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Bonnette S, Riley MA, Riehm C, DiCesare C, Christy M, Wilson J, Schille A, Diekfuss JA, Kiefer AW, Jayanthi N, Myer GD. Differences in Lower Extremity Coordination Patterns as a Function of Sports Specialization. J Mot Behav 2023; 55:245-255. [PMID: 36642425 PMCID: PMC11187714 DOI: 10.1080/00222895.2023.2166453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/19/2022] [Accepted: 10/24/2022] [Indexed: 01/17/2023]
Abstract
The practice of early sport specialization, defined as intense year-round training in a single sport at the exclusion of others, is increasing in youth athletics. Despite potential benefits, sport specialization may be detrimental to the health of young athletes, as specialization may increase the risk of musculoskeletal injuries-particularly overuse injuries. However, there remains limited knowledge about how sports specialization uniquely alters underlying sports-related motor behavior. The purpose of this study was to compare the variability of movement patterns exhibited by highly sports specialized youth athletes to that of nonspecialized athletes during performance of a sport-specific, virtual reality based cutting task. It was hypothesized that highly specialized athletes would display different patterns of movement coordination compared to nonspecialized athletes during both the run-up phase and cut-and-decelerate phase. In support of the hypothesis, specialized athletes exhibited both intra- and inter-limb coordination that were significantly different than unspecialized athletes. Overall, the results indicate that the highly specialized athletes tended to exhibit greater degrees of coordination but also the ability to break the coordinated patterns of joint angle changes to execute a cutting maneuver, which requires asymmetric demands on the lower extremities while planting on one leg and changing direction.
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Affiliation(s)
- Scott Bonnette
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | - Michael A. Riley
- Department of Rehabilitation, Exercise, & Nutrition Sciences, University of Cincinnati, Cincinnati, USA
| | - Christopher Riehm
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
| | | | - Michele Christy
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - John Wilson
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew Schille
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
| | - Jed A. Diekfuss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
| | - Adam W. Kiefer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Neeru Jayanthi
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
| | - Gregory D. Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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2
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Hollin G. Consider the woodpecker: The contested more-than-human ethics of biomimetic technology and traumatic brain injury. SOCIAL STUDIES OF SCIENCE 2022; 52:149-173. [PMID: 34657493 PMCID: PMC8978470 DOI: 10.1177/03063127211052513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Chronic Traumatic Encephalopathy, or CTE, is a neurodegenerative disease caused by traumatic brain injury and most frequently associated with contact sports such as American Football. Perhaps surprisingly, the woodpecker - an animal apparently immune to the effects of head impacts - has increasingly figured into debates surrounding CTE. On the one hand, the woodpecker is described as being contra-human and used to underscore the radical inappropriateness of humans playing football. On the other, there have been attempts to mitigate against the risk of CTE through the creation of biomimetic technologies inspired by woodpeckers. In this article I examine the highly politicized encounters between humans and woodpeckers and discuss how the politics of re-/dis-/en-tanglement during these interspecies relations is rendered meaningful. I show here, first, that those who seek to keep the human and the woodpecker apart envisage social overhaul while biomimetic technologies are put to work for the status quo. Second, I stress that different forms of entanglement have diverse sociopolitical consequences. I conclude by suggesting that the case of the woodpecker troubles a strand of contemporary scholarship in Science and Technology Studies that argues that biotechnologies are inherently transformatory and that foregrounding entanglement and interspecies relations is ethically generative. Instead, a discursive separation of nature and culture may be innovative.
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Occupational Risk of Low-Level Blast Exposure and TBI-Related Medical Diagnoses: A Population-Based Epidemiological Investigation (2005-2015). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412925. [PMID: 34948535 PMCID: PMC8700773 DOI: 10.3390/ijerph182412925] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022]
Abstract
Because traumatic brain injury (TBI)—most often caused by exposure to high-level blast (HLB)—is a leading cause of medical evacuations of deployed U.S. service members in recent conflicts, researchers seek to identify risk factors for TBI. Previous research using self-reported data has identified low-level blast (LLB) as one such risk factor and suggests an association with susceptibility to and symptoms associated with TBI. This article presents a population-based study of all branches of military service that examines the association between occupational risk for LLB and both clinically diagnosed TBIs—from concussions to severe and penetrating TBIs—and conditions commonly comorbid with concussion. Using archival medical and career records from >2 million service members between 2005–2015, this work demonstrates that occupational risk of LLB is associated with any TBI, mild TBI, moderate TBI, cognitive problems, communication problems, hearing problems, headaches, any behavioral health condition, anxiety, drug abuse/dependence, alcohol abuse/dependence, delirium/dementia, posttraumatic stress disorder, post-concussive syndrome, tinnitus, fatigue, and migraines. Understanding the full scope of the effects of LLB on service members will help ensure the health and readiness of service members and may influence both military policy and clinical practice guidelines for blast-induced injuries.
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Dinsmore M, Hajat Z, Brenna CT, Fisher J, Venkatraghavan L. Effect of a neck collar on brain turgor: a potential role in preventing concussions? Br J Sports Med 2021; 56:605-607. [PMID: 34824061 DOI: 10.1136/bjsports-2021-103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Mild internal jugular vein (IJV) compression, aimed at increasing intracranial fluid volume to prevent motion of the brain relative to the skull, has reduced brain injury markers in athletes suffering repeated traumatic brain injuries. However, an increase in intracranial volume with IJV compression has not been well demonstrated. This study used transorbital ultrasound to identify changes in optic nerve sheath diameter (ONSD) as a direct marker of accompanying changes in intracranial volume. METHODS Nineteen young, healthy adult volunteers (13 males and 6 females) underwent IJV compression of 20 cm H2O low in the neck, while in upright posture. IJV cross-sectional area at the level of the cricoid cartilage, and the change in right ONSD 3 mm behind the papillary segment of the optic nerve, were measured by ultrasound. Statistical analysis was performed using a paired t-test with Bonferroni correction. RESULTS Mean (SD) cross-sectional area for the right IJV before and after IJV compression was 0.10 (0.05) cm2 and 0.57 (0.37) cm2, respectively (p=0.001). ONSD before and after IJV compression was 4.6 (0.5) mm and 4.9 (0.5) mm, respectively (p=0.001). CONCLUSIONS These data verify increased cerebral volume following IJV compression, supporting the potential for reduced brain 'slosh' as a mechanism connecting IJV compression to possibly reducing traumatic brain injury following head trauma.
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Affiliation(s)
- Michael Dinsmore
- Department of Anaesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Zakir Hajat
- Department of Anaesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Connor Ta Brenna
- Department of Anaesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Fisher
- Department of Anaesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Lashmi Venkatraghavan
- Department of Anaesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada
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5
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Yuan W, Dudley J, Slutsky-Ganesh AB, Leach J, Scheifele P, Altaye M, Barber Foss KD, Diekfuss JD, Rhea CK, Myer GD. White Matter Alteration Following SWAT Explosive Breaching Training and the Moderating Effect of a Neck Collar Device: A DTI and NODDI Study. Mil Med 2021; 186:1183-1190. [PMID: 33939823 DOI: 10.1093/milmed/usab168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/18/2021] [Accepted: 04/20/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Special Weapons and Tactics (SWAT) personnel who practice breaching with blast exposure are at risk for blast-related head trauma. We aimed to investigate the impact of low-level blast exposure on underlying white matter (WM) microstructure based on diffusion tensor imaging (DTI) and neurite orientation and density imaging (NODDI) in SWAT personnel before and after breacher training. Diffusion tensor imaging is an advanced MRI technique sensitive to underlying WM alterations. NODDI is a novel MRI technique emerged recently that acquires diffusion weighted data from multiple shells modeling for different compartments in the microstructural environment in the brain. We also aimed to evaluate the effect of a jugular vein compression collar device in mitigating the alteration of the diffusion properties in the WM as well as its role as a moderator on the association between the diffusion property changes and the blast exposure. MATERIALS AND METHODS Twenty-one SWAT personnel (10 non-collar and 11 collar) completed the breacher training and underwent MRI at both baseline and after blast exposure. Diffusion weighted data were acquired with two shells (b = 1,000, 2,000 s/mm2) on 3T Phillips scanners. Diffusion tensor imaging metrices, including fractional anisotropy, mean, axial, and radial diffusivity, and NODDI metrics, including neurite density index (NDI), isotropic volume fraction (fiso), and orientation dispersion index, were calculated. Tract-based spatial statistics was used in the voxel-wise statistical analysis. Post hoc analyses were performed for the quantification of the pre- to post-blast exposure diffusion percentage change in the WM regions with significant group difference and for the assessment of the interaction of the relationship between blast exposure and diffusion alteration. RESULTS The non-collar group exhibited significant pre- to post-blast increase in NDI (corrected P < .05) in the WM involving the right internal capsule, the right posterior corona radiation, the right posterior thalamic radiation, and the right sagittal stratum. A subset of these regions showed significantly greater alteration in NDI and fiso in the non-collar group when compared with those in the collar group (corrected P < .05). In addition, collar wearing exhibited a significant moderating effect for the alteration of fiso for its association with average peak pulse pressure. CONCLUSIONS Our data provided initial evidence of the impact of blast exposure on WM diffusion alteration based on both DTI and NODDI. The mitigating effect of WM diffusivity changes and the moderating effect of collar wearing suggest that the device may serve as a promising solution to protect WM against blast exposure.
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Affiliation(s)
- Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Jonathan Dudley
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Alexis B Slutsky-Ganesh
- Department of Kinesiology, The University of North Carolina at Greensboro, Greensboro, NC 27412, USA
| | - James Leach
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Pete Scheifele
- Department of Communication Sciences and Disorders, University of Cincinnati, College of Allied Health Sciences, Cincinnati, OH 45219, USA.,Department of Medical Education, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Kim D Barber Foss
- Emory Sports Performance and Research Center, Flowery Branch, GA 30542, USA
| | - Jed D Diekfuss
- Emory Sports Performance and Research Center, Flowery Branch, GA 30542, USA.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Christopher K Rhea
- Department of Kinesiology, The University of North Carolina at Greensboro, Greensboro, NC 27412, USA
| | - Gregory D Myer
- Emory Sports Performance and Research Center, Flowery Branch, GA 30542, USA.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA 30322, USA.,Emory Sports Medicine Center, Atlanta, GA 30329, USA.,The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA
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6
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Belding JN, Englert RM, Fitzmaurice S, Jackson JR, Koenig HG, Hunter MA, Thomsen CJ, da Silva UO. Potential Health and Performance Effects of High-Level and Low-Level Blast: A Scoping Review of Two Decades of Research. Front Neurol 2021; 12:628782. [PMID: 33776888 PMCID: PMC7987950 DOI: 10.3389/fneur.2021.628782] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/10/2021] [Indexed: 01/06/2023] Open
Abstract
Although blast exposure has been recognized as a significant source of morbidity and mortality in military populations, our understanding of the effects of blast exposure, particularly low-level blast (LLB) exposure, on health outcomes remains limited. This scoping review provides a comprehensive, accessible review of the peer-reviewed literature that has been published on blast exposure over the past two decades, with specific emphasis on LLB. We conducted a comprehensive scoping review of the scientific literature published between January 2000 and 2019 pertaining to the effects of blast injury and/or exposure on human and animal health. A three-level review process with specific inclusion and exclusion criteria was used. A full-text review of all articles pertaining to LLB exposure was conducted and relevant study characteristics were extracted. The research team identified 3,215 blast-relevant articles, approximately half of which (55.4%) studied live humans, 16% studied animals, and the remainder were non-subjects research (e.g., literature reviews). Nearly all (99.49%) of the included studies were conducted by experts in medicine or epidemiology; approximately half of these articles were categorized into more than one medical specialty. Among the 51 articles identified as pertaining to LLB specifically, 45.1% were conducted on animals and 39.2% focused on human subjects. Animal studies of LLB predominately used shock tubes to induce various blast exposures in rats, assessed a variety of outcomes, and clearly demonstrated that LLB exposure is associated with brain injury. In contrast, the majority of LLB studies on humans were conducted among military and law enforcement personnel in training environments and had remarkable variability in the exposures and outcomes assessed. While findings suggest that there is the potential for LLB to harm human populations, findings are mixed and more research is needed. Although it is clear that more research is needed on this rapidly growing topic, this review highlights the detrimental effects of LLB on the health of both animals and humans. Future research would benefit from multidisciplinary collaboration, larger sample sizes, and standardization of terminology, exposures, and outcomes.
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Affiliation(s)
- Jennifer N. Belding
- Defense Health Group, Leidos, San Diego, CA, United States
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
| | - Robyn M. Englert
- Defense Health Group, Leidos, San Diego, CA, United States
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
| | - Shannon Fitzmaurice
- Defense Health Group, Leidos, San Diego, CA, United States
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
| | - Jourdan R. Jackson
- Defense Health Group, Leidos, San Diego, CA, United States
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
| | - Hannah G. Koenig
- Defense Health Group, Leidos, San Diego, CA, United States
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
| | - Michael A. Hunter
- Defense Health Group, Leidos, San Diego, CA, United States
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
| | - Cynthia J. Thomsen
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
| | - Uade Olaghere da Silva
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA, United States
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7
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Barpujari A, Pierre K, Dodd W, Dagra A, Small C, Williams E, Clark A, Lucke-Wold B. Lessons from NATURE: methods for traumatic brain injury prevention. ARCHIVES OF CLINICAL TOXICOLOGY 2021; 3:34-41. [PMID: 34993525 PMCID: PMC8730289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Multiple species obtain repetitive head collisions throughout the course of their lifetimes with minimal neurologic deficit. Nature has allowed the unique development of multiple protective mechanisms to help prevent neurotrauma. In this review, we examine the concept of rapid brain movement within the skull 'Slosh' and what nature teaches on how to prevent this from occurring. We look at individual animals and the protective mechanisms at play. Marching from macroscopic down to the molecular level, we pinpoint key elements of neuroprotection that are likely contributing. We also introduce new concepts for neuroprotection and address avenues of further discovery.
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Affiliation(s)
- Arnav Barpujari
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Kevin Pierre
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - William Dodd
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Abeer Dagra
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Coulter Small
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Eric Williams
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Alec Clark
- Department of Neurosurgery, University of Florida, Gainesville, USA
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8
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Dual-Task Gait Stability after Concussion and Subsequent Injury: An Exploratory Investigation. SENSORS 2020; 20:s20216297. [PMID: 33167407 PMCID: PMC7663806 DOI: 10.3390/s20216297] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022]
Abstract
Persistent gait alterations can occur after concussion and may underlie future musculoskeletal injury risk. We compared dual-task gait stability measures among adolescents who did/did not sustain a subsequent injury post-concussion, and uninjured controls. Forty-seven athletes completed a dual-task gait evaluation. One year later, they reported sport-related injuries and sport participation volumes. There were three groups: concussion participants who sustained a sport-related injury (n = 8; age =15.4 ± 3.5 years; 63% female), concussion participants who did not sustain a sport-related injury (n = 24; 14.0 ± 2.6 years; 46% female), and controls (n = 15; 14.2 ± 1.9 years; 53% female). Using cross-recurrence quantification, we quantified dual-task gait stability using diagonal line length, trapping time, percent determinism, and laminarity. The three groups reported similar levels of sports participation (11.8 ± 5.8 vs. 8.6 ± 4.4 vs. 10.9 ± 4.3 hours/week; p = 0.37). The concussion/subsequent injury group walked slower (0.76 ± 0.14 vs. 0.65 ± 0.13 m/s; p = 0.008) and demonstrated higher diagonal line length (0.67 ± 0.08 vs. 0.58 ± 0.05; p = 0.02) and trapping time (5.3 ± 1.5 vs. 3.8 ± 0.6; p = 0.006) than uninjured controls. Dual-task diagonal line length (hazard ratio =1.95, 95% CI = 1.05–3.60), trapping time (hazard ratio = 1.66, 95% CI = 1.09–2.52), and walking speed (hazard ratio = 0.01, 95% CI = 0.00–0.51) were associated with subsequent injury. Dual-task gait stability measures can identify altered movement that persists despite clinical concussion recovery and is associated with future injury risk.
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9
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Diekfuss JA, Yuan W, Barber Foss KD, Dudley JA, DiCesare CA, Reddington DL, Zhong W, Nissen KS, Shafer JL, Leach JL, Bonnette S, Logan K, Epstein JN, Clark J, Altaye M, Myer GD. The effects of internal jugular vein compression for modulating and preserving white matter following a season of American tackle football: A prospective longitudinal evaluation of differential head impact exposure. J Neurosci Res 2020; 99:423-445. [PMID: 32981154 DOI: 10.1002/jnr.24727] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 01/17/2023]
Abstract
The purpose of this clinical trial was to examine whether internal jugular vein compression (JVC)-using an externally worn neck collar-modulated the relationships between differential head impact exposure levels and pre- to postseason changes in diffusion tensor imaging (DTI)-derived diffusivity and anisotropy metrics of white matter following a season of American tackle football. Male high-school athletes (n = 284) were prospectively assigned to a non-collar group or a collar group. Magnetic resonance imaging data were collected from participants pre- and postseason and head impact exposure was monitored by accelerometers during every practice and game throughout the competitive season. Athletes' accumulated head impact exposure was systematically thresholded based on the frequency of impacts of progressively higher magnitudes (10 g intervals between 20 to 150 g) and modeled with pre- to postseason changes in DTI measures of white matter as a function of JVC neck collar wear. The findings revealed that the JVC neck collar modulated the relationships between greater high-magnitude head impact exposure (110 to 140 g) and longitudinal changes to white matter, with each group showing associations that varied in directionality. Results also revealed that the JVC neck collar group partially preserved longitudinal changes in DTI metrics. Collectively, these data indicate that a JVC neck collar can provide a mechanistic response to the diffusion and anisotropic properties of brain white matter following the highly diverse exposure to repetitive head impacts in American tackle football. Clinicaltrials.gov: NCT# 04068883.
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Affiliation(s)
- Jed A Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kim D Barber Foss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jonathan A Dudley
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher A DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Danielle L Reddington
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Wen Zhong
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Katharine S Nissen
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica L Shafer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - James L Leach
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kelsey Logan
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jeffery N Epstein
- Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Medical Center, Cincinnati, OH, USA
| | - Joseph Clark
- Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mekibib Altaye
- Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Gregory D Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA.,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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10
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Youth With Concussion Have Less Adaptable Gait Patterns Than Their Uninjured Peers: Implications for Concussion Management. J Orthop Sports Phys Ther 2020; 50:438-446. [PMID: 32441192 DOI: 10.2519/jospt.2020.9133] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To compare cross-recurrence quantification analysis measurements obtained during gait between adolescents who sustained a diagnosed concussion within 14 days of assessment and healthy adolescents. DESIGN Cross-sectional study. METHODS Youth athletes with concussion (n = 43; mean ± SD age, 14.4 ± 2.3 years; 56% female; tested median, 7 days post concussion) and healthy controls (n = 38; age, 14.9 ± 2.0 years; 55% female) completed a single-task and dual-task gait protocol while wearing a set of inertial sensors. We used cross-recurrence quantification analysis techniques to quantify the similarity between accelerations obtained from the sensor on the dorsum of each foot. Four outcome variables were compared between groups: percent determinism, average diagonal-line length, laminarity, and trapping time. RESULTS Athletes with concussion had significantly higher percent determinism, laminarity, and trapping time than the control group in single-task and dual-task conditions (P<.05). Gait patterns, when simultaneously completing a secondary cognitive task (dual task), were no different from gait patterns under a single-task condition. CONCLUSION Higher percent determinism, laminarity, and trapping time among athletes with concussion suggest that concussion may be associated with a more stuck and predictable gait pattern. These altered movement patterns may be one reason for underlying slower gait speeds that have been observed following concussion. J Orthop Sports Phys Ther 2020;50(8):438-446. Epub 22 May 2020. doi:10.2519/jospt.2020.9133.
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11
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Mannix R, Morriss NJ, Conley GM, Meehan WP, Nedder A, Qiu J, Float J, DiCesare CA, Myer GD. Internal Jugular Vein Compression Collar Mitigates Histopathological Alterations after Closed Head Rotational Head Impact in Swine: A Pilot Study. Neuroscience 2020; 437:132-144. [PMID: 32283181 DOI: 10.1016/j.neuroscience.2020.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/05/2020] [Indexed: 12/14/2022]
Abstract
Recently, there has been increased concern about microstructural brain changes after head trauma. Clinical studies have investigated a neck collar that applies gentle bilateral jugular vein compression, designed to increase intracranial blood volume and brain stiffness during head trauma, which neuroimaging has shown to result in a reduction in brain microstructural alterations after a season of American football and soccer. Here, we utilized a swine model of mild traumatic brain injury to investigate the effects of internal jugular vein (IJV) compression on histopathological outcomes after injury. Animals were randomized to collar treatment (n = 8) or non-collar treatment (n = 6), anesthetized and suspended such that the head was supported by breakable tape. A custom-built device was used to impact the head, thus allowing the head to break the tape and rotate along the sagittal plane. Accelerometer data were collected for each group. Sham injured animals (n = 2) were exposed to anesthesia only. Following single head trauma, animals were euthanized and brains collected for histology. Whole slide immunohistochemistry was analyzed using Qupath software. There was no difference in linear or rotational acceleration between injured collar and non-collar animals (p > 0.05). Injured animals demonstrated higher levels of the phosphorylated tau epitope AT8 (p < 0.05) and the inflammatory microglial marker IBA1 (p < 0.05) across the entire brain, but the effect of injury was markedly reduced by collar treatment (p < 0.05) The current results indicate that internal jugular venous compression protects against histopathological alterations related to closed head trauma exposure.
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Affiliation(s)
- Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, United States; Harvard Medical School, United States.
| | - Nicholas J Morriss
- Division of Emergency Medicine, Boston Children's Hospital, United States
| | - Grace M Conley
- Division of Emergency Medicine, Boston Children's Hospital, United States
| | - William P Meehan
- Harvard Medical School, United States; Department of Orthopedics, Boston Children's Hospital, United States; Department of Pediatrics, Boston Children's Hospital, United States; Micheli Center for Sports Injury Prevention, United States
| | - Arthur Nedder
- DVM. Animal Resources Children's Hospital, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jianhua Qiu
- Division of Emergency Medicine, Boston Children's Hospital, United States; Department of Pediatrics, Boston Children's Hospital, United States
| | | | | | - Gregory D Myer
- Micheli Center for Sports Injury Prevention, United States; Priority Designs, Columbus, OH, United States; The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Departments of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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Integrated linear and nonlinear trunk dynamics identify residual concussion deficits. Neurosci Lett 2020; 729:134975. [DOI: 10.1016/j.neulet.2020.134975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 03/18/2020] [Accepted: 04/07/2020] [Indexed: 11/23/2022]
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Bonnette S, Diekfuss JA, Grooms DR, Kiefer AW, Riley MA, Riehm C, Moore C, Foss KDB, DiCesare CA, Baumeister J, Myer GD. Electrocortical dynamics differentiate athletes exhibiting low- and high- ACL injury risk biomechanics. Psychophysiology 2020; 57:e13530. [PMID: 31957903 PMCID: PMC9892802 DOI: 10.1111/psyp.13530] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/19/2019] [Accepted: 12/18/2019] [Indexed: 02/04/2023]
Abstract
Anterior cruciate ligament (ACL) injuries are physically and emotionally debilitating for athletes,while motor and biomechanical deficits that contribute to ACL injury have been identified, limited knowledge about the relationship between the central nervous system (CNS) and biomechanical patterns of motion has impeded approaches to optimize ACL injury risk reduction strategies. In the current study it was hypothesized that high-risk athletes would exhibit altered temporal dynamics in their resting state electrocortical activity when compared to low-risk athletes. Thirty-eight female athletes performed a drop vertical jump (DVJ) to assess their biomechanical risk factors related to an ACL injury. The athletes' electrocortical activity was also recorded during resting state in the same visit as the DVJ assessment. Athletes were divided into low- and high-risk groups based on their performance of the DVJ. Recurrence quantification analysis was used to quantify the temporal dynamics of two frequency bands previously shown to relate to sensorimotor and attentional control. Results revealed that high-risk participants showed more deterministic electrocortical behavior than the low-risk group in the frontal theta and central/parietal alpha-2 frequency bands. The more deterministic resting state electrocortical dynamics for the high-risk group may reflect maladaptive neural behavior-excessively stable deterministic patterning that makes transitioning among functional task-specific networks more difficult-related to attentional control and sensorimotor processing neural regions.
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Affiliation(s)
- Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jed A. Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dustin R. Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, GA, USA,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Adam W. Kiefer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA,Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael A. Riley
- Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA
| | - Christopher Riehm
- Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA
| | - Charles Moore
- Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA
| | - Kim D. Barber Foss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher A. DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jochen Baumeister
- Exercise Science and Neuroscience, Department Exercise & Health, Paderborn University, Paderborn, Germany
| | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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