Author Interviews, Brain Injury, Exercise - Fitness, Nature, Science / 11.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50651" align="alignleft" width="200"]Adnan Hirad, PhD MD Candidate, Medical Scientist Training Program University of Rochester School of Medicine and Dentistry Dr. Hirad[/caption] Adnan Hirad, PhD MD Candidate, Medical Scientist Training Program University of Rochester School of Medicine and Dentistry  MedicalResearch.com: What is the background for this study? Response: Concussion is defined based on the manifestation of observable signs and symptoms (e.g., dizziness, difficulty with concentration, loss of consciousness, inter alia). A non-concussive head injury is when someone hits their head but does not exhibit the signs and symptoms of concussion -- IE concussion is defined by observable signs, and sub-concussive is defined as sustaining  head impacts similar (in magnitude and mechanism) to those sustained with concussion without observable signs and/or symptoms. These hits are a problem not only in football, but also with IED/bomb blasts experienced during war and potentially rugby. 
Abuse and Neglect, Brain Injury / 24.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50390" align="alignleft" width="128"]Fanny Lecuyer Giguère, PhD candidate Centre de Recherche en Neuropsychologie et Cognition (CERNEC) Université de Montréal Fanny Lecuyer Giguere[/caption] Fanny Lecuyer Giguère, PhD candidate Centre de Recherche en Neuropsychologie et Cognition (CERNEC) Université de Montréal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous work on moderate-severe traumatic brain injury (TBI) showed clear olfactory impairments (OI) months and years after the trauma. Within these impairments, hyposmia (partial loss of smell) and anosmia (total loss of smell) were the most described OI. Moreover, TBI patients with OI generally developed more long-term anxiety and depression symptoms, when compared to patients without OI. Almost no study evaluated such impairments after a mild TBI, which is none to be the most prevalent form of TBI (80% of all TBI). We evaluated quantitative olfactory scores, post-concussive symptoms, anxiety and depression, within the first 24 hours and one year after the trauma, on a cohort of 20 mild TBI patients and compared these results with a 22 patients control orthopaedic group. Results showed that, within the first 24-hour post-trauma, more than 50% of the mild TBI patients had clinical sing of reduced olfactory capacities (hyposmia) compared to only 5% (1 patient) within the control group. Consequently, patients with mild traumatic brain injury had lower olfactory threshold and had more difficulty to discriminate and identify different odors. Also, when comparing the mild TBI patients with OI (OI+) to the mild TBI patients without OI (OI-), we realized that OI+ mild TBI patients reported more anxiety and post-concussion symptoms 1 year after the trauma.  
Author Interviews, Brain Injury, Pediatrics / 11.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50220" align="alignleft" width="144"]Sean C. Rose, MD Pediatric sports neurologist and co-director of the Complex Concussion Clinic Nationwide Children’s Hospital  Dr. Rose[/caption] Sean C. Rose, MD Pediatric sports neurologist and co-director of the Complex Concussion Clinic Nationwide Children’s Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Very limited data has been collected in children while they are playing contact sports to study the relationship between repetitive head impacts and neurocognitive outcomes.  We previously published a 1-year analysis of youth tackle football players and found no association between the number or severity of head impacts and performance on neurocognitive testing before to after the football season.  We are now reporting the results from the 2nd year of our study, tracking children through two seasons of football participation. We measured head impacts using helmet sensors during the 2016 and 2017 football seasons.  In the total group of 166 players age 9-18, one outcome measure (processing speed), out of the 23 outcome measures studied, declined over time.  However, several other measures that also assessed processing speed did not decline.  Neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance over the course of the two seasons.
Author Interviews, Brain Injury, Columbia, Critical Care - Intensive Care - ICUs, NEJM, Neurology / 27.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49981" align="alignleft" width="134"]Jan Claassen, MD, PhD, FNCS Associate Professor of Neurology Division of Division of Critical Care and Hospitalist Neurology Columbia University Medical Center Dr. Claassen[/caption] Jan Claassen, MD, PhD, FNCS Associate Professor of Neurology Division of Division of Critical Care and Hospitalist Neurology Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unconsciousness is common and predicting recovery is challenging – often inaccurate. Many patients do not show movements on commands and typically this is interpreted as unconsciousness. Some of these patients may be able to have brain response to these commands raising the possibility of some preservation of consciousness. This has previously been shown months or years after the injury mostly using MRI. We were able to detect this activation at the bedside in the ICU shortly after brain injury. For this we applied machine learning to the EEG to distinguish the brain’s responses to commands. Patients that showed this activation were more likely to follow commands prior to discharge and had better outcomes one year later. 
Author Interviews, Brain Injury, University Texas / 24.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49930" align="alignleft" width="175"]Kevin F. Bieniek, Ph.D. Assistant Professor, Department of Pathology & Laboratory Medicine Joe R. & Teresa Lozano Long School of Medicine Director, Biggs Institute Brain Bank Core Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases University of Texas Health Science Center San Antonio San Antonio, Texas 78229 Dr. Bieniek[/caption] Kevin F. Bieniek, Ph.D. Assistant Professor, Department of Pathology & Laboratory Medicine Joe R. & Teresa Lozano Long School of Medicine Director, Biggs Institute Brain Bank Core Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases University of Texas Health Science Center San Antonio San Antonio, Texas 78229 MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by CTE?   Response: CTE, or chronic traumatic encephalopathy, is a progressive neurodegenerative disorder that is linked to prior exposure to repetitive traumatic brain injuries.  CTE pathology, characterized by a distinct deposition pattern of the protein ‘tau’, is most often observed in the brains former contact sport athletes and military veterans.  The public health impacts of this disorder are largely unknown, as this disease is often studied in individuals which advanced levels of exposure, particularly professional American football player. This study aimed to understand what the presence of this disorder might be in the general population by studying athletes and non-athletes, a number of different sports, different levels of participation, and both males and females.
Accidents & Violence, Author Interviews, Brain Injury, ENT, Pediatrics / 12.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49726" align="alignleft" width="144"]Amishav Bresler MD Department of Otolaryngology - Head and Neck Surgery Rutgers - New Jersey Medical School Dr. Bresler[/caption] Amishav Bresler MD Department of Otolaryngology - Head and Neck Surgery Rutgers - New Jersey Medical School  MedicalResearch.com: What is the background for this study? Response: This study was inspired by a personal experience with the rental scooters. The most recent American Academy of Otolaryngology-Head and Neck Surgery annual conference was in Atlanta this year. At the time of the conference, the scooter rental industry had recently entered the region. A friend of mine, another ENT resident, was encouraging others to use these scooters for transportation for both the novelty and convenience. However, he didn't even have a helmet! Here was a well-educated doctor who takes call for craniofacial injuries, who was about to get on a scooter without a helmet. This experience made me wonder if scooters were dangerous scooters and their overall impact on public health. In terms of the backgroud, the personal transportation industry is undergoing a revolution. The search for efficient and environmentally-friendly urban transportation ignited an ongoing debate in the United States regarding the role of motorized scooters. Although known to be a popular method of transportation in Europe and Asia, motorized scooters have only recently begun to make inroads in the United States. The gradual rise in popularity has been attributed to their convenience, affordability, and status as a “green” alternative to vehicles with combustion engines. These advantages combined with the fact electric scooters enable users to travel longer distances than conventional scooters present an attractive method of transportation to school, work, and leisure.
Author Interviews, Brain Injury, Cognitive Issues, Technology / 22.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49309" align="alignleft" width="165"]Dr.. Mahncke Dr. Mahncke[/caption] Dr. Henry W. Mahncke PhD Research neuroscientist CEO of Posit Science Corporation  MedicalResearch.com: What makes this study newsworthy?  Response: Mild Traumatic Brain Injury (mTBI) is a complex condition to treat. Patients can report many symptoms (e.g., cognitive deficits, depression, anxiety, stress, fatigue, pain, sleep difficulties, disorientation, emotional issues). Prior to this study, conducted at five military and veterans’ medical centers, there has been no highly-scalable intervention to treat the cognitive deficits associated with mTBI. This study showed that a plasticity-based, computerized, brain-training app can drive statistically and clinically significant gains in overall cognitive performance. Given the number of service members and vets with persistent cognitive deficits from TBIs, that’s a big deal.
Author Interviews, Brain Injury, Neurological Disorders, Neurology, Stroke / 12.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49129" align="alignleft" width="128"]Thomas M Van Vleet PhDPosit Science  Dr. Van Vleet[/caption] Thomas M Van Vleet PhD Posit Science  Dr. Tom Van Vleet,  presented results on a common symptom of stroke and acquired brain injury (hemi-spatial neglect) at the American Academy of Neurology May 2019 MedicalResearch.com: What makes this study newsworthy? Response For the first time ever a highly-scalable intervention — computerized brain training (BrainHQ made by Posit Science) —was found to improve symptoms of hemi-spatial neglect, which is a common and often intractable and debilitating problem after stroke or other acquired brain injury. MedicalResearch.com: What can you tell us about the medical condition (hemi-spatial neglect) investigated in this study? Response About a third of patients with a brain injury exhibit a complex and debilitating array of neurological deficits known as the “neglect syndrome” (sometimes called, “hemi-spatial neglect” or “neglect”). The most apparent symptom of neglect is the inability of patients to efficiently process information on the side of space opposite the injury; often completely missing relevant events without awareness. As a result, patients often fail to adopt compensatory strategies or respond to other conventional rehabilitation protocols. The cost is significant, as patients with neglect experience longer hospital stays and have higher requirements for assistance, including greater skilled nursing home placements relative to patients with similar extent of brain injury without neglect. To date, there’s been no broadly-applicable and highly-scalable intervention for addressing neglect. An alarming reality given the increasing cost of stroke, which is currently estimated to exceed $34 billion per annum
Accidents & Violence, Author Interviews, Brain Injury / 29.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48921" align="alignleft" width="133"]Dr. Joseph A Schwartz PhD Public Affairs and Community Service, Criminology and Criminal Justice University of Nebraska Omaha, 6001 Dodge Street, Omaha, NE Dr. Schwartz[/caption] Dr. Joseph A Schwartz PhD Public Affairs and Community Service, Criminology and Criminal Justice University of Nebraska Omaha, Omaha, NE  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: My larger research agenda is focused on identifying the ways in which environmental and biological influences work collectively to shape behavioral patterns across major stages of the life course. I am particularly interested in identifying environmental influences that can change biological functioning or activity to result in behavioral change. Brain injury was a natural progression of these interests since brain injury is expected to result in changes in the structure and functioning of the brain, which has been linked to meaningful changes in behavior. There have also been a sizable number of studies that indicate that justice involved populations experience brain injury at a rate that is between five and eight times what is observed in the general population. I was fascinated by this finding and thought that brain injury may be a good candidate influence to investigate further.
Author Interviews, Brain Injury, Stem Cells, Surgical Research, University of Pittsburgh / 18.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48666" align="alignleft" width="133"]Dr. David Okonkwo, M.D., Ph.D., Professor of Neurological surgery Director of the Neurotrauma Clinical Trials CenterUniversity of Pittsburgh Dr. Okonkwo[/caption] Dr. David Okonkwo, M.D., Ph.D., Professor of Neurological surgery Director of the Neurotrauma Clinical Trials Center University of Pittsburgh Dr. Okonkwo discusses the results from the STEMTRA Phase 2 trial evaluating the efficacy and safety of SB623 in patients with chronic motor deficit from traumatic brain injury. The results were presented at the American Association of Neurological Surgeons (AANS), April 2019 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Traumatic brain injury (TBI) is a major cause of death and disability in the US and around the globe. The effects of TBI are often long-lasting, with more than one-third of severe TBI patients displaying a neuromotor abnormality on physical examination 2 years following injury and, yet, there are no effective treatments. The public health implications are staggering: there are approximately 1.4 million new cases of TBI in the US annually, resulting in over 50,000 deaths and 80,000 disabilities; over 5 million Americans currently suffer from long-term disability caused by TBI. A successful neuroregenerative or neurorestorative therapy, such as stem cell implantation, would have significant impact.
Author Interviews, Brain Injury, Exercise - Fitness, JAMA, Pediatrics / 07.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47249" align="alignleft" width="133"]John J. Leddy, MD Clinical Professor Department of Orthopaedics Jacobs School of Medicine & Biomedical Sciences University of Buffalo Dr. Leddy[/caption] John J. Leddy, MD Clinical Professor Department of Orthopaedics Jacobs School of Medicine & Biomedical Sciences University of Buffalo MedicalResearch.com: What is the background for this study? Response: Sport-related concussion (SRC) is a significant public health problem without an effective treatment. Recent International Guidelines have questioned the efficacy of recommending complete rest to treat concussion and have called for prospective studies to evaluate early active treatments for sport-related concussion. 
Author Interviews, Brain Injury, Orthopedics, Pediatrics, PNAS / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47062" align="alignleft" width="200"]Kelly Russell PhD Department of Pediatrics and Child Health University of Manitoba Dr. Russell[/caption] Kelly Russell PhD Department of Pediatrics and Child Health University of Manitoba MedicalResearch.com: What is the background for this study? Response: Health-related quality of life (HRQOL) is an important patient-reported outcome that measures the patient’s perception on how their condition effects various aspects of their life, such as their physical, emotional, social and school quality of life.  HRQOL can measure the more subtle or hidden consequences of a condition, such as concussion.  Patient reported outcomes are important because they give a more complete picture of the patient’s condition than just reporting symptoms or outcomes that are only measured by their clinician.  We wanted to compare the effects of sport-related concussions versus sport-related limb fractures on HRQOL in adolescents after their injury and during their recovery. We chose to compare adolescents with sport-related concussions to a sport-related limb fracture group because we wanted to be able to attribute the results to having a concussion since not being able to play sports with their friends and teammates may decrease HRQOL regardless of the actual type of injury.  We also wanted to identify which clinical variables were associated with worse HRQOL in adolescent patients with sports-related concussion.
Author Interviews, Brain Injury / 03.01.2019

MedicalResearch.com Interview with: Robert Ross, Ph.D. Assistant Professor McConnell Hall, Room 424 University of New Hampshire  MedicalResearch.com: What is the background for this study? Response: In the United States, 1.5-2 million people suffer from mild traumatic brain injuries, more commonly referred to as concussions, per year. There is a large body of work illustrating the cognitive impairments associated with concussions in the immediate aftermath of the concussive event. However, it is not clear whether concussions can change cognition more long-term and how concussions might change how the brain functions during specific types of cognition. In our study, we examined executive function, which is a cognitive process that helps control or manage other cognitive functions, in a group of healthy young adults aged 18-24 that had suffered at least two concussions and compared their performance and their brain oscillations to a group that had not suffered any concussions. Brain oscillations help the brain coordinate the activity of the thousands of neurons necessary for any sort of cognitive process to occur. The participants in the study self-reported their concussions with all concussions occurring at least one month prior to participating in the experiment.
Author Interviews, Brain Injury / 08.11.2018

MedicalResearch.com Interview with: Clara E. Dismuke-Greer, PhD Health Equity and Rural Outreach Innovation Center Ralph H. Johnson Department of Veterans Affairs Medical Center Charleston, SC 29401 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is that previous research we had published had shown that Hispanic U.S. Veterans diagnosed with Traumatic Brain Injury (TBI) had higher risk of mortality than non-Hispanic White U.S. Veterans, even after accounting for the effects of comorbidities as well as socio-demographics. This study sought to investigate further this apparent racial/ethnic disparity. Using a 10 year cohort followed for up to 14 years, and adjusting for TBI severity as well as comorbidities, socio-demographics and military factors, when we included location (urban vs. rural vs. highly rural vs. U.S. Territory (Puerto Rico, U.S. Virgin Islands, Guam, America Samoa and Mariana Islands), as well as race/ethnicity, we found that the racial/ethnic disparity disappeared, and that it was location which became statistically significant. Our main findings were that Veterans diagnosed with TBI residing in U.S. Territories have lower survival and higher risk of mortality relative to Veterans residing on the U.S. Mainland , even after statistical adjustment for the factors listed above.
Author Interviews, Brain Injury, Gender Differences, JAMA, Pediatrics / 05.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45692" align="alignleft" width="142"]Andrée-Anne Ledoux, PhD Children’s Hospital of Eastern Ontario Research Institute Ottawa, Ontario, Canada Dr. Ledoux[/caption] Andrée-Anne Ledoux, PhD Children’s Hospital of Eastern Ontario Research Institute Ottawa, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: The natural recovery processes from a pediatric concussion remains poorly characterized throughout childhood. Children’s brains go through many phases of growth during development and sex differences exist. Therefore a 6-year-old child may not have the same recovery trajectory as an adolescent because of biopsychosocial differences. Thus, this study explored symptom improvement after concussion while considering these two key demographic factors. Understanding symptom improvement at different stages of development is important in order to provide the best possible care. The study examined data from 2,716 children and adolescents who had presented at nine emergency departments across Canada and were diagnosed with concussion. We examined the natural progression of self-reported symptom recovery following pediatric concussion over the initial three months after injury. Participants in the study were aged 5 to 18 years old with acute concussion, enrolled from August 1, 2013, to May 31, 2015. We examined different age cohorts – 5 to 7 years of age, 8 to 12 years of age, and 13 to 18 years of age, and investigated how sex is associated with recovery. Our study represents the largest study to evaluate symptom improvement trajectories in concussed pediatric population.
Author Interviews, Brain Injury, Heart Disease, JAMA, Neurology / 31.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45585" align="alignleft" width="133"]Dr-Marion Moseby-Knappe Dr. Moseby-Knappe[/caption] Marion Moseby-Knappe, MD Neurologist and Researcher Center for Cardiac Arrest at Lund University and Skane University Hospital Lund, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our research focuses on improving methods for examining unconscious patients treated on intensive care units after cardiac arrest. If a patient does not wake up within the first days after cardiac arrest, physicians need to evaluate how likely it is that the patient will awaken at all and to which extent there is brain injury. According to European and American guidelines, decisions on further medical treatment of cardiac arrest patients should always be based on a combination of examinations and not only one single method. Various methods are combined when assessing the patient such as examining different neurologic reflexes, head scans (computed tomography or magnetic resonance imaging), other specialist examinations (electroencephalogram or somatosensory evoked potentials) or blood markers. Our research focuses on patients included in the largest cardiac arrest trial to date, the Targeted Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) Trial.
Author Interviews, Brain Injury, Exercise - Fitness, Pediatrics / 26.10.2018

MedicalResearch.com Interview with: Sean C. Rose, MD Pediatric sports neurologist and co-director Complex Concussion Clinic Nationwide Children’s Hospital Assistant professor of Pediatrics The Ohio State UniversitySean C. Rose, MD Pediatric sports neurologist and co-director Complex Concussion Clinic Nationwide Children’s Hospital Assistant professor of Pediatrics The Ohio State University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The link between sub-concussive head impacts and declines in neurocognitive function has been reported by some studies, yet refuted by others.  There is very little evidence that has been collected in children as they are sustaining these head impacts. We initiated a multi-year study of youth football players to provide a more in-depth look at the question.  We measured head impacts using helmet sensors during the 2016 football season.  112 players age 9-18 completed a battery of neurocognitive tests before and after the football season. We found that neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance from pre to post-season.
Author Interviews, Brain Injury, Critical Care - Intensive Care - ICUs, JAMA / 25.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45433" align="alignleft" width="200"]Jamie Cooper AO BMBS MD FRACP FCICM FAHMS Professor of Intensive Care Medicine Monash University Deputy Director & Head of Research,  Intensive Care & Hyperbaric Medicine The Alfred, Melbourne Prof. Cooper[/caption] Jamie Cooper AO BMBS MD FRACP FCICM FAHMS Professor of Intensive Care Medicine Monash University Deputy Director & Head of Research, Intensive Care & Hyperbaric Medicine The Alfred, Melbourne MedicalResearch.com: What is the background for this study? Response: 50-60 million people each year suffer a traumatic brain injury (TBI) . When the injury is severe only one half are able to live independently afterwards. Cooling the brain (hypothermia) is often used in intensive care units for decades to  decrease inflammation and brain swelling and hopefully to improve outcomes, but clinical staff have had uncertainty whether benefits outweigh complications. We conducted the largest randomised trial of hypothermia in TBI, in 500 patients, in 6 countries, called POLAR. We started cooling by ambulance staff, to give hypothermia the best chance to benefit patients. We continued for 3-7 days in hospital ind ICU. We measured functional outcomes at 6 months.
Author Interviews, Brain Injury, Pediatrics, Pediatrics, University Texas / 18.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45340" align="alignleft" width="144"]Dr. Ewing-Cobbs PhD Professor in the Department of Pediatrics McGovern Medical School University of Texas Health Science Center at Houston Harriet and Joe Foster Chair in Cognitive Neuroscience Dr. Ewing-Cobbs[/caption] Dr. Linda Ewing-Cobbs PhD Professor in the Department of Pediatrics McGovern Medical School University of Texas Health Science Center at Houston Harriet and Joe Foster Chair in Cognitive Neuroscience MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children may have long-lasting psychological and physical symptoms after an injury. Post-concussive symptoms (PCS) are nonspecific cognitive, physical, and mood symptoms such as difficulty concentrating, headache, and irritability. These symptoms occur in approximately 15 to 30% children after mild traumatic brain injury (TBI). Although PCS often resolve within one month, some children experience symptoms for longer periods of time.
Author Interviews, Brain Injury, CT Scanning, Emergency Care, Lancet, Technology / 16.10.2018

MedicalResearch.com Interview with: Qure-ai.jpgSasank Chilamkurthy AI Scientist, Qure.ai MedicalResearch.com: What is the background for this study? Response: Head CT scan is one of the most commonly used imaging protocols besides chest x-ray. They are used for patients with symptoms suggesting stroke, rise in intracranial pressure or head trauma. These manifest in findings like intracranial haemorrhage, midline shift or fracture. Scans with these critical findings need to be read immediately. But radiologists evaluate the scans on first-come-first-serve basis or based on stat/routine markers set by clinicians. If the scans with critical findings are somehow pushed to the top of radiologists’ work list, it could substantially decrease time to diagnosis and therefore decrease mortality and morbidity associated with stroke/head trauma.
Author Interviews, Brain Injury, CDC, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44746" align="alignleft" width="156"]Juliet Haarbauer-Krupa, PhD Senior Health Scientist Division of Unintentional Injury Prevention CDC Dr. Haarbauer-Krupa[/caption] Juliet Haarbauer-Krupa, PhD Senior Health Scientist Division of Unintentional Injury Prevention CDC MedicalResearch.com: What is the background for this study?
  • Traumatic brain injury in children results in a large number of emergency department visits each year and can result in long term difficulties
  • The purpose of this study was to estimate lifetime prevalence of TBI in children based on a nationally representative sample of U.S. parents/adults and to describe the association between TBI and other childhood health conditions.
  • CDC researchers examined the National Survey of Children’s Health, a cross-sectional telephone survey of U.S. households, to provide a national estimate of TBI in children.
Author Interviews, Brain Injury, CT Scanning, Emergency Care, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44691" align="alignleft" width="200"]Erik P. Hess MD MSc Professor and Vice Chair for Research Department of Emergency Medicine UAB Medicine | The University of Alabama at Birmingham Birmingham Alabama 35249 Dr. Hess[/caption] Erik P. Hess MD MSc Professor and Vice Chair for Research Department of Emergency Medicine UAB Medicine he University of Alabama at Birmingham Birmingham Alabama 35249 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: 450,000 children present to U.S emergency departments each year for evaluation of head trauma.  Physicians obtain head computed tomography (CT) scans in 37%-50% of these patients, with less than 10% showing evidence of traumatic brain injury and only 0.2% that require neurosurgical treatment. In order to avoid unnecessary CT scans and to limit radiation exposure, the Pediatric Emergency Care Applied Research Network (PECARN) developed clinical prediction rules that consist of 6 readily available factors that can be assessed from the history and physical examination.  If none of these risk factors are present, a CT scan is not indicated. If either of 2 high risk factors such as signs of a skull fracture are present, CT scanning is indicated. If 1 or 2 non-high risk factors are present, then either CT scanning or observation are recommended, depending on considerations such as parental preference, clinician experience and/or symptom progression. In this study we designed a parent decision aid, “Head CT Choice” to educate the parent about the difference between a concussion – which does not show up on a CT scan – and a more serious brain injury causing bleeding in or around the brain.  The decision aid also shows parents their child’s risk for a serious brain injury – less than 1% risk in the majority of patients in our trial – what to observe their child at home for should they opt not to obtain a CT scan, and the advantages and disadvantages of CT scanning versus home observation. In our trial, we did not observe a difference in the rate of head CT scans obtained in the ED but did find that parents who were engaged in shared decision-making using Head CT Choice were more knowledgeable about their child’s risk for serious brain injury, has less difficulty making the decision because they were clearer about the advantages and disadvantages of the diagnostic options, and were more involved in decision-making by their physician.  Parents also less frequently sought additional testing for their child within 1 week of the emergency department visit.
Author Interviews, Brain Injury, CDC, JAMA, Pediatrics / 05.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44283" align="alignleft" width="174"]Matt Breiding, PhD Team Lead, Division of Unintentional Injury Prevention Center for Disease Control and Prevention Dr. Breiding[/caption] Matt Breiding, PhD Team Lead, Division of Unintentional Injury Prevention Center for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Caused by a bump, blow or jolt to the head or body, a mild traumatic brain injury (mTBI) can lead to short- or long-term problems that can affect how a child thinks, acts, feels, and learns. CDC’s Pediatric mTBI Guideline is based on the most comprehensive review of the science on pediatric mTBI diagnosis and management to date—covering 25 years of research. The guideline consists of 19 sets of clinical recommendations that cover diagnosis, prognosis, and management and treatment. These recommendations are applicable to healthcare providers who care for pediatric patients with mTBI in all practice settings and outline actions healthcare providers can take to improve the health of their patients with this injury. The CDC Pediatric mTBI Guideline outlines specific actions healthcare providers can take to help young patients and includes 5 key recommendations.  Specifically, they recommend that physicians:
  1. Refrain from routinely imaging pediatric patients to diagnose mTBI.
  2. Use validated, age-appropriate symptom scales to diagnose mTBI.
  3. Assess for risk factors for prolonged recovery, including: history of mTBI or other brain injury, severe symptom presentation immediately after the injury, and personal characteristics and family history (such as learning difficulties and family and social stressors).
  4. Provide patients with instructions on returning to activity customized to their symptoms.
  5. Counsel patients to return gradually to non-sports activities after no more than a 2-3 days of rest.
Author Interviews, Brain Injury, Environmental Risks, Science, UCSF / 22.05.2018

MedicalResearch.com Interview with: “Space Shuttle Model” by terren in Virginia is licensed under CC BY 2.0Susanna Rosi, PhD Director of Neurocognitive Research Brain and Spinal Injury Center Professor in the departments of Physical Therapy and Rehabilitation Science and of Neurological Surgery UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: NASA and private space companies like SpaceX plan to send humans to the red planet within the next 15 years — but among the major challenges facing future crewed space missions is how to protect astronauts from the dangerous cosmic radiation of deep space. In this study we identified the first potential treatment for the brain damage caused by exposure to cosmic rays — a treatment can be given after exposure and that prevents memory impairment in mice exposed to simulated space radiation.
Alzheimer's - Dementia, Author Interviews, Brain Injury, JAMA / 08.05.2018

MedicalResearch.com Interview with: Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist, San Francisco VA Medical Center Senior Investigator, Tideswell at UCSF: http://www.tideswellucsf.org/ Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?
  • Previous studies have found a link between moderate to severe head injuries and increased dementia risk.
  • The association between mild head injuries and dementia – especially mild head injury that doesn’t result in loss of consciousness – is less well established
  • We examined the association between mild head injuries with and without loss of consciousness and dementia diagnoses in nearly 360,000 Veterans receiving care in the VA health care system.
  • We found that Veterans with a head injury diagnoses were two to four times more likely to be diagnosed with dementia than those without head injury diagnoses.
  • The risk of dementia diagnosis was doubled in Veterans who experienced head injury without loss of consciousness compared to those with no head injury. 
Author Interviews, Brain Injury, Occupational Health / 04.04.2018

MedicalResearch.com Interview with: [caption id="attachment_41019" align="alignleft" width="200"]Jeffrey A. (Jeff) Russell, PhD, AT, FIADMS Science and Health in Artistic Performance Division of Athletic Training, School of Applied Health Sciences and Wellness Ohio University Athens, OH 45701 Dr. Jeff Russell[/caption] Jeffrey A. (Jeff) Russell, PhD, AT, FIADMS Science and Health in Artistic Performance Division of Athletic Training, School of Applied Health Sciences and Wellness Ohio University Athens, OH 45701 MedicalResearch.com: What is the background for this study? What are the main findings?     Response: Everyone knows that enormous attention is given to concussions in sports today. Those involved in performing arts experience many head impacts, too; yet, they receive neither the attention nor the specialized care for concussions that athletes do. At Ohio University’s Clinic for Science and Health in Artistic Performance (SHAPe Clinic) that I direct, we were seeing a number of theater students suffer concussions. So, Brooke Daniell and I decided explore this trend more closely. This is the first known published research to evaluate the prevalence of head impacts in theater personnel. In the sample we studied, which comprised predominantly those involved in various aspects of theater production, the prevalence of receiving at least one head impact in a theater career was 67%. Of those who sustained at least one head impact from theater, 77% reported three or more head impacts, and 39% reported more than five impacts. More troubling, of those who said they had received a head impact that was accompanied by concussion-like symptoms, 70% indicated that they continued their work, and half of those did not report the incident to anyone.
ADHD, Author Interviews, Brain Injury, JAMA, Pediatrics / 20.03.2018

MedicalResearch.com Interview with: Dr. Megan E. Narad, PhD Division of Behavioral Medicine and Clinical Psychology Cincinnati Children's Hospital Medical Center | CCHMC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that children with a history of traumatic brain injury (TBI) demonstrate difficulties with attention following injury; however, most studies only follow children 2-3 years after injury. Our study followed a group of children with a history of TBI 7-10 years after injury. The main finding is that those with severe TBI were at greater risk for developing secondary attention deficit hyperactivity disorder (SADHD) than those with orthopedic injury; however, it should also be noted that kids with less severe injuries were also at risk of developing SADHD. In addition to injury severity, environmental factors (maternal education and family functioning) also played a role in SADHD development. It should also be noted that a number of kids developed SADHD >3.5 years after injury suggesting that these difficulties may not surface until many years after injury.
Author Interviews, Brain Injury, JAMA / 12.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40530" align="alignleft" width="200"]Christopher Abeare, Ph.D. Associate Professor Clinical Neuropsychology Department of Psychology University of Windsor Windsor, Ontario Dr. Christopher Abeare[/caption] Christopher Abeare, Ph.D. Associate Professor Clinical Neuropsychology Department of Psychology University of Windsor Windsor, Ontario MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In this study, we examined the prevalence of invalid performance on baseline neurocognitive testing in sport concussion. Baseline testing is a commonly employed practice in which the cognitive abilities of athletes are assessed pre-season. These baseline test results are then used as a point of comparison against which post-injury neurocognitive test results can be compared, thereby creating a more individualized approach to the assessment of neurocognitive functioning. However, there has been growing concern about the validity of baseline test results, meaning that there is concern over the degree to which the scores on these baseline tests actually reflect an athlete’s true cognitive ability. There are many reasons why their test scores might not reflect their actual ability, ranging from inattentiveness during testing and lack of appreciation of the importance of doing their best on testing to intentional underperformance (aka “sandbagging” or malingering). As a result of these concerns, 4 different validity measures have been developed. We compared these 4 validity measures, head to head, in a sample of 7897 athletes aged 10 to 21 years. We found that 56% of athletes failed at least 1 of these validity measures, suggesting that as many as 56% of  athletes have scores that may not reflect their true ability level. We then tested the hypothesis that age would be related to the proportion of athletes with invalid performance. Our findings supported this hypothesis in that nearly 84% of 10-year-olds failed at least one validity measure and 29% of 21-year-olds failed at least one. 
Author Interviews, Brain Injury, Imperial College, Pediatrics / 30.11.2017

MedicalResearch.com Interview with: “Baby” by Victor is licensed under CC BY 2.0Dr Chris Gale Clinical Senior Lecturer in Neonatal Medicine Imperial College London and Consultant Neonatologist at Chelsea and Westminster Hospital NHS Foundation Trust     MedicalResearch.com: What is the background for this study? What are the main findings? Response: As part of a drive to make England a safer place to give birth, the Department of Health in England has set a target of reducing the number of babies that incur brain injury during or soon after birth by 20% by 2020 and to halve them by 2030. Before now United Kingdom health services did not have a standard definition of brain injury in babies and there has been no systematic collection of data for this purpose. With colleagues and in collaboration with the Department of Health, we have devised a practical way to measure the incidence rate of brain injury in babies using routinely recorded data held in the National Neonatal Research Database. The research estimated that 3,418 babies suffered conditions linked to brain injury at or soon after birth in 2015, which equates to an incidence rate of 5.14 per 1,000 live births. For preterm births (babies born at or less than 37 weeks) the rate was 25.88 per 1,000 live births in 2015, almost six times greater than the rate for full-term births, which was 3.47 per 1,000 live births. Overall, the research found that the most common type of condition that contributed brain injuries was damage caused by lack of oxygen to the brain, called hypoxic ischaemic encephalopathy; this is seen mainly in term babies. For preterm babies, the largest contributor to brain injuries is from bleeding into and around the ventricles of the brain, a condition called periventricular haemorrhage. It is also the first time that brain injuries in babies have been measured using data gathered routinely during day to day clinical care on NHS neonatal units. The use of routine data required no additional work for clinical staff and provides a valuable way to measure the effectiveness of interventions to reduce brain injury.
Author Interviews, Biomarkers, Brain Injury, JAMA / 21.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38373" align="alignleft" width="153"]Dr. Steven D. Hicks,  M.D., Ph.D Penn State Health Dr. Hicks[/caption] Dr. Steven D. Hicks,  M.D., Ph.D Penn State Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that small epigenetic molecules called microRNAs are altered in the blood after a traumatic brain injury. Our own pilot research showed that microRNAs were also changed in the saliva after brain injury and that some of these changes mirrored changes in cerebrospinal fluid. In this study we investigated whether salivary microRNA patterns after a concussion could be used to predict the duration and character of symptoms one month after injury. We found that levels of five microRNAs predicted presence of symptoms one month later with greater accuracy (~85%) than standard surveys of symptom burden (~65%). Interestingly, one of the predictive salivary microRNAs (miR-320c) targets pathways involved in synaptic plasticity and was significantly correlated with attention difficulties one month after concussive injury.