Concussion Mechanism: Biomechanical Perspectives

Laksari, Kaveh; Kurt, Mehmet; Wu, Long

doi:10.1007/978-3-030-93813-0_1

Cited by 2 publications

(2 citation statements)

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“…Concussions can damage the brain by either direct collision or the acceleration/deceleration forces associated with impact [ 77 ]. Direct collisions can cause diffuse damage due to the propagation of waves through the brain [ 78 ]. Biochemically, the effect of these forces on the brain is thought to activate a ‘neurometabolic cascade’ of events that, following the sheering/disruption of neuronal membranes, involves non-specific depolarization, the release of neurotransmitters (particularly excitatory amino acids), and the influx/efflux of ions such as calcium, magnesium, and potassium across the neuronal cytoplasmic membrane [ 78 , 79 , 80 ].…”

Section: Role Of Neuroimaging In Concussionmentioning

confidence: 99%

Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging

Santos

Jia-Richards

Kontos

et al. 2023

IJERPH

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Emotional dysregulation symptoms following a concussion are associated with an increased risk for emotional dysregulation disorders (e.g., depression and anxiety), especially in adolescents. However, predicting the emergence or worsening of emotional dysregulation symptoms after concussion and the extent to which this predates the onset of subsequent psychiatric morbidity after injury remains challenging. Although advanced neuroimaging techniques, such as functional magnetic resonance imaging and diffusion magnetic resonance imaging, have been used to detect and monitor concussion-related brain abnormalities in research settings, their clinical utility remains limited. In this narrative review, we have performed a comprehensive search of the available literature regarding emotional regulation, adolescent concussion, and advanced neuroimaging techniques in electronic databases (PubMed, Scopus, and Google Scholar). We highlight clinical evidence showing the heightened susceptibility of adolescents to experiencing emotional dysregulation symptoms following a concussion. Furthermore, we describe and provide empirical support for widely used magnetic resonance imaging modalities (i.e., functional and diffusion imaging), which are utilized to detect abnormalities in circuits responsible for emotional regulation. Additionally, we assess how these abnormalities relate to the emotional dysregulation symptoms often reported by adolescents post-injury. Yet, it remains to be determined if a progression of concussion-related abnormalities exists, especially in brain regions that undergo significant developmental changes during adolescence. We conclude that neuroimaging techniques hold potential as clinically useful tools for predicting and, ultimately, monitoring the treatment response to emotional dysregulation in adolescents following a concussion.

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Section: Role Of Neuroimaging In Concussionmentioning

confidence: 99%

Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging

Santos

Jia-Richards

Kontos

et al. 2023

IJERPH

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“…The diagnosis of concussion itself relies on subjective symptoms, as currently there is no consensus with conventional MRI/CT ( McCrory et al, 2017 ). Researchers have correlated head kinematics with brain injury by recording real time linear acceleration and angular velocity on the field using 6 degrees-of-freedom wearable sensor technology embedded into mouth guards ( Hernandez et al, 2015 ; Wu L. C. et al, 2018 ; Laksari et al, 2022 ). Concussive levels of impact exposure typically range between 50 and 100 g of head acceleration ( Laksari et al, 2018 , 2019 ), whereas sub-concussive impacts range between 10 and 30 g ( Wu et al, 2016 ; Nguyen et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Hyper-acute effects of sub-concussive soccer headers on brain function and hemodynamics

Grijalva,

Hale,

et al. 2023

Front. Hum. Neurosci.

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IntroductionSub-concussive head impacts in soccer are drawing increasing research attention regarding their acute and long-term effects as players may experience thousands of headers in a single season. During these impacts, the head experiences rapid acceleration similar to what occurs during a concussion, but without the clinical implications. The physical mechanism and response to repetitive impacts are not completely understood. The objective of this work was to examine the immediate functional outcomes of sub-concussive level impacts from soccer heading in a natural, non-laboratory environment.MethodsTwenty university level soccer athletes were instrumented with sensor-mounted bite bars to record impacts from 10 consecutive soccer headers. Pre- and post-header measurements were collected to determine hyper-acute changes, i.e., within minutes after exposure. This included measuring blood flow velocity using transcranial Doppler (TCD) ultrasound, oxyhemoglobin concentration using functional near infrared spectroscopy imaging (fNIRS), and upper extremity dual-task (UEF) neurocognitive testing.ResultsOn average, the athletes experienced 30.7 ± 8.9 g peak linear acceleration and 7.2 ± 3.1 rad/s peak angular velocity, respectively. Results from fNIRS measurements showed an increase in the brain oxygenation for the left prefrontal cortex (PC) (p = 0.002), and the left motor cortex (MC) (p = 0.007) following the soccer headers. Additional analysis of the fNIRS time series demonstrates increased sample entropy of the signal after the headers in the right PC (p = 0.02), right MC (p = 0.004), and left MC (p = 0.04).DiscussionThese combined results reveal some variations in brain oxygenation immediately detected after repetitive headers. Significant changes in balance and neurocognitive function were not observed in this study, indicating a mild level of head impacts. This is the first study to observe hemodynamic changes immediately after sub-concussive impacts using non-invasive portable imaging technology. In combination with head kinematic measurements, this information can give new insights and a framework for immediate monitoring of sub-concussive impacts on the head.

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Concussion Mechanism: Biomechanical Perspectives

Cited by 2 publications

References 136 publications

Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging

Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging

Hyper-acute effects of sub-concussive soccer headers on brain function and hemodynamics

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