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, Eating Disorders, Exercise - Fitness, JAMA, Pediatrics / 31.12.2021

MedicalResearch.com Interview with: Sean C. Rose, MD Child Neurology Nationwide Children’s Hospital The Ohio State University, Columbus MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is conflicting evidence regarding the association between repetitive head impacts during youth contact sports and worse neurocognitive outcomes.   Most research has been conducted in older adults, while the research in children is mostly limited to 1-2 sports seasons. (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, 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, 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, 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…)
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, Medical Imaging, Mental Health Research, UCSD / 13.05.2019

MedicalResearch.com Interview with: Dr. Mingxiong Huang, PhD Professor, Electrical and Computer Engineering University of California, San Diego MedicalResearch.com: What is the background for this study?   Response: Combat-related mild traumatic brain injury (mTBI) is a leading cause of sustained impairments in military service members and Veterans. Yet, conventional neuroimaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) are typically insensitive to physiological alterations caused by mild and some moderate TBIs. With funding from the VA, we have pursued in developing sensitive imaging markers based on magnetoencephalography (MEG) for mTBI. This paper reflects the news MEG findings in this research field.  (more…)
Accidents & Violence, Author Interviews, Brain Injury / 29.04.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, JAMA, Pediatrics / 07.02.2019

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Brain Injury, Gender Differences, JAMA, Pediatrics / 05.11.2018

MedicalResearch.com Interview with: 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. (more…)
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. (more…)
Author Interviews, Brain Injury, Pediatrics, Pediatrics, University Texas / 18.10.2018

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brain Injury, CT Scanning, Emergency Care, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brain Injury, JAMA / 12.03.2018

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Biomarkers, Brain Injury / 06.04.2017

MedicalResearch.com Interview with: Sergey A. Dryga, PhD, MBA Chief Scientific Officer BioDirection, Inc.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: When patients have suffered a head injury, they typically undergo a series of subjective cognitive tests to confirm a diagnosis of a concussion or other traumatic brain injury. In many cases these tests are inaccurate and inconsistent, increasing the risk of misdiagnosis. In other cases, patients may undergo an unnecessary CT scan, which is costly and exposes them to radiation. Early, objective diagnostic testing of patients who have experienced a head injury can support more rapid and appropriate treatment decisions while potentially reducing the use of unnecessary CT scans or other forms of intervention. We know that protein biomarkers, including S100 calcium binding protein beta (S100β) and glial fibrillary acidic protein (GFAP), are released from the brain into the bloodstream immediately following a concussion or other traumatic brain injury. The Tbit™ System is a new medical device based on a nanotechnology biosensor that rapidly detects and accurately measures these protein biomarkers. The system includes a disposable cartridge and portable analyzer designed for testing using a single drop of blood at the earliest stages of a concussion. This pre-clinical study was designed to evaluate the ability of the Tbit System to screen traumatic brain injury patients for a CT positive or CT negative test. Frozen plasma samples were collected from a total of 100 patients who had undergone CT scans post hospital admission. The Tbit System demonstrated 100% sensitivity with no false negative results, and a 41% specificity level. (more…)
Author Interviews, Brain Injury, Neurological Disorders, Pediatrics / 06.04.2017

MedicalResearch.com Interview with: Emily Dennis PhD Postdoctoral Scholar Imaging Genetics Center Mark and Mary Stevens Neuroimaging and Informatics Institute USC MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that there is heterogeneity in outcome post-traumatic brain injury (TBI), but we generally think of this as a continuous variable - with most patients falling in the middle and only a few at the extremes in terms of recovery process and outcome. Our main finding was that interhemispheric transfer time (IHTT - the time it takes for information to move from one hemisphere of the brain to the other) identified 2 subgroups of TBI patients - those with slow IHTT and those with normal IHTT. These two groups show differences in cognitive function and brain structure, with the IHTT slow group showing structural disruptions that become progressively worse while the IHTT normal group seems to be recovering from the injury. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Gender Differences, Mental Health Research / 16.03.2017

MedicalResearch.com Interview with: Wellington K. Hsu, MD Clifford C. Raisbeck, MD, Professor of Orthopaedic Surgery Associate Professor of Orthopaedic Surgery Northwestern University Chicago, IL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Concussions remains a significant problem in youth sports. The recent enactment of Traumatic brain injury laws have certainly heightened awareness regarding this problem. Our study looked at publicly available data regarding diagnosis of concussion in high school athletes. We found that females are more likely to be diagnosed with a concussion than males. We also concluded that girl soccer players and boys football players are at highest risk for a diagnosis of concussion. Since the neck meant of the Traumatic brain injury state laws, the diagnosis of concussion in this patient group increased significantly past decade. (more…)
Accidents & Violence, Author Interviews, Brain Injury / 08.02.2017

MedicalResearch.com Interview with: Julianne Schmidt, PhD, ATC Assistant Professor Department of Kinesiology The University of Georgia Athens GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Less than half of all people with a concussion intend to reduce their driving at any point. Current recommendations surrounding concussion focus on when it is safe to return to sport or return to the classroom, but return to driving is usually ignored and has not been studied. (more…)
Author Interviews, Brain Injury, JAMA, Pediatrics / 21.12.2016

MedicalResearch.com Interview with: Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario Ottawa, ON MedicalResearch.com: What is the background for this study? Response: While current concussion protocols endorse the conservative view that children should avoid physical activity until completely symptom-free, there is little evidence beyond expert opinion regarding the ideal timing of physical activity re-introduction. In fact, while rest does play a role in concussion recovery, protracted physical rest may actually negatively impact concussion recovery. Further, physiological, psychological, and functional benefits of early physical rehabilitation are observed in other disease processes such as stroke (which is an example of a severe traumatic brain injury). Therefore, our objective was to investigate the relationship between early physical activity (defined within 7 days of the concussion) and the eventual development of persistent post-concussion symptoms at one month. (more…)
Author Interviews, Brain Injury / 02.12.2016

MedicalResearch.com Interview with: Dr. Charles Tator, Neurosurgeon Toronto Western Hospital and Director Canadian Concussion Centre  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main findings of this study are that the number of symptoms of post-concussion syndrome (PCS) are related to how long PCS lasts. Furthermore, physicians need to be more vigorous in their treatment of PCS symptoms and use the treatments that exist for each symptom where possible such as headache, vertigo, anxiety. The sooner sufferers of PCS receive treatment for their symptoms, the better. (more…)
Author Interviews, Brain Injury, JAMA, Pediatrics / 24.10.2016

MedicalResearch.com Interview with: Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion University of Ottawa Director, Clinical Research Unit Children’s Hospital of Eastern Ontario Ottawa, ON MedicalResearch.com: What is the background for this study? Response: Concussion remains a major public health concern in children. Approximately 30% of affected children experience persistent post-concussive symptoms (PPCS) for at least one month post-injury. These symptoms may negatively impact their health related quality of life. Examples may include cognition, memory and attention affecting school attendance and performance, mood and social engagement, as well as physical performance. Prior to this study, there was little evidence that examined the relationship between PPCS and quality of life following concussion. This was important to better understand in order to provide appropriate interventions, expectation management and ultimately a better standard of care to affected patients and their families. (more…)
Author Interviews, Brain Injury, JAMA, Pediatrics / 02.08.2016

MedicalResearch.com Interview with: Danny G. Thomas, MD, MPH Department of Pediatrics, Emergency Medicine Children’s Hospital of Wisconsin Corporate Center Milwaukee, WI MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a secondary analysis of a randomized controlled trial of strict rest after concussion published last year. We wanted to find out how mental and physical activity levels related to symptom spikes or sudden increases in concussion symptoms. We found that one in three patients had symptoms spikes in recovery. Patients who had symptom spikes tended to have higher symptoms in the emergency department and throughout recovery. Most symptom spikes were not associated with an increase in physical and mental activity level the day prior. We did find that a sudden increase in activity like returning to school did increase the risk of having a symptom spike, but the good news is these symptom spikes seemed to resolve the following day and did not impact recovery by 10 days. (more…)
Author Interviews, Brain Injury, Neurological Disorders / 13.04.2016

MedicalResearch.com Interview with: Thomas A. Buckley Ed.D Assistant Professor Kinesiology & Applied Physiology 144 Human Performance Lab College of Health Sciences University of Delaware MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Buckley: The most recent international consensus statement recommends 24 - 48 hours of cognitive and physical rest in the immediate aftermath of a concussion; however, our clinical experience was that patients who were "shut down" for a few days did worse than patients who were allowed to be out and about as tolerated by symptoms.  This was a retrospective study (chart review) comparing symptom reporting among patients who were shut down for 24 hours and those who were not. The main finding of the study was the addition of a day of cognitive and physical rest (i.e., 'shut down") did not improve symptom recovery recovery.  In fact, we were surprised to see that the non-rest group was symptom free 1.3 days sooner than the rest group and this was statistically significant. (more…)
Author Interviews, Brain Injury, JAMA, UT Southwestern / 18.05.2015

C. Munro Cullum, PhD, ABPP Professor of Psychiatry and Neurology & Neurotherapeutics Pamela Blumenthal Distinguished Professor of Clinical Psychology Chief of Psychology Director of Neuropsychology Univ. of Texas Southwestern Medical Center Dallas, TX 75390-9044 MedicalResearch.com Interview with: C. Munro Cullum, PhD, ABPP Professor of Psychiatry and Neurology & Neurotherapeutics Pamela Blumenthal Distinguished Professor of Clinical Psychology Chief of Psychology , Director of Neuropsychology Univ. of Texas Southwestern Medical Center Dallas, TX Medical Research: What is the background for this study? What are the main findings? Dr. Cullum: My colleague and principal investigator of the study, Dr. John Hart and I have been interested in the acute and longer-term effects of traumatic brain injury for years, and because of my roles in the Alzheimer’s Disease Center and the Texas Institute for Brain Injury and Repair at the University of Texas Southwestern Medical Center, it seemed like a natural to begin studying older individuals with and without cognitive disorder who have a history of traumatic brain injury.  Our main findings are two-fold: First, we demonstrated that a history of concussion with loss of consciousness (which make up only about 10% of all concussions) was associated with smaller memory centers in the brain (the hippocampus) and lower memory results in our sample of retired professional football players. Concussions that did not result in loss of consciousness did not show that same strong association. Second, our data suggest that patients with a clinical diagnosis of mild cognitive impairment (ie a memory disorder that does not grossly impair overall functioning but may lead to dementia) who also have a history of concussion with loss of consciousness show worse memory results and more brain atrophy than similar individuals diagnosed with mild cognitive impairment in the absence of a history of concussion. (more…)
Author Interviews, Brain Injury / 21.08.2014

Li-Shan Chou, Ph.D Professor and Department Head Department of Human Physiology University of Oregon Eugene, OR 97403-124MedicalResearch.com Interview with: Li-Shan Chou, Ph.D Professor and Department Head Department of Human Physiology University of Oregon Eugene, OR 97403-1240 Medical Research: What are the main findings of the study? Prof. Li-Shan Chou: The findings from this study indicate that pre return-to-activity (RTA), the adolescents with concussion reduced their medial/lateral displacement and velocity during dual-task walking, suggesting an improvement in gait balance control, while significantly increasing these frontal plane motion variables during dual-task walking post RTA, suggesting a worsening of frontal plane COM control following RTA. These data suggest that frontal plane motion during dual-task walking are sensitive to the effects of return to activity following concussion and may reveal a possible regression in gait stability following return to activity. (more…)