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  • May 31, 2017
  • 05:30 AM
  • 960 views

Self-Reported Concussion Details Takes a Hit with High School Athletes

by Catherine E Lewis in Sports Medicine Research (SMR): In the Lab & In the Field

More targeted concussion education for high school athletes with a history of concussion is needed. Athletes with more prior concussions, especially negative experiences, are less likely to disclose symptoms, more likely to play with symptoms, and have poorer attitudes regarding concussion reporting.... Read more »

  • May 8, 2017
  • 05:30 AM
  • 353 views

Athletic Trainers in High Schools Could Help to Bridge the Gap in Racial Disparities in Adolescent Athlete Health Care

by Jane McDevitt in Sports Medicine Research (SMR): In the Lab & In the Field

White athletes had more concussion knowledge compared to African Americans; however, African Americans that had access to an athletic trainer had greater knowledge of concussion sign and symptoms than those without an athletic trainer.... Read more »

  • April 3, 2017
  • 11:23 AM
  • 539 views

Financial Scam Vulnerability: Brain Risk Factors

by William Yates, M.D. in Brain Posts

It is always frustrating when you hear about a financial scam that has target a vulnerable population like the elderly population.Elderly individuals may be targeted for a variety of reasons. First, they often have financial resources. Second, they may be a generally more trustworthy group increasing risk for falling for a scam. Third, elderly may suffer from some age-related brain changes that impair cognition and judgment.A recent research study suggests specific brain deficits may increase vulnerability to financial scams in elderly populations.The designed a study with the following key design elements:Subjects: 13 older adults with a mean age of 70 years who had been financially exploited after age 60. A matched control group of 13 subjects who had been exposed to a financial scam but not been compliantMeasures: Neuropsychological testing of cognition, personality and behavior. Additionally, subjects completed structural and functional brain MRI imagingStatistics: Cases were compared to controls on key study measuresVictims of financial scams showed key differences from controls including:Brain cortex thinning in the anterior insula and posterior temporal regionsFunctional brain connectivity was reduced in default and salience regionsFunctional between network connectivity was increasedHigher scores on measures of anger and hostilityThe authors their findings support a potential role for brain impairment in salience and social cognition regions as markers for risk of financial exploitation.They note significant weaknesses in their study design including a small sample size. Nevertheless, they note clinicians should be aware of potential for increased risk of financial exploitation in elderly with evidence of damage to these key brain regions.This is an important study and goes beyond risk associated with general cognitive decline and early dementia. This study suggests that specific brain regions associated with social cognition may be linked to risk of financial scams in elderly populations.The free full-text manuscript can be accessed by clicking on the link in the citation below.Follow me on Twitter @WRY999Image of brain insula is from my iPad screen shot using the 3D Brain app.Spreng, R., Cassidy, B., Darboh, B., DuPre, E., Lockrow, A., Setton, R., & Turner, G. (2017). Financial Exploitation Is Associated With Structural and Functional Brain Differences in Healthy Older Adults The Journals of Gerontology: Series A DOI: 10.1093/gerona/glx051... Read more »

  • April 3, 2017
  • 05:30 AM
  • 432 views

Don’t Let Your Concussed Athletes Spin Out of Control; PT is Feasible!

by Jane McDevitt in Sports Medicine Research (SMR): In the Lab & In the Field

Closely supervised cervical and vestibular ocular therapy may help safely return concussed athletes to play.... Read more »

  • March 27, 2017
  • 01:07 PM
  • 557 views

Theory of Mind in Brain Development

by William Yates, M.D. in Brain Posts

Theory of Mind (ToM) is a concept describing the ability to understand what another person is thinking or feeling.Today in my neuroscience medicine news review I ran across a novel, interesting and important research study targeting brain development in ToM.Normally developing children develop ToM around 4 years of age. In the study published in Nature Communications, a research team at the Max Planck Institute in Germany studied white matter development in 3 to 4 year old children.Using a series of neuropsychological tasks, they studied white matter development using diffusion tensor brain imaging as it related to ToM skill.The research team was able to identify the following brain development features in ToM:White matter changes in the temperoparietal regions, the precuneus and the medial prefrontal cortexIncreased white matter connectivity between temperoparietal and inferior frontal brain regionsThese changes were independent of development of non-ToM cognitive abilityThe authors note in the discussion section that non-human primates fail to develop explicit ToM cognitive ability. Non-human primate brain show poor arcuate fascicle connectivity. They note that arcuate fascicle white matter connectivity appears to be key for ToM cognitive skills.This manuscript is available in free full-text format and readers with more interest in this study can access the manuscript by clicking on the citation link below.Follow me on Twitter @WRY999Image of white matter tract in human brain is from the iPad app Brain Tutor.Grosse Wiesmann C, Schreiber J, Singer T, Steinbeis N, & Friederici AD (2017). White matter maturation is associated with the emergence of Theory of Mind in early childhood. Nature communications, 8 PMID: 28322222... Read more »

  • March 13, 2017
  • 12:38 PM
  • 526 views

Earliest Brain Changes in Alzheimer's Disease

by William Yates, M.D. in Brain Posts

Amyloid brain plaques are well-known pathological changes associated with Alzheimer's disease. Changes preceding amyloid plaque build up are less well studied and understood. Some of this relates to limitations to current imaging technology.Klementieva and colleagues from Sweden and Spain recently published an important reserach topic in this area.Their studied used a rat model of Alzheimer's disease and imaging techniques that included infrared microspectroscopy and gel electrophoresis.The main findings of their study included the following:Conformation changes of beta amyloid and it's amyloid precursor protein (APP) start before the development of amyloid plaquesThe early changes in beta amyloid localize to the synaptic terminalsThese early changes may provide novel targets for drug developmentThese findings suggest current strategies to alter beta amyloid plaques after development may be too late to alter the course of the disease.Identification and reversal of earlier mechanisms may be a more productive drug development strategy.Readers with more interest in this topic can access the free full-text manuscript by clicking on the citation link below.Follow be on Twitter WRY999Photo of robin in back yard waterer is from my photography files.Klementieva, O., Willén, K., Martinsson, I., Israelsson, B., Engdahl, A., Cladera, J., Uvdal, P., & Gouras, G. (2017). Pre-plaque conformational changes in Alzheimer’s disease-linked Aβ and APP Nature Communications, 8 DOI: 10.1038/ncomms14726... Read more »

Klementieva, O., Willén, K., Martinsson, I., Israelsson, B., Engdahl, A., Cladera, J., Uvdal, P., & Gouras, G. (2017) Pre-plaque conformational changes in Alzheimer’s disease-linked Aβ and APP. Nature Communications, 14726. DOI: 10.1038/ncomms14726  

  • March 2, 2017
  • 01:19 PM
  • 505 views

Improving Hearing-Aid Access in Older Adults

by William Yates, M.D. in Brain Posts

There are significant barriers to widespread use of hearing-aids in older adults with age-related hearing loss.Sensitivity to the stigma of wearing a hearing-aid is one barrier.Cost is another significant barrier. In the U.S., bilateral hearing-aid purchase amounts to a cost of $2400 to $5800. This cost is typically not covered by Medicare or other health insurance plans.I ran into a interesting manuscript on looking at an alternative less costlier approach to hearing-aid selection and purchase.Larry Humes and colleagues compared the outcome of a older adults randomized to one of three hearing aid interventions. One was standard audiology best practices, one was a placebo hearing-aid (device without amplication). A third alternative was also studied that was called an over-the-counter (OTC) intervention. This intervention included the following elements:Self-selection of hearing aid tips, tubes and devicesThree types of hearing-aids were provided for selection. Each was programmed with one of the three most common patterns of hearing lossSubjects tried various combinations of devices and listened to sample sounds of speech, music and environmental soundsSubjects were assessed after a six week trial for hearing function, satisfaction and desire to keep the deviceSubjects were randomized to pay a fee of $3500 versus $600 for devices that were identical in features. This allowed for study of the effect of cost on outcome measures.Interestingly, the OTC intervention resulted in outcomes (i.e. hearing improvement) that were very similar to audiology best practices. However, OTC subjects showed a slightly lower satisfaction score and were somewhat more likely to return devices after the study for a refund. Higher price also predicted return for refund following the study.The authors conclude:"Efficacious OTC service-delivery models (and devices) may increase accessibility and affordability of hearing aids for millions of older adults, but further research is required to evaluate various devices and approaches as well as to examine the generalization of the findings from this clinical trial."This study provides an impetus for further study of the OTC model in hearing aid selection and use. Cost issues appear to continue to be a significant barrier to wider hearing-aid access.Readers with more interest in this study can access the free full-text manuscript by clicking on the link in the citation below.Photo of wood duck is from my photography file.Follow me on Twitter WRY999Humes, L., Rogers, S., Quigley, T., Main, A., Kinney, D., & Herring, C. (2017). The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial American Journal of Audiology DOI: 10.1044/2017_AJA-16-0111... Read more »

  • February 13, 2017
  • 05:30 AM
  • 539 views

Blood Test Could Help Provide Information on Prolonged Concussion Recovery

by Jane McDevitt in Sports Medicine Research (SMR): In the Lab & In the Field

Elevated plasma tau concentrations within 6 hours of sport-related concussion was associated with prolonged return to play.... Read more »

Gill, J., Merchant-Borna, K., Jeromin, A., Livingston, W., & Bazarian, J. (2017) Acute plasma tau relates to prolonged return to play after concussion. Neurology, 88(6), 595-602. DOI: 10.1212/WNL.0000000000003587  

  • February 8, 2017
  • 05:30 AM
  • 526 views

Physical Activity Within 7 Days May Lead to Better Long-Term Outcomes After a Concussion

by Jane McDevitt in Sports Medicine Research (SMR): In the Lab & In the Field

Among children and adolescents with acute concussion, participation in physical activity within 7 days of acute injury compared with no physical activity was associated with lower risk of persistent postconcussion symptoms at 28 days post injury.... Read more »

  • January 18, 2017
  • 05:30 AM
  • 602 views

Alterations in Leg Stiffness Following A Concussion May Lead to Changes in Return-to-Play Protocol

by Jane McDevitt in Sports Medicine Research (SMR): In the Lab & In the Field

An athlete with a recent concussion has altered lower extremity stiffness at the leg, hip, and knee, which could increase their risk for musculoskeletal injury.... Read more »

Dubose DF, Herman DC, Jones DL, Tillman SM, Clugston JR, Pass A, Hernandez JA, Vasilopoulos T, Horodyski M, & Chmielewski TL. (2017) Lower Extremity Stiffness Changes after Concussion in Collegiate Football Players. Medicine and science in sports and exercise, 49(1), 167-172. PMID: 27501359  

  • December 23, 2016
  • 06:13 AM
  • 662 views

Bad news for DARPA's RAM program: Electrical Stimulation of Entorhinal Region Impairs Memory

by The Neurocritic in The Neurocritic





The neural machinery that forms new memories is fragile and vulnerable to insults arising from brain injuries, cerebral anoxia, and neurodegenerative diseases such as Alzheimer's. Unlike language, which shows a great deal of plasticity after strokes and other injuries, episodic memory – memory for autobiographical events and contextual details of past experiences – doesn't recover after

... Read more »

  • December 23, 2016
  • 05:30 AM
  • 617 views

Do Low Neurocognitive Scores Increase the Risk of Injury?

by Stephan Bodkin in Sports Medicine Research (SMR): In the Lab & In the Field

An athlete with low baseline neurocognitive scores is likely to produce knee movement patterns that are associated to anterior cruciate ligament (ACL) injury.... Read more »

  • December 18, 2016
  • 01:41 AM
  • 576 views

On the Interpretation of Neuroscientific Findings

by Justin A. Sattin in The Ghost of Charcot

A review of classic "split brain" research and critique of a new paper regarding "functional" splits in brain function.... Read more »

Sasai, S., Boly, M., Mensen, A., & Tononi, G. (2016) Functional split brain in a driving/listening paradigm. Proceedings of the National Academy of Sciences, 113(50), 14444-14449. DOI: 10.1073/pnas.1613200113  

  • December 16, 2016
  • 05:30 AM
  • 543 views

Frequency and Location of Head Impacts in Division 1 Men’s Lacrosse Players

by Patricia Kelshaw, MS, LAT, ATC in Sports Medicine Research (SMR): In the Lab & In the Field

Player position and session type such as practice or game are the main factors that influence head impact frequencies and magnitudes for lacrosse athletes.... Read more »

  • December 5, 2016
  • 05:30 AM
  • 541 views

Is Normative Data the New Normal?

by Sam Walton in Sports Medicine Research (SMR): In the Lab & In the Field

Individual differences may be seen in baseline SCAT3 data between sex, history of concussion, and history of comorbidities. Therefore, using the patient’s personal medical history may add value to the SCAT3 sideline screening.... Read more »

  • November 29, 2016
  • 12:24 PM
  • 742 views

Your Brain On God: Reward and Motivation

by William Yates, M.D. in Brain Posts

William James authored a seminal book titled The Varieties of Religious Experience: A Study in Human Nature that was published in 1902.In this work, James reviewed the nature of religious experiences and noted a lack of scientific inquiry into this human phenomenon.James would have been extremely interested in a recent scientific inquiry into the religious experience from brain researchers at the University of Utah and Harvard University.In this study, functional magnetic resonance imaging (fMRI) was used to study the brain during a religious experience cue in a group of 19 individuals who were devout Mormons.The key elements of this study design included:Subjects: 19 young adults (7 female, 12 male) reporting weekly church attendance and daily experience of spirtitual feelingsExperimental cues: Control cues: resting state and audiovisual control. Religious experience cues: quotations from religious authorities, a period of prayer and scripture readingBrain imaging/analysis: Standard fMRI imaging using a 3T MRI scanner with analysis of areas of activation with religious experience compared with control activationsThe research team was able to identify significant brain regional areas of activation with religious cue stimulation.The authors summarized their finding in the discussion section of the manuscript:"We demonstrated in a group of devout Mormons that religious experience, identified as "feeling the Spirit," was associated with consistent brain activation across individuals within bilateral nucleus accumbens, frontal attentional, and ventromedial prefrontal cortical loci."The figure above notes the location of the key nucleus accumbens region of the brain known to be important in the brain reward response network. This brain region has been identified as a key region activated by a variety of reward experiences including feeling love, music appreciation and the euphoria associated with euphoric states induced by stimulants such as cocaine and methamphetamine.The authors propose that the observed activation of the frontal and prefrontal cortex regions may indicate a network that includes individual perception of salience of religious experience and "representation of affective meaning for the religious stimuli".This is an important study of brain effects of the religious experience. The results show exposure to religious stimuli in devout individuals activates a non-specific powerful reward response. This reward response may contribute to the motivational mechanism for doctrinal beliefs and church attendance.It is likely this type of response is not limited to devout Mormons but similar in other Christian believers and non-Christian believers where a "spiritual experience" is part of the religious experience.Readers with more interest in this research can access the full free-text manuscript by clicking on the PMID link in the citation below.Figure is an iPad screenshot from the app 3D Brain.Follow me on Twitter @WRY999Ferguson MA, Nielsen JA, King JB, Dai L, Giangrasso DM, Holman R, Korenberg JR, & Anderson JS (2016). Reward, Salience, and Attentional Networks are Activated by Religious Experience in Devout Mormons. Social neuroscience PMID: 27834117... Read more »

Ferguson MA, Nielsen JA, King JB, Dai L, Giangrasso DM, Holman R, Korenberg JR, & Anderson JS. (2016) Reward, Salience, and Attentional Networks are Activated by Religious Experience in Devout Mormons. Social neuroscience. PMID: 27834117  

  • November 28, 2016
  • 05:51 AM
  • 636 views

Airplane Headache II: The Sequel

by The Neurocritic in The Neurocritic




Airline travel during the holidays is one big headache. But for some people, “airplane headache” is a truly painful experience. The headache occurs during take-off and landing, is unique to plane travel, and is not associated with other conditions. The pain is severe, with a jabbing or stabbing quality, and located on one side of the head (usually around the eye sockets or forehead).



... Read more »

Bui, S., Petersen, T., Poulsen, J., & Gazerani, P. (2016) Headaches attributed to airplane travel: a Danish survey. The Journal of Headache and Pain, 17(1). DOI: 10.1186/s10194-016-0628-7  

Headache Classification Committee of the International Headache Society (IHS). (2013) The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 33(9), 629-808. DOI: 10.1177/0333102413485658  

  • November 21, 2016
  • 12:10 PM
  • 720 views

Benefits of Physical Activity in Parkison's Disease

by William Yates, M.D. in Brain Posts

Parkinson's disease (PD) is a progressive neurodegerative disorder estimated to affect 7 to 10 million individual worldwide.The primary mechanism for Parkinson's disease is a reduction in the neurotransmitter dopamine in the midbrain region of the substantia nigra highlighted in red in the figure.PD impairs motor and cognitive functions and leads to significant decline in psychosocial functioning.Drugs for PD can be effective in reversing and slowing the progression of the illness. However, response is often limited with relapse over time.Physical exercise appears to be an adjunctive option in the multidisciplinary treatment of PD. Martine Lauze along with colleagues in France and the U.S. recently conducted a literature review of this topic.Their review covered 106 published papers between 1981 and 2015. A total of 868 outcome measures were examined. The key findings from their review included:Physical activity is most effective in improving physical capabilitiesPhysical activity is also effective in improving physical and cognitive function capacityPhysical activity appears to improve flexibilityLesser response to physical activity was found in the domains of PD clinical symptoms, depression, psychosocial function They noted clinical PD symptoms of bradykinesia, freezing of gait and tremor were very resistant to physical acitivity interverventions. On a more hopeful note, gait and postural alterations in PD are more responsive to physical activity.Physical therapy protocols that appear to have the best chance of producing improving PD include:Gait training, walking for increased speed and enduranceStrength training for improvement muscle mass in legs and armsFlexibility exercises for upper, lower extremities and trunkInterventions to reduce risk of falls (balance)The evidence supports routine referral for physical therapy and physical rehabilitation in those suffering from Parkinson's disease.You can access the free full text manuscript in this post by clicking on the citation link below.The figure in this post is a Creative Commons file from Wikipedia authored:By Madhero88 - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=7157181Follow me on Twitter.Lauzé M, Daneault JF, & Duval C (2016). The Effects of Physical Activity in Parkinson's Disease: A Review. Journal of Parkinson's disease, 6 (4), 685-698 PMID: 27567884... Read more »

Lauzé M, Daneault JF, & Duval C. (2016) The Effects of Physical Activity in Parkinson's Disease: A Review. Journal of Parkinson's disease, 6(4), 685-698. PMID: 27567884  

  • November 17, 2016
  • 12:00 PM
  • 740 views

Missed Opportunities in Stroke Prevention

by William Yates, M.D. in Brain Posts

Rates of myocardial infarction and stroke have been declining over the last decade in the U.S. and Europe. However, a recent manuscript suggests there are still significant missed opportunities to prevent stroke.This manuscript presents results of review of electronic primary care records in the United Kingdom.The authors examines a group of over 29,000 subjects with a diagnosis of stroke or transient ischemic attack over a 10 year period.Records were reviewed to assess for compliance with guideline drug treatments that are proven to reduce the incidence of stroke including:Lipid-lowering drugsAnticoagulant drug use in those with atrial fibrillationAntihypertension drug use in hypertensionThe record review found that around 50% of subjects experiencing stroke or TIA had indications but were not receiving lipid-lowering or anticoagulant drugs prior to their cerebrovascular event. For hypertension, compliance with antihypertension drug use was 75% with 25% not receiving drug.One of the attractive features of this type of primary prevention is the potential for electronic records. Centralized records could be scanned with identification of high-risk patients that might benefit from targeted drug therapy. Patients and physicians could be alerted and a medical visit triggered to address the issue.The authors conclude that improving prevention efforts in these areas could potentially reduce the number of first strokes in the U.K. by 12,000 every year.Here is a table from the Creative Commons free full-text manuscript that outlines the indications and methods in the study for use of stroke prevention drugs.I am not aware of a similar type of study of stroke prevention in the United States.We do know that despite some promising trends in stroke reduction, significant geographic challenges remain.This map from the U.S. CDC shows the clustering of high stroke rates in the Southeastern portion of the U.S.Stroke prevention intervention efforts could be directed to areas of high risk for stroke as these areas are likely to yield the greatest results.Readers with more interest in this research can access the free full-text manuscript by clicking on the link in the citation below.U.S. Stroke map is from the U.S. CDC with data source the National Vital Statistics System, National Center for Health Statistics.Follow me on Twitter WRY999Turner GM, Calvert M, Feltham MG, Ryan R, Fitzmaurice D, Cheng KK, & Marshall T (2016). Under-prescribing of Prevention Drugs and Primary Prevention of Stroke and Transient Ischaemic Attack in UK General Practice: A Retrospective Analysis. PLoS medicine, 13 (11) PMID: 27846215... Read more »

  • November 2, 2016
  • 05:30 AM
  • 623 views

What Came First the Concussion Or the Lower Extremity Musculoskeletal Injury?

by Kyle Harris in Sports Medicine Research (SMR): In the Lab & In the Field

Athletes who reported sustaining a concussion were 1.6 to 2.9 times more likely to have also sustained a lower extremity musculoskeletal injury at the end of their intercollegiate athletic careers.... Read more »

Gilbert, F., Burdette, G., Joyner, A., Llewellyn, T., & Buckley, T. (2016) Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes. Sports Health: A Multidisciplinary Approach, 8(6), 561-567. DOI: 10.1177/1941738116666509  

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