短期和长期影响。运动相关的脑震荡短期影响可能包括改变播放能力，思维混乱，记忆障碍，意识丧失，反应时间慢，协调，头痛，头晕，呕吐的丧失，睡眠方式的改变和情绪变化。这些症状通常解决天的事。2,10然而，尽管一些人从一个单一的脑震荡中恢复相当快，很多经验挥之不去的影响，可以持续数周或数月后的伤害。10,11,12这些症状的扰动日常功能可以通过认知和性能与量化ð测试。虽然没有一个单一的测试应该确定脑震荡，测试电池的诊断和测试之间的已知关系可以做出诊断帮助医务人员，回到教室，并返回到播放的决定。2 有一个在个人的风险冲击及其相应的恢复很大差异。11〜震荡易感性和恢复时间课程相关的因素没有得到很好的已知或理解的。几个因素已经提出了可能影响个体的震荡易感性和恢复。这些因素包括个体的震荡历史，初始损伤的严重程度，偏头痛史，学习障碍的病史，精神病合并症的历史，以及可能的遗传因素。7，第9，第13，14 许多研究已经调查了单独的具体因素对两者的短期和长期影响脑震荡，恢复时间当然和遗传学作为脑震荡的一个因素。4,8,15-17什么还没有明确规定是一种有效的多方面的方法来评价震荡，将产生相关的病因，功能改变有价值的信息，并恢复从脑震荡。由于各种症状和恢复的不确定当然，从多方面震荡的评价是必要的，这应该包括所有的运动员在参赛前的练习和比赛基准测试以及及时评估后受伤。最近的审查表明，神经认知评估可能是从震荡比单独监控症状更加敏感复苏。18这可能是有其他目的的措施，可能是从震荡复苏的更好的指标。 此协议中，我们使用几个任务，以评估该系统的各种部件，看看它们是如何影响B雅震荡。计算机化的神经认知测试可以评估的内存，处理速度快，解决问题的能力，认知效率和冲动控制。6 EEG与听觉和视觉处理任务，可以使用通过事件相关电位的检查，以评估neuroefficiency。19将体感识别任务可以用于评估外周和中枢感觉处理能力。20余额和步态措施可以用来评估功能表现能力。6,21此外，我们评估，可能有关系到震荡历史，震荡恢复和认知功能的各种基因型。22，我们在这组测试基准测试我们校队的学生运动员，重复测试，如果他们收取震荡时无症状。 本项目的目的是利用基因，neuroc评估性能震荡的结果潜在的短期和长期的递减ognitive，电生理，行为，体感，平衡和步态的措施。了解这可能与脑震荡发生在推动我们对震荡的知识很重要的各种症状和损伤的潜在机制。这些变化可能在震荡诊断未来援助大knowledgle以及脑震荡的管理，因为它涉及到回到赛场，回到学术界。 下面描述的所有措施都采取了在基准（前体育学生运动员参与）。我们目前的协议来完成电脑的神经认知测试在48小时伴随着平衡的协议，因为我们相信这些提供关于恢复和可能返回到播放，并返回到学者的有用信息。当学生运动员报告无症状，他们再次返回到除了基因检测再次进行的所有基本措施，实验室。完整的协议，BASELINE和无症状，大约需要90分钟才能完成一个测试阶段。

<table><tbody><tr><td>ImPACT</td><td>ImPACT, Pittsburgh, PA</td><td></td><td>Neurocognitive concussion testing</td></tr><tr><td>EEG</td><td>EGI, Eugene, OR</td><td></td><td>EEG 32-channel system</td></tr><tr><td>Stim2</td><td>Compumedics Neuroscan, Charlotte, NC</td><td></td><td>Software for task presentation for flanker task and auditory oddball</td></tr><tr><td>NetStation</td><td>EGI, Eugene, OR</td><td></td><td>Software for data collection and analysis of EEG</td></tr><tr><td>Sensory Device</td><td>Cortical Metrics</td><td></td><td>Sensory testing</td></tr><tr><td>Balance System SD</td><td>Biodex Medical Systems, Inc., Shirley, NY</td><td></td><td>balance testing</td></tr><tr><td>GAITRite&amp;nbsp;</td><td>CIR systems, Inc., Sparta, NJ, USA</td><td></td><td>Gait analysis</td></tr><tr><td>PCR</td><td>Applied Biosystems, Foster City, CA</td><td></td><td>Genetic Analysis</td></tr><tr><td>Matlab</td><td>Mathworks, Natick, MA, USA</td><td></td><td>Gait and balance analysis</td></tr></tbody></table>

a neuroscientific approach to the examination of concussions in student-athletes

脑震荡是发生在美国惊人的速度，已经成为一个严​​重的公共卫生问题。疾病预防控制中心估计，1.6至380万，每年脑震荡发生在体育和娱乐活动。震荡的2013震荡共识声明定义为"可能造成或者通过直接打击头部，面部，颈部或身体其他部位有传送到头上的&#39;冲动&#39;的力量。"脑震荡留下个人提供短期和长期影响。运动相关的脑震荡短期影响可能包括改变播放能力，思维混乱，记忆障碍，意识丧失，反应时间慢，协调，头痛，头晕，呕吐的丧失，睡眠方式的改变和情绪变化。这些症状通常解决天的事。然而，尽管一些人从一个单一的震荡而迅速恢复，许多经验挥之不去的影响，可以持续数周或数月。该因素相关的震荡易感性和随后的恢复时间是不为人所熟知或理解，在这个时候。几个因素已经提出，它们包括个人的历史震荡，初始损伤的严重程度，偏头痛史，学习障碍的病史，精神病合并症的历史，以及可能的话，遗传因素。许多研究都单独调查某些因素均震荡，恢复时间当然，易感性和复苏的短期和长期影响。什么还没有明确规定是一种有效的多方面的方法来评价震荡，将产生相关的病因，功能改变和恢复有价值的信息。这份手稿的目的是要表明这样一个多层面的接触使用电脑的神经认知测试，事件相关电位，体感知觉反应会检查脑震荡，平衡驴sment，步态评估和基因检测。

计算机化神经认知测试 结果计算机化神经认知测试的一个例子可以看出，在图1中的计算机程序引发综合得分上言语记忆，视觉记忆，可视电动机速度和其经常被用来使返回到播放并返回到反应时间-learn震荡的管理协议。在语言和视觉记忆力的复合材料评估注意过程，学习和记忆。视觉电机速度的措施视觉处理，学习记忆和视觉运动反应速度（影响?...

Watch this Scientific Journal Video about A Neuroscientific Approach to the Examination of Concussions in Student-Athletes at JoVE.com

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

有一个在个人的风险冲击及其相应的恢复极大的可变性。从多方面入手，以震荡评价是必要的;包括运动员参与体育运动，及时的评估后受伤之前的基准测试。此协议的目的是提供一个合适的多方面的方法来检查脑震荡。

一个神经科学方法脑震荡的学生运动员的考试

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 ...

a-neuroscientific-approach-to-examination-concussions-student

Research

JoVE Journal

Medicine

12.7K 次观看.  Elon University. 有一个在个人的风险冲击及其相应的恢复极大的可变性。从多方面入手，以震荡评价是必要的;包括运动员参与体育运动，及时的评估后受伤之前的基准测试。此协议的目的是提供一个合适的多方面的方法来检查脑震荡。 

视频: A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth involved in organized sports such as competitive hockey are nearly six times more likely to suffer a severe concussion compared to children involved in other leisure physical activities2. While the most common cognitive sequelae of mTBI appear similar for children and adults, the recovery profile and breadth of consequences in children remains largely unknown2, as does the influence of pre-injury characteristics (e.g. gender) and injury details (e.g. magnitude and direction of impact) on long-term outcomes. Competitive sports, such as hockey, allow the rare opportunity to utilize a pre-post design to obtain pre-injury data before concussion occurs on youth characteristics and functioning and to relate this to outcome following injury. Our primary goals are to refine pediatric concussion diagnosis and management based on research evidence that is specific to children and youth. To do this we use new, multi-modal and integrative approaches that will:
 1.Evaluate the immediate effects of head trauma in youth 
2.Monitor the resolution of post-concussion symptoms (PCS) and cognitive performance during recovery 
3.Utilize new methods to verify brain injury and recovery
To achieve our goals, we have implemented the Head Impact Telemetry (HIT) System. (Simbex; Lebanon, NH, USA). This system equips commercially available Easton S9 hockey helmets (Easton-Bell Sports; Van Nuys, CA, USA) with single-axis accelerometers designed to measure real-time head accelerations during contact sport participation 3 - 5. By using telemetric technology, the magnitude of acceleration and location of all head impacts during sport participation can be objectively detected and recorded. We also use functional magnetic resonance imaging (fMRI) to localize and assess changes in neural activity specifically in the medial temporal and frontal lobes during the performance of cognitive tasks, since those are the cerebral regions most sensitive to concussive head injury 6. Finally, we are acquiring structural imaging data sensitive to damage in brain white matter.

This article provides an overview of a multi-modal approach to mild traumatic brain injury diagnosis and recovery in youth. This approach combines neuropsychological testing with functional magnetic resonance imaging and the Head Impact Telemetry System to monitor the relationship between head impacts and brain activity during cognitive testing.

在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth ...

科研

医学

Bronchial Thermoplasty:  A Novel Therapeutic Approach to Severe Asthma

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled manner to reduce excessive airway smooth muscle. Reducing airway smooth muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks. Bronchial thermoplasty is delivered by the Alair System and is performed in three outpatient procedure visits, each scheduled approximately three weeks apart. The first procedure treats the airways of the right lower lobe, the second treats the airways of the left lower lobe and the third and final procedure treats the airways in both upper lobes. After all three procedures are performed the bronchial thermoplasty treatment is complete.
Bronchial thermoplasty is performed during bronchoscopy with the patient under moderate sedation. All accessible airways distal to the mainstem bronchi between 3 and 10 mm in diameter, with the exception of the right middle lobe, are treated under bronchoscopic visualization. Contiguous and non-overlapping activations of the device are used, moving from distal to proximal along the length of the airway, and systematically from airway to airway as described previously. Although conceptually straightforward, the actual execution of bronchial thermoplasty is quite intricate and procedural duration for the treatment of a single lobe is often substantially longer than encountered during routine bronchoscopy. As such, bronchial thermoplasty should be considered a complex interventional bronchoscopy and is intended for the experienced bronchoscopist. Optimal patient management is critical in any such complex and longer duration bronchoscopic procedure. This article discusses the importance of careful patient selection, patient preparation, patient management, procedure duration, postoperative care and follow-up to ensure that bronchial thermoplasty is performed safely.
Bronchial thermoplasty is expected to complement asthma maintenance medications by providing long-lasting asthma control and improving asthma-related quality of life of patients with severe asthma. In addition, bronchial thermoplasty has been demonstrated to reduce severe exacerbations (asthma attacks) emergency rooms visits for respiratory symptoms, and time lost from work, school and other daily activities due to asthma.

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled manner to reduce excessive airway smooth muscle. Reducing airway smooth muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks.

支气管Thermoplasty：严重哮喘的一种新的治疗方法

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled ...

A Strategy to Identify de Novo Mutations in Common Disorders such as Autism and Schizophrenia

There are several lines of evidence supporting the role of de novo mutations as a mechanism for common disorders, such as autism and schizophrenia. First, the de novo mutation rate in humans is relatively high, so new mutations are generated at a high frequency in the population. However, de novo mutations have not been reported in most common diseases. Mutations in genes leading to severe diseases where there is a strong negative selection against the phenotype, such as lethality in embryonic stages or reduced reproductive fitness, will not be transmitted to multiple family members, and therefore will not be detected by linkage gene mapping or association studies. The observation of very high concordance in monozygotic twins and very low concordance in dizygotic twins also strongly supports the hypothesis that a significant fraction of cases may result from new mutations. Such is the case for diseases such as autism and schizophrenia. Second, despite reduced reproductive fitness1 and extremely variable environmental factors, the incidence of some diseases is maintained worldwide at a relatively high and constant rate. This is the case for autism and schizophrenia, with an incidence of approximately 1% worldwide. Mutational load can be thought of as a balance between selection for or against a deleterious mutation and its production by de novo mutation. Lower rates of reproduction constitute a negative selection factor that should reduce the number of mutant alleles in the population, ultimately leading to decreased disease prevalence. These selective pressures tend to be of different intensity in different environments. Nonetheless, these severe mental disorders have been maintained at a constant relatively high prevalence in the worldwide population across a wide range of cultures and countries despite a strong negative selection against them2. This is not what one would predict in diseases with reduced reproductive fitness, unless there was a high new mutation rate. Finally, the effects of paternal age: there is a significantly increased risk of the disease with increasing paternal age, which could result from the age related increase in paternal de novo mutations. This is the case for autism and schizophrenia3. The male-to-female ratio of mutation rate is estimated at about 4&#x2013;6:1, presumably due to a higher number of germ-cell divisions with age in males. Therefore, one would predict that de novo mutations would more frequently come from males, particularly older males4. A high rate of new mutations may in part explain why genetic studies have so far failed to identify many genes predisposing to complexes diseases genes, such as autism and schizophrenia, and why diseases have been identified for a mere 3% of genes in the human genome. Identification for de novo mutations as a cause of a disease requires a targeted molecular approach, which includes studying parents and affected subjects. The process for determining if the genetic basis of a disease may result in part from de novo mutations and the molecular approach to establish this link will be illustrated, using autism and schizophrenia as examples.

Molecular genetic strategy for finding de novo mutations causing common disorders such as autism and schizophrenia.

一项战略，以确定在常见的疾病，如自闭症和精神分裂症的新突变

There are several lines of evidence supporting the role of de novo mutations as a mechanism for common disorders, such as autism and schizophrenia. First, ...

In Vivo Protocol of Controlled Subconcussive Head Impacts for the Validation of Field Study Data

Subconcussive hits pose a threat to neuronal health as they have shown to induce neuronal structural damage and functional impairment without causing outward symptomology and appear to be a key contributor to an irreversible neurodegenerative disease, chronic traumatic encephalopathy (CTE). In addition, athletes can incur more than 1,000 of these hits per season. The subconcussive soccer heading model (SSHM) is a relevant, reproducible, and leading method of isolating and examining the effects of these subconcussive head impacts. By controlling variables such as ball traveling speed, the frequency of impacts, interval, ball placement to the head, as well as by measuring head impact magnitude, the SSHM provides the scientific community with a superior avenue of investigating the acute subconcussive effects on neuronal health. In this paper, we demonstrate the utility of SSHM in studying a time-course expression of neurofilament-light polypeptide (NF-L) in plasma in a repeated measures fashion. NF-L is an axonal injury marker that has previously been shown to be elevated in boxers and football players following subconcussive head trauma. Thirty-four adult aged soccer players were recruited and randomly assigned to either a soccer heading (n = 18) or kicking (n = 16) group. The heading group executed 10 headers with soccer balls projected at a velocity of 25 mph over 10 min. The kicking group followed the same protocol with 10 kicks. Plasma samples were obtained before and at 0 h, 2 h, and 24 h after heading/kicking and assessed for NF-L expressions. The heading group showed a gradual increase in plasma NF-L expression and peaked at 24 h after the heading protocol, whereas the kicking group remained consistent across the time points. These results confirmed the NF-L data from clinical field studies, encouraging the use of SSHM to validate clinical subconcussion data.

The subconcussive soccer heading model is a safe and concise methodological approach to isolate and measure the effects of subconcussive head impacts.

控制下冲击头冲击的活体协议对现场研究数据的验证

Subconcussive hits pose a threat to neuronal health as they have shown to induce neuronal structural damage and functional impairment without causing ...

行为学

Revised and Neuroimaging-Compatible Versions of the Dual Task Screen

Dual task paradigms simultaneously assess motor and cognitive abilities, and they can detect subtle, residual impairments in athletes with recent mild traumatic brain injury (mTBI). However, past dual task paradigms have focused solely on lower extremity skills and have relied on cumbersome, expensive laboratory equipment - thus limiting their practicality for everyday mTBI evaluation. Subsequently, we developed the Dual Task Screen (DTS), which takes &#60;10 minutes to administer and score, uses low-cost portable equipment, and includes lower extremity (LE) and upper extremity (UE) subtasks. The purpose of this manuscript was twofold. First, we describe the administration protocol for the revised DTS, which we revised to address the limitations of the original DTS. Specifically, the revisions included additions of smart devices to acquire more detailed gait data and inclusion of single cognitive conditions to test for disrupted cognitive performance under dual task conditions. Importantly, the revised DTS is a measure intended for future clinical use, and we present representative results from three male athletes to illustrate the type of clinical data that can be acquired from the measure. Importantly, we have yet to evaluate the sensitivity and specificity of the revised DTS in athletes with mTBI, which is the next research initiative. The second purpose of this manuscript is to describe a neuroimaging-compatible version of the DTS. We developed this version so we could evaluate the neural underpinnings of single and dual task performance, for a better empirical understanding of the behavioral deficits associated with mTBI. Thus, this manuscript also describes the steps we took to enable simultaneous functional near-infrared spectroscopy (fNIRS) measurement during the DTS, along with how we acquired and completed first-level processing of the fNIRS data.

We developed the original Dual Task Screen (DTS) as a portable, low-cost measure that can evaluate athletes with sports-induced mild traumatic brain injury. We revised the original DTS for future clinical use and developed a neuroimaging-compatible version of the DTS to measure neural underpinnings of single and dual task performance.

双任务屏幕的修订和神经成像兼容版本

Dual task paradigms simultaneously assess motor and cognitive abilities, and they can detect subtle, residual impairments in athletes with recent mild ...

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

Concussion is one of the most commonly reported injuries amongst children and youth involved in sport participation. Following a concussion, youth can experience a range of short and long term neurobehavioral symptoms (somatic, cognitive and emotional/behavioral) that can have a significant impact on one&#8217;s participation in daily activities and pursuits of interest (e.g., school, sports, work, family/social life, etc.). Despite this, there remains a paucity in clinically driven research aimed specifically at exploring concussion within the youth sport population, and more specifically, multi-modal approaches to measuring recovery. This article provides an overview of a novel and multi-modal approach to measuring recovery amongst youth athletes following concussion. The presented approach involves the use of both pre-injury/baseline testing and post-injury/follow-up testing to assess performance across a wide variety of domains (post-concussion symptoms, cognition, balance, strength, agility/motor skills and resting state heart rate variability). The goal of this research is to gain a more objective and accurate understanding of recovery following concussion in youth athletes (ages 10-18 years). Findings from this research can help to inform the development and use of improved approaches to concussion management and rehabilitation specific to the youth sport community.

This article provides an overview of a multi-modal approach to assessing recovery following concussion in youth athletes. The described protocol uses pre- and post-concussion assessment of performance across a wide variety of domains and can inform the development of improved concussion rehabilitation protocols specific to the youth sport community.

多模式的方法来评估恢​​复的青少年运动员脑震荡之后

Concussion is one of the most commonly reported injuries amongst children and youth involved in sport participation. Following a concussion, youth can ...

A Novel and Translational Rat Model of Concussion Combining Force and Rotation with In Vivo Cerebral Microdialysis

Persistent cognitive and motor symptoms are known consequences of concussions/mild traumatic brain injury (mTBIs) that can be partly attributable to altered neurotransmission. Indeed, cerebral microdialysis studies in rodents have demonstrated an excessive extracellular glutamate release in the hippocampus within the first 10 min following trauma. Microdialysis offers the clear advantage of in vivo neurotransmitter continuous sampling while not having to sacrifice the animal. In addition to the aforementioned technique, a closed head injury model that exerts rapid acceleration and deceleration of the head and torso is needed, as such a factor is not available in many other animal models. The Wayne State weight-drop model mimics this essential component of human craniocerebral trauma, allowing the induction of an impact on the head of an unrestrained rodent with a falling weight. Our novel and translational rat model combines cerebral microdialysis with the Wayne State weight-drop model to study, in lightly anesthetized and unrestrained adult rats, the acute changes in extracellular neurotransmitter levels following concussion. In this protocol, the microdialysis probe was inserted inside the hippocampus as region of interest, and was left inserted in the brain at impact. There is a high density of terminals and receptors in the hippocampus, making it a relevant region to document altered neurotransmission following concussion. When applied to adult Sprague-Dawley rats, our combined model induced increases in hippocampal extracellular glutamate concentrations within the first 10 min, consistent with the previously reported post-concussion symptomology. This combined weight-drop model provides a reliable tool for researchers to study early therapeutic responses to concussions in addition to repetitive brain injury, since this protocol induces a closed-head mild trauma.

Neurotransmitter alteration is a mechanism of neural dysfunction that occurs after concussion and contributes to the sometimes-catastrophic long-term consequences. This rat model combines microdialysis, allowing in vivo neurotransmitter quantification, with a weight-drop technique exerting rapid acceleration and deceleration of the head and torso, an important factor of human craniocerebral trauma.

脑震荡结合力与旋转与Vivo脑微透析的新型和转化大鼠模型

Persistent cognitive and motor symptoms are known consequences of concussions/mild traumatic brain injury (mTBIs) that can be partly attributable to ...

神经科学

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To date, return-to-activity decision-making has been anchored in the monitoring of self-reported concussion symptoms and neurocognitive testing. However, multi-modal assessments that corroborate objective physiological measures with traditional subjective symptom reporting are needed and can be valuable. Heart rate variability (HRV) is a non-invasive physiological indicator of the autonomic nervous system, capturing the reciprocal interplay between the sympathetic and parasympathetic nervous systems. There is a dearth of literature exploring the effect of concussion on HRV in youth athletes, and developmental differences preclude the application of adult findings to a pediatric population. Further, the current state of HRV methodology has primarily included short-term (5-15 min) recordings, by using resting state or short-term physical exertion testing to elucidate changes following concussion. The novelty in utilizing a 24 h&#160;recording methodology is that it has the potential to capture natural variation in autonomic function, directly related to the activities a youth athlete performs on a regular basis. Within a prospective, longitudinal research setting, this novel approach to quantifying autonomic function can provide important information regarding the recovery trajectory, alongside traditional self-report symptom measures. Our objectives regarding a 24 h recording methodology were to (1) evaluate the physiological effects of a concussion in youth athletes, and (2) describe the trajectory of physiological change, while considering the resolution of self-reported post-concussion symptoms. To achieve these objectives, non-invasive sensor technology was implemented. The raw beat-to-beat time intervals captured can be transformed to derive time domain and frequency domain measures, which reflect an individual&#39;s ability to adapt and be flexible to their ever-changing environment. By using non-invasive heart rate technology, autonomic function can be quantified outside of a traditional controlled research setting.

We demonstrate a 24 h heart rate recording methodology to evaluate the influence of concussion across the recovery trajectory in youth athletes, within an ecologically valid context.

青年运动员脑震荡后的自主功能: 用24小时记录法探讨心率变异性

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To ...

Objectively Assessing Sports Concussion Utilizing Visual Evoked Potentials

A portable system capable of measuring steady-state visual-evoked potentials (SSVEP) was developed to provide an objective, quantifiable method of electroencephalogram (EEG) testing following a traumatic event. In this study, the portable system was used on 65 healthy rugby players throughout a season to determine whether SSVEP are a reliable electrophysiological biomarker for concussion. Preceding the competition season, all players underwent a baseline SSVEP assessment. During the season, players were re-tested within 72 h of a match for either test-retest reliability or post-injury assessment. In the case of a medically diagnosed concussion, players were reassessed again once deemed recovered by a physician. The SSVEP system consisted of a smartphone housed in a VR-frame delivering a 15 Hz flicker stimulus, while a wireless EEG headset recorded occipital activity. Players were instructed to stare at the screen's fixation point while remaining seated and quiet. Electrodes were arranged according to the 10-20 EEG-positioning nomenclature, with O1-O2 being the recording channels while P1-P2 the references and bias, respectively. All EEG data was processed using a Butterworth bandpass filter, Fourier transformation, and normalization to convert data for frequency analysis. Players SSVEP responses were quantified into a signal-to-noise ratio (SNR), with 15 Hz being the desired signal, and summarized into respective study groups for comparison. Concussed players were seen to have a significantly lower SNR compared to their baseline; however, post-recovery, their SNR was not significantly different from the baseline. Test-retest indicated high device reliability for the portable system. An improved portable SSVEP system was also validated against an established EEG amplifier to ensure the investigative design is capable of obtaining research quality EEG measurements. This is the first study to identify differences in SSVEP responses in amateur athletes following a concussion and indicates the potential for SSVEP as an aid in concussion assessment and management.

A portable system capable of measuring steady-state visual-evoked potentials was developed and trialed on 65 amateur rugby players over 18 weeks to investigate SSVEP as a potential electrophysiological biomarker for concussion. Players' baselines were measured pre-season, with retesting for reliability, concussion, and recovery assessment being conducted within controlled time-periods, respectively.

利用视觉诱发电位客观评估运动脑震荡

A portable system capable of measuring steady-state visual-evoked potentials (SSVEP) was developed to provide an objective, quantifiable method of ...

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury

Mild traumatic brain injuries (mTBIs) are a prevalent health issue in North America. There is increasing pressure to utilize ecologically valid models of closed-head mTBI in the preclinical setting to increase translatability to the clinical population. The awake closed-headed injury (ACHI) model uses a modified controlled cortical impactor to deliver closed-headed injury, inducing clinically relevant behavioral deficits without the need for a craniotomy or the use of an anesthetic.
This technique does not normally induce fatalities, skull fractures, or brain bleeds, and is more consistent with being a mild injury. Indeed, the mild nature of the ACHI procedure makes it ideal for studies investigating repetitive mTBI (r-mTBI). Growing evidence indicates that r-mTBI can result in a cumulative injury that produces behavioral symptoms, neuropathological changes, and neurodegeneration. r-mTBI is common in youths playing sports, and these injuries occur during a period of robust synaptic reorganization and myelination, making the younger population particularly vulnerable to the long-term influences of r-mTBI.
Further, r-mTBI occurs in cases of intimate partner violence, a condition for which there are few objective screening measures. In these experiments, synaptic function was assessed in the hippocampus in juvenile rats that had experienced r-mTBI using the ACHI model. Following the injuries, a tissue slicer was utilized to make hippocampal slices to evaluate bidirectional synaptic plasticity in the hippocampus at either 1 or 7 days following the r-mTBI. Overall, the ACHI model provides researchers with an ecologically valid model to study changes in synaptic plasticity following mTBI and r-mTBI.

Here, it is demonstrated how an awake closed-head injury model can be used for examining the effects of repeated mild traumatic brain injury (r-mTBI) on synaptic plasticity in the hippocampus. The model replicates important features of r-mTBI in patients and is used in conjunction with in vitro electrophysiology.

使用轻度创伤性脑损伤的清醒闭合性头部损伤模型评估突触可塑性的变化

Mild traumatic brain injuries (mTBIs) are a prevalent health issue in North America. There is increasing pressure to utilize ecologically valid models of ...

一个神经科学方法脑震荡的学生运动员的考试

摘要

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在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

支气管Thermoplasty：严重哮喘的一种新的治疗方法

一项战略，以确定在常见的疾病，如自闭症和精神分裂症的新突变

控制下冲击头冲击的活体协议对现场研究数据的验证

双任务屏幕的修订和神经成像兼容版本

多模式的方法来评估恢复的青少年运动员脑震荡之后

脑震荡结合力与旋转与Vivo脑微透析的新型和转化大鼠模型

青年运动员脑震荡后的自主功能: 用24小时记录法探讨心率变异性

利用视觉诱发电位客观评估运动脑震荡

使用轻度创伤性脑损伤的清醒闭合性头部损伤模型评估突触可塑性的变化

一个神经科学方法脑震荡的学生运动员的考试

摘要

探索更多视频

此视频中的章节

在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

支气管Thermoplasty：严重哮喘的一种新的治疗方法

一项战略，以确定在常见的疾病，如自闭症和精神分裂症的新突变

控制下冲击头冲击的活体协议对现场研究数据的验证

双任务屏幕的修订和神经成像兼容版本

多模式的方法来评估恢​​复的青少年运动员脑震荡之后

脑震荡结合力与旋转与Vivo脑微透析的新型和转化大鼠模型

青年运动员脑震荡后的自主功能: 用24小时记录法探讨心率变异性

利用视觉诱发电位客观评估运动脑震荡

使用轻度创伤性脑损伤的清醒闭合性头部损伤模型评估突触可塑性的变化

多模式的方法来评估恢复的青少年运动员脑震荡之后