It has been known for some time there is an increased risk of neurologic decline following mild traumatic brain injury (mTBI). A new study published in PLOS ONE adds further proof. In a recent study, epidemiologists reported a 56% increased risk of veterans with mild traumatic brain injury developing Parkinson’s disease within 12 years post-injury. According to the researchers, “the goal of the study was to obtain evidence for premature cognitive decline in young veterans with a positive mTBI by comparing their cognitive scores against veterans without mTBI, healthy non-veteran controls and older early-stage, non-demented subjects with Parkinson’s disease.”
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Federal Court Upholds the Admissibility of Diffusion Tensor Imaging
There’s been another victory for plaintiffs and the admissibility of diffusion tensor imaging to confirm a diagnosis of traumatic brain injury (TBI). The United States District Court for the Middle District of Pennsylvania rejected a Daubert motion filed by Goodyear Tire and Rubber Company. In this case, plaintiff was injured when an employee of defendant Goodyear threw a large tire over a railing from the second floor, striking the plaintiff in the back of his head and neck. Plaintiff was evaluated by Randall Benson, M.D., an expert in behavioral neurology and functional neuroimaging. Dr. Benson undertook an exhaustive review of the evidence including deposition testimony, school records, medical records, radiologic records, and advanced brain imaging records. In addition, he conducted a three-hour, in-person examination which involved various forms of testing, questioning, and a blind medical evaluation.
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Children With Concussions Are Four Times More Likely to Sustain a New Concussion
Representing children who have sustained a traumatic brain injury can be challenging. Because the brain does not fully mature until around the age of 25, it is difficult to predict the child’s chances of full recovery. The antiquated view was that due to brain elasticity, children who sustain mild traumatic brain injuries will fully recover. According to evidence in a recent study published in the British Journal of Sports Medicine, that is not the case.
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New Neuroscience Study Analyzes Head Impact in Youth Football
A new study published in the Journal of Neurosurgical Pediatrics utilized diffusion tensor imaging (DTI) to characterize changes in head impact exposure across multiple football seasons. The study also helped determine whether changes in head impact exposure (HIE) correlated with changes in imaging metrics in young football players. The researchers examined 47 adolescent football players between the ages of ten and twelve during a total of 22 team-seasons between 2012 and 2017. A control group of 16 non-contact sport athletes were also enrolled in the project. Study participants completed a pre and post-season neuroimaging protocol using diffuser tensor imaging.
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May’s International Brain Injury Association Journal Studies
This month’s issue of Brain Injury, the official journal of the International Brain Injury Association, was devoted to pediatric traumatic brain injury. Multiple research studies were conducted and included in the journal. Below are summaries of some of these studies:
A study out of Sydney, Australia compared children who sustained traumatic brain injury to children who sustained orthopedic injuries. Specifically, researchers examined objective sleep outcomes in 23 children ages 5-15 who sustained moderate to severe traumatic brain injury. This group was compared to 13 children who sustained an orthopedic injury. The primary measurements were objective sleep measures using actigraphy watch, and secondarily a subjective sleep measure and fatigue questionnaires. The findings showed “evidence of objective and subjective sleep disturbance in children with moderate to severe TBI, but these two types of sleep measures were not related. It is possible the distinct mechanisms underpin objective and subjective sleep disturbance, which may require different interventions.”
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Florida Court Upholds Admissibility of Quantitative Electroencephalogram (qEEG)
A Florida trial court has denied a defendant’s Daubert motion to strike the plaintiff’s expert’s testimony regarding qEEG testing. In Snyder v. ESURANCE Property and Casualty Insurance Company, Case No. 01-2018-CA-2651 (8th Judicial Circ. Ala. Chua. Cty., FL), the defendant sought to bar the testimony of Dr. Lisa Avery, an eligible board neurologist, from testifying regarding her interpretation of a quantitative electroencephalogram (qEEG). To support its motion, the defendant submitted “only” three articles and argued at a hearing that using qEEG for diagnosing mild traumatic brain injury had been prohibited by the American Academy of Neurology (AAN) for over 20 years. Noteworthy in the court’s opinion was that the AAN guideline relied upon by the defense was “retired” in January 2020 and was no longer the official position of the Academy.
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Long-Term Residuals Following Mild Traumatic Brain Injury
A new study published in the Journal of Sports Medicine and Physical Fitness entitled “Subtle Long-Term Cognitive Effects of a Single Mild Traumatic Brain Injury and the Impact of a Three-Month Aerobic Exercise Intervention” debunks the myth that a single, uncomplicated mTBI won’t have any permanent residuals. The researchers sought to determine the long-term effects of a single mTBI on cognition in patients aged 55-70 years old. In addition, they wanted to see the impact the aerobic exercise programs would have on these patients’ recovery.
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Sleep Disorders and Traumatic Brain Injury
A new study out of the University of California, San Francisco, and the San Francisco Veterans Affairs Healthcare System investigated the increased risk of sleep disorders following traumatic brain injury.
In this study, the researchers performed a cohort study of all patients diagnosed with a traumatic brain injury in the Veterans Health Administration system from 2001 to 2015. These patients were aged-matched with veterans who had not sustained a traumatic brain injury. Any veteran who had a prevalent sleep disorder at the baseline was excluded from the study. The disorders were defined as any inpatient or outpatient diagnosis of sleep apnea, hypersomnia, insomnia, or sleep-related mood disorders. The researcher’s analysis was restricted to those for at least one year.
Pediatric Mild-Traumatic Brain Injury and Long Term Consequences
For a long time, clinicians believed children who sustained a mild traumatic brain injury went on to an uneventful recovery. More recent research has demonstrated the fallacy of this outdated belief. A new study published in Brain Injury explored the behavioral and emotional difficulties following pediatric mild traumatic brain injury.
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Women Found To Be More Vulnerable Than Men Regarding Persistent Mild TBI
A recent study published in JAMA Neurology explored whether post-acute mild traumatic brain injury (mTBI) symptoms differ between men and women. In this cohort study, a total of 2,000 patients with mild traumatic brain injury (1,331 men and669 women) were included. These mTBI patients were then compared to 299 patients with orthopedic trauma who served as control subjects. The patients were recruited from 18 Level 1 trauma centers and followed for up to 12 months.
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