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    ABSTRACT: Objective(s): It is unclear the extent to which prior concussion history and post-concussive symptoms are related to brain structure in healthy athletes. Herein, we investigate the degree to which concussion history and post-concussive symptoms are associated with cortical morphology among male hockey players. Study design: Twenty-nine male subjects were recruited from preparatory school and collegiate ice hockey teams, ranging from 14 to 23 years of age (M = 17.8), and underwent neuroimaging and baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Cerebral cortical thickness was regressed against ImPACT Total Symptom Score (TSS), concussion history, as well as baseline measures of psychopathology. Reconstruction of surfaces and cortical thickness analysis were conducted using FreeSurfer (version 5.3.0). Results: ImPACT TSS was negatively associated with local cortical thickness in widespread brain areas. Associations were revealed bilaterally in a host of frontal as well as temporo-parietal cortices. Conversely, concussion history was not associated with cortical thickness. An “Age by Concussion History” interaction was associated with thickness in the right ventrolateral and right parietal cortices. Post-hoc analysis revealed that concussed participants did not exhibit age-related cortical thinning in these regions. Conclusion(s): This is the first report of an association between brain structure and post-concussive symptoms among young, otherwise healthy male athletes. One potential explanation for our findings is that reduced thickness in fronto-temporo-parietal areas may be tied to more subtle, repetitive blows to the head (which may not be recognized as concussive events) as opposed to discrete concussive episodes.
    Journal of Pediatrics 10/2014; · 3.74 Impact Factor
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    ABSTRACT: [Link to text: http://www.annualreviews.org/doi/pdf/10.1146/annurev-clinpsy-032814-112814] Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that is most often identified in postmortem autopsies of individuals exposed to repetitive head impacts, such as boxers and football players. The neuropathology of CTE is characterized by the accumulation of hyperphosphorylated tau protein in a pattern that is unique from that of other neurodegenerative diseases, including Alzheimer's disease. The clinical features of CTE are often progressive, leading to dramatic changes in mood, behavior, and cognition, frequently resulting in debilitating dementia. In some cases, motor features, including parkinsonism, can also be present. In this review, the historical origins of CTE are revealed and an overview of the current state of knowledge of CTE is provided, including the neuropathology, clinical features, proposed clinical and pathological diagnostic criteria, potential in vivo biomarkers, known risk factors, and treatment options. Expected final online publication date for the Annual Review of Clinical Psychology Volume 11 is March 28, 2015. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
    Annual Review of Clinical Psychology 01/2015; 11(1). · 12.42 Impact Factor
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    ABSTRACT: Sports-related concussions are one of the major causes of mild traumatic brain injury. Although most patients recover completely within days to weeks, those who experience repetitive brain trauma (RBT) may be at risk for developing a condition known as chronic traumatic encephalopathy (CTE). While this condition is most commonly observed in athletes who experience repetitive concussive and/or subconcussive blows to the head, such as boxers, football players, or hockey players, CTE may also affect soldiers on active duty. Currently, the only means by which to diagnose CTE is by the presence of phosphorylated tau aggregations post-mortem. Non-invasive neuroimaging, however, may allow early diagnosis as well as improve our understanding of the underlying pathophysiology of RBT. The purpose of this article is to review advanced neuroimaging methods used to investigate RBT, including diffusion tensor imaging, magnetic resonance spectroscopy, functional magnetic resonance imaging, susceptibility weighted imaging, and positron emission tomography. While there is a considerable literature using these methods in brain injury in general, the focus of this review is on RBT and those subject populations currently known to be susceptible to RBT, namely athletes and soldiers. Further, while direct detection of CTE in vivo has not yet been achieved, all of the methods described in this review provide insight into RBT and will likely lead to a better characterization (diagnosis), in vivo, of CTE than measures of self-report.
    Alzheimer's Research and Therapy 01/2014; 6(1):10. · 3.50 Impact Factor

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