Youth sports-related concussion (SRC) is a public health problem in the United States, as evidenced by the public health approach of youth concussion laws which are now in effect in more than 40 states. Youth are felt to be particularly vulnerable to concussion, due to differences in physiological response to injury. One of the critical aspects of care for youth with SRC is determining when it is safe for youth to return to their sports activities; this is a particularly important decision in youth, compared to older athletes with SRC, because youth are at increased risk for catastrophic outcomes if a second injury is incurred during recovery from SRC. Evidence-based management of youth SRC is limited by the lack of age-appropriate evaluation methods with validity for assessing recovery of brain physiology. The overall goal of this project is to evaluate the utility of a novel, clinicall-relevant measure of somatosensory information processing (SSIP) as a biomarker for youth SRC and recovery from SRC with relevance for evaluating the neurologic basis of SRC and recovery from SRC. The SSIP testing battery makes use of inexpensive, portable technology to deliver vibrotactile stimuli to the fingertips and does not require baseline data, making it readil applicable for widespread use in schools and on sidelines.
The aims of this project are to 1) evaluate the sensitivity of SSIP to youth SRC and recovery from SRC and 2) to assess the neurological basis of SSIP in youth with SRC through magnetic resonance spectroscopy (MRS) evaluation of GABA and glutamate in sensorimotor cortex. We will evaluate 25 youth aged 13-17 years with SRC within 1 week post-injury and again 2-3 weeks post-injury; youth who remain symptomatic from SRC at the second visit will return for a third visit after they have achieved clinically recovery. We will compare SSIP and MRS GABA and glutamate in youth with SRC within 1 week post-injury to that of age- and gender-matched peer athletes with no history of concussion and will evaluate for correlation of SSIP with MRS GABA and glutamate. We will evaluate changes in SSIP and MRS in association with clinical recovery from SRC versus persisting symptoms from SRC. Lastly, we will evaluate whether alterations in SSIP or MRS GABA or glutamate persist even after clinical recovery from SRC, as this may represent a marker for predicting short-term outcome from subsequent SRC and/or emergence of late concussion-related deficits (such as chronic traumatic encephalopathy). This project will determine the utility of further work using this novel methodology in youth SRC.
Some youth experience catastrophic and/or chronic problems after sports-related concussions. The goal of this project is to evaluate whether sensory perceptual testing is useful for evaluating youth concussion and recovery from concussion, to help with deciding when youth can safety return to play after concussion.
| Stephens, Jaclyn A; Denckla, Martha B; McCambridge, Teri et al. (2018) Preliminary use of the PANESS for detecting subtle motor signs in adolescents with sport-related concussion: a brief report. Am J Phys Med Rehabil : |
| Stephens, Jaclyn A; Denckla, Martha B; McCambridge, Teri et al. (2018) Preliminary Use of the Physical and Neurological Examination of Subtle Signs for Detecting Subtle Motor Signs in Adolescents With Sport-Related Concussion. Am J Phys Med Rehabil 97:456-460 |
