Utah concussion clinic booked with Dutch patients (6/27/19 newsletter)
As reported by the Times Publishing Group, concussions account for 15% of all high school athlete injuries. In an effort to combat this, Dignity Health and the California Interscholastic Federation partnered together to allow nearly one million California high school athletes access to the Dignity Health Concussion Network. The network provides educational resources for concussion prevention and identification, and students must show adequate understanding of the material to participate in their respective sports. The Dignity Health Concussion Network also provides baseline testing and Telehealth software that gives trainers and physicians access to neurologists who specialize in concussions and TBIs.
A retrospective study done by Thomas A. Connor et al. found that head injuries were reported in 70% of equestrian fall injury reports. Their analysis showed that stiffer helmets may increase the risk for TBIs— there was a positive correlation between helmets remaining undamaged and riders sustaining head injuries during falls. The authors encourage the reassessment of helmet design and certification through further research. The paper was published in Sports Medicine.
A study conducted by Dr. Kelly Russell et al. compared the grades, attendance, and academic accommodations between students who sustained sports-related concussions and students who sustained sports-related fractures (grades K-12). The researchers found that while the two groups of students had similar changes in grades after their injuries, the students who sustained concussions had significantly worsened attendance rates post-injury. This difference sheds light on how academic accommodations may need to be injury-specific. The study was published in PLOS ONE.
The authors Dr. Rúbia W. de Oliveira et al. performed a qualitative evaluation of studies that reported “participation of cannabinoids on the regulation of any step of neurogenesis,” or the formation of new neurons in the brain and nervous system. The study, published in Acta Neuropsychiatrica, found that “the activation of cannabinoid receptors may change neurogenesis.” The authors note that further understanding of cannabinoid signaling may aid in the development of “therapeutic strategies for neurodevelopmental, psychiatric, and neurological disorders.” The study doesn’t specifically mention TBI/concussion but does reference brain injuries such as different types of stroke.
A recent study by Dr. Sophie Stukas et al. looked at the accuracy of using the protein tau as a blood-based biomarker for diagnosing TBIs in pediatric cases. Published in The Lancet Child & Adolescent Health, the study found that serum total tau may be used to determine TBI severity. The authors also note that “serum total tau might help differentiate between patients with mild TBI (Glascow Coma Scale 13-14 vs. Glascow Coma Scale 15). The authors acknowledge that these results need to be confirmed by further research.
The Daily Herald reports that Dutch patients are flocking to CognitiveFX, a concussion clinic in Provo, Utah. The clinic specializes in treating post-concussion syndrome or symptoms (PCS) and uses functional Neurocognitive Imaging (fNCI), which can “reliably detect which regions of the brain are affected,” according to CognitiveFX. This information is used to create a customized week-long rehabilitation program, after which fNCI is used for a follow-up assessment. Dutch patients have heavily booked the clinic after a patient posted an article on LinkedIn, which generated additional coverage on radio and TV. CognitiveFX has published several peer-reviewed articles, and the founder of CognitiveFX, Alina K. Fong, PhD, presented research at the 13th World Congress on Brain Injury (2019, Toronto, Canada.)
A recent study published in the Journal of Neurotrauma found that veterans who have the genetic risk factor for Alzheimer’s disease called apolipoprotein (APOE) ε4 may also be at a higher risk of neurodegeneration following blast exposure. Dr. Danielle R. Sullivan et al. discovered a significant relationship between close-range blast exposure and APOE ε4 status in predicting the degree of neurodegeneration. This association, of close-range blast exposures, genetic risk for Alzheimer’s Disease, and white matter abnormalities was independent of a diagnosis of traumatic brain injury; white matter abnormalities were observed even in those veterans not diagnosed with TBI. While this study highlights an important genetic factor’s role in brain injuries, the molecular mechanisms are still unclear.
The British Journal of Occupational Therapy recently published a paper by Robyn Chen Sang et al. that examined how a six-week active rehabilitation intervention affected occupational performance and symptoms of young people who sustained concussions (ages 9-18). For these youth, occupational performance issues were categorized into their performance at school, sports, social activities, and self-care. Rehabilitation improved concussion symptoms and occupational performance. The authors suggest that standardized measurement of occupational performance issues, such as the Canadian Occupational Performance Measure, could also be used as an indicator of concussion recovery.
The authors Hector Arciniega et al. found that undergraduates who had a history of a concussion performed worse on tests of visual working memory than their peers with no concussion history. The study, published in the journal Attention, Perception, & Psychophysics, found that this impairment in visual working memory was present even years after a concussion. Noting that a history of concussion is prevalent amongst undergraduates, the authors suggest that additional research should “determine the breadth of cognitive deficits” in those with a history of a concussion. In a separate study published in Trends in Cognitive Sciences, authors Steven J. Luck et al. define visual working memory as “the active maintenance of visual information to serve the needs of ongoing tasks” and state that visual working memory is “strongly correlated with overall cognitive ability.”
Dr. Deva D. Chan et al. conducted a study to determine how the brain reacts to rotational acceleration, which is crucial for designing protective equipment such as helmets. Unlike other studies of its kind that use cadavers and crash dummies, these experiments were in vivo, with “human volunteers under mild angular accelerations of the head.” Learning how the brain moves and deforms as a result of acceleration can be useful in creating effective protective gear, future computation modeling, and TBI prevention. The study was published in the Journal of Biomechanical Engineering.
Additional contributors and this week's editor
Concussion Alliance co-founder Malayka Gormally