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Donahue CC, Walton SR, Oldham JR, Beidler E, Larson MJ, Broshek D, Cifu DX, Resch JE. Influence of sleep symptoms on recovery from concussion in collegiate athletes: a LIMBIC MATARS consortium investigation. Brain Inj 2024:1-7. [PMID: 38679931 DOI: 10.1080/02699052.2024.2347542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Changes in sleep quality and quantity are commonly endorsed by individuals following a concussion. Limited data exists examining the role of sleep disturbances within 72 hours, and throughout recovery, from concussion. The objective of this study was to determine if the number of days to symptom resolution varied between collegiate athletes with or without sleep-related symptoms following a concussion. DESIGN Retrospective chart review. METHODS Collegiate athletes (n = 539) who were diagnosed with a concussion between the 2015-2020 sport seasons participated in this retrospective chart review. Participants were divided into groups based on the presence or absence of sleep symptoms within 72 hours of a diagnosed concussion. A Mann-Whitney U test was used to compare days to symptom resolution between groups with α = 0.05. RESULTS Of the 539 participants, 250 (46.3%) reported sleep-related symptoms. Participants with sleep-related symptoms took significantly longer (U = 30656, p = 0.002) to report symptom resolution at rest (median [full range] = 8.00[0-423]) as compared to participants who did not report sleep-related symptoms (6.00[0-243] days). CONCLUSION Collegiate athletes that report sleep-related symptoms immediately following concussion (<72 hours) were observed to take, on median, two days longer to achieve symptom resolution at rest when compared to athletes who did not endorse the same symptoms.
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Affiliation(s)
- Catherine C Donahue
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Sports Medicine Center, Children's Hospital of Colorado, Aurora, Colorado, USA
| | - Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jessie R Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Michael J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Donna Broshek
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health, Charlottesville, Virginia, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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Helm TC, Bowman TG, Kelshaw PM, Beidler E, Cifu DX, Resch JE. Academic adjustments and concussion recoveries in NCAA student-athletes: a LIMBIC MATARS investigation. Brain Inj 2024; 38:282-287. [PMID: 38345018 DOI: 10.1080/02699052.2024.2310786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the association between academic adjustments and recovery from sport-related concussions (SRCs) in collegiate athletes. MATERIALS AND METHODS A retrospective medical chart review was performed between the 2015-2016 and 2019-2020 sport seasons at 11 Long-term Impact of Military-relevant Brain Injury Consortium Military and Tactical Athlete Research Study (LIMBIC MATARS) sites. Days between injury and symptom resolution, and injury and return to sport (dependent variables) for collegiate athletes who did or did not receive academic adjustments (independent variable) were analyzed using Mann-Whitney U tests. RESULTS The number of days between date of injury and symptom-resolution between those who did (median = 9 [interquartile range = 5,16]) and did not have (7[3,12]) academic adjustments were statistically different (z=-2.76, p < 0.01, r=-0.17). However, no differences were observed between days to return to sport among those who did (14[10,22]) and did not (13[8,20]) receive assigned academic adjustments (z= -1.66, p = 0.10, r= -.10). CONCLUSIONS Recovery trajectories were similar between athletes diagnosed with a SRC who did or did not receive academic adjustments.. Our findings suggest academic adjustments supported recovery for those who needed academic adjustments. Clinicians and healthcare professionals should assist and support collegiate athletes after SRCs on an individual basis, including academic adjustments when appropriate based on patient presentation.
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Affiliation(s)
- Tenesha C Helm
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Patricia M Kelshaw
- Department of Kinesiology, Brain Research and Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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Didehbani N, Kelshaw P, Oldham J, Bowman T, Higgins K, Beidler E, Wilmoth K, Valentine V, Munce T, Larson M, Cullum M, Cifu DX, Resch J. The influence of ADHD on recovery from sport concussion among collegiate athletes in the United States: LIMBIC MATARS consortium investigation. Brain Inj 2024:1-6. [PMID: 38363822 DOI: 10.1080/02699052.2024.2304879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/09/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE The present study aimed to assess the potential influence of a diagnosis of ADHD on concussion recovery among collegiate athletes. DESIGN Retrospective and cross-sectional. METHODS Data were extracted retrospectively from medical records across LIMBIC MATARS member institutions (n = 11), representing 1,044 concussion cases among collegiate athletes. After exclusions, 406 concussions were included in our analysis (ADHD: n = 38, age = 20.2 ± 1.67 years, 18.4% female; No ADHD: n = 368, age = 19.8 ± 1.39 years, 40.1% female). Mann-Whitney U tests were used to compare days from injury to diagnosis, symptom resolution, and return to sport among athletes with and without ADHD. RESULTS No differences were observed for days from concussion until diagnosis (z = -0.33, p = 0.74), until days to symptom resolution (z = -1.30, p = 0.19), or days until return to sport (z = -0.68, p = 0.49); among concussion cases with or without a previously reported diagnosis of ADHD. CONCLUSION Our findings further expand the literature that suggests ADHD is not strongly associated with recovery trajectory following sport concussion in collegiate athletes. Future research should extend these findings to be inclusive of additional preexisting health conditions and moderating effects related to medication usage among diverse athlete levels.
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Affiliation(s)
- Nyaz Didehbani
- Psychiatry & Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, USA
| | | | - Jessie Oldham
- Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Thomas Bowman
- Athletic Training, University of Lynchburg, Lynchburg, USA
| | - Kate Higgins
- Nebraska Medicine, University of Nebraska-Lincoln Athletics, Omaha, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, USA
| | - Kristin Wilmoth
- Psychiatry & Physical Medicine & Rehabilitation, Durham, USA
| | | | - Thanye Munce
- Environmental Influences on Health & Disease Group, Sanford Health, Sioux Falls, USA
| | | | - Munro Cullum
- Psychiatry,University of Texas Southwestern Medical Center, Durham, USA
| | - David X Cifu
- Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, USA
| | - Jake Resch
- Department of Kinesiology, University of Virginia, Charlottesville, USA
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Bouchard HC, Kelshaw PM, Bowman TG, Beidler E, Resch JE, Cifu DX, Higgins KL. Exploring the relationship between contraceptive medication use and concussion recovery in female collegiate athletes: a LIMBIC MATARS consortium investigation. Brain Inj 2024:1-7. [PMID: 38335246 DOI: 10.1080/02699052.2024.2310780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 01/23/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE While recovery from concussion is variable, women are more likely to report symptoms, experience worse outcomes, and have longer recovery trajectories following concussion than men. Preliminary data suggest that hormonal fluctuations, specifically progesterone, may be associated with this variability. This study aimed to understand the effect of contraceptive medication on concussion recovery. METHODS A retrospective chart review using consensus-based common data elements was conducted at 11 NCAA institutions as part of the LIMBIC MATARS consortium. Participants included female collegiate athletes diagnosed with a concussion who did (n = 117) or did not report (n = 339) contraceptive medication use. Number of days between diagnosis and symptom resolution were compared using Mann-Whitney U tests. Self-reported diagnosis of attention deficit hyperactivity disorder, concussion history, anxiety, and depression was compared using Chi-squared tests. RESULTS The proportions of participants who did or did not take contraceptive medication were similar across covariates. Female athletes regardless of contraceptive medication use recovered similarly following a concussion. CONCLUSIONS Our findings suggest that contraceptive medication use did not significantly impact concussion recovery. Future prospective investigations should examine documentation practices and operationalize terminology for hormonal contraceptive medication to better understand their role on recovery from sport-related concussion in female collegiate athletes.
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Affiliation(s)
- Heather C Bouchard
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Patricia M Kelshaw
- Department of Kinesiology, Brain Research & Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Kate L Higgins
- Department of Athletics, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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Munce TA, Peplowski AD, Bowman TG, Kelshaw PM, Campbell TR, Ahonen SB, Valentine VD, Cifu DX, Resch JE. Concussion diagnosis and recovery in relation to collegiate athletic department classification: a LIMBIC MATARS consortium investigation. Brain Inj 2024:1-11. [PMID: 38334036 DOI: 10.1080/02699052.2024.2310800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE We investigated time to reach concussion diagnosis and recovery milestones in collegiate athletes relative to their schools' National Collegiate Athletic Association (NCAA) classification. METHODS We retrospectively examined 849 (43.1% female) concussion cases from 11 NCAA institutions (Division I Power 5 [n = 4], Division I Non-Power 5 [n = 4], and Division II/III [n = 3]) from the 2015-16 to 2019-20 athletic seasons. Our primary outcome measures were days to reach specific clinical milestones following concussion. RESULTS Median (IQR) time from injury to diagnosis was significantly longer at Division II/III institutions (1 [0-4] days) compared to Division I Power 5 (0 [0-1] days) and Division I Non-Power 5 (0 [0-1] days) institutions (p < 0.001). Likewise, Division II/III athletes (15 [11-22] days) took significantly longer to return to sport after concussion than Division I Power 5 (10 [7-16] days) and Division I Non-Power 5 (11 [7-18.5] days) athletes (p < 0.001). CONCLUSION Division II/III athletes had delayed concussion diagnoses and return to sport timelines compared to Division I athletes. Our results suggest that differences in sports medicine resources across NCAA divisions may influence injury recognition and recovery in collegiate athletes with concussion.
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Affiliation(s)
- Thayne A Munce
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Allison D Peplowski
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
- Department of Biology, University of South Dakota, Vermillion, South Dakota, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Patricia M Kelshaw
- Department of Kinesiology, Brain Research and Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - Thomas R Campbell
- School of Rehabilitation Sciences, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Sean B Ahonen
- Intercollegiate Athletics and Community Wellness, Virginia Union University, Richmond, Virginia, USA
| | - Verle D Valentine
- Sanford Orthopedics and Sports Medicine, Sanford Health, Sioux Falls, South Dakota, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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Resch JE, Beidler E, Bowman TJ, Kelshaw T, Larson MJ, Munce TA, Oldham J, Walton SR, Cifu DX. Placing the keystone: the LIMBIC Military and Tactical Athlete Research Study. Brain Inj 2024:1-8. [PMID: 38328943 DOI: 10.1080/02699052.2024.2304861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE The LIMBIC Military and Tactical Athletic Research Study (MATARS) framework was established to confirm and extend understanding of concussion with initial studies driven by clinical data collected between 2015 and 2020 in a collegiate sports setting. The LIMBIC MATARS framework will be leveraged to apply gold-standard and innovative research designs to advance the science of concussion. This manuscript provides the background, methodology, and initial demographic data associated with the LIMBIC MATARS. METHODS Consensus-based common data elements were used to conduct a retrospective chart review, specific to collegiate athletes diagnosed with concussions between 2015 and 2020 at 11 universities. RESULTS A final sample of 1,311 (47.8% female) concussions were diagnosed during the five-year study period from athletes participating in a variety of National Collegiate Athlete Association (NCAA) sports. The LIMBIC MATARS demographic data, align with the NCAA and other pioneering multi-site concussion-related studies in terms of biological sex, race and ethnicity, and sport participation. CONCLUSION This pragmatic, methodological approach was used to address several a priori hypotheses related to concussion, align with other multi-site studies of concussion, and establish a consortium for future investigations.
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Affiliation(s)
- J E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - E Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - T J Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - T Kelshaw
- Department of Kinesiology, University of New Hampshire, Durham, New Hampshire, USA
| | - M J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - T A Munce
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - J Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - S R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - D X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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Bowman TG, Lininger MR, Oldham JR, Smetana RM, Kelshaw PM, Beidler E, Campbell TR, Walton SR, Munce TA, Larson MJ, Didehbani N, Cullum CM, Rosenblum DJ, Cifu DX, Resch JE. Physical activity and recovery following concussion in collegiate athletes: a LIMBIC MATARS Consortium Investigation. Brain Inj 2024:1-8. [PMID: 38324635 DOI: 10.1080/02699052.2024.2310791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To investigate whether routine daily activities (RDA), non-prescribed exercise (Non-ERx), or prescribed exercise (ERx) were associated with recovery from sport-related concussion (SRC) in collegiate athletes. MATERIALS AND METHODS Data for this cross-sectional, retrospective chart review of collegiate athletes diagnosed with SRC (n = 285[39.6% female], age = 19.5 ± 1.4 years) were collected during the 2015-16 to 2019-20 athletic seasons. The independent variable was group (RDA, Non-ERx, ERx). Dependent variables included days from date of diagnosis to symptom resolution (Dx-SR) and SR to return to sport (SR-RTS). RESULTS Those in the Non-ERx group took nearly 1.3 times longer to achieve SR (IRR = 1.28, 95% CI: 1.11, 1.46) and, 1.8 times longer for RTS (IRR = 1.82, 95% CI: 1.11, 2.71) when compared to those in the RDA group. No other comparisons were significant. CONCLUSION Collegiate athletes in the Non-ERx group took approximately 1 week longer to achieve SR as compared to the RDA and ERx groups. Our findings suggest that if exercise is recommended following SRC, it must be clearly and specifically prescribed. If exercise parameters cannot be prescribed, or monitored, RDA appear to be similarly beneficial during recovery for collegiate athletes with concussion.
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Affiliation(s)
- Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Monica R Lininger
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, USA
| | - Jessie R Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Racheal M Smetana
- Neuropsychology Assessment Clinic, University of Virginia Health, Charlottesville, Virginia, USA
| | - Patricia M Kelshaw
- Department of Kinesiology, Brain Research and Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, NH, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Thomas R Campbell
- School of Rehabilitation Sciences, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Thayne A Munce
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Michael J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Nyaz Didehbani
- Departments of Psychiatry and Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - C Munro Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Daniel J Rosenblum
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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Walton SR, Kelshaw PM, Munce TA, Beidler E, Bowman TG, Oldham JR, Wilmoth K, Broshek DK, Rosenblum DJ, Cifu DX, Resch JE. Access to athletic trainers and sex as modifiers of time to reach clinical milestones after sport-related concussion in collegiate athletes. Brain Inj 2024:1-8. [PMID: 38318792 DOI: 10.1080/02699052.2024.2310787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE Investigate whether an athlete's biological sex and exposure to a dedicated athletic trainer (AT) were related to clinical milestones after a sports-related concussion (SRC). DESIGN Retrospective chart review. METHODS Medical charts of collegiate athletes (n = 196 [70.9% female]) diagnosed with SRC were reviewed to extract: biological sex, dedicated AT exposure for their sport (yes/no), and time (days) to reaching clinical milestones (diagnosis, symptom resolution, unrestricted return to sport [RTS]). Mann-Whitney U tests were used to determine whether time to clinical milestones differed by sex, AT exposure, or their interaction. Proportions of same-day diagnoses and times to diagnosis, symptom resolution, and unrestricted RTS were evaluated with chi-squared and spearman's rank correlations, respectively. RESULTS There were no significant differences in times to reaching any clinical milestone by sex, AT exposure, or their interaction (ps > 0.05). Forty-three percent of participants were diagnosed on the day of their SRC. This did not differ by sex or AT exposure (ps > 0.29). Longer times to SRC diagnosis were associated with more days to symptom resolution (ρ = 0.236, p = 0.001) and unrestricted RTS (ρ = 0.223, p < 0.001). CONCLUSIONS Athlete sex and AT exposure were not associated with times to reach any clinical milestone; however, delayed diagnosis was associated with longer times to reach clinical recovery.
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Affiliation(s)
- Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Patricia M Kelshaw
- Department of Kinesiology, Brain Research and Assessment Initiative of New Hampshire Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - Thayne A Munce
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Jessie R Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Kristin Wilmoth
- Departments of Psychiatry and of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Donna K Broshek
- Department of Psychiatry & Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Daniel J Rosenblum
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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Oldham JR, Bowman TG, Walton SR, Beidler E, Campbell TR, Smetana RM, Munce TA, Larson MJ, Cullum CM, Bushaw MA, Rosenblum DJ, Cifu DX, Resch JE. Sport Type and Risk of Subsequent Injury in Collegiate Athletes Following Concussion: a LIMBIC MATARS Consortium Investigation. Brain Inj 2024:1-9. [PMID: 38317302 DOI: 10.1080/02699052.2024.2310782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To investigate the association between sport type (collision, contact, non-contact) and subsequent injury risk following concussion in collegiate athletes. MATERIALS AND METHODS This retrospective chart review of 248 collegiate athletes with diagnosed concussions (age: 20.0 ± 1.4 years; height: 179.6 ± 10.9 cm; mass: 79.0 ± 13.6 kg, 63% male) from NCAA athletic programs (n = 11) occurred between the 2015-2020 athletic seasons. Acute injuries that occurred within six months following concussion were evaluated. Subsequent injuries were grouped by lower extremity, upper extremity, trunk, or concussion. The independent variable was sport type: collision, contact, non-contact. A Cox proportional hazard model was used to assess the risk of subsequent injury between sport types. RESULTS Approximately 28% (70/248) of athletes sustained a subsequent acute injury within six months post-concussion. Collision sport athletes had a significantly higher risk of sustaining any injury (HR: 0.41, p < 0.001, 95% CI: 0.28, 0.62), lower extremity (HR: 0.55, p = 0.04, 95% CI: 0.32, 0.97), and upper extremity (HR: 0.41, p = 0.01, 95% CI: 0.20, 0.81) injuries following concussion. No differences between sport types were observed for other injuries. CONCLUSION Collision sport athletes had a higher rate of any subsequent injury, lower, and upper extremity injuries following concussion. Future research should focus on sport-specific secondary injury prevention efforts.
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Affiliation(s)
- Jessie R Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Thomas R Campbell
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Racheal M Smetana
- Neuropsychology Assessment Clinic, University of Virginia Health, Charlottesville, Virginia, USA
| | - Thayne A Munce
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Michael J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - C Munro Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Daniel J Rosenblum
- United States Navy, Virginia Beach, Virginia, USA
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- United States Navy, Virginia Beach, Virginia, USA
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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Kroenke K, Corrigan JD, Ralston RK, Zafonte R, Brunner RC, Giacino JT, Hoffman JM, Esterov D, Cifu DX, Mellick DC, Bell K, Scott SG, Sander AM, Hammond FM. Effectiveness of care models for chronic disease management: A scoping review of systematic reviews. PM R 2024; 16:174-189. [PMID: 37329557 DOI: 10.1002/pmrj.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/14/2023] [Accepted: 05/31/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To conduct a scoping review of models of care for chronic disease management to identify potentially effective components for management of chronic traumatic brain injury (TBI). METHODS Information sources: Systematic searches of three databases (Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews) from January 2010 to May 2021. ELIGIBILITY CRITERIA Systematic reviews and meta-analyses reporting on the effectiveness of the Chronic Care Model (CCM), collaborative/integrated care, and other chronic disease management models. DATA Target diseases, model components used (n = 11), and six outcomes (disease-specific, generic health-related quality of life and functioning, adherence, health knowledge, patient satisfaction, and cost/health care use). SYNTHESIS Narrative synthesis, including proportion of reviews documenting outcome benefits. RESULTS More than half (55%) of the 186 eligible reviews focused on collaborative/integrated care models, with 25% focusing on CCM and 20% focusing on other chronic disease management models. The most common health conditions were diabetes (n = 22), depression (n = 16), heart disease (n = 12), aging (n = 11), and kidney disease (n = 8). Other single medical conditions were the focus of 22 reviews, multiple medical conditions of 59 reviews, and other or mixed mental health/behavioral conditions of 20 reviews. Some type of quality rating for individual studies was conducted in 126 (68%) of the reviews. Of reviews that assessed particular outcomes, 80% reported disease-specific benefits, and 57% to 72% reported benefits for the other five types of outcomes. Outcomes did not differ by the model category, number or type of components, or target disease. CONCLUSIONS Although there is a paucity of evidence for TBI per se, care model components proven effective for other chronic diseases may be adaptable for chronic TBI care.
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Affiliation(s)
- Kurt Kroenke
- Department of Medicine, Indiana School of Medicine and Regenstrief Institute, Indianapolis, Indiana, USA
| | - John D Corrigan
- Department of Physical Medicine & Rehabilitation, The Ohio State University, Columbus, Ohio, USA
| | - Rick K Ralston
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, and Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Robert C Brunner
- Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, Alabama, USA
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, and Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Jeanne M Hoffman
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Dmitry Esterov
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA
- U.S. Department of Veterans Affairs, Washington, DC, USA
| | | | - Kathleen Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, Texas, USA
| | - Steven G Scott
- Center of Innovation on Disability & Rehab Research (CINDRR), James A Haley Veterans' Hospital, Tampa, Florida, USA
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, and Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, USA
| | - Flora M Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
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11
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Huggins AA, Baird CL, Briggs M, Laskowitz S, Hussain A, Fouda S, Haswell C, Sun D, Salminen LE, Jahanshad N, Thomopoulos SI, Veltman DJ, Frijling JL, Olff M, van Zuiden M, Koch SBJ, Nawjin L, Wang L, Zhu Y, Li G, Stein DJ, Ipser J, Seedat S, du Plessis S, van den Heuvel LL, Suarez-Jimenez B, Zhu X, Kim Y, He X, Zilcha-Mano S, Lazarov A, Neria Y, Stevens JS, Ressler KJ, Jovanovic T, van Rooij SJH, Fani N, Hudson AR, Mueller SC, Sierk A, Manthey A, Walter H, Daniels JK, Schmahl C, Herzog JI, Říha P, Rektor I, Lebois LAM, Kaufman ML, Olson EA, Baker JT, Rosso IM, King AP, Liberzon I, Angstadt M, Davenport ND, Sponheim SR, Disner SG, Straube T, Hofmann D, Qi R, Lu GM, Baugh LA, Forster GL, Simons RM, Simons JS, Magnotta VA, Fercho KA, Maron-Katz A, Etkin A, Cotton AS, O'Leary EN, Xie H, Wang X, Quidé Y, El-Hage W, Lissek S, Berg H, Bruce S, Cisler J, Ross M, Herringa RJ, Grupe DW, Nitschke JB, Davidson RJ, Larson CL, deRoon-Cassini TA, Tomas CW, Fitzgerald JM, Blackford JU, Olatunji BO, Kremen WS, Lyons MJ, Franz CE, Gordon EM, May G, Nelson SM, Abdallah CG, Levy I, Harpaz-Rotem I, Krystal JH, Dennis EL, Tate DF, Cifu DX, Walker WC, Wilde EA, Harding IH, Kerestes R, Thompson PM, Morey R. Smaller total and subregional cerebellar volumes in posttraumatic stress disorder: a mega-analysis by the ENIGMA-PGC PTSD workgroup. Mol Psychiatry 2024:10.1038/s41380-023-02352-0. [PMID: 38195980 DOI: 10.1038/s41380-023-02352-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
Although the cerebellum contributes to higher-order cognitive and emotional functions relevant to posttraumatic stress disorder (PTSD), prior research on cerebellar volume in PTSD is scant, particularly when considering subregions that differentially map on to motor, cognitive, and affective functions. In a sample of 4215 adults (PTSD n = 1642; Control n = 2573) across 40 sites from the ENIGMA-PGC PTSD working group, we employed a new state-of-the-art deep-learning based approach for automatic cerebellar parcellation to obtain volumetric estimates for the total cerebellum and 28 subregions. Linear mixed effects models controlling for age, gender, intracranial volume, and site were used to compare cerebellum volumes in PTSD compared to healthy controls (88% trauma-exposed). PTSD was associated with significant grey and white matter reductions of the cerebellum. Compared to controls, people with PTSD demonstrated smaller total cerebellum volume, as well as reduced volume in subregions primarily within the posterior lobe (lobule VIIB, crus II), vermis (VI, VIII), flocculonodular lobe (lobule X), and corpus medullare (all p-FDR < 0.05). Effects of PTSD on volume were consistent, and generally more robust, when examining symptom severity rather than diagnostic status. These findings implicate regionally specific cerebellar volumetric differences in the pathophysiology of PTSD. The cerebellum appears to play an important role in higher-order cognitive and emotional processes, far beyond its historical association with vestibulomotor function. Further examination of the cerebellum in trauma-related psychopathology will help to clarify how cerebellar structure and function may disrupt cognitive and affective processes at the center of translational models for PTSD.
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Affiliation(s)
- Ashley A Huggins
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.
| | - C Lexi Baird
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Melvin Briggs
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Sarah Laskowitz
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Ahmed Hussain
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Samar Fouda
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, Duke School of Medicine, Durham, NC, USA
| | - Courtney Haswell
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Delin Sun
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychology, The Education University of Hong Kong, Ting Kok, Hong Kong
| | - Lauren E Salminen
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Dick J Veltman
- Amsterdam UMC Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jessie L Frijling
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Miranda Olff
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Mirjam van Zuiden
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Saskia B J Koch
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Laura Nawjin
- Amsterdam UMC Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Li Wang
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ye Zhu
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Gen Li
- Laboratory for Traumatic Stress Studies, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Center for Global Health Equity, New York University Shanghai, Shanghai, China
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jonathan Ipser
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders (GBD), Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Stefan du Plessis
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders (GBD), Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Leigh L van den Heuvel
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders (GBD), Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | | | - Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Yoojean Kim
- New York State Psychiatric Institute, New York, NY, USA
| | - Xiaofu He
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Amit Lazarov
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Anna R Hudson
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Anika Sierk
- University Medical Centre Charité, Berlin, Germany
| | | | | | - Judith K Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Julia I Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Pavel Říha
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
- CEITEC-Central European Institute of Technology, Multimodal and Functional Neuroimaging Research Group, Masaryk University, Brno, Czech Republic
| | - Ivan Rektor
- CEITEC-Central European Institute of Technology, Multimodal and Functional Neuroimaging Research Group, Masaryk University, Brno, Czech Republic
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Milissa L Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Elizabeth A Olson
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Justin T Baker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Isabelle M Rosso
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard University, Belmont, MA, USA
| | - Anthony P King
- Department of Psychiatry and Behavioral Health, Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA
| | - Isreal Liberzon
- Department of Psychiatry, Texas A&M University, Bryan, Texas, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas D Davenport
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Lee A Baugh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
| | - Gina L Forster
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Brain Health Research Centre, Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Raluca M Simons
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
- Disaster Mental Health Institute, Vermillion, SD, USA
| | - Jeffrey S Simons
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Vincent A Magnotta
- Departments of Radiology, Psychiatry, and Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Kelene A Fercho
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Sioux Falls VA Health Care System, Sioux Falls, SD, USA
- Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, OK, USA
| | - Adi Maron-Katz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Andrew S Cotton
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Erin N O'Leary
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, OH, USA
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Yann Quidé
- School of Psychology, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Wissam El-Hage
- UMR1253, Université de Tours, Inserm, Tours, France
- CIC1415, CHRU de Tours, Inserm, Tours, France
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Hannah Berg
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Steven Bruce
- Department of Psychological Sciences, Center for Trauma Recovery University of Missouri-St. Louis, St. Louis, MO, USA
| | - Josh Cisler
- Department of Psychiatry, University of Texas at Austin, Austin, TX, USA
| | - Marisa Ross
- Northwestern Neighborhood and Network Initiative, Northwestern University Institute for Policy Research, Evanston, IL, USA
| | - Ryan J Herringa
- School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, USA
| | - Daniel W Grupe
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Jack B Nitschke
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Terri A deRoon-Cassini
- Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Carissa W Tomas
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Epidemiology and Social Sciences, Institute of Health and Equity, Medical College of Wisconsin Milwaukee, Milwaukee, WI, USA
| | | | - Jennifer Urbano Blackford
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Michael J Lyons
- Dept. of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Evan M Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Geoffrey May
- Veterans Integrated Service Network-17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, TX, USA
| | - Steven M Nelson
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Institute for the Developing Brain, Minneapolis, MN, USA
| | - Chadi G Abdallah
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Ifat Levy
- Departments of Comparative Medicine, Neuroscience and Psychology, Wu Tsai Institute, Yale University, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
- Departments of Psychiatry and of Psychology, Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Division of Clinical Neuroscience, National Center for PTSD, West Haven, CT, USA
| | - Emily L Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - William C Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
- Veterans Affairs (VA) Richmond Health Care, Richmond, VA, USA
| | - Elizabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Ian H Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Vic, Australia
| | - Rebecca Kerestes
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic, Australia
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Rajendra Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
- Department of Veteran Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
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Lew HL, Yu J, Combs D, Cifu DX. Enhancing Musculoskeletal Examination Training in Medical Education. Am J Phys Med Rehabil 2023:00002060-990000000-00337. [PMID: 37922375 DOI: 10.1097/phm.0000000000002365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Affiliation(s)
- Henry L Lew
- Professor, University of Hawaii at Manoa, Director of Rehabilitation Medicine Education, Office of Medical Education, John A. Burns School of Medicine, 651 Ilalo Street, Honolulu, HI 96813, USA
| | - Jaime Yu
- Associate Professor, Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | | | - David X Cifu
- Associate Dean of Innovation and System Integration and Eminent Scholar, Herman J. Flax, MD Professor and Chair, Department of Physical Medicine and Rehabilitation, Senior Consultant, Sheltering Arms Institute, Virginia Commonwealth University School of Medicine, Senior TBI Specialist, U.S. Department of Veterans Affairs
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Beidler E, Kelshaw PM, Wallace J, Larson MJ, Munce TA, Donahue CC, Bowman TG, Pappadis MR, Decker MN, Walton SR, Didehbani N, Cifu DX, Resch JE. Racial identity and concussion diagnosis and recovery trajectories in collegiate athletes: a LIMBIC MATARS investigation. Brain Inj 2023:1-9. [PMID: 37691328 DOI: 10.1080/02699052.2023.2253528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/20/2023] [Accepted: 08/27/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To determine if there were concussion diagnosis and recovery disparities between collegiate athletes with Black and White racial identities. DESIGN Retrospective cohort study. METHODS Concussion information was extracted from NCAA athlete medical files at LIMBIC MATARS member institutions from the 2015-16' to 2019-20' academic years. A total of 410 concussions from 9 institutions were included that provided all independent (i.e. racial identity of Black or White) and dependent variable information (i.e. dates of injury, diagnosis, symptom resolution, and return to sport) that were analyzed using Mann-Whitney U tests. The sample consisted of 114 (27.8%) concussions sustained by Black athletes and 296 (72.1%) sustained by White athletes. RESULTS The overall sample had a median of 0 days between injury occurrence to diagnosis, 7 days to symptom resolution, and 12 days to return to sport. No significant timing differences were observed for concussion diagnosis (p = .14), symptom resolution (p = .39), or return to sport (p = 0.58) between collegiate athletes with Black versus White racial identities. CONCLUSIONS These findings may reflect equitable access to onsite sports medicine healthcare resources that facilitate concussion management in the collegiate sport setting. Future work should explore these associations with a larger and more diverse sample of collegiate athletes.
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Affiliation(s)
- Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - P M Kelshaw
- Department of Kinesiology, Brain Research & Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - J Wallace
- Department of Health Science, Athletic Training Program, The University of Alabama, Tuscaloosa, Alabama, USA
| | - M J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - T A Munce
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - C C Donahue
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - T G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - M R Pappadis
- Department of Population Health and Health Disparities, School of Public and Population Health, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - M N Decker
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
| | - S R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - N Didehbani
- Departments of Psychiatry and Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - D X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - J E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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14
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Patel PR, Armistead-Jehle P, Eltman NR, Heath KM, Cifu DX, Swanson RL. Brain Injury: How Dietary Patterns Impact Long-Term Outcomes. Curr Phys Med Rehabil Rep 2023; 11:367-376. [PMID: 37732170 PMCID: PMC10506931 DOI: 10.1007/s40141-023-00413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 09/22/2023]
Abstract
Purpose of Review Individuals with a history of traumatic brain injury (TBI) are at a much greater risk for developing cardiovascular disease (CVD) compared to the general population. This review discusses dietary patterns as a means of addressing modifiable risk factors following TBI exposure. Evidence-based resources for practicing Physiatrists and Brain Injury Medicine specialists pertaining to nutrition education and counseling are also provided. Recent Findings We examined Mediterranean, Dietary Approaches to Stop Hypertension, plant-based, ketogenic, and intermittent fasting dietary patterns through publications of clinical trials and systematic reviews. While many reviews had significant positive findings, some were limited by generalizability. Summary While there is extensive literature on the immediate nutrition goals in the inpatient setting following an acute TBI exposure, there is limited literature discussing the nature of diet and nutrition in the post-acute setting. Fortunately, most individuals with TBI exposure survive their initial injury and continue into the recovery phase. The scientific literature supports increased morbidity and mortality with chronic TBI exposure compared to matched counterparts, most notably with CVD. A diet rich in fiber and nutrients but limited in added sugars, saturated fats, and excess calories would likely have the greatest cardiovascular and related neurologic protection. Future studies are needed to assess the specific impact of dietary interventions in the chronic phase of brain injury recovery.
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Affiliation(s)
- Palak R. Patel
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | | | - Nicholas R. Eltman
- Corporal Michael J. Crescenz VA Medical Center, Center for Neurotrauma, Neurodegeneration, and Restoration, Philadelphia, PA USA
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ USA
| | - Kelly M. Heath
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
- Rehab Medicine Service, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Mail Stop #117, Philadelphia, PA 19104 USA
| | - David X. Cifu
- Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, USA
- Physical Medicine and Rehabilitation, Central Virginia Veterans Health Care System, Richmond, USA
| | - Randel L. Swanson
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
- Corporal Michael J. Crescenz VA Medical Center, Center for Neurotrauma, Neurodegeneration, and Restoration, Philadelphia, PA USA
- Rehab Medicine Service, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Mail Stop #117, Philadelphia, PA 19104 USA
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15
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Kennedy E, Vadlamani S, Lindsey HM, Lei PW, Jo-Pugh M, Adamson M, Alda M, Alonso-Lana S, Ambrogi S, Anderson TJ, Arango C, Asarnow RF, Avram M, Ayesa-Arriola R, Babikian T, Banaj N, Bird LJ, Borgwardt S, Brodtmann A, Brosch K, Caeyenberghs K, Calhoun VD, Chiaravalloti ND, Cifu DX, Crespo-Facorro B, Dalrymple-Alford JC, Dams-O’Connor K, Dannlowski U, Darby D, Davenport N, DeLuca J, Diaz-Caneja CM, Disner SG, Dobryakova E, Ehrlich S, Esopenko C, Ferrarelli F, Frank LE, Franz C, Fuentes-Claramonte P, Genova H, Giza CC, Goltermann J, Grotegerd D, Gruber M, Gutierrez-Zotes A, Ha M, Haavik J, Hinkin C, Hoskinson KR, Hubl D, Irimia A, Jansen A, Kaess M, Kang X, Kenney K, Keřková B, Khlif MS, Kim M, Kindler J, Kircher T, Knížková K, Kolskår KK, Krch D, Kremen WS, Kuhn T, Kumari V, Kwon JS, Langella R, Laskowitz S, Lee J, Lengenfelder J, Liebel SW, Liou-Johnson V, Lippa SM, Løvstad M, Lundervold A, Marotta C, Marquardt CA, Mattos P, Mayeli A, McDonald CR, Meinert S, Melzer TR, Merchán-Naranjo J, Michel C, Morey RA, Mwangi B, Myall DJ, Nenadić I, Newsome MR, Nunes A, O’Brien T, Oertel V, Ollinger J, Olsen A, de la Foz VOG, Ozmen M, Pardoe H, Parent M, Piras F, Piras F, Pomarol-Clotet E, Repple J, Richard G, Rodriguez J, Rodriguez M, Rootes-Murdy K, Rowland J, Ryan NP, Salvador R, Sanders AM, Schmidt A, Soares JC, Spalleta G, Španiel F, Stasenko A, Stein F, Straube B, Thames A, Thomas-Odenthal F, Thomopoulos SI, Tone E, Torres I, Troyanskaya M, Turner JA, Ulrichsen KM, Umpierrez G, Vilella E, Vivash L, Walker WC, Werden E, Westlye LT, Wild K, Wroblewski A, Wu MJ, Wylie GR, Yatham LN, Zunta-Soares GB, Thompson PM, Tate DF, Hillary FG, Dennis EL, Wilde EA. Bridging Big Data: Procedures for Combining Non-equivalent Cognitive Measures from the ENIGMA Consortium. bioRxiv 2023:2023.01.16.524331. [PMID: 36712107 PMCID: PMC9882238 DOI: 10.1101/2023.01.16.524331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Investigators in neuroscience have turned to Big Data to address replication and reliability issues by increasing sample sizes, statistical power, and representativeness of data. These efforts unveil new questions about integrating data arising from distinct sources and instruments. We focus on the most frequently assessed cognitive domain - memory testing - and demonstrate a process for reliable data harmonization across three common measures. We aggregated global raw data from 53 studies totaling N = 10,505 individuals. A mega-analysis was conducted using empirical bayes harmonization to remove site effects, followed by linear models adjusting for common covariates. A continuous item response theory (IRT) model estimated each individual's latent verbal learning ability while accounting for item difficulties. Harmonization significantly reduced inter-site variance while preserving covariate effects, and our conversion tool is freely available online. This demonstrates that large-scale data sharing and harmonization initiatives can address reproducibility and integration challenges across the behavioral sciences.
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Affiliation(s)
- Eamonn Kennedy
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- Division of Epidemiology, University of Utah, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Shashank Vadlamani
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
| | - Hannah M Lindsey
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Pui-Wa Lei
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA, 16801
| | - Mary Jo-Pugh
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- Division of Epidemiology, University of Utah, Salt Lake City, UT, 84132
| | - Maheen Adamson
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA, USA
- Neurosurgery, Stanford School of Medicine, Stanford, CA, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Silvia Alonso-Lana
- FIDMAG Research Foundation, Barcelona, Spain
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Tim J Anderson
- Department of Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Neurology, Te Whatu Ora – Health New Zealand Waitaha Canterbury, Christchurch, New Zealand
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Robert F Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Brain Research Institute, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Laura J Bird
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
- Center of Brain, Behaviour and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Amy Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University University, Atlanta, GA, USA
| | - Nancy D Chiaravalloti
- Centers for Neuropsychology, Neuroscience & Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
| | - David X Cifu
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Virgen del Rocio University Hospital, School of Medicine, University of Seville, IBIS, Seville, Spain
| | - John C Dalrymple-Alford
- Department of Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - David Darby
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Nicholas Davenport
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
| | - John DeLuca
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Kessler Foundation, East Hanover, NJ, USA
| | - Covadonga M Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Seth G Disner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
| | - Ekaterina Dobryakova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lea E Frank
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Carol Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Paola Fuentes-Claramonte
- FIDMAG Research Foundation, Barcelona, Spain
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Helen Genova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Autism Research, Kessler Foundation, East Hanover, NJ, USA
| | - Christopher C Giza
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
- Department of Pediatrics, Division of Neurology, UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Alfonso Gutierrez-Zotes
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitari Institut Pere Mata, Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Tarragona, Spain
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Charles Hinkin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Kristen R Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH
- Section of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Daniela Hubl
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
- Department of Quantitative & Computational Biology, Dornsife College of Arts & Sciences, University of Southern California, Los Angeles CA, USA
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Xiaojian Kang
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA, USA
| | - Kimbra Kenney
- Department of Neurology, Uniformed Services University, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | | | - Mohamed Salah Khlif
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Karolina Knížková
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Knut K Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Denise Krch
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Taylor Kuhn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Veena Kumari
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Roberto Langella
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Sarah Laskowitz
- Brain Imaging and Analysis Center, Duke University, Durham, NC
| | - Jungha Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Jean Lengenfelder
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ
| | - Spencer W Liebel
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | | | - Sara M Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Marianne Løvstad
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Astri Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Cassandra Marotta
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
| | - Craig A Marquardt
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
| | - Paulo Mattos
- Institute D’Or for Research and Education (IDOR), São Paulo, Brazil
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences and Psychiatry, UC San Diego, La Jolla, CA, USA
- Center for Multimodal Imaging and Genetics, UC San Diego, San Diego, CA, USA
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Tracy R Melzer
- Department of Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Jessica Merchán-Naranjo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Rajendra A Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC
- VISN 6 MIRECC, Durham VA, Durham, NC
| | - Benson Mwangi
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Daniel J Myall
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Mary R Newsome
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | - Abraham Nunes
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Terence O’Brien
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Neuroscience, The Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapiey, Frankfurt University, Frankfurt, Germany
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- NorHEAD - Norwegian Centre for Headache Research, Trondheim, Norway
| | - Victor Ortiz García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Mustafa Ozmen
- Department of Electrical and Electronics Engineering, Antalya Bilim University, Antalya, Turkey
| | - Heath Pardoe
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Marise Parent
- Neuroscience Institute & Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | | | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Jonathan Rodriguez
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic
| | - Kelly Rootes-Murdy
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University University, Atlanta, GA, USA
| | - Jared Rowland
- W.G. (Bill) Hefner VA Medical Center, Salisbury, NC
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MA-MIRECC), Durham, NC
| | - Nicholas P Ryan
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Raymond Salvador
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Anne-Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Andre Schmidt
- University of Basel, Department of Psychiatry (UPK), Basel, Switzerland
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Filip Španiel
- National Institute of Mental Health, Klecany, Czech Republic
- 3rd Faculty of Medicine Charles University, Prague, Czech Republic
| | - Alena Stasenko
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Multimodal Imaging and Genetics, UC San Diego, San Diego, CA, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - April Thames
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | | | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, 90007
| | - Erin Tone
- Department of Psychology, Georgia State University, Atlanta, GA
| | - Ivan Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Maya Troyanskaya
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | - Jessica A Turner
- Psychiatry and Behavioral Health, Ohio State Wexner Medical Center, Columbus, OH, USA
| | - Kristine M Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Guillermo Umpierrez
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA
| | - Elisabet Vilella
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitari Institut Pere Mata, Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Tarragona, Spain
| | - Lucy Vivash
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
| | - William C Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
- Richmond Veterans Affairs (VA) Medical Center, Central Virginia VA Health Care System , Richmond, VA
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Krista Wild
- Department of Psychology, Phoenix VA Health Care System, Phoenix, AZ, USA
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Mon-Ju Wu
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Glenn R Wylie
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Rocco Ortenzio Neuroimaging Center, Kessler Foundation, East Hanover, NJ, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Giovana B Zunta-Soares
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, 90007
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Los Angeles, CA, 90007
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Frank G Hillary
- Department of Psychology, Penn State University, State College, PA, 16801
- Department of Neurology, Hershey Medical Center, State College, PA, 16801
- Social Life and Engineering Science Imaging Center, Penn State University, State College, PA, 16801
| | - Emily L Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
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Pickett TC, Walker WC, Lippa SM, Lange RT, Brickell TA, Dittmer TA, Smith JM, Cifu DX, French LM. Cross-walk comparison of the DVBIC-TBICoE and LIMBIC-CENC combat-related concussion prospective longitudinal study datasets. Arch Phys Med Rehabil 2023:S0003-9993(23)00102-8. [PMID: 36842617 DOI: 10.1016/j.apmr.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVE To describe and compare cohorts between two large, longitudinal, federally-funded TBI studies of Service members and veterans across demographic, self-report, and neuropsychological variables. DESIGN Analysis of data from the DVBIC-TBICoE and LIMBIC-CENC prospective longitudinal studies (PLS). SETTING Recruitment locations spanning Department of Defense and Veterans Affairs hospitals across the U.S. PARTICIPANTS 1,463 participants enrolled in the DVBIC-TBICoE study and divided among non-injured (NIC) (n=191), injured control (IC) (n=349), mild TBI (mTBI) (n=682), and (moderate-severe-penetrating TBI (smcTBI) (n=241) subgroups. 1,550 participants enrolled in the LIMBIC-CENC study and divided between IC (n=285) and mTBI (n=1,265) subgroups. IC and mTBI study groups were compared across demographic and military characteristics, self-reported symptoms, and neuropsychological test scores. INTERVENTIONS None MAIN OUTCOME MEASURES: Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Military Version (PCL-C), TBI Quality of Life (TBI-QOL), Test of Premorbid Functioning (TOPF), Wechsler Adult Intelligence Scale-IV (WAIS-IV) Visual Puzzles, Symbol Search, Coding, Letter-Number Sequencing, and Digit Span, Trail Making Test (TMT), Delis-Kaplan Executive Functioning System (DKEFS) Verbal Fluency, Letter Fluency, and Category Fluency, California Verbal Learning Test-II (CVLT-II), and Grooved Pegboard (GP). RESULTS Compared to DVBIC-TBICoE, LIMBIC-CENC participants have higher enrollment age, education level, proportion of Black race, and time from injury as well as less combat deployments and are less likely to be married. The distribution of military service branches also differed. Further, symptom profiles differed between cohorts. LIMBIC-CENC participants endorsed higher posttraumatic stress disorder symptomatology. DVBIC-TBICoE study IC participants endorsed higher somatosensory and vestibular symptoms (medium effect sizes). Other symptom measure differences had very small effect sizes (≤0.2). Differences were found on many cognitive test results, but are difficult to interpret given the demographic differences and generally very small effect sizes. CONCLUSIONS The heavy use of NIH common data elements in both studies and collaboration with the DVBIC-TBICoE study team on development of the LIMBIC-CENC assessment battery enabled this comparative analysis. Results highlight unique differences in study cohorts, and adds perspective and interpretability for assimilating past and future findings.
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Affiliation(s)
- Treven C Pickett
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Department of Rehabilitation, Uniform Services University, Bethesda, MD.
| | - William C Walker
- Department of Physical Medicine and Rehabilitation (PM&R), School of Medicine, Virginia Commonwealth University, Richmond, VA; Department of Physical Medicine and Rehabilitation (PM&R), Central Virginia VA Healthcare System, Richmond, VA
| | - Sara M Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | - Rael T Lange
- TBI Center of Excellence (TBICoE), J9, Defense Health Agency, Silver Spring, MD
| | - Tracey A Brickell
- TBI Center of Excellence (TBICoE), J9, Defense Health Agency, Silver Spring, MD
| | | | - Johanna M Smith
- TBI Center of Excellence (TBICoE), J9, Defense Health Agency, Silver Spring, MD
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation (PM&R), School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Louis M French
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
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Walker WC, O'Neil ME, Ou Z, Pogoda TK, Belanger HG, Scheibel RS, Presson AP, Miles SR, Wilde EA, Tate DF, Troyanskaya M, Pugh MJ, Jak A, Cifu DX. Can mild traumatic brain injury alter cognition chronically? A LIMBIC-CENC multicenter study. Neuropsychology 2023; 37:1-19. [PMID: 36174184 PMCID: PMC10117581 DOI: 10.1037/neu0000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE While outcome from mild traumatic brain injury (mTBI) is generally favorable, concern remains over potential negative long-term effects, including impaired cognition. This study examined the link between cognitive performance and remote mTBIs within the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) multicenter, observational study of Veterans and service members (SMs) with combat exposure. METHOD Baseline data of the participants passing all cognitive performance validity tests (n = 1,310) were used to conduct a cross-sectional analysis. Using multivariable regression models that adjusted for covariates, including age and estimated preexposure intellectual function, positive mTBI history groups, 1-2 lifetime mTBIs (nonrepetitive, n = 614), and 3 + lifetime mTBIs (repetitive; n = 440) were compared to TBI negative controls (n = 256) on each of the seven cognitive domains computed by averaging Z scores of prespecified component tests. Significance levels were adjusted for multiple comparisons. RESULTS Neither of the mTBI positive groups differed from the mTBI negative control group on any of the cognitive domains in multivariable analyses. Findings were also consistently negative across sensitivity analyses (e.g., mTBIs as a continuous variable, number of blast-related mTBIs, or years since the first and last mTBI). CONCLUSIONS Our findings demonstrate that the average veteran or SM who experienced one or more mTBIs does not have postacute objective cognitive deficits due to mTBIs alone. A holistic health care approach including comorbidity assessment is indicated for patients reporting chronic cognitive difficulties after mTBI(s), and strategies for addressing misattribution may be beneficial. Future study is recommended with longitudinal designs to assess within-subjects decline from potential neurodegeneration. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Terri K Pogoda
- Center for Healthcare Organization and Implementation Research
| | | | | | | | | | | | - David F Tate
- Department of Physical Medicine and Rehabilitation
| | | | - Mary Jo Pugh
- George E. Wahlen Veterans Affairs Salt Lake City Healthcare System
| | - Amy Jak
- VA San Diego Healthcare System
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation
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Gorgey AS, Khalil RE, Alrubaye M, Gill R, Rivers J, Goetz LL, Cifu DX, Castillo T, Caruso D, Lavis TD, Lesnefsky EJ, Cardozo CC, Adler RA. Testosterone and long pulse width stimulation (TLPS) for denervated muscles after spinal cord injury: a study protocol of randomised clinical trial. BMJ Open 2022; 12:e064748. [PMID: 36198461 PMCID: PMC9535184 DOI: 10.1136/bmjopen-2022-064748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Long pulse width stimulation (LPWS; 120-150 ms) has the potential to stimulate denervated muscles and to restore muscle size in denervated people with spinal cord injury (SCI). We will determine if testosterone treatment (TT)+LPWS would increase skeletal muscle size, leg lean mass and improve overall metabolic health in persons with SCI with denervation. We hypothesise that the 1-year TT+LPWS will upregulate protein synthesis pathways, downregulate protein degradation pathways and increase overall mitochondrial health. METHODS AND ANALYSIS Twenty-four male participants (aged 18-70 years with chronic SCI) with denervation of both knee extensor muscles and tolerance to the LPWS paradigm will be randomised into either TT+neuromuscular electrical stimulation via telehealth or TT+LPWS. The training sessions will be twice weekly for 1 year. Measurements will be conducted 1 week prior training (baseline; week 0), 6 months following training (postintervention 1) and 1 week after the end of 1 year of training (postintervention 2). Measurements will include body composition assessment using anthropometry, dual X-ray absorptiometry and MRI to measure size of different muscle groups. Metabolic profile will include measuring of basal metabolic rate, followed by blood drawn to measure fasting biomarkers similar to hemoglobin A1c, lipid panels, C reactive protein, interleukin-6 and free fatty acids and then intravenous glucose tolerance test to test for insulin sensitivity and glucose effectiveness. Finally, muscle biopsy will be captured to measure protein expression and intracellular signalling; and mitochondrial electron transport chain function. The participants will fill out 3 days dietary record to monitor their energy intake on a weekly basis. ETHICS AND DISSEMINATION The study was approved by Institutional Review Board of the McGuire Research Institute (ID # 02189). Dissemination plans will include the Veteran Health Administration and its practitioners, the national SCI/D services office, the general healthcare community and the veteran population, as well as the entire SCI community via submitting quarterly letters or peer-review articles. TRIAL REGISTRATION NUMBER NCT03345576.
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Affiliation(s)
- Ashraf S Gorgey
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Refka E Khalil
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Malak Alrubaye
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Ranjodh Gill
- Endocrine Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Jeannie Rivers
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Lance L Goetz
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - David X Cifu
- Physical Medicine and Rehab, Commonwealth of Virginia, Richmond, Virginia, USA
| | - Teodoro Castillo
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Deborah Caruso
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Timothy D Lavis
- Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Edward J Lesnefsky
- Cardiology Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Christopher C Cardozo
- National Center for the Medical Consequences of Spinal Cord Injury and Medical and Surgical Service, James J Peters VA Medical Center, Bronx, New York, USA
| | - Robert A Adler
- Endocrine Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
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Swanson RL, Acharya NK, Cifu DX. Cerebral Microvascular Pathology Is a Common Endophenotype Between Traumatic Brain Injury, Cardiovascular Disease, and Dementia: A Hypothesis and Review. Cureus 2022; 14:e25318. [PMID: 35774720 PMCID: PMC9236636 DOI: 10.7759/cureus.25318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/05/2022] Open
Abstract
Traumatic brain injury (TBI) exposure has been associated with an increased risk of age-related cognitive decline or dementia in multiple epidemiological studies. Current therapeutic interventions in the field of Brain Injury Medicine focus largely on episodic symptom management during the chronic phase of TBI recovery, rather than targeting specific underlying pathological processes. This approach may be especially problematic for secondary age-related cognitive decline or dementia following TBI exposure. Although there are likely multiple pathophysiological mechanisms involved, a growing body of literature demonstrates that cerebral microvascular pathology is a common endophenotype across the spectrum of TBI severity. Similarly, a combination of pre-clinical and clinical research over the past two decades has implicated cerebral microvascular pathology in the initiation and progression of multiple neurodegenerative diseases, including Alzheimer’s disease and other dementias. We hypothesize that cerebral microvascular pathology is a common endophenotype between TBI, cardiovascular disease (CVD), and dementia, which can be targeted through modifiable cardiovascular risk factor reductions during the chronic phase of TBI recovery. We posit that our hypothesis is supported by the currently available scientific literature, as detailed in our review.
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Stein DM, Braverman MA, Phuong J, Shipper E, Price MA, Bixby PJ, Adelson PD, Ansel BM, Cifu DX, DeVine JG, Galvagno SM, Gelb DE, Harris O, Kang CS, Kitagawa RS, McQuillan KA, Patel MB, Robertson CS, Salim A, Shutter L, Valadka AB, Bulger EM. Developing a National Trauma Research Action Plan: Results from the Neurotrauma Research Panel Delphi Survey. J Trauma Acute Care Surg 2022; 92:906-915. [PMID: 35001020 DOI: 10.1097/ta.0000000000003527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In 2016, the National Academies of Science, Engineering and Medicine called for the development of a National Trauma Research Action Plan. The Department of Defense funded the Coalition for National Trauma Research to generate a comprehensive research agenda spanning the continuum of trauma and burn care. Given the public health burden of injuries to the central nervous system, neurotrauma was one of 11 panels formed to address this recommendation with a gap analysis and generation of high-priority research questions. METHODS We recruited interdisciplinary experts to identify gaps in the neurotrauma literature, generate research questions, and prioritize those questions using a consensus-driven Delphi survey approach. We conducted four Delphi rounds in which participants generated key research questions and then prioritized the importance of the questions on a 9-point Likert scale. Consensus was defined as 60% or greater of panelists agreeing on the priority category. We then coded research questions using an National Trauma Research Action Plan taxonomy of 118 research concepts, which were consistent across all 11 panels. RESULTS Twenty-eight neurotrauma experts generated 675 research questions. Of these, 364 (53.9%) reached consensus, and 56 were determined to be high priority (15.4%), 303 were deemed to be medium priority (83.2%), and 5 were low priority (1.4%). The research topics were stratified into three groups-severe traumatic brain injury (TBI), mild TBI (mTBI), and spinal cord injury. The number of high-priority questions for each subtopic was 46 for severe TBI (19.7%), 3 for mTBI (4.3%) and 7 for SCI (11.7%). CONCLUSION This Delphi gap analysis of neurotrauma research identified 56 high-priority research questions. There are clear areas of focus for severe TBI, mTBI, and spinal cord injury that will help guide investigators in future neurotrauma research. Funding agencies should consider these gaps when they prioritize future research. LEVEL OF EVIDENCE Diagnostic Test or Criteria, Level IV.
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Affiliation(s)
- Deborah M Stein
- From the Program in Trauma, University of Maryland School of Medicine (D.M.S.), Baltimore, Maryland; Department of Biomedical Informatics and Medical Education (J.P.), University of Washington, Seattle, Washington; Coalition for National Trauma Research (M.A.B., E.S., M.A.P., P.J.B.), San Antonio, Texas; Department of Neurosurgery, Mayo Clinic (P.D.A.), Barrow Neurological Institute at Phoenix Children's Hospital; Division of Neurosurgery, Department of Child Health (P.D.A.), University of Arizona, Phoenix, Arizona; Department of Neurological Surgery (B.M.A.), Indiana University School of Medicine, Indianapolis, Indiana; Department of Physical Medicine and Rehabilitation (D.X.C.), Virginia Commonwealth University School of Medicine, Richmond, Virginia; Department of Orthopaedics, Augusta University Health (J.G.D.), Augusta, Georgia; Department of Anesthesiology (S.M.G.), Department of Orthopaedics (D.E.G.), University of Maryland School of Medicine, Baltimore, Maryland; Department of Neurosurgery (O.H.), Stanford University, Palo Alto, California; Department of Emergency Medicine (C.S.K.), Madigan Army Medicine Center, Tacoma, Washington; Department of Neurosurgery (R.S.K.), McGovern Medical School, Houston, Texas; R Adams Cowley Shock Trauma Center (K.A.M.), University of Maryland Medical Center, Baltimore, Maryland; Department of Surgery (M.B.P.), Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Neurosurgery (C.S.R.), Baylor College of Medicine, Houston, Texas; Department of Surgery (A.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Critical Care Medicine (L.S.), Neurology & Neurosurgery, University of Pittsburg, Pittsburgh, Pennsylvania; Department of Neurosurgery (A.B.V.), Virginia Commonwealth University School of Medicine, Richmond, Virginia; Department of Surgery (E.M.B.), Harborview Medical Center, University of Washington, Seattle, Washington
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Eapen BC, Bowles AO, Sall J, Lang AE, Hoppes CW, Stout KC, Kretzmer T, Cifu DX. The management and rehabilitation of post-acute mild traumatic brain injury. Brain Inj 2022; 36:693-702. [DOI: 10.1080/02699052.2022.2033848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Blessen C. Eapen
- Physical Medicine and Rehabilitation Service Va Greater Los Angeles Healthcare System, Division of Physical Medicine and Rehabilitation David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Amy O. Bowles
- Physical Medicine and Rehabilitation Brooke Army Medical Center, Fort Sam Houston, Texas, USA
| | - James Sall
- Clinical Quality Program Specialist, Quality and Patient Safety, Veterans Administration Central Office, Washington, District of Columbia, USA
| | - Adam Edward Lang
- Department of Primary Care, McDonald Army Health Center, Fort Eustis, Virginia, USA
| | - Carrie W. Hoppes
- Army-Baylor University Doctoral Program in Physical Therapy, Army Medical Center of Excellence, Fort Sam Houston, Texas, USA
| | - Katharine C. Stout
- Defense Health Agency Research and Development (J-9), Director of Clinical Affairs Division Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA
| | - Tracy Kretzmer
- Neuropsychology, Mental Health and Behavioral Sciences Inpatient Polytrauma, Rehabilitation, Post-Deployment Rehabilitation and Evaluation Program (PREP), James A. Haley Veterans’ Hospital, Tampa, Florida, USA
| | - David X. Cifu
- Physical Medicine and Rehabilitation, Senior TBI Specialist, Department of Veterans Affairs Associate Dean of Innovation and System Integration, Richmond, VA, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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22
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O’Neil ME, Agyemang A, Walker WC, Pogoda TK, Klyce DW, Perrin PB, Hsu NH, Nguyen H, Presson AP, Cifu DX. Demographic, military, and health comorbidity variables by mild TBI and PTSD status in the LIMBIC-CENC cohort. Brain Inj 2022; 36:598-606. [DOI: 10.1080/02699052.2022.2033847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Maya E. O’Neil
- VA Portland Health Care System, Portland, Oregon, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Amma Agyemang
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
| | - William C. Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
- Central Virginia VA Healthcare System, Richmond, Virginia, USA
| | - Terri K. Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
| | - Daniel W. Klyce
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
- Central Virginia VA Healthcare System, Richmond, Virginia, USA
- Sheltering Arms Institute, Richmond, Virginia, USA
| | - Paul B. Perrin
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
- Central Virginia VA Healthcare System, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nancy H. Hsu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
| | - Huong Nguyen
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
| | - Angela P. Presson
- Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - David X. Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
- Innovation and System Integration, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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23
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Dennis EL, Taylor BA, Newsome MR, Troyanskaya M, Abildskov TJ, Betts AM, Bigler ED, Cole J, Davenport N, Duncan T, Gill J, Guedes V, Hinds SR, Hovenden ES, Kenney K, Pugh MJ, Scheibel RS, Shahim PP, Shih R, Walker WC, Werner JK, York GE, Cifu DX, Tate DF, Wilde EA. Advanced brain age in deployment-related traumatic brain injury: A LIMBIC-CENC neuroimaging study. Brain Inj 2022; 36:662-672. [PMID: 35125044 PMCID: PMC9187589 DOI: 10.1080/02699052.2022.2033844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To determine if history of mild traumatic brain injury (mTBI) is associated with advanced or accelerated brain aging among the United States (US) military Service Members and Veterans. METHODS Eight hundred and twenty-two participants (mean age = 40.4 years, 714 male/108 female) underwent MRI sessions at eight sites across the US. Two hundred and one participants completed a follow-up scan between five months and four years later. Predicted brain ages were calculated using T1-weighted MRIs and then compared with chronological ages to generate an Age Deviation Score for cross-sectional analyses and an Interval Deviation Score for longitudinal analyses. Participants also completed a neuropsychological battery, including measures of both cognitive functioning and psychological health. RESULT In cross-sectional analyses, males with a history of deployment-related mTBI showed advanced brain age compared to those without (t(884) = 2.1, p = .038), while this association was not significant in females. In follow-up analyses of the male participants, severity of posttraumatic stress disorder (PTSD), depression symptoms, and alcohol misuse were also associated with advanced brain age. CONCLUSION History of deployment-related mTBI, severity of PTSD and depression symptoms, and alcohol misuse are associated with advanced brain aging in male US military Service Members and Veterans.
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Affiliation(s)
- Emily L Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, USA
| | - Brian A Taylor
- Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, USA
| | - Mary R Newsome
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
- H. Baylor College of Medicine, Houston, USA
| | - Maya Troyanskaya
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
- H. Baylor College of Medicine, Houston, USA
| | - Tracy J Abildskov
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, USA
| | - Aaron M Betts
- Brooke Army Medical Center, Fort Sam Houston, USA
- Department of Radiology and Radiological Sciences, Uniformed Services University, Bethesda, USA
| | - Erin D Bigler
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, USA
- Department of Psychology, Brigham Young University, Provo, USA
- Neuroscience Center, Brigham Young University, Provo, USA
| | - James Cole
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Nicholas Davenport
- Minneapolis VA Health Care System, Minneapolis, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, USA
| | | | - Jessica Gill
- National Institutes of Health, National Institute of Nursing Research, Bethesda, USA
- Center for Neuroscience and Regenerative Medicine (CNRM), UniFormed Services University, Bethesda, USA
| | - Vivian Guedes
- National Institutes of Health, National Institute of Nursing Research, Bethesda, USA
| | - Sidney R Hinds
- Department of Neurology, Uniformed Services University, Bethesda, USA
| | - Elizabeth S Hovenden
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, USA
| | - Kimbra Kenney
- Department of Neurology, Uniformed Services University, Bethesda, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, USA
| | - Mary Jo Pugh
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, USA
- Information Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City, Salt Lake City, USA
| | - Randall S Scheibel
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
- H. Baylor College of Medicine, Houston, USA
| | - Pashtun-Poh Shahim
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, USA
| | - Robert Shih
- Department of Radiology and Radiological Sciences, Uniformed Services University, Bethesda, USA
| | - William C Walker
- Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, USA
| | - J. Kent Werner
- Department of Neurology, Uniformed Services University, Bethesda, USA
| | | | - David X Cifu
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, USA
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, USA
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, USA
- H. Baylor College of Medicine, Houston, USA
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Cifu DX. Clinical research findings from the long-term impact of military-relevant brain injury consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) 2013-2021. Brain Inj 2022; 36:587-597. [PMID: 35080997 DOI: 10.1080/02699052.2022.2033843] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This is a summary of the published research from the 14 observational, longitudinal and big-data, epidemiological studies supported by the LIMBIC-CENC program from 2013-2021 examining the long-term effects of combat-related traumatic brain injury (TBI). Findings from these 43 primary and secondary analyses include: 1) unique fluid, advanced neuroimaging and electrophysiologic biomarkers associated with mild traumatic brain injury (mTBI), number of mTBIs and related dysfunction, 2) increases in a range of chronic difficulties, including neurosensory, sleep, pain, cognitive deficits, behavioral disorders, overall symptom burden, healthcare costs and service-connected disability, associated with mTBI, all-severity traumatic brain injury (TBI), blast exposure, and number of mTBIs, and 3) increases in the risk for suicide and neurodegeneration, including dementia and Parkinson's disease, associated with mTBI and all-severity TBI. Ongoing LIMBIC-CENC longitudinal and epidemiologic research will clarify, confirm and expand upon these findings.
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Affiliation(s)
- David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Veterans Affairs, Washington, DC, USA
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Gorgey AS, Sutor TW, Goldsmith JA, Ennasr AN, Lavis TD, Cifu DX, Trainer R. Epidural stimulation with locomotor training ameliorates unstable blood pressure after tetraplegia. A case report. Ann Clin Transl Neurol 2022; 9:232-238. [PMID: 35068086 PMCID: PMC8862417 DOI: 10.1002/acn3.51508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/13/2022] Open
Abstract
A male with C7 complete tetraplegia participated in 14 weeks of body weight supported treadmill training (BWSTT) combined with spinal cord epidural stimulation (SCES), 4 weeks of no intervention, and two more weeks of BWSTT + SCES. The participant presented with unstable resting seated blood pressure (BP; 131/66 mmHg). After retrospective analysis, resting systolic BP decreased and diastolic BP increased, yielding a safe mean arterial BP. There was a fivefold increase in BWSTT bouts per session, and percentage of body weight support decreased to 69%. BWSTT + SCES safely and effectively regulated resting BP and mitigated symptoms of orthostatic intolerance. These effects were not maintained after 4 weeks without training.
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Affiliation(s)
- Ashraf S. Gorgey
- Spinal Cord Injury and Disorders Center Hunter Holmes McGuire VAMC 1201 Broad Rock Boulevard Richmond Virginia 23249 USA
- Department of Physical Medicine & Rehabilitation Virginia Commonwealth University Richmond Virginia 23298 USA
| | - Tommy W. Sutor
- Spinal Cord Injury and Disorders Center Hunter Holmes McGuire VAMC 1201 Broad Rock Boulevard Richmond Virginia 23249 USA
| | - Jacob A. Goldsmith
- Spinal Cord Injury and Disorders Center Hunter Holmes McGuire VAMC 1201 Broad Rock Boulevard Richmond Virginia 23249 USA
| | - Areej N. Ennasr
- Spinal Cord Injury and Disorders Center Hunter Holmes McGuire VAMC 1201 Broad Rock Boulevard Richmond Virginia 23249 USA
| | - Timothy D. Lavis
- Spinal Cord Injury and Disorders Center Hunter Holmes McGuire VAMC 1201 Broad Rock Boulevard Richmond Virginia 23249 USA
- Department of Physical Medicine & Rehabilitation Virginia Commonwealth University Richmond Virginia 23298 USA
| | - David X. Cifu
- Department of Physical Medicine & Rehabilitation Virginia Commonwealth University Richmond Virginia 23298 USA
| | - Robert Trainer
- Physical Medicine and Rehabilitation Hunter Holmes McGuire VAMC 1201 Broad Rock Boulevard Richmond Virginia 23249 USA
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Siedhoff HR, Chen S, Song H, Cui J, Cernak I, Cifu DX, DePalma RG, Gu Z. Perspectives on Primary Blast Injury of the Brain: Translational Insights Into Non-inertial Low-Intensity Blast Injury. Front Neurol 2022; 12:818169. [PMID: 35095749 PMCID: PMC8794583 DOI: 10.3389/fneur.2021.818169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/20/2021] [Indexed: 12/18/2022] Open
Abstract
Most traumatic brain injuries (TBIs) during military deployment or training are clinically "mild" and frequently caused by non-impact blast exposures. Experimental models were developed to reproduce the biological consequences of high-intensity blasts causing moderate to severe brain injuries. However, the pathophysiological mechanisms of low-intensity blast (LIB)-induced neurological deficits have been understudied. This review provides perspectives on primary blast-induced mild TBI models and discusses translational aspects of LIB exposures as defined by standardized physical parameters including overpressure, impulse, and shock wave velocity. Our mouse LIB-exposure model, which reproduces deployment-related scenarios of open-field blast (OFB), caused neurobehavioral changes, including reduced exploratory activities, elevated anxiety-like levels, impaired nesting behavior, and compromised spatial reference learning and memory. These functional impairments associate with subcellular and ultrastructural neuropathological changes, such as myelinated axonal damage, synaptic alterations, and mitochondrial abnormalities occurring in the absence of gross- or cellular damage. Biochemically, we observed dysfunctional mitochondrial pathways that led to elevated oxidative stress, impaired fission-fusion dynamics, diminished mitophagy, decreased oxidative phosphorylation, and compensated cell respiration-relevant enzyme activity. LIB also induced increased levels of total tau, phosphorylated tau, and amyloid β peptide, suggesting initiation of signaling cascades leading to neurodegeneration. We also compare translational aspects of OFB findings to alternative blast injury models. By scoping relevant recent research findings, we provide recommendations for future preclinical studies to better reflect military-operational and clinical realities. Overall, better alignment of preclinical models with clinical observations and experience related to military injuries will facilitate development of more precise diagnosis, clinical evaluation, treatment, and rehabilitation.
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Affiliation(s)
- Heather R. Siedhoff
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, United States
- Harry S. Truman Memorial Veterans' Hospital Research Service, Columbia, MO, United States
| | - Shanyan Chen
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, United States
- Harry S. Truman Memorial Veterans' Hospital Research Service, Columbia, MO, United States
| | - Hailong Song
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, United States
- Harry S. Truman Memorial Veterans' Hospital Research Service, Columbia, MO, United States
| | - Jiankun Cui
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, United States
- Harry S. Truman Memorial Veterans' Hospital Research Service, Columbia, MO, United States
| | - Ibolja Cernak
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA, United States
| | - David X. Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Ralph G. DePalma
- Office of Research and Development, Department of Veterans Affairs, Washington, DC, United States
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Zezong Gu
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, United States
- Harry S. Truman Memorial Veterans' Hospital Research Service, Columbia, MO, United States
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Caruso D, Chaggar RS, McDonald SD, Arbonies CX, Cifu DX. The Implications of Power Mobility on Body Weight in a Veteran Population. Fed Pract 2021; 38:406-410. [PMID: 34737537 DOI: 10.12788/fp.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background The prevalence of obesity is increasing in the United States. A common concern among health care providers is that prescribing a power mobility device (PMD) may decrease physical activity and lead to obesity and increasing morbidity. This study analyzes the effect of PMD prescriptions over a 2-year period on body mass index (BMI) and body weight in a population of veterans both as a whole and in BMI/age subgroups. Methods Prosthetics department medical records of veterans who received PMDs for the first time between January 1, 2011 and June 30, 2012 were reviewed. Of 399 records reviewed, 185 veterans met criteria for data analysis. The primary outcome measure was the change in BMI and body weight from time 1 (date of PMD prescription) to time 2 (2 years later). Results There was a significant decrease in BMI and weight in the first 2 years after receiving a PMD prescription. However, age moderated the relationship between BMI and time. Conclusions PMD use does not seem to be associated with significant weight change. Further studies using control groups and assessing comorbidities are needed.
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Affiliation(s)
- Deborah Caruso
- is a Physical Medicine and Rehabilitation Staff Physician, and is a Clinical Psychologist, both at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia. is a Senior Traumatic Brain Injury Specialist for the US Department of Veterans Affairs. is a Physical Medicine and Rehabilitation Staff Physician at Ochsner Medical Center in New Orleans, Louisiana. is a Physical Medicine and Rehabilitation Resident Physician, and David Cifu is Associate Dean of Innovation and Systems Integration, both at Virginia Commonwealth University Health System in Richmond
| | - Rajbir S Chaggar
- is a Physical Medicine and Rehabilitation Staff Physician, and is a Clinical Psychologist, both at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia. is a Senior Traumatic Brain Injury Specialist for the US Department of Veterans Affairs. is a Physical Medicine and Rehabilitation Staff Physician at Ochsner Medical Center in New Orleans, Louisiana. is a Physical Medicine and Rehabilitation Resident Physician, and David Cifu is Associate Dean of Innovation and Systems Integration, both at Virginia Commonwealth University Health System in Richmond
| | - Scott D McDonald
- is a Physical Medicine and Rehabilitation Staff Physician, and is a Clinical Psychologist, both at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia. is a Senior Traumatic Brain Injury Specialist for the US Department of Veterans Affairs. is a Physical Medicine and Rehabilitation Staff Physician at Ochsner Medical Center in New Orleans, Louisiana. is a Physical Medicine and Rehabilitation Resident Physician, and David Cifu is Associate Dean of Innovation and Systems Integration, both at Virginia Commonwealth University Health System in Richmond
| | - Christo X Arbonies
- is a Physical Medicine and Rehabilitation Staff Physician, and is a Clinical Psychologist, both at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia. is a Senior Traumatic Brain Injury Specialist for the US Department of Veterans Affairs. is a Physical Medicine and Rehabilitation Staff Physician at Ochsner Medical Center in New Orleans, Louisiana. is a Physical Medicine and Rehabilitation Resident Physician, and David Cifu is Associate Dean of Innovation and Systems Integration, both at Virginia Commonwealth University Health System in Richmond
| | - David X Cifu
- is a Physical Medicine and Rehabilitation Staff Physician, and is a Clinical Psychologist, both at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia. is a Senior Traumatic Brain Injury Specialist for the US Department of Veterans Affairs. is a Physical Medicine and Rehabilitation Staff Physician at Ochsner Medical Center in New Orleans, Louisiana. is a Physical Medicine and Rehabilitation Resident Physician, and David Cifu is Associate Dean of Innovation and Systems Integration, both at Virginia Commonwealth University Health System in Richmond
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O'Neil ME, Klyce DW, Pogoda TK, Cifu DX, Eggleston BE, Cameron DC, Wilde EA, Walker WC, Carlson KF. Associations Among PTSD and Postconcussive Symptoms in the Long-Term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium Prospective, Longitudinal Study Cohort. J Head Trauma Rehabil 2021; 36:E363-E372. [PMID: 33656490 DOI: 10.1097/htr.0000000000000665] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe rates of mild traumatic brain injury (mTBI) with and without concurrent posttraumatic stress disorder a sample of former and current military personnel, and to compare the factor structure of the Neurobehavioral Symptom Inventory (NSI) based on whether participants sustained mTBI with and without a positive posttraumatic stress disorder (PTSD) screen. SETTING Participants recruited and tested at 7 Veterans Affairs (VA) sites and 1 military training facility as part of a national, longitudinal study of mental health, physical, and cognitive outcomes among veterans and service members. Participants: Total of 1540 former and current military personnel with a history of combat exposure. DESIGN Cross-sectional analysis of observational data, including confirmatory factor analysis. Main Measures: NSI and PTSD Checklist for DSM-5 (PCL-5). RESULTS Most participants (81.5%) had a history of mTBI and almost half of these screened positive for PTSD (40.5%); only 23.9% of participants without a history of mTBI screened positive for PTSD. Participants with a history of mTBI reported higher elevations of NSI and PCL-5 symptoms compared with those without a history of mTBI. Confirmatory factor analyses of the NSI demonstrated good model fit using a 4-factor structure (somatosensory, affective, cognitive, and vestibular symptoms) among groups of participants both with and without a history of mTBI. CONCLUSION Symptoms of mTBI and PTSD are strongly associated with each other among veterans and service members with a history of combat exposure. The 4-factor NSI structure is supported among participants with and without a history of mTBI. These findings suggest the potential benefit of a holistic approach to evaluation and treatment of veterans and service members with concurrent and elevated postconcussive and posttraumatic stress symptoms.
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Affiliation(s)
- Maya E O'Neil
- VA Portland Health Care System, Portland, Oregon (Drs O'Neil and Carlson and Mr Cameron); Departments of Psychiatry and Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (Dr O'Neil); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond (Drs Klyce, Cifu, and Walker); Central VA Healthcare System, Richmond, and Sheltering Arms Institute, Richmond, Virginia (Drs Klyce and Cifu); Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, and Boston University School of Public Health, Boston, Massachusetts (Dr Pogoda); Research Triangle Park, Research Triangle Park, North Carolina (Mr Eggleston); George E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, and Department of Neurology, University of Utah, Salt Lake City (Dr Wilde); and School of Public Health, Oregon Heath & Science University, Portland (Dr Carlson)
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Lumba-Brown A, Prager EM, Harmon N, McCrea MA, Bell MJ, Ghajar J, Pyne S, Cifu DX. A Review of Implementation Concepts and Strategies Surrounding Traumatic Brain Injury Clinical Care Guidelines. J Neurotrauma 2021; 38:3195-3203. [PMID: 34714147 DOI: 10.1089/neu.2021.0067] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Despite considerable efforts to advance the science surrounding traumatic brain injury (TBI), formal efforts supporting the current and future implementation of scientific findings within clinical practice and healthcare policy are limited. While many and varied guidelines inform the clinical management of TBI across the spectrum, clinicians and healthcare systems are not broadly adopting, implementing, and/or adhering to them. As part of the Brain Trauma Blueprint TBI State of the Science, an expert workgroup was assembled to guide this review article, which describes: (1) possible etiologies of inadequate adoption and implementation; (2) enablers to successful implementation strategies; and (3) strategies to mitigate the barriers to adoption and implementation of future research.
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Affiliation(s)
- Angela Lumba-Brown
- Department of Emergency Medicine, Stanford University, Stanford, California, USA
| | | | | | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Neurosurgery Research Laboratory, Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA
| | - Michael J Bell
- Pediatrics, Critical Care Medicine, Children's National Hospital, Washington DC, USA
| | - Jamshid Ghajar
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Scott Pyne
- Traumatic Brain Injury Center of Excellence, Defense Health Agency, Silver Spring, Maryland, USA
| | - David X Cifu
- Virginia Commonwealth University School of Medicine, and Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA
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McDonald SD, Walker WC, Cusack SE, Yoash-Gantz RE, Pickett TC, Cifu DX, Mid-Atlantic Mirecc Workgroup V, Tupler LA. Health symptoms after war zone deployment-related mild traumatic brain injury: contributions of mental disorders and lifetime brain injuries. Brain Inj 2021; 35:1338-1348. [PMID: 34543115 DOI: 10.1080/02699052.2021.1959058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PRIMARY OBJECTIVE To gain a better understanding of the complex relationship between combat deployment-related mild traumatic brain injury (mTBI) and persistent post-concussive symptoms (PPCSs), taking into consideration a wide range of potentially mediating and confounding factors. RESEARCH DESIGN Cross-sectional. METHODS AND PROCEDURES Subjects were 613 U. S. military Veterans and Service Members who served during operations Enduring Freedom, Iraqi Freedom, or New Dawn (OEF/OIF/OND) and completed a structured interview of mental disorders and a battery of questionnaires. Hierarchical binary logistic regression analyses were used to test the hypotheses. MAIN OUTCOMES AND RESULTS After accounting for mental disorders, lifetime mTBIs outside of OEF/OIF/OND deployment, medical conditions, and injury/demographic characteristics, deployment-related mTBI continued to be associated with several PPCSs (headaches, sleep disturbance, and difficulty making decisions). Deployment-related mTBI was also associated with two symptoms not normally associated with mTBI (nausea/upset stomach and numbness/tingling). CONCLUSIONS After adjusting for a wide range of factors, OEF/OIF/OND deployment-related mTBI was still associated with PPCSs on average 10 years after the injury. These findings suggest that mTBI sustained during OEF/OIF/OND deployment may have enduring negative health effects. More studies are needed that prospectively and longitudinally track health and mental health outcomes after TBI.
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Affiliation(s)
- Scott D McDonald
- Mental Health Service, Hunter Holmes McGuire Va Medical Center, Richmond, VA, USA.,Department Of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Department Of Physical Medicine And Rehabilitation, School Of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - William C Walker
- Mental Health Service, Hunter Holmes McGuire Va Medical Center, Richmond, VA, USA.,Department Of Physical Medicine And Rehabilitation, School Of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Shannon E Cusack
- Department Of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Virginia Institute for Psychiatric and Behavioral Genetics (Vipbg), School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Ruth E Yoash-Gantz
- Va Mid-Atlantic Mental Illness, Research, And Clinical Center, Durham, NC, USA
| | | | - David X Cifu
- Mental Health Service, Hunter Holmes McGuire Va Medical Center, Richmond, VA, USA.,Department Of Physical Medicine And Rehabilitation, School Of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Larry A Tupler
- Va Mid-Atlantic Mental Illness, Research, And Clinical Center, Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA.,Duke University Medical Center, Durham, NC, USA
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Cifu DX, Eapen BC. Integrative Medicine and Rehabilitation: Toward a New Beginning. Phys Med Rehabil Clin N Am 2020; 31:xv-xvi. [PMID: 32981589 DOI: 10.1016/j.pmr.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA USA; U.S. Department of Veterans Affairs, Richmond, VA, USA; Long-term Impact of Military-relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC), Richmond, VA, USA.
| | - Blessen C Eapen
- Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, Los Angeles CA, USA; Department of Medicine, Division of Physical Medicine and Rehabilitation, David Geffen School of Medicine at UCLA, Los Angeles, CA USA.
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Gill S, Sumrell RM, Sima A, Cifu DX, Gorgey AS. Waist circumference cutoff identifying risks of obesity, metabolic syndrome, and cardiovascular disease in men with spinal cord injury. PLoS One 2020; 15:e0236752. [PMID: 32726371 PMCID: PMC7390405 DOI: 10.1371/journal.pone.0236752] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives To apply spinal cord injury (SCI) specific waist circumference (WC) cutoff point to identify risks of 1) obesity, 2) metabolic syndrome (MetS), 3) cardiovascular disease (CVD). Methods Thirty-six men with chronic SCI underwent anthropometric measurements, dual-energy x-ray absorptiometry (DXA), and magnetic resonance imaging (MRI) to measure total and regional adiposity. An SCI specific WC cutoff point of 86.5 cm was applied to the existing general population criteria. Pearson chi-square (χ2) analyses tested the difference in the number of participants classified as obese using the SCI specific cutoff point compared to the general population criteria. Sensitivity and specificity analyses relative to percentage body fat mass and visceral adipose tissue was used to assess classification performance of this cutoff point. The interrater reliability for three definitions of MetS was assessed using Cohen’s Kappa (κ) values. Linear regression analyses were utilized to propose SCI specific Framingham Coronary Heart Disease Risk Score (FRS) cutoff value. Results Using SCI specific WC cutoff point of 86.5 cm, 36% of participants were classified as obese compared to only 3% when using WC of 102 cm (P < 0.001). Relative to percentage body fat mass, the general population WC cutoff point of 102 cm had a sensitivity of 6.3% and specificity of 100% both which changed to 68.8% and 90%, respectively, with a SCI specific cutoff point of 86.5 cm. Similar results were obtained when using visceral adipose tissue as a reference. The Kappa (κ) values improved substantially after using SCI specific criteria (0.95 ± 0.05) compared to the general population criteria (0.47 ± 0.28) for three definitions of MetS. The SCI specific FRS cutoff value of 6 was predicted after applying a WC cutoff of 86.5 cm. Conclusions Using the existing general population criteria underestimated persons with SCI who are at risk of developing obesity, MetS, and CVD. The recommended SCI specific criteria are likely to distinguish those at risks of developing comorbidities and allow healthcare providers to intervene in a timely manner.
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Affiliation(s)
- Satinder Gill
- Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA, United States of America
| | - Ryan M. Sumrell
- Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA, United States of America
| | - Adam Sima
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States of America
| | - David X. Cifu
- Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Ashraf S. Gorgey
- Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA, United States of America
- Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States of America
- * E-mail:
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Abstract
The global outbreak of coronavirus disease 2019 has created an unprecedented challenge to the society. Currently, the United States stands as the most affected country, and the entire healthcare system is affected, from emergency department, intensive care unit, postacute care, outpatient, to home care. Considering the debility, neurological, pulmonary, neuromuscular, and cognitive complications, rehabilitation professionals can play an important role in the recovery process for individuals with coronavirus disease 2019. Clinicians across the nation's rehabilitation system have already begun working to initiate intensive care unit-based rehabilitation care and develop programs, settings, and specialized care to meet the short- and long-term needs of these individuals. We describe the anticipated rehabilitation demands and the strategies to meet the needs of this population. The complications from coronavirus disease 2019 can be reduced by (1) delivering interdisciplinary rehabilitation that is initiated early and continued throughout the acute hospital stay, (2) providing patient/family education for self-care after discharge from inpatient rehabilitation at either acute or subacute settings, and (3) continuing rehabilitation care in the outpatient setting and at home through ongoing therapy either in-person or via telehealth.
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Affiliation(s)
- Henry L Lew
- From the Department of Communication Sciences and Disorders, Speech and Hearing Clinic, University of Hawaii at Mānoa, John A. Burns School of Medicine, Honolulu, Hawaii (HLL); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia (HLL, DXC); Burke Rehabilitation Hospital, White Plains, New York (MO-P); The Arthur S. Abramson Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, New York (MO-P); US Department of Veterans Affairs, Montrose, Virginia (DXC); and Long-term Impact of Military-relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC), Richmond, Virginia (DXC)
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Hoffman SW, DePalma RG, Cifu DX. Veteran's affairs traumatic brain injury conference: State of the art Introduction to special edition of brain injury: Guest editors. Brain Inj 2019; 31:1165-1167. [PMID: 28981344 DOI: 10.1080/02699052.2017.1359336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Stuart W Hoffman
- a Rehabilitation Research and Development Service , ORD , Washington , DC
| | - Ralph G DePalma
- b ORD Department of Veterans Affairs , Washington , DC.,c Uniformed Services University of the Health Sciences, Bethesda MD , Richmond , VA
| | - David X Cifu
- d Department of Physical Medicine and Rehabilitation , Virginia Commonwealth University School of Medicine.,e US Department of Veterans Affairs , Richmond , VA , Medical Center
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35
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Eapen BC, Cifu DX. Polytrauma Rehabilitation. Phys Med Rehabil Clin N Am 2019. [DOI: 10.1016/s1047-9651(18)30856-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Eapen BC, Cifu DX. Preface. Phys Med Rehabil Clin N Am 2018; 30:xvii-xviii. [PMID: 30470433 DOI: 10.1016/j.pmr.2018.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Blessen C Eapen
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, US Department of Veterans Affairs, VA/DoD Chronic Effects of NeuroTrauma Consortium, 1223 East Marshall Street, PO Box 980677, Richmond, VA 23284-0667, USA.
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Cifu DX, Williams R, Hinds SR, Agyemang AA. Chronic effects of neurotrauma consortium: a combined comparative analysis of six studiesIntroduction to Special edition of Brain Injury. Brain Inj 2018; 32:1149-1155. [PMID: 30010435 DOI: 10.1080/02699052.2018.1496274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- David X Cifu
- a Department of Physical Medicine and Rehabilitation , Virginia Commonwealth University , Richmond , VA , USA.,b Hunter Holmes McGuire VA Medical Center , Richmond , VA , USA
| | - Rick Williams
- c RTI International, Research Triangle Park , Durham , NC , USA
| | - Sidney R Hinds
- d DoD Blast Injury Research Program Coordinating Office, US Army Medical Research and Materiel Command , MD , USA
| | - Amma A Agyemang
- a Department of Physical Medicine and Rehabilitation , Virginia Commonwealth University , Richmond , VA , USA
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Abstract
PRIMARY OBJECTIVE The primary objective of the study is to identify and delineate effective recruitment practises in a large, multi-site, longitudinal, observational study employing both military service members and Veterans. SETTING Four Chronic Effects of Neurotrauma Consortium sites. DESIGN A descriptive study. RESULTS Overall and cohort-specific recruitment increased with the addition of focused recruitment strategies and a military/Veteran-centric recruitment director. CONCLUSION Use of site-specific strategies aligned with local Institutional Review Board procedures and emphasizing awareness of service member organizational allegiances was the key to effective recruiting. Adding a recruitment director with background similar to study participants coincided with significantly improved overall participant numbers and specific subpopulations of research subjects, thus adding to the value of the study.
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Affiliation(s)
- Kevin Sickinger
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond, VA , USA
| | - William C Walker
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond, VA , USA.,b Hunter Holmes McGuire VA Medical Center Richmond , VA , USA
| | - Amma A Agyemang
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond, VA , USA
| | - David X Cifu
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond, VA , USA
| | - Tiffany L Lewis
- c Defense and Veterans Brain Injury Center Program , Silver Spring , MD
| | - William Carne
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond, VA , USA.,b Hunter Holmes McGuire VA Medical Center Richmond , VA , USA
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Walker WC, Hirsch S, Carne W, Nolen T, Cifu DX, Wilde EA, Levin HS, Brearly TW, Eapen BC, Williams R. Chronic Effects of Neurotrauma Consortium (CENC) multicentre study interim analysis: Differences between participants with positive versus negative mild TBI histories. Brain Inj 2018; 32:1079-1089. [PMID: 29851515 DOI: 10.1080/02699052.2018.1479041] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Compare characteristics and outcomes of combat-exposed military personnel with positive versus negative mild traumatic brain injury (mTBI) histories. SETTING Recruitment was from registration lists and ambulatory clinics at four veterans administration hospitals. PARTICIPANTS Consented veterans and service members completing initial evaluation by September 2016 (n = 492). DESIGN Observational with cross-sectional analyses. MAIN MEASURES Multimodal assessments including structured interviews, record review, questionnaires, neuroendocrine labs and neurocognitive and sensorimotor performance. RESULTS In unadjusted comparisons to those absent lifetime mTBI, the mTBI positive group (84%) had greater combat exposure, more potential concussive events, less social support and more comorbidities, including asthma, sleeping problems and post-traumatic stress disorder. They also fared worse on all sensory and pain symptom scores and self-reported functional and global outcomes. They had poorer scores on Wechsler Adult Intelligence Scale-IV coding (processing speed), TMT-B (visual-motor integration and executive function) and two posturography subtests, but were otherwise equal to TBI negative participants on neurocognitive and sensorimotor testing and neuroendocrine levels. CONCLUSIONS Although differences in characteristics exist which were not adjusted for, participants with historical mTBI have greater symptomatology and life functioning difficulties compared with non-TBI. Performance measures were less dissimilar between groups. These findings will guide further research within this accruing cohort.
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Affiliation(s)
- William C Walker
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond , VA , USA.,b Hunter Holmes McGuire VA Medical Center , Richmond , VA , USA
| | | | - William Carne
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond , VA , USA.,b Hunter Holmes McGuire VA Medical Center , Richmond , VA , USA
| | - Tracy Nolen
- c RTI International, RTP , Durham , NC , USA
| | - David X Cifu
- a Department of Physical Medicine & Rehabilitation , Virginia Commonwealth University , Richmond , VA , USA.,b Hunter Holmes McGuire VA Medical Center , Richmond , VA , USA
| | - Elisabeth A Wilde
- d Michael E. DeBakey VA Medical Center , Houston , TX , USA.,e Baylor College of Medicine , Houston , TX , USA
| | - Harvey S Levin
- d Michael E. DeBakey VA Medical Center , Houston , TX , USA.,e Baylor College of Medicine , Houston , TX , USA
| | | | - Blessen C Eapen
- g Polytrauma Rehabilitation Center, South Texas Veterans Health Care System , San Antonio , TX , USA.,h Department of Rehabilitation Medicine , UT Health San Antonio , TX , USA
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Gorgey AS, Khalil RE, Gill R, O'Brien LC, Lavis T, Castillo T, Cifu DX, Savas J, Khan R, Cardozo C, Lesnefsky EJ, Gater DR, Adler RA. Effects of Testosterone and Evoked Resistance Exercise after Spinal Cord Injury (TEREX-SCI): study protocol for a randomised controlled trial. BMJ Open 2017; 7:e014125. [PMID: 28377392 PMCID: PMC5387951 DOI: 10.1136/bmjopen-2016-014125] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Individuals with spinal cord injury (SCI) are at a lifelong risk of obesity and chronic metabolic disorders including insulin resistance and dyslipidemia. Within a few weeks of injury, there is a significant decline in whole body fat-free mass, particularly lower extremity skeletal muscle mass, and subsequent increase in fat mass (FM). This is accompanied by a decrease in anabolic hormones including testosterone. Testosterone replacement therapy (TRT) has been shown to increase skeletal muscle mass and improve metabolic profile. Additionally, resistance training (RT) has been shown to increase lean mass and reduce metabolic disturbances in SCI and other clinical populations. METHODS AND ANALYSIS 26 individuals with chronic, motor complete SCI between 18 and 50 years old were randomly assigned to a RT+TRT group (n=13) or a TRT group (n=13). 22 participants completed the initial 16-week training phase of the study and 4 participants withdrew. 12 participants of the 22 completed 16 weeks of detraining. The TRT was provided via transdermal testosterone patches (4-6 mg/day). The RT+TRT group had 16 weeks of supervised unilateral progressive RT using surface neuromuscular electrical stimulation with ankle weights. This study will investigate the effects of evoked RT+TRT or TRT alone on body composition (muscle cross-sectional area, visceral adipose tissue, %FM) and metabolic profile (glucose and lipid metabolism) in individuals with motor complete SCI. Findings from this study may help in designing exercise therapies to alleviate the deterioration in body composition after SCI and decrease the incidence of metabolic disorders in this clinical population. ETHICS AND DISSEMINATION The study is currently approved by the McGuire VA Medical Center and Virginia Commonwealth University. All participants read and signed approved consent forms. Results will be submitted to peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER Pre-result, NCT01652040.
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Affiliation(s)
- Ashraf S Gorgey
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, Virginia, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Refka E Khalil
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, Virginia, USA
| | - Ranjodh Gill
- Endocrinology Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
- Endocrine Division, Virginia Commonwealth University School of Medicine¸ Richmond, Virginia,USA
| | - Laura C O'Brien
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, Virginia, USA
| | - Timothy Lavis
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, Virginia, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Teodoro Castillo
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, Virginia, USA
| | - David X Cifu
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, Virginia, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jeannie Savas
- Surgical Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Rehan Khan
- Radiology Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Christopher Cardozo
- National Center for the Medical Consequences of Spinal Cord Injury, James J Peters VA Medical Center, Bronx, New York, USA
- Department of Medicine, Icahn School of Medicine at Mt. Sinai, New York City, New York, USA
| | - Edward J Lesnefsky
- Cardiology Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
- Division of Cardiology, Department of Medicine, Pauley Heart Center Virginia Commonwealth University, Richmond, Virginia, USA
| | - David R Gater
- Department of Physical Medicine and Rehabilitation, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Robert A Adler
- Endocrinology Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
- Endocrine Division, Virginia Commonwealth University School of Medicine¸ Richmond, Virginia,USA
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Abstract
Disorder of consciousness (DOC) is a state of prolonged altered consciousness, which can be categorized into coma, vegetative state, or minimally conscious state based on neurobehavioral function. The pathophysiology of DOC is poorly understood but recent advances in neuroimaging and advanced electrophysiological techniques may provide an improved understanding for the neural network involved with consciousness. The primary aim of DOC rehabilitation programs is to promote arousal while preventing secondary medical complications while providing education and training to families. Treatment interventions include both pharmacologic and nonpharmacologic programs, but there are currently no consensus treatment guidelines for individuals with DOC.
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Affiliation(s)
- Blessen C Eapen
- Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, 7400 Merton Minter, San Antonio, TX 78229, USA.
| | - Jason Georgekutty
- Kessler Institute for Rehabilitation, 201 Pleasant Hill Road, Chester, NJ 07830, USA
| | - Bruno Subbarao
- Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, 7400 Merton Minter, San Antonio, TX 78229, USA
| | - Sheital Bavishi
- Traumatic Brain Injury Rehabilitation Program, Department of Physical Medicine and Rehabilitation, Ohio State University Wexner Medical Center, 480 Medical Center Drive, Columbus, OH 43210, USA
| | - David X Cifu
- Department of PM&R, Virginia Commonwealth University, US Department of Veterans Affairs, VA/DoD Chronic Effects of NeuroTrauma Consortium, 1223 E. Marshall Street, P.O. Box 980677, Richmond, Virginia 23284-0667, USA
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Cifu DX, Uchima OK, Davis AS, Lower AE, Jin JL, Lew HL. Significance of Concussions in Hawai'i: From Land to Sea. Hawaii J Med Public Health 2016; 75:262-265. [PMID: 27688951 PMCID: PMC5030788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Head injuries are a particular concern in Hawai'i given the large military population, the presence of many land and water sports such as football and surfing, and the lenient helmet laws for motorcycle and bicycle riders. Physical, psychological, and cognitive symptoms from single or repeated concussions can affect an individual's reentry to society and activity. Current literature indicates that repeated head injuries are associated with chronic traumatic encephalopathy (CTE) which is thought to lead to dementia. This paper reviews literature discussing causes of concussion including its incidence and prevalence in Hawai'i. Furthermore, the neurophysiological and neurobiological etiologies are discussed followed by an overview of methods for identification and management of concussion. The paper serves as information for professionals in the community such as educators, military personnel, and healthcare workers to identify risks of concussion, management of symptoms, and to connect with resources and programs available in Hawai'i.
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Affiliation(s)
- David X Cifu
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond VA; Department of Physical Medicine and Rehabilitation, Department of Veteran's Affairs, Washington, DC (DXC)
| | - Olivia K Uchima
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond VA; Department of Physical Medicine and Rehabilitation, Department of Veteran's Affairs, Washington, DC (DXC)
| | - Alaina S Davis
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond VA; Department of Physical Medicine and Rehabilitation, Department of Veteran's Affairs, Washington, DC (DXC)
| | - Amy E Lower
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond VA; Department of Physical Medicine and Rehabilitation, Department of Veteran's Affairs, Washington, DC (DXC)
| | - Jingyu L Jin
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond VA; Department of Physical Medicine and Rehabilitation, Department of Veteran's Affairs, Washington, DC (DXC)
| | - Henry L Lew
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond VA; Department of Physical Medicine and Rehabilitation, Department of Veteran's Affairs, Washington, DC (DXC)
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Carlson KF, O’Neil ME, Forsberg CW, McAndrew LM, Storzbach D, Cifu DX, Sayer NA. Risk of hospitalization due to motor vehicle crashes among Iraq and Afghanistan War Veterans diagnosed with traumatic brain injury. NeuroRehabilitation 2016; 39:351-61. [DOI: 10.3233/nre-161367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Kathleen F. Carlson
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR, USA
- School of Public Health, Oregon Health and Science University, Portland, OR, USA
| | - Maya E. O’Neil
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR, USA
- Department of Psychiatry and Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
| | - Christopher W. Forsberg
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D 66), Portland, OR, USA
| | - Lisa M. McAndrew
- Department of Educational and Counseling Psychology, War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ, USA
- University at Albany, State University of New York, Albany, NY, USA
| | - Daniel Storzbach
- Neuropsychiatry Section, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - David X. Cifu
- Physical Medicine and Rehabilitation Services, Veterans Health Administration, Department ofVeterans Affairs, Washington, D.C., USA
- Physical Medicine and Rehabilitation Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Nina A. Sayer
- Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, USA
- Departments of Medicine and Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
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Weinrich M, Good DC, Reding M, Roth EJ, Cifu DX, Silver KH, Craik RL, Magaziner J, Terrin M, Schwartz M, Gerber L. Timing, Intensity, and Duration of Rehabilitation for Hip Fracture and Stroke: Report of a Workshop at the National Center for Medical Rehabilitation Research. Neurorehabil Neural Repair 2016; 18:12-28. [PMID: 15035960 DOI: 10.1177/0888439003262041] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article summarizes the proceedings of an NIH workshop on timing, intensity, and duration of rehabilitation for acute stroke and hip fracture. Participants concentrated on methodological issues facing investigators and suggested priorities for future research in this area.
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Affiliation(s)
- Uchenna S Uchendu
- Uchenna S. Uchendu is with the United States Department of Veterans Affairs, Washington, DC. Bennet I. Omalu is with the Department of Pathology, University of California, Davis. David X. Cifu is with the Virginia Commonwealth University School of Medicine, Richmond, and the United States Department of Veterans Affairs Medical Center, Richmond. Leonard E. Egede is with the Medical University of South Carolina, Charleston, and the United States Department of Veterans Affairs Medical Center, Charleston
| | - Bennet I Omalu
- Uchenna S. Uchendu is with the United States Department of Veterans Affairs, Washington, DC. Bennet I. Omalu is with the Department of Pathology, University of California, Davis. David X. Cifu is with the Virginia Commonwealth University School of Medicine, Richmond, and the United States Department of Veterans Affairs Medical Center, Richmond. Leonard E. Egede is with the Medical University of South Carolina, Charleston, and the United States Department of Veterans Affairs Medical Center, Charleston
| | - David X Cifu
- Uchenna S. Uchendu is with the United States Department of Veterans Affairs, Washington, DC. Bennet I. Omalu is with the Department of Pathology, University of California, Davis. David X. Cifu is with the Virginia Commonwealth University School of Medicine, Richmond, and the United States Department of Veterans Affairs Medical Center, Richmond. Leonard E. Egede is with the Medical University of South Carolina, Charleston, and the United States Department of Veterans Affairs Medical Center, Charleston
| | - Leonard E Egede
- Uchenna S. Uchendu is with the United States Department of Veterans Affairs, Washington, DC. Bennet I. Omalu is with the Department of Pathology, University of California, Davis. David X. Cifu is with the Virginia Commonwealth University School of Medicine, Richmond, and the United States Department of Veterans Affairs Medical Center, Richmond. Leonard E. Egede is with the Medical University of South Carolina, Charleston, and the United States Department of Veterans Affairs Medical Center, Charleston
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Stratton KJ, Wells BD, Hawn SE, Amstadter AB, Cifu DX, Walker WC. Pain Descriptors Used by Military Personnel Deployed to Iraq and Afghanistan Following Combat-Related Blast Experience. Mil Psychol 2016; 27:376-383. [PMID: 26726285 DOI: 10.1037/mil0000089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Kelcey J Stratton
- Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Blvd. (116-B), Richmond, VA 23249, USA ; Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, PO Box 842018, Richmond, VA 23284, USA ; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Biotech 1, Suite 101, Richmond VA 23219, USA
| | - Benjamin D Wells
- Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Blvd. (116-B), Richmond, VA 23249, USA ; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Biotech 1, Suite 101, Richmond VA 23219, USA
| | - Sage E Hawn
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, PO Box 842018, Richmond, VA 23284, USA ; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Biotech 1, Suite 101, Richmond VA 23219, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Biotech 1, Suite 101, Richmond VA 23219, USA
| | - David X Cifu
- Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Blvd. (116-B), Richmond, VA 23249, USA ; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, 1223 E. Marshall St., 4th Fl., PO Box 980677, Richmond, VA 23298, USA
| | - William C Walker
- Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Blvd. (116-B), Richmond, VA 23249, USA ; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, 1223 E. Marshall St., 4th Fl., PO Box 980677, Richmond, VA 23298, USA
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Stratton KJ, Hawn SE, Amstadter AB, Cifu DX, Walker WC. Correlates of pain symptoms among Iraq and Afghanistan military personnel following combat-related blast exposure. ACTA ACUST UNITED AC 2015; 51:1189-1202. [PMID: 25789376 DOI: 10.1682/jrrd.2014.04.0111] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pain complaints are highly prevalent among military servicemembers and Veterans of the recent combat operations in Iraq and Afghanistan. The high comorbidity of pain with conditions such as posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) underscores the importance of a greater understanding of factors associated with complex polytraumatic injuries among military personnel. The present study aimed to identify correlates of current pain among 201 U.S. military personnel who reported at least one blast experience during combat deployment (age [mean +/– standard deviation]: 27.20 +/– 7.58 yr). Theoretically derived subsets of variables were analyzed in successive hierarchical regression models to determine correlates of self-reported pain symptoms. Preliminary models evaluated demographic features, medical and injury characteristics (e.g., TBI classification), psychosocial history (e.g., trauma exposure), and psychiatric variables. A final model was then derived, in which older age, possible or probable mild TBI, depression symptoms, and PTSD re-experiencing symptoms emerged as significant correlates of pain. The findings further the understanding of polytrauma symptoms among military personnel by identifying specific patient characteristics and comorbidity patterns related to pain complaints. Increased awareness of demographic, psychiatric, or medical factors implicated in pain will enhance comprehensive clinical assessment and intervention efforts.
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Caruso D, Carter WE, Cifu DX, Carne W. Survival of patients with spinal cord injury after cardiac arrest in Department of Veterans Affairs hospital: Pilot study. ACTA ACUST UNITED AC 2015; 51:1103-8. [PMID: 25436984 DOI: 10.1682/jrrd.2013.05.0119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 03/25/2014] [Indexed: 11/05/2022]
Abstract
Survivability characteristics after cardiopulmonary resuscitation in the population with spinal cord injury (SCI) are unclear but may be useful for advanced care planning discussions with patients. Retrospective evaluation from records of all SCI patients over 10 yr at a Department of Veterans Affairs medical center who experienced in-hospital cardiac arrest was performed. Demographic data and other common measurements were recorded. Thirty-six male subjects were identified, and only two patients survived to discharge (5.5% survival rate), both of whom were admitted for nonacute issues and were asymptomatic shortly before the cardiac arrest. The mean age at the time of cardiopulmonary arrest was 62.4 yr, with a mean time from cardiac arrest to death of 3.02 d. No significant demographic parameters were identified. Overall, SCI likely portends worse outcome for acutely ill patients in the situation of a cardiac arrest. Conclusions are limited by sample size.
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