Persisting effects of minor head injury observable during hypoxic stress

Ewing, Rachel; McCarthy, Dianne; Gronwall, Dorothy; Wrightson, Philip

doi:10.1080/01688638008403789

Cited by 106 publications

(48 citation statements)

References 7 publications

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“…NH may be particularly useful as a stress paradigm for mTBI assessment for several reasons. Most of the literature investigating the hypoxia-induced effects on sensoryintegrative function has been limited to normally functioning individuals, however, our work [60,61] and that of others [59], demonstrate that, when challenged with hypoxic stress, individuals with mTBI show a statistically significant and disproportionate cognitive impairment as compared with healthy individuals, consistent with the BRC model. Furthermore, Temme et al found that the peripheral oxygenation (SpO 2 ) response to hypoxia differed between healthy individuals and asymptomatic individuals with a history of mTBI, suggesting that the assessment of additional functional modalities (i.e., oculo motor, pupillometric, vestibular, auditory, etc.)…”

Section: Hypoxia and Cerebral Resource Depletionsupporting

confidence: 71%

“…The idea that mTBI and hypoxic stress may have combinational, and thereby disproportionate, effects were formulated from observations made during a 1980 study of a group of ten university students who had experienced 'minor head injury' 1-3 years prior to the study [59]. At the time of the study, these students were asymptomatic and performing comparably to preinjury levels.…”

Section: Using Hypoxia In Mtbi Assessmentmentioning

confidence: 99%

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Feasibility of using normobaric hypoxic stress in mTBI research

et al. 2017

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Studies of mild traumatic brain injury (mTBI) recovery generally assess patients in unstressed conditions that permit compensation for impairments through increased effort expenditure. This possibility may explain why a subgroup of individuals report persistent mTBI symptoms yet perform normally on objective assessment. Accordingly, the development and utilization of stress paradigms may be effective for enhancing the sensitivity of mTBI assessment. Previous studies, discussed here, indirectly but plausibly support the use of normobaric hypoxia as a stressor in uncovering latent mTBI symptoms due to the overlapping symptomatology induced by both normobaric hypoxia and mTBI. Limited studies by our group and others further support this plausibility through proof-of-concept demonstrations that hypoxia reversibly induces disproportionately severe impairments of oculomotor, pupillometric, cognitive and autonomic function in mTBI individuals.

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Section: Hypoxia and Cerebral Resource Depletionsupporting

confidence: 71%

Section: Using Hypoxia In Mtbi Assessmentmentioning

confidence: 99%

Feasibility of using normobaric hypoxic stress in mTBI research

et al. 2017

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“…Animal models have been used to test clinically relevant hypotheses about cerebral reserve capacity and increased vulnerability after concussion i n humans (Ewing, McCarthy, Gronwall, & Wrightson, 1980). Increased vulnerability to challenge by an anticholinergic drug, scopolamine, was demonstrated in rats on a visual-spatial learning task 13 days after their intact skulls were concussed (Dixon, Hamm, Taft, & Hayes, 1994).…”

Section: Pathophysiological and Experi-mental Researchmentioning

confidence: 99%

A review of mild head trauma. part II: Clinical implications

Binder

1997

Journal of Clinical and Experimental Neuropsychology

225

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In Binder et al. (1997) a metal-analytic review revealed a small effect size attributable to a history of mild head trauma (MHT). The results suggested a weak association between MHT and persistent neuropsychological deficits. In this paper, additional outcome data are summarized and the results are discussed. On a chronic basis, 7-8% of MHT patients remain symptomatic and 14% are disabled from work. Magnetic resonance studies of acutely injured persons may show lesions that are not detected in usual clinical practice. It is likely that the effects of these lesions dissipate with time, consistent with the neuropsychological data. The association between MHT and cognitive deficits, symptoms, and disability may not be casual; data suggest that MHT patients have more psychosocial problems prior to injury than do non-injured persons. The examiner of the MHT patient with chronic complaints must consider alternative medical and psychiatric explanations and perform a differential diagnosis. The possibility of a neurological basis for sustained neuropsychological problems cannot be completely dismissed. Presently, however, there is little evidence for neurological causation of most persisting complaints.

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“…135 If so, an earlier impairment from climbing could combine with and magnify the degradation from a new trauma.…”

Section: Temporary Versus Long-term Effectsmentioning

confidence: 99%

Cognitive performance, mood, and neurological status at high terrestrial elevation

Banderet¹,

Shukitt-Hale²

2002

PsycEXTRA Dataset

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. ABSTRACT (Maximum 200 words)Cognitive and psychomotor performance and mood states, including many critical behavioral functions such as sleep, memory, ■ reasoning, and vigilance, are significantly impaired by ascent to HTE higher than 3,000 m. Impairments in behavior caused by HTE can degrade military operations because the judgment and rate and accuracy of performance of military personnel can be affected. Such adverse effects have distinct and measurable time courses; onset of some effects is immediate (cognitive performance), whereas the onset of others is delayed (symptoms of AMS or adverse moods). The behavioral consequences of HTE are primarily dependent on the level of altitude, the duration of exposure the rate of ascent, an individual's state of physiological acclimation or acclimatization, characteristics of the task performed, and characteristics of the individual such as hypoxic sensitivity. Military history documents that the adverse effects induced by HTE need to be considered when military operations at altitude are planned and undertaken. Current research indicates that some performance decrements induced by ascent to extremely high mountains (e.g., Mount Everest, 8,848 m) may persist for a year or longer after return to lower elevations. Psychological, operational, and medical strategies have been employed to minimize these adverse effects. Psychological strategies often involve training and familiarization with the adverse effects that will be experienced at high altitude. Operational strategies include staging at intermediate altitudes, acclimatizing, and using supplemental oxygen from tanks of oxygen generators. Medical strategies often involve the use of medications to improve functioning at altitude and techniques to avoid complications. In most situations, multiple strategies are employed. The strategies now available and new developments to come will ensure that high-altitude military operations in the future will be less affected by adverse changes in cognitive and psychomotor performance and mood.14. SUBJECT TERMS high altitude, hypoxia, cognitive performance, moods, symptoms, time course of altitude effects, behavior NUMBER OF PAGES 3516. PRICE CODE

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Persisting effects of minor head injury observable during hypoxic stress

Cited by 106 publications

References 7 publications

Feasibility of using normobaric hypoxic stress in mTBI research

Feasibility of using normobaric hypoxic stress in mTBI research

A review of mild head trauma. part II: Clinical implications

Cognitive performance, mood, and neurological status at high terrestrial elevation

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