Monthly Archives: October 2015
SOLVING THE CONCUSSION CRISIS: PRACTICAL SOLUTIONS
This white paper is an international collaborative effort to address concussion management, science, policy and future directions. This article is driven by data and rooted in science. There has been no sponsorship or financial interest influencing the development of this statement of agreement. This consensus statement will be constantly updated based on advances in science. These efforts aim to provide much needed direction for concussion management rendered by school boards, workers’ compensation boards, amateur and professional sporting associations, as well as insurance providers and government. The aforementioned groups are encouraged to strive towards the best medical practices outlined in this white paper. Concussed individuals may reference this policy paper when advocating for care.
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Persistent Differences in Patterns of Brain Activation after Sports-Related Concussion
Persistent Differences in Patterns of Brain Activation after Sports-Related Concussion: A Longitudinal Functional Magnetic Resonance Imaging Study
Abstract
Avoiding recurrent injury in sports-related concussion (SRC) requires understanding the neural mechanisms involved during the time of recovery after injury. The decision for return-to-play is one of the most difficult responsibilities facing the physician, and so far this decision has been based primarily on neurological examination, symptom checklists, and neuropsychological (NP) testing. Functional magnetic resonance imaging (fMRI) may be an additional, more objective tool to assess the severity and recovery of function after concussion. The purpose of this study was to define neural correlates of SRC during the 2 months after injury in varsity contact sport athletes who suffered a SRC. All athletes were scanned as they performed an n-back task, for n = 1, 2, 3. Subjects were scanned within 72 hours (session one), at 2 weeks (session two), and 2 months (session three) post-injury. Compared with age and sex matched normal controls, concussed subjects demonstrated persistent, significantly increased activation for the 2 minus 1 n-back contrast in bilateral dorsolateral prefrontal cortex (DLPFC) in all three sessions and in the inferior parietal lobe in session one and two (a £ 0.01 corrected). Measures of task performance revealed no significant differences between concussed versus control groups at any of the three time points with respect to any of the three n-back tasks. These findings suggest that functional brain activation differences persist at 2 months after injury in concussed athletes, despite the fact that their performance on a standard working memory task is comparable to normal controls and normalization of clinical and NP test results. These results might indicate a delay between neural and behaviorally assessed recovery after SRC.
Key words: concussion; DLPFC; fMRI; n-back task; working memory
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Over the Ball with Kevin Flynn Interview
Kevin Flynn covers the futures of FIFA and Sepp Blatter with Jeremy Schaap, MLS’ perception with Ben Grossman and the management of head injuries with David Goldstein.
Country Wide Concussion Coverage
Minute 40