Rehabilitation of Concussion and Persistent Postconcussive Symptoms

Wilber, Charles G.; Leddy, John J.; Bezherano, Itai; Bromley, Lacey; Edwards, Amanda E.; Willer, Barry; Haider, Mohammad Nadir

doi:10.1055/s-0041-1725134

Cited by 10 publications

(5 citation statements)

References 86 publications

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“…Multidisciplinary approaches could incorporate a combination of neuroimaging in conjunction with neuropsychological measures, and self-report questionnaires, that includes both objective biomarkers and standardized scores, in addition to more subjective profiles. 115 , 120 , 121 Doing so would paint a clearer picture as to a particular presentation, in addition to consistent biological targets.…”

Section: Discussionmentioning

confidence: 99%

A Scoping Review of Magnetic Resonance Modalities Used in Detection of Persistent Postconcussion Symptoms in Pediatric Populations

et al. 2022

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Up to 30% of youth with concussion experience PPCSs (PPCS) lasting 4 weeks or longer, and can significantly impact quality of life. Magnetic resonance imaging (MRI) has the potential to increase understanding of causal mechanisms underlying PPCS. However, there are no clear modalities to assist in detecting PPCS. This scoping review aims to synthesize findings on utilization of MRI among children and youth with PPCS, and summarize progress and limitations. Thirty-six studies were included from 4907 identified papers. Many studies used multiple modalities, including (1) structural (n = 27) such as T1-weighted imaging, diffusion weighted imaging, and susceptibility weighted imaging; and (2) functional (n = 23) such as functional MRI and perfusion-weighted imaging. Findings were heterogeneous among modalities and regions of interest, which warrants future reviews that report on the patterns and potential advancements in the field. Consideration of modalities that target PPCS prediction and sensitive modalities that can supplement a biopsychosocial approach to PPCS would benefit future research.

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Section: Discussionmentioning

confidence: 99%

A Scoping Review of Magnetic Resonance Modalities Used in Detection of Persistent Postconcussion Symptoms in Pediatric Populations

et al. 2022

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“…No PPCS symptoms are specific to PPCS. Assessment and treatment must therefore be comprehensive, considerate of the individual presentation and history and encompass the multiple contributing aetiologies (Quinn et al, 2018; Wilber et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Examining the interdisciplinary approach for treatment of persistent post-concussion symptoms in adults: a systematic review

Jennings

Islam²

2022

Brain Impairment

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Background: The objective of this review is to examine the evidence for the interdisciplinary approach in treatment of persistent post-concussion symptoms in adults. Methods: This systematic literature search was undertaken according to the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) guidelines. Five electronic databases were searched: CINAHL, Informit, ProQuest, PubMed and Scopus. After screening and quality assessment, the review included six studies published in English and peer-reviewed journals, between 2011 and 2021 to return contemporary evidence. Results: The results revealed that there was significant variation between measures used and the timing of the pre- and post-treatment assessment. The studies found an interdisciplinary approach to be beneficial, however, the challenges of inherent heterogeneity, lack of clarity for definitions and diagnosis, and mixed results were apparent. The interdisciplinary interventions applied in all identified studies were found to reduce post-concussion symptoms across the symptom subtypes: headache/migraine, vestibular, cognitive, ocular motor and anxiety/mood. Conclusions: The results demonstrated evidence for a reduction in persistent post-concussion symptoms following interdisciplinary intervention. This evidence will inform health services, clinicians, sports administrators and researchers with regard to concussion clinic and rehabilitation team design and service delivery.

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“…It has been estimated that sports and other recreational activities result in between 1.6 and 3.8 million concussions annually in the U.S. ( 2 ). Moreover, 15% of mTBI patients suffer from post-concussion syndrome (PCS) characterized by delayed recovery after 3–4 weeks with physical, cognitive, and emotional complaints including headaches, poor sleep, poor concentration, dizziness, and irritability ( 3 , 4 ). Furthermore, it has been reported that concussed subjects are at three times higher risk of depression even decades after the injury ( 5 ) with characteristic imaging patterns of white matter tracts ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Post-concussive mTBI in Student Athletes: MRI Features and Machine Learning

et al. 2022

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Purpose: To determine and characterize the radiomics features from structural MRI (MPRAGE) and Diffusion Tensor Imaging (DTI) associated with the presence of mild traumatic brain injuries on student athletes with post-concussive syndrome (PCS).Material and Methods: 122 student athletes (65 M, 57 F), median (IQR) age 18.8 (15–20) years, with a mixed level of play and sports activities, with a known history of concussion and clinical PCS, and 27 (15 M, 12 F), median (IQR) age 20 (19, 21) years, concussion free athlete subjects were MRI imaged in a clinical MR machine. MPRAGE and DTI-FA and DTI-ADC images were used to extract radiomic features from white and gray matter regions within the entire brain (2 ROI) and the eight main lobes of the brain (16 ROI) for a total of 18 analyzed regions. Radiomic features were divided into five different data sets used to train and cross-validate five different filter-based Support Vector Machines. The top selected features of the top model were described. Furthermore, the test predictions of the top four models were ensembled into a single average prediction. The average prediction was evaluated for the association to the number of concussions and time from injury.Results: Ninety-one PCS subjects passed inclusion criteria (91 Cases, 27 controls). The average prediction of the top four models had a sensitivity of 0.80, 95% CI: [0.71, 0.88] and specificity of 0.74 95%CI [0.54, 0.89] for distinguishing subjects from controls. The white matter features were strongly associated with mTBI, while the whole-brain analysis of gray matter showed the worst association. The predictive index was significantly associated with the number of concussions (p < 0.0001) and associated with the time from injury (p < 0.01).Conclusion: MRI Radiomic features are associated with a history of mTBI and they were successfully used to build a predictive machine learning model for mTBI for subjects with PCS associated with a history of one or more concussions.

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Rehabilitation of Concussion and Persistent Postconcussive Symptoms

Cited by 10 publications

References 86 publications

A Scoping Review of Magnetic Resonance Modalities Used in Detection of Persistent Postconcussion Symptoms in Pediatric Populations

A Scoping Review of Magnetic Resonance Modalities Used in Detection of Persistent Postconcussion Symptoms in Pediatric Populations

Examining the interdisciplinary approach for treatment of persistent post-concussion symptoms in adults: a systematic review

Post-concussive mTBI in Student Athletes: MRI Features and Machine Learning

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