Author Interviews, Brain Injury, Brigham & Women's - Harvard, Inflammation / 14.01.2024

MedicalResearch.com Interview with: Samir Mitragotri Ph.D. Hiller Professor of Bioengineering Hansjorg Wyss Professor of Biologically Inspired Engineering Area Chair, Bioengineering Core Faculty Member, Wyss Institute for Biologically Inspired Engineering Harvard John A. Paulson School Of Engineering And Applied Sciences MedicalResearch.com: What is the background for this study? Response: Traumatic brain injury (TBI) has a heavy burden on the world, affecting ~70 million people globally each year. Despite its prevalence, there are no clinically approved treatments beyond symptom management. There is an urgent need to develop effective therapies to alleviate the damage caused by TBI.   MedicalResearch.com:  What do macrophages typically do?  As part of the innate immune system, macrophages migrate to areas of injury to eat pathogens or debris and manage inflammation in response to injury or infection. However, in the majority of cases of TBI, there is no actual infection from a foreign pathogen, leading to excessive inflammation that spreads damage beyond the initial impact. (more…)
Author Interviews, Brain Injury / 16.11.2023

pexels-photo-7578808-medical-practitioner.webpIf you've been in a scrape and your noggin took a knock, playing it tough and shaking it off isn't the way to go. A traumatic brain injury (TBI), even one that seems no biggie, can be sneaky. At first, you might feel fine, but your brain's had a jolt, and it needs a look-over. Ignoring it? Bad move. That little headache or dizziness might be your brain's way of saying, "Hey, I'm not okay." Small signs like mood swings, sleep changes, or even just feeling "off" can be the early whispers of something bigger brewing. It's like ignoring a weird noise in your car's engine—let it go and you might just find yourself broken down on the highway of health.

The Domino Effect of Ignoring Symptoms

Let's talk about what happens if you shrug off those symptoms. A tiny injury can start a chain reaction. Before you know it, you could be dealing with big-time problems like memory issues, serious concentration hiccups, or even long-term disabilities. And here's the kicker: these troubles don't always show up on day one. They can sneak up on you, turning from "I'm fine" to "Why can't I remember my passwords?" in no time. Think about it—your brain runs the show, so even a small glitch can throw off the whole performance.
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Accidents & Violence, Aging, Author Interviews, BMJ, Brain Injury, Brigham & Women's - Harvard, Exercise - Fitness / 15.12.2022

MedicalResearch.com Interview with: Rachel Grashow PhD Research Scientist Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Anecdotally, we heard from former NFL players that they felt older than their chronological age. At the same time, doctors and medical care providers treating former players also observed that players appeared clinically older in some health domains. These observations motivated us to ask:  despite superior fitness and success as young men, are football players experiencing early aging and living with illness and disability for more years than their non-football peers? (more…)
Author Interviews, Brain Injury, NEJM / 09.06.2022

MedicalResearch.com Interview with: Daniel Perl MD Uniformed Services University of the Health Sciences Professor of Pathology at USUHS and Director of the CNRM's Brain Tissue Repository Uniformed Services University of the Health Sciences Bethesda, Maryland MedicalResearch.com:  What is the background for this study?  Response: Chronic traumatic encephalopathy (CTE) is a brain disorder that is predominantly seen in individuals who have suffered from repeated impact head trauma, such as occurs in former boxers or American football players.  CTE has very specific alterations in the brain and can only be diagnosed at autopsy.  Some have claimed that, in addition to former contact sport participants, individuals who served in the military and were repeatedly exposed to blast (explosions) are also at increased risk for developing CTE.  However, this claim has been based on a rather small number of anecdotal cases.  The DoD/USU Brain Tissue Repository is the only facility in the world that is exclusively dedicated to the collection and study of donated brain specimens derived from deceased active duty and retired service members.  We used the resources of this facility to examine 225 consecutively collected brain specimens for the presence of CTE.  This would to provide a view of how common CTE was in this setting and, when diagnosed, was the disease correlated with prior blast exposure, participation in contact sports and other forms of head trauma, and with certain forms of symptomatology such as development of PTSD, alcohol/substance abuse, death by suicide, etc. (more…)
Author Interviews, Brain Injury, Neurology / 11.10.2021

Dr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity was discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO. Earlier this year, MedicalResearch.com interviewed Dr. Henry Mahncke about the BRAVE Study he led, which showed a digital health app (BrainHQ) was effective in addressing chronic cognitive issues in servicemembers who had been diagnosed with “mild” Traumatic Brain Injury. This week, MedicalResearch.com interviews Dr. Mahncke again about a new independent study among civilians showing similar results in patients with all kinds of Brain Injuries. MedicalResearch.com: What is the background for this study? Response: The Centers for Disease Control (CDC) estimates that about 5.3 million people currently live with a chronic disability from a Traumatic Brain Injury (TBI). While most people who suffer a blow to the head recover in a couple days or weeks, for some (estimated as high as 15 percent) the injury persists with a variety of life-disrupting symptoms, including impairments in cognitive abilities, behavior, emotions, and motor function affecting work, relationships, and daily function. TBIs have been the signature injury of recent wars. Nearly 400,000 service members have been diagnosed with TBIs, of which 82% were diagnosed with so-called “mild” TBIs from concussions and blast injuries. More than a decade ago, we began being asked by military and Veterans organizations, to study whether our brain exercises – which had shown positive effects in measures of cognition, everyday function, mood, and motor function in healthy older adults – could have an impact on people with chronic symptoms from TBIs. We talked earlier this year, when an 83-person, gold-standard, randomized controlled trial on mTBI (called the BRAVE Study) announced quite positive results from using BrainHQ exercises. That study was funded by the Department of Defense and run as five military and Veterans medical centers. The BRAVE Study found the BrainHQ group showed a statistically and clinically significant improvement on a standard measure of overall cognitive function (compared to a computer games control), and this benefit persisted for at least 12 weeks after training completed. Cognitive function improvements were nearly four times larger in the BrainHQ group than the control (as measured immediately following training) and grew to nearly five times larger (when measured again 12 weeks after training ended). On average, participants in the BrainHQ group improved on the cognitive performance composite measure by 24 percentile ranks – as though they went from the 50th percentile to the 74th percentile. One large question left unanswered from the BRAVE study was whether this approach might also work for other categories of TBIs, such as moderate and severe TBIs. A new study from independent researchers at NYU answers that question. (more…)
Author Interviews, Brain Injury / 12.08.2021

MedicalResearch.com Interview with: Henry Mahncke, PhD Chief Executive Officer Posit Science Dr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity as discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO. This week, MedicalResearch.com interviews Dr. Mahncke about a new study, with breakthrough results for service members and Veterans grappling with the signature injury of recent wars. MedicalResearch.com: What makes this study newsworthy? Response: As the last troops come home from Afghanistan, the battle is not over for many who served and continue to grapple with the signature injury of recent conflicts — mild Traumatic Brain Injury (or mTBI). Typically, such injures were caused by blasts or concussions, and they’ve been diagnosed in more than 300,000 service members. Most recover within a couple days or weeks, but for many — some estimate fifteen percent — physical, psychological, emotional, and cognitive problems persist for years. Such injuries often go untreated, because treatments focus on in-person, customized, cognitive rehabilitation, which can be helpful, but is costly, time-consuming, requires travel for treatment, and relies on the craft and expertise of the healthcare provider. Up until now, there’s been no effective intervention that’s highly-scalable and that can be delivered remotely. This study showed that remotely-administered BrainHQ computerized exercises improved overall cognitive performance in a population with very persistent cognitive issues. On average, patients in this study had cognitive issues for more than seven years. That means we finally have a tool shown effective in a gold-standard study that practitioners can employ in treating this large and underserved population, who sacrificed so much to serve our nation. (more…)
Author Interviews, Brain Injury, Exercise - Fitness / 04.08.2021

MedicalResearch.com Interview with: Willie Stewart, MBChB, PhD, DipFMS, FRCPath, FRCP Edin Consultant Neuropathologist Honorary Professor Department of Neuropathology Queen Elizabeth University Hospital Glasgow, UK MedicalResearch.com: What is the background for this study? Response: There is concern over the association between participation in contact sports and later life risk of dementia and associated neurodegenerative disease. Much of this comes from observations of a specific form of neurodegenerative pathology - chronic traumatic encephalopathy (CTE)- linked to history of traumatic brain injury (TBI) and repetitive head impacts in autopsy studies of relatively small numbers of former athletes, including boxers and soccer players. Nevertheless, although this brain injury linked pathology is described, surprisingly little is known about what this might mean for later life health, specifically risk of dementia. In a previous study published from our programme of research looking at "Football's Influence on Lifelong health and Dementia risk' (the FIELD Study), we demonstrated that former professional soccer players had an approximately three-and-a-half-fold higher mortality from neurodegenerative disease than matched general population controls. However, these mortality data did not allow us to consider the relationships between varying head injury/impact exposure variables, such as player position and career length, and risk of neurodegenerative disease.  (more…)
Accidents & Violence, Author Interviews, Brain Injury, Exercise - Fitness / 01.07.2021

MedicalResearch.com Interview with: Mireille E. Kelley Ph.D. Staff Consultant for Engineering Systems Inc. MedicalResearch.com: What is the background for this study? Response: Youth and high school football players can sustain hundreds of head impacts in a season and while most of these impacts do not result in any signs or symptoms of concussion, there is concern that these repetitive subconcussive impacts may have a negative effect on the brain. The results of this study are part of an NIH-funded study to understand the effects of subconcussive head impact exposure on imaging data collected at pre- and post-season time points. The present study leveraged the longitudinal data that was collected in the parent study to understand how head impact exposure changes among athletes from season to season and how that relates to changes measured from imaging. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Gender Differences, Pediatrics, University of Pennsylvania / 30.01.2021

MedicalResearch.com Interview with: Christina L. Master, MD, FAAP, CAQSM, FACSM Professor of Clinical Pediatrics Perelman School of Medicine at the University of Pennsylvania Co-Director, Minds Matter Concussion Program Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics Attending Physician, Care Network - Karabots Center The Children's Hospital of Philadelphia Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? Response: There have been multiple studies investigating potential sex differences in outcomes from concussion which have sometimes had conflicting results with some studies indicating that females take longer to recover than males and some studies reporting no difference in recovery between females and males, with most of these studies being conducted either retrospectively or prospectively in smaller cohorts. This large-scale multi-center prospective study in collegiate athletes provided an opportunity to compare females and males across comparable sports to examine both potential intrinsic or biologic factors (sex differences) or extrinsic (environmental or gender differences) that contribute to outcomes. (more…)
Author Interviews, Brain Injury, Brigham & Women's - Harvard / 03.01.2021

MedicalResearch.com Interview with: Nitin Joshi, Ph.D. Engineering in Medicine/Department of Medicine Brigham and Women's Hospital   Dr. Jeffrey M Karp Ph.D Principal Investigator Professor of Medicine at Brigham and Women’s Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Would you explain what is meant by the blood brain barrier? How will nanoparticles facilitate transport of drugs into the brain? Response: Over the past few decades, researchers have identified promising therapeutic agents that can target the biological pathways involved in brain diseases. Unfortunately, clinical translation of these therapeutics is limited by their inability to cross the blood brain barrier (BBB) and enter the brain at therapeutically effective levels. The BBB is a highly selective semipermeable border of cells that prevents molecules in the circulating blood from non-selectively crossing into the brain tissue. We have developed a simple targeted nanoparticle platform that can stably encapsulate therapeutic agents and enable their therapeutically effective delivery into the brain. In this work, we have demonstrated the utility of this platform for the treatment of traumatic brain injury (TBI), which is a leading cause of death and disability in children and young adults, with millions of people suffering TBI each year in accidents, sports, and military conflicts. Following primary injury, which is a result of the mechanical impact to the brain, secondary injury gradually occurs over months to years and can lead to neurological dysfunctions, including Alzheimer’s and Parkinson’s diseases. After TBI, the BBB is physically breached for a short time and previous approaches to achieve therapeutically effective transport of drugs across the BBB have been severely limited to utilizing this very short window. However, the extent to which the BBB is physically breached in TBI varies greatly across the patient population. Therefore, current approaches are applicable to only a subset of injuries with substantially breached BBB. Moreover, BBB can self-repair within a few hours to weeks post-injury to restore its integrity. Hence, physical breaching of BBB offers a limited window for therapeutic interventions, which is not ideal as the secondary injury can last months to years and may require repeated dosing over long term. The nanoparticle platform developed in this work can enable therapeutically effective delivery of drugs into the brain, irrespective of the state of the BBB. We achieved this by precise engineering of the surface properties of nanoparticles, which maximized their transport across the BBB. The therapeutic used in this study was a small interfering RNA (siRNA) molecule designed to inhibit the expression of the tau protein, which is believed to play a key role in neurodegeneration. Poly(lactic-co-glycolic acid), or PLGA, a biodegradable and biocompatible polymer used in several existing products approved by the U.S. Food and Drug Administration was used as the base material for nanoparticles. We systematically engineered and studied the surface properties of the nanoparticles to maximize their penetration across the intact, undamaged BBB in healthy mice. This led to the identification of a unique nanoparticle design that maximized the transport of the encapsulated siRNA across the intact BBB and also significantly improved the uptake by the brain cells.  (more…)
Author Interviews, Brain Injury, Exercise - Fitness, JAMA / 17.11.2020

MedicalResearch.com Interview with: Tara L Sharma DO Clinical Assistant Professor of Neurology at UWMC Seattle, WA 98133 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Flying can lead to reduced oxygen partial pressures and cerebral blood flow causing worsening clinical outcome in cases of moderate to severe TBI; however, not much is known regarding the clinical consequences of flying in individuals with concussion or mild TBI. Because many athletes suffer concussions during games, it is necessary to know if flying afterward may potentially hinder their ability to return to play. Overall, we found no associated between air travel and increased symptom severity in both our entire cohort and the subset of football players. (more…)
Author Interviews, Brain Injury, Brigham & Women's - Harvard, JAMA / 25.09.2020

MedicalResearch.com Interview with: Maria Gabriela Figueiro Longo, MD, MSc Department of Radiology, Massachusetts General Hospital Harvard Medical School, Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcranial low-level light therapy (3LT) has been shown to be effective in animal models of traumatic brain injury. Our goal was to assess the 3LT in humans with acute TBI. We tested (1) safety, and (2) any effect in the brain in a measurable way. We found positive results for both - there was no event adverse during the trial related to the 3LT; and we found some differences in the brain MRI diffusivity parameters in the patients who received light therapy compared to the sham group. The study was not powered for clinical evaluation, although there was a trend towards lower symptom burden in the treated group. (more…)
Author Interviews, Brain Injury, JAMA / 16.09.2020

MedicalResearch.com Interview with: Susan Rowell MD, MBA, MCR Associate Professor, Department of Surgery Division of Trauma, Acute & Critical Care Surgery Duke University School of Medicine Durham, NC 27710 MedicalResearch.com: What is the background for this study? Response: Tranexamic acid (TXA) has been increasingly used in trauma patients since publication of the CRASH-2 trial in 2010 demonstrated a survival benefit for patients at risk for traumatic hemorrhage. Subsequently, it was shown that the earlier TXA was administered, the better the outcome. There had been several small studies suggesting that TXA may also be beneficial in patients with traumatic brain injury (TBI), however, an adequate prospective randomized trial was needed. In this trial we randomized over 1000 patients with moderate and severe TBI as early as possible after injury (by paramedics in the prehospital setting an average of 42 minutes after injury) to either a 1-gram TXA bolus followed by a 1-gram 8-hour TXA infusion (the dose typically used for trauma patients), a 2-gram TXA bolus only (a logistically easier route of administration requiring no maintenance infusion), or placebo only. (more…)
Author Interviews, Brain Injury, Cognitive Issues, Depression, Mental Health Research / 15.07.2020

MedicalResearch.com Interview with: Dr. Steve Erickson, MD Concussion Expert at Banner University Medicine Neuroscience Institute Dr. Erikson discusses the recent Neurology publication associating repetitive head impacts with depression. MedicalResearch.com: What is the background for this study? Response: The study compared depression and cognitive function of adults (middle aged and older) who have had repetitive head impacts (RHI) and/or TBI to adults without a history of these. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Pediatrics / 05.03.2020

MedicalResearch.com Interview with: Robert F. Heary, M.D. Co-Director, Reynolds Family Spine Laboratory Director, Spine Center of New Jersey Professor, Rutgers New Jersey Medical School Newark, New Jersey MedicalResearch.com: What is the background for this study? Response: This article was written to assess the relative danger versus safety of youth football.  As this is a hot-button topic in the world of neurosurgery and neurology, we decided to look into this issue. In a suburban town, middle school football players were studied.  They wore helmets with accelerometers mounted inside the hemet to measure how many hits the player absorbs and the magnitude of the force behind the hits.  Also, soft “guardian caps” we worn over the outside of the helmets during practices. For all football activities (practices and games), the helmets were worn and data were accumulated.  In addition, specialized coaching related to safe tackling techniques was provided. (more…)
Accidents & Violence, Author Interviews, Brain Injury, JAMA, Pediatrics, UCSF / 08.01.2020

MedicalResearch.com Interview with: Benjamin N. Breyer MD, MAS, FACS Associate Professor Departments of Urology and Epidemiology and Biostatistics University of California, San Francisco Vice-Chair of Urology Chief of Urology, Zuckerberg San Francisco General Hospital and Trauma Center Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship MedicalResearch.com: What is the background for this study? Response: There has been a large increase in upright scooter usage among adults as a mode of transportation. It's convenient for commuters and may encourage greater use of public transit leading to less car traffic in cities. (more…)
Alzheimer's - Dementia, Author Interviews, Brain Injury, Medical Imaging, UCSF / 06.01.2020

MedicalResearch.com Interview with: William G. Mantyh, MD Clinical Fellow, UCSF Memory and Aging Center Weill Institute for Neurosciences UCSF MedicalResearch.com: What is the background for this study? Response: Similar to Alzheimer’s disease (AD) and other dementing illnesses, Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative condition associated with abnormally folded tau protein in the brain. CTE is thought to be caused by exposure to repetitive head trauma, and recently has been the subject of intense media coverage given the frequency of CTE found in brains of deceased former American professional football players. CTE is almost impossible to confidently diagnose during life as the symptoms are diverse and vary from patient-to-patient. Symptoms can include impairments in memory, multi-tasking, behavioral/mood regulation, and movement. As there are no blood, imaging, or other tests for this disease, one active area of research is developing a test to help doctors diagnose this condition. As tau tangles in CTE are similar in many respects to those in Alzheimer’s disease, there was hope that PET tracers that detect tau in AD might also work in CTE. Flortaucipir (FTP) is probably the most widely used tau tracer in AD. Recent work has reported some signal from FTP-PET in symptomatic former NFL players and other patients at risk for CTE (Stern et al. New Engl Jour Med 2019; Lesman-Segev et al. Neuroimage Clinical 2019). The overall signal was lower than that observed in Alzheimer’s disease, and, in lieu of correlations with post-mortem findings, it was unclear how well FTP binds to tau pathology in CTE. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, JAMA / 18.12.2019

MedicalResearch.com Interview with: John Breck, DO,  CAQSM Medical Services at University of Colorado, Boulder MedicalResearch.com: What is the background for this study? Response: To date, most concussion research has focused on sport-related concussion, though it is known that a substantial number of concussions occur outside of participating in sport. Focusing solely on sport-related concussion may result in an underestimation of the underlying incidence and prevalence of concussion in the general population and leads to the widely held perception that most concussions are sport-related. An understudied population at risk for concussion are United States undergraduate college students.  (more…)
Author Interviews, Biomarkers, Brain Injury, Emergency Care, Pediatrics / 31.08.2019

MedicalResearch.com Interview with: Linda Papa, MD Emergency Physicians of Central Florida Orlando Health Orlando, Florida  MedicalResearch.com: What is the background for this study? Response: In 2018 serum biomarkers Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal hydrolase (UCH-L1) were FDA-approved in adults to detect abnormalities on CT scan in mild to moderate traumatic brain injury. However, they have not been approved to detect concussion and they have not been approved for use in children. Previous studies have focused on detecting lesions on CT in more severely injured patients. However, not having brain lesions on a CT scan does not mean there is no brain injury or concussion. Therefore, this study focused on patients with concussion who looked well and likely had normal-appearing CT scans of the brain. This study includes THREE groups of trauma patients:
  • 1) those with concussion,
  • 2) those who hit their head but had no symptoms (subconcussive), and
  • 3) those who injured their bones but did not hit their head (no concussion).
There is a group of individuals with head trauma who have been significantly understudied, and in whom biomarkers are rarely, if at all, examined. These are people who experience head trauma without symptoms of concussion. They may be classified as having “no injury” or they may represent milder forms of concussion that do not elicit the typical signs or symptoms associated with concussion and are referred to as “subconcussive” injuries.  (more…)
Author Interviews, Brain Injury, Erectile Dysfunction, JAMA / 26.08.2019

MedicalResearch.com Interview with: Rachel Grashow PhD Research Associate Department of Environmental Health Football Players Health Study at Harvard University Harvard T.H. Chan  MedicalResearch.com: What is the background for this study? Response: It has been previously shown in small studies of boxers and military personnel that traumatic brain injuries can damage the pituitary gland, which serves as the "master controller" of hormone function in the brain. These studies on individuals at risk for repeated head injury found that hits on the head caused deficiencies in certain hormones, such as growth hormone and testosterone, which could have downstream effects on sexual function. Only one large study was conducted that used Taiwanese health insurance data and looked at single traumatic brain injuries and risk of erectile function (ED). In that study, men who experienced a single severe TBI were more than twice as like to report ED after their injury. In light of these findings, important questions remain regarding whether multiple head injuries are associated with pituitary or sexual dysfunction in a large population with other ED-related health issues. The Football Players Health Study at Harvard University asked former NFL players to fill out a questionnaire that interrogated demographic factors, football-related exposures and current health conditions. Specifically, we asked participants to self-report the frequency of ten different concussion symptoms experienced during professional play, as well as whether a clinician had ever recommended or prescribed medication for low testosterone or ED.   (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Nature, Science / 11.08.2019

MedicalResearch.com Interview with: 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.  (more…)
Abuse and Neglect, Brain Injury / 24.07.2019

MedicalResearch.com Interview with: 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.   (more…)
Author Interviews, Brain Injury, Pediatrics / 11.07.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brain Injury, Columbia, Critical Care - Intensive Care - ICUs, NEJM, Neurology / 27.06.2019

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Brain Injury, University Texas / 24.06.2019

MedicalResearch.com Interview with: 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. (more…)
Accidents & Violence, Author Interviews, Brain Injury, ENT, Pediatrics / 12.06.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brain Injury, Cognitive Issues, Technology / 22.05.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brain Injury, Neurological Disorders, Neurology, Stroke / 12.05.2019

MedicalResearch.com Interview with: 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 (more…)