Browsing by Subject "Brain Concussion"
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Item Does a Prior History Predict Prolonged Recovery Times from Sports-Related Concussion in Adolescents Seen In A Specialty Clinic?(2023-05) Elliott, William C.; Mathis, Keisa W.; Gwirtz, Patricia A.Purpose: The goal of our study was to examine the effect a prior history of concussion has on clinical recovery times for adolescent patients seen in a specialty clinic for sports related concussion (SRC). Additionally, concussion clinical profiles were compared in patients with a prior history of concussion and prolonged recovery to expand empirical evidence for the therapeutic use of these profiles in specialty clinics. Hypothesis: Patients with a prior history of concussion will have similar recovery times compared to patients with no prior history of concussion. Methods: A retrospective chart review was used to identify eligible patients for analysis (n=302). A non-inferiority analysis was used to assess if patients with a history of concussion had significantly non-inferior recovery times compared to patients with no history. Chi-square analysis was used to compare clinical profiles. Exploratory analysis conducted for a small cohort (n=12) of patients who were treated for two separate concussions using within-subjects design. Results: Recovery time in patients with a history was significantly noninferior to the recovery time of patients without a history (p = 0.01). There was no association of clinical profiles across groups. The exploratory analysis revealed a non-significant decrease in recovery time across injuries, but this analysis had low power due to small sample size. Conclusion: Recovery times do not significantly increase for patients with prior history of concussion seen at a specialty clinic.Item Effect of Vestibular Rehabilitaiton on Recovery Outcomes in Adolescents with Sports Related Concussions(2023-05) McCorkle, Megan J.; Romero, Steven A.Purpose: To examine the association between timing of vestibular rehabilitation initiation and recovery time in adolescents with sports related concussions. Hypothesis: Earlier intervention with vestibular rehabilitation following a sports related concussion will reduce recovery time Methods: This retrospective case-control study included patients 12-22 years old who were seeking treatment for a sports related concussion and received vestibular rehabilitation. Measures for clinical profiles, benign paroxysmal positional vertigo, and recovery time were analyzed. Results: The early intervention group (8-10 days) had a median recovery time that was 10 days less than the late intervention group (>10 days) despite similar treatment times with 46.15% of those with primary vestibular profile being designated as cleared ("Not Applicable") after vestibular rehabilitation. Of note, only 5.95% of the patients were diagnosed with benign paroxysmal positional vertigo. Conclusion: In adolescents with sports related concussion, earlier vestibular rehabilitation reduces recovery time.Item Examining the association between sleep modifiers and recovery time following sports-related concussion(2022-05) Kim, Chol Ho J.; Stankowska, Dorota L.Although previous researchers support the association of sleep disturbances negatively impacting recovery time from sports-related concussion (SRC), the degree of impact sleep disturbances have on recovery time from SRC is not well-defined. This study uses the presence and absence of sleep modifiers in the Concussion Clinical Profiles Screening tool to compare and quantify recovery time from SRC in a preadolescent, adolescent, and young adult sample. We examined patient records data obtained between August 2019 and December 2021 with inclusion criteria (1) injury date <30 days from initial evaluation, (2) SRC diagnosis, and (3) completion of treatment. Patients (sample median age 15.4 (14.3, 17.1)) were grouped based on the presence or absence of sleep modifier. Adjusting for other risk factors of prolonged recovery time (i.e., vestibular primary clinical profile, personal/family history of migraines, and personal history of anxiety/depression), the presence of sleep modifiers substantially increased recovery time by 1.45-fold (p<0.001).Item Sigma-1 Receptors and and their Effects on Mice with rmTBI(2023-05) Kuo, Aaron, J.; Schreihofer, Derek A.; Sumien, Nathalie; Ortega, SterlingRepetitive mild traumatic brain (rmTBI) injury is common in contact sports, yet there are no specific treatments to mitigate the potential long-term detrimental effects of such injuries. Retrospective studies have observed athletes in contact sports such as American football, boxing, rugby, soccer, and martial arts have higher rates of Chronic Traumatic Encephalopathy (CTE), mood and behavior disturbance, motor and dementia-related diseases, and other neuropathological diseases. We propose that activation of S1R can mitigate detrimental behavioral and biochemical consequences of repetitive mild head injury in a mouse model. Sigma-1 receptors (S1R) are intracellular chaperone proteins that are involved in numerous cell processes. Among their diverse actions, activation of the S1R has been observed to reduce neurodegeneration in experimental models of stroke, Alzheimer's disease, Parkinson's disease and others. This wide range of effectiveness suggests that targeting S1R could also be beneficial for other neurological injuries including traumatic brain injury. In this short-term study of rmTBI in male mice, we observed only minor behavioral deficits 5 weeks after the last of 7 closed head injuries that may be mitigated by treatment with the prototypical S1R agonist PRE-084. However, PRE-084 itself had basal effects on cognition, making firm conclusions premature. Continued observation of these mice will help to determine whether there are additional long-term effects of the injury modelItem The Effect of Attention Deficit Hyperactivity Disorder (ADHD) on Vestibular Outcomes Following a Sports-Related Concussion (SRC)(2021-05) Gilliland, Taylor J.; Millar, J. Cameron; Gwirtz, Patricia A.; Mathew, Stephen O.Purpose: The goal of this study was to examine the effects of a history of Attention Deficit Hyperactivity Disorder (ADHD) on vestibular outcomes following a sports related concussion (SRC) in adolescents. Hypothesis: History of ADHD in adolescent athletes will be associated with worsened vestibular outcomes following an SRC, including longer recovery time and more severe symptoms such as worsened dizziness and balance. Methods: This case-control study included patients aged 13-21 years who were seeking treatment at the Baylor Scott and White Sports Concussion Program for an SRC. Measures for neuropsychology and vestibular therapy initial evaluation were analyzed. Results: The sample size consisted of 166 patients. The data suggested a higher prevalence of dizziness in patients with a history of ADHD. Patients with a history of ADHD were also more likely to be referred to vestibular therapy. Vertical vestibulo-ocular reflex (VOR) testing during vestibular ocular motor screening (VOMS) was more provocative for dizziness in patients with ADHD. Measures from the vestibular therapy evaluation indicated patients with a history of ADHD were more likely to display abnormalities during VOR x1 testing. There was no significant difference in balance measures between patients with and without ADHD. Conclusion: These results indicate that adolescents with a history of ADHD may experience a protracted recovery time following an SRC, worsened performance on VOMS, as well as a more abnormal VOR when compared to patients without a history of ADHD.