Chronic Head Trauma Research Articles

Sports-Related Concussion Assessment: A New Physiological, Biomechanical, and Cognitive Methodology Incorporating a Randomized Controlled Trial Study Protocol.

Taking part in moderate-to-vigorous exercise in contact sports on a regular basis may be linked to an increase in cerebrovascular injury and head trauma. Validated objective measures are lacking in the initial post-event diagnosis of head injury. The exercise style, duration, and intensity may also confound diagnostic indicators. As a result, we propose that the new Interdisciplinary Group in Movement & Performance from Acute & Chronic Head Trauma (IMPACT) analyze a variety of functional (biomechanical and motor control) tests as well as related biochemistry to see how they are affected by contact in sports and head injury. The study's goal will be to look into the performance and physiological changes in rugby players after a game for head trauma and injury. This one-of-a-kind study will use a randomized controlled trial (RCT) utilizing a sport participation group and a non-participation control group. Forty male rugby 7 s players will be recruited for the study and allocated randomly to the experimental groups. The intervention group will participate in three straight rugby matches during a local 7 s rugby event. At the pre-match baseline, demographic and anthropometric data will be collected. This will be followed by the pre-match baseline collection of biochemical, biomechanical, and cognitive-motor task data. After three consecutive matches, the same measures will be taken. During each match, a notational analysis will be undertaken to obtain contact information. All measurements will be taken again 24, 48, and 72 h after the third match. When the number of games increases owing to weariness and/or stressful circumstances, we expect a decline in body movement, coordination, and cognitive-motor tasks. Changes in blood biochemistry are expected to correspond to changes in biomechanics and cognitive-motor processes. This research proposal will generate considerable, ecologically valid data on the occurrence of head trauma events under game conditions, as well as the influence of these events on the biological systems of the performers. This will lead to a greater understanding of how sports participants react to exercise-induced injuries. This study's scope will have far-reaching ramifications for doctors, coaches, managers, scientists, and sports regulatory bodies concerned with the health and well-being of athletic populations at all levels of competition, including all genders and ages.

CT Findings and Histological Evaluation of Red Foxes (Vulpes vulpes) with Chronic Head Trauma Injury: A Retrospective Study.

Simple SummaryLarge numbers of wild animals are injured every year in road traffic accidents (RTA) and need first aid and assistance procedures, depending on the severity of the trauma and lesions. Head trauma may lead to traumatic brain injury (TBI), which causes neurologic and behavioral disorders. In this study, we retrospectively evaluated the clinical records of red foxes rescued and clinically evaluated to characterize computed tomography (CT) findings in a cohort of foxes with chronic head trauma and identify survival rates. On average, CT scans were performed 260 days after fox rescue. We speculate that persisting clinical signs could be attributed to TBI. CT scan helped diagnose chronic lesion and their effect on prognostic judgment for animals that should be released to wildlife environments.Large numbers of wild animals are injured every year in road traffic accidents. Scant data are available for rescued wild carnivores, in particular for red foxes. Cases of foxes with head trauma were retrospectively considered for inclusion in this study. Clinical examination, modified Glasgow coma scale (MGCS), computed tomography (CT) examination, therapy, outcome, and post mortem findings of the brain were investigated. In all foxes, cranial vaults lesion occurred in single (67%) or multiple sites (33%). Midline shift and hydrocephalus were observed in this population. The mean survival was 290 (±176) days. In our study, we performed CT scans on average 260 days after fox rescue, and we speculate that persisting clinical signs could be attributed to TBI. In our study, only two foxes were alive at the time of writing. Other foxes were euthanized due to the severity of the clinical signs. CT scans help diagnose chronic lesions and their effect on prognostic judgment for animals released to wildlife environments.

Characterizing changes in network connectivity following chronic head trauma in special forces military personnel: a combined resting-fMRI and DTI study

ABSTRACT Background Soldiers are exposed to significant repetitive head trauma, which may disrupt functional and structural brain connectivity patterns. Purpose/hypothesis Integrate resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) to characterize changes in connectivity biomarkers within Canadian Special Operations Forces (CANSOF), hypothesizing that alterations in architectural organization of cortical hubs may follow chronic repetitive head trauma. Methods Fifteen CANSOFs with a history of chronic exposure to sub-concussive head trauma and concussive injuries (1.9 ± 2.0 concussions (range: [0–6])), as well as an equal age-matched cohort of controls (CTLs) were recruited. BOLD-based rs-fMRI was combined with DTI to reconstruct functional and structural networks using independent component analyses and probabilistic tractography. Connectivity markers were computed based on the distance between functional seeds to assess for possible differences in injury susceptibility of short- and long-range connections. Results/discussion Significant hyper- and hypo-connectivity differences in cortical connections were observed suggesting that chronic head trauma may predispose soldiers to changes in the functional organization of brain networks. Significant structural alterations in axonal fibers directly connecting disrupted functional nodes were specific to hyper-connected long-range connections, suggesting a potential relationship between axonal injury and increases in neural recruitment following repetitive head trauma from high-exposure military duties.

Systematic review on the characterization of chronic traumatic encephalopathy by MRI and MRS.

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that is found in people who have suffered from chronic traumatic brain injury (TBI). Up to now, diagnosis of CTE could only be made based on postmortem histopathological examinations. The application of MR techniques might offer a promising possibility for in vivo diagnoses. To provide a critical systematic review of the characterization of chronic TBI and CTE by considering the range of MR techniques. This was a systematic review for which the electronic databases PubMed and Embase were searched using the terms ("chronic traumatic encephalopathy" OR "punch drunk syndrome" OR "chronic traumatic brain injury" OR "dementia pugilistica" OR "chronic head trauma") AND ("magnetic resonance imaging" OR mri OR imaging OR mrs OR "magnetic resonance spectroscopy" OR spectroscopy). Of the 432 studies identified by the database search, 25 were included in this review. Diffusion, structural, and functional MRI sequences and MR spectroscopy were evaluated at 1.5T or 3T and at 11.74T for the ex vivo studies. Data were extracted by two reviewers independently. Specific inclusion and exclusion criteria like the study design, publication type, and applied MR techniques were used to select studies for review. Results of the original research articles were stated in this review as significant if P ≤ 0.05. Of the included articles, two were ex vivo studies focusing on the coregistration of histology and MRI. All other studies were based on in vivo data. The included studies varied considerably regarding study setup, MR techniques, and results. Nevertheless, this work aims to establish links between the studies and discusses the results and limitations associated with the characterization of chronic TBI and CTE based on MR. 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:212-228.

Boxing Lessons: An Historical Review of Chronic Head Trauma in Boxing and Football

In recent years there has been a significant increase in the scrutiny of head trauma in football. This attention is due largely to a host of studies that have been highly publicized and linked the repetitive head trauma in football to late-life neurological impairment. Scientists and physicians familiar with boxing have been aware of such impairment, resulting from repeated head impacts, for more than 80 years. Few, however, made the connection between the similarity of head impacts in boxing and football until recent decades. This article examines the medical and scientific literature related to head trauma in both boxing and football, paying particular attention to the different emphases of that research. Further, the literature is used to trace the understanding of sport-related chronic head trauma as well as how that understanding has prompted reform efforts in each sport. Finally, in light of the current understanding of the long-term sequelae of repetitive head trauma, some consideration is given to what football administrators can learn from the reform efforts in boxing.

Brief Communication: Pituitary Volume and Function in Competing and Retired Male Boxers

Pituitary consequences of chronic head trauma in boxing have not been investigated in detail. To investigate the pituitary function in retired or active amateur boxers. Cross-sectional, observational study. Turkey. 61 actively competing (n = 44) or retired (n = 17) male boxers of the Turkish National Boxing Team. Body composition variables, pituitary volume (in 38 of 61 boxers), and pituitary function. 9 of 61 boxers (15%) had growth hormone (GH) deficiency and 5 of 61 boxers (8%) had adrenocorticotropic hormone deficiency. All boxers with GH deficiency except 1 were retired from boxing. Of 17 retired boxers, 8 (47%) had GH deficiency. Retired boxers with GH deficiency had significantly lower pituitary volume than retired boxers with normal GH. Pituitary volume was measured in only 38 of 61 boxers, and the study had no comparison group. This study suggests that retired boxers have a high rate of pituitary dysfunction. Therefore, investigation of pituitary function in boxers, particularly retired ones, is recommended.

Chronic Trauma in Sports as a Cause of Hypopituitarism

TBI is one of the most important public health problems in the world. Although the relationship between TBI and hypopituitarism has been known for a long time, neuroendocrine changes were investigated in detail recently. The prevalence of neuroendocrine abnormalities in patients with TBI is very high. Gonadotropin and GH deficiencies appear to be the most common defects. Although combative sports are very popular around the world, trauma due to sports is not generally considered as a cause of TBI in most of the epidemiological studies. All the studies regarding TBI in sports published so far in the literature based on neuropshycological or radiological assessment and no neuroendocrine changes were investigated. In a recent study, pituitary functions in amateur boxers have been investigated and it has been reported that boxing is a cause of TBI and isolated GH deficiency is very common among amateur boxers. It seems that acute or chronic head trauma in sports is a possible cause of hypopituitarism. In this review, current data regarding TBI in sports are discussed.

Spontaneous complaints of long-term traumatic brain injured subjects and their close relatives

Long term consequences of head injury for patients and families are not well known, given the complexity of variables that have to be studied. Subject's self-experience is one of these less studied aspects. The purpose of this study is to examine the spontaneous complaints of long term brain injured adult subjects to be compared to the impression of their relatives. A total of 48 chronic head trauma subjects were studied more than 6 years after injury together with a relative, usually a mother or wife. At the beginning of the interview the participants were asked to freely refer their present complaints. In general, relatives referred more complaints about the injured subjects than the injured subjects referred about themselves. This occurred in several domains: somatic, physical, cognitive and behavioural. Memory problems were highly reported by both groups. Somatic complaints were more frequently reported by patients and behavioural problems were more often reported by relatives. Mothers and wives had different profiles of responses. Mothers opinions were identical to those of their TBI sons in all domains. These different results must be taken into consideration so that the real needs of patients and relatives can be addressed.

Enhanced emotional reactions in chronic head trauma patients.

The emotional characteristics of head injury patients referred for neuropsychological testing were examined as a function of the time since injury. Patients referred more than 6 months from injury were more emotionally distressed on the MMPI and Katz Adjustment Scale (relatives form) compared to those tested 6 months or earlier. The more chronic head trauma patients were more anxious and depressed, more confused in their thinking, and more socially withdrawn compared to the acute patient group. These differences in emotional functioning appeared to be independent of level of neuropsychological impairment and the initial length of coma. Premorbid personality and increased awareness of impaired functioning with the passage of time are discussed as possible mediators of enhanced emotional distress in some chronic head injury patients.