Concussion in Professional Football: Brain Responses by Finite Element Analysis: Part 9

Viano, David C.; Casson, Ira R.; Pellman, Elliot J.; Zhang, Liying; King, Albert I.; Yang, King H.

doi:10.1227/01.neu.0000186950.54075.3b

Cited by 261 publications

(203 citation statements)

References 101 publications

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“…This was from a player concussed on a kick return who had brief LOC, and PCS symptoms of headache, fatigue, dizziness, and photophobia and sleep disorder as physical symptoms. Note that the modeling of this subjects brain would involve all of the structures identified in Figure 1, and indeed, the high strain findings modeled in this subject supported such a locus of injury (see Appendix 1B of the Viano et al, 2005b paper that detail individual characteristics of the subjects).…”

Section: Pathophysiology Of Concussionmentioning

confidence: 64%

“…The Viano et al (2005b) modeling study found, in general, excursions of the concussed brain to be between 3-6 mm at 24-26 ms post-impact. Of particular importance to neuropsychology is that this modeling shows 4-5 mm displacements of the hippocampus, caudate, amygdala, anterior commissure, and midbrain (again refer to Fig.…”

Section: Physics Of Tbimentioning

confidence: 91%

“…Bayly et al (2006) have also performed this type of modeling on the rat pup brain with similar findings of significant transient mechanical deformation of the brain. Viano et al (2005b) used a different approach by simulating movement within the cranium by a "finite element analysis using a detailed anatomic model of the brain and head accelerations from laboratory reconstructions of game impacts (p. 891)" based on National Football League (NFL) players who experienced on the field concussions that were videotaped. The exceptional innovativeness of this study was the ability to model the brain, including white and gray matter, the ventricular system, meninges, and in particular the falx cerebri and tentorium cerebelli along with the skull (most of these anatomical regions are shown in Figs.…”

Section: Physics Of Tbimentioning

confidence: 99%

“…More importantly, even those without clinical abnormalities as a group exhibited DTI differences from their matched controls, suggesting subtle white matter abnormalities, particularly at the level of the corpus callosum. Recall that Viano et al (2005b) showed that the corpus callosum was one of the brain regions receiving the biggest strain effect in concussion. Similarly, Chappell et al (2006) using DTI methods demonstrated similar white matter pathology in a group of 81 professional boxers.…”

Section: Pathophysiology Of Concussionmentioning

confidence: 99%

“…Blumbergs et al (1995) in a follow-up study demonstrated that the microscopic pathology was on a continuum from mild (GCS of 13-15) to severe (GCS of 3-8), again demonstrating the susceptibility of the fornix. As shown by Viano et al (2005b), the fornix is distinctly vulnerable to the stress0strain effects of concussion and is a common area of damage in moderate-to-severe TBI, as visualized using MRI (Gale et al, 1995;Tate & Bigler, 2000;Tomaiuolo et al, 2004), where the degree of atrophy is related to severity of injury Tate & Bigler, 2000;Tomaiuolo et al, 2004;Wilde et al, 2006b). Because the fornix is a white matter structure containing projecting axons from the hippocampus, disruption in fornix integrity likely relates to the concussive effects of disrupted short-term memory, at least transiently.…”

Section: Is Brain Injury On a Continuum: Concussion R Severe Tbi?mentioning

confidence: 99%

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Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Bigler

2007

J Int Neuropsychol Soc

363

248

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On the mild end of the acquired brain injury spectrum, the terms concussion and mild traumatic brain injury (mTBI) have been used interchangeably, where persistent post-concussive syndrome (PPCS) has been a label given when symptoms persist for more than three months post-concussion. Whereas a brief history of concussion research is overviewed, the focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of concussion in human and animal studies, particularly directed at a better understanding of the neuropathology associated with concussion. These studies implicate common regions of injury, including the upper brainstem, base of the frontal lobe, hypothalamic-pituitary axis, medial temporal lobe, fornix, and corpus callosum. Limitations of current neuropsychological techniques for the clinical assessment of memory and executive function are explored and recommendations for improved research designs offered, that may enhance the study of long-term neuropsychological sequelae of concussion. (JINS, 2008, 14, 1-22.)

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Section: Pathophysiology Of Concussionmentioning

confidence: 64%

Section: Physics Of Tbimentioning

confidence: 91%

Section: Physics Of Tbimentioning

confidence: 99%

Section: Pathophysiology Of Concussionmentioning

confidence: 99%

Section: Is Brain Injury On a Continuum: Concussion R Severe Tbi?mentioning

confidence: 99%

See 3 more Smart Citations

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Bigler

2007

J Int Neuropsychol Soc

363

248

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Preliminary evidence from a prospective DTI study suggests a posterior‐to‐anterior pattern of recovery in college athletes with sports‐related concussion

et al. 2018

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ObjectivesWe compared the integrity of white matter (WM) microstructure to the course of recovery in athletes who sustained one sports‐related concussion (SRC), assessing individual longitudinal changes in WM fiber tracts following SRC using pre‐ and post‐injury measurements.Materials and MethodsBaseline diffusion tensor imaging (DTI) scans and neuropsychological tests were collected on 53 varsity contact‐sport college athletes. Participants (n = 13) who subsequently sustained an SRC underwent DTI scans and neuropsychological testing at 2 days, 2 weeks, and 2 months following injury.ResultsRelying on tract‐based spatial statistics (TBSS) analyses, we found that radial diffusivity (RD) and mean diffusivity (MD) were significantly increased at 2 days post‐injury compared to the same‐subject baseline (corrected p < 0.02). These alterations were visible in anterior/posterior WM regions spanning both hemispheres, demonstrating a diffuse pattern of injury after concussion. Implicated WM fiber tracts at 2 days include the following: right superior/inferior longitudinal fasciculus; right/left inferior fronto‐occipital fasciculus; right corticospinal tract; right acoustic radiation; right/left anterior thalamic radiations; right/left uncinate fasciculus; and forceps major/minor. At 2 weeks post‐injury, persistently elevated RD and MD were observed solely in prefrontal portions of WM fiber tracts (using same‐subject contrasts). No significant differences were found for FA in any of the post‐injury comparisons to baseline. Plots of individual subject RD and MD in prefrontal WM demonstrated homogenous increases from baseline to just after SRC; thereafter, trajectories became more variable. Most subjects’ diffusivity values remained elevated at 2 months post‐injury relative to their own baseline. Over the 2‐month period after SRC, recovery of WM fiber tracts appeared to follow a posterior‐to‐anterior trend, paralleling the posterior–anterior pattern of WM maturation previously identified in the normal population.ConclusionThese results suggest greater vulnerability of prefrontal regions to SRC, underline the importance of an individualized approach to concussion management, and show promise for using RD and MD for imaging‐based diagnosis of SRC.

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A window into eye movement dysfunction following mTBI: A scoping review of magnetic resonance imaging and eye tracking findings

et al. 2022

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Mild traumatic brain injury (mTBI), commonly known as concussion, is a complex neurobehavioral phenomenon affecting six in 1000 people globally each year. Symptoms last between days and years as microstructural damage to axons and neurometabolic changes result in brain network disruption. There is no clinically available objective biomarker to diagnose the severity of injury or monitor recovery. However, emerging evidence suggests eye movement dysfunction (e.g., saccades and smooth pursuits) in patients with mTBI. Patients with a higher symptom burden and prolonged recovery time following injury may show higher degrees of eye movement dysfunction. Likewise, recent advances in magnetic resonance imaging (MRI) have revealed both white matter tract damage and functional network alterations in mTBI patients, which involve areas responsible for the ocular motor control. This scoping review is presented in three sections: Section 1 explores the anatomical control of eye movements to aid the reader with interpreting the discussion in subsequent sections. Section 2 examines the relationship between abnormal MRI findings and eye tracking after mTBI based on the available evidence. Finally, Section 3 communicates gaps in our knowledge about MRI and eye tracking, which should be addressed in order to substantiate this emerging field.

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Concussion in Professional Football: Brain Responses by Finite Element Analysis: Part 9

Cited by 261 publications

References 101 publications

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Preliminary evidence from a prospective DTI study suggests a posterior‐to‐anterior pattern of recovery in college athletes with sports‐related concussion

A window into eye movement dysfunction following mTBI: A scoping review of magnetic resonance imaging and eye tracking findings

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