Alteration of Brain Default Network in Subacute Phase of Injury in Concussed Individuals: Resting-state fMRI study

Currently neuropsychological testing and traditional anatomical imaging are not sufficiently sensitive to detect differences in an individual’s brain less then three weeks post mild traumatic brain injury (mTBI). After a college athlete is cleared post concussion to return to play they may still report physical and emotional symptoms that can persist over one-year post injury. A study was done using 15 student-athletes without a history of mTBI (control) and 14 collegiate athletes who suffered a grade 1 mTBI, diagnosed by a certified athletic trainer at on the field at initial contact. Functional connectivity characteristics were assessed between the control and athletes recovering from mTBI using a resting state function magnetic resonance imaging (rs-fMRI). Major findings include: resting state of default mode network (DMN) in mTBI subjects showed an overall reduced connectivity, specifically connections from the posterior cingulated cortex (PCC) with the anterior cingulated gyrus (ACC) and right supramarginal guyrus  and hyper-connectivity in the medial prefrontal cortex (MPFC). They also found a reduced interhemispheric connectivity which is consistent with previous studies. To see full study

Use of Modified Acute Concussion Evaluation Tools in the Emergency Department in a Pediatric Population

In the pediatric population, mild traumatic brain injuries (concussions) make up 75%-90% of all acquired brain injuries evaluated in emergency departments (ER) in the US.  The Acute Concussion Evaluation (ACE) system published by the Centers for Disease Control and Prevention was developed to assist in identification and diagnosis of concussions. The ACE Care Plan tool was developed to guide management, including individualized recommendations for daily life, school, work and return to play. This tool was originally felt to be too time consuming for ER physicians. For this study a modified version was created and preformed on a patient population between ages 5-21. A primary concern of post ED management of concussions was the importance of ongoing outpatient rehabilitation, in this study it was found that this tool improved reported follow-up post-implementation for all patients. It also found an improvement in parent recall of concussion education. For full study.