Carrie Esopenko

Icahn School of Medicine at Mount Sinai | MSSM · Department of Rehabilitation Medicine

Military sexual trauma (MST) has deleterious long-term psychological consequences. Among female U.S. military members, MST is associated with increased risk for future interpersonal victimization, such as experiencing intimate partner violence (IPV). Few studies have investigated the implications of the cumulative effects of IPV and MST on psycholo...

Objectives The purpose of this study was to determine sex differences in recovery trajectories of assessments for sport-related concussion using Concussion Assessment, Research and Education (CARE) Consortium data. Methods National Collegiate Athletic Association athletes (N = 906; 61% female) from sex-comparable sports completed a pre-season base...

Intimate partner violence (IPV) is a significant, global public health concern. Women, individuals with historically underrepresented identities, and disabilities are at high risk for IPV and tend to experience severe injuries. There has been growing concern about the risk of exposure to IPV-related head trauma, resulting in IPV-related brain injur...

Background and objectives: Traumatic brain injury (TBI) is a concern for US service members and veterans (SMV), leading to heterogeneous psychological and cognitive outcomes. We sought to identify neuropsychological profiles of mild TBI (mTBI) and posttraumatic stress disorder (PTSD) among the largest SMV sample to date. Methods: We analyzed cro...

Individuals who experience intimate partner violence (IPV) often report posttraumatic stress disorder (PTSD) and depressive symptoms and IPV-related head trauma (IPV-HT), which can also affect mental health. We aimed to estimate rates of IPV-HT and examine the unique associations of IPV, HT, and IPV-HT with PTSD and depression symptom severity in a...

Purpose Women exposed to intimate partner violence (IPV) may experience head, neck, and facial trauma, increasing their risk for concomitant brain injury (BI). The study of IPV-BI poses unique challenges due to safety, demographic, biological, and social factors, requiring considerations beyond the commonly used methods employed in BI research. Thu...

Introduction Service academy members are at high risk for concussions as a result of participation in both sports and military-specific training activities. Approximately 17% of active duty service members are female, and they face unique challenges in achieving timely recovery from concussions. Understanding the unique characteristics affecting re...

Importance Blast-related mild traumatic brain injuries (TBIs), the “signature injury” of post-9/11 conflicts, are associated with clinically relevant, long-term cognitive, psychological, and behavioral dysfunction and disability; however, the underlying neural mechanisms remain unclear. Objective To investigate associations between a history of re...

Lesion characteristics (e.g., types, extents, and locations) vary widely in patients with moderate to severe Traumatic Brain Injury (ms-TBI). Automated tools for parcellating anatomical MRI scans, such as FastSurfer, assume the input brain has normal anatomy. Thus, heterogeneous lesions often cause parcellation errors. In this lesion simulation stu...

Background Growing interest has motivated recent studies to examine differences in recovery after sport-related concussion (SRC) by sex. However, heterogeneity in study design, participants, and recovery outcomes has led to mixed findings. Further work is needed to evaluate potential differences by sex and to investigate the role of related charact...

Objective To describe sex differences in concussion characteristics in US Service Academy cadets. Design Descriptive epidemiology study. Setting Four US service academies. Participants 2209 cadets (n = 867 females, n = 1342 males). Independent Variable Sex. Outcome Measures Injury proportion ratios (IPR) compared the proportion of injuries by...

Objective COVID-19 has been associated with myocardial involvement in collegiate athletes. The first report from the Big Ten COVID-19 Cardiac Registry (Registry) was an ecological study that reported myocarditis in 37 of 1597 athletes (2.3%) based on local clinical diagnosis. Our objective was to assess the relationship between athlete and clinical...

Abstract: Deficits in memory performance have been linked to a wide range of neurological and neuropsychiatric conditions. While many studies have assessed the memory impacts of individual conditions, this study considers a broader perspective by evaluating how memory recall is differentially associated with nine common neuropsychiatric conditions...

Objective: This proof-of-concept study was to investigate the relationship between photobiomodulation (PBM) and neuromuscular control. Background: The effects of concussion and repetitive head acceleration events (RHAEs) are associated with decreased motor control and balance. Simultaneous intranasal and transcranial PBM (itPBM) is emerging as a po...

Background Intimate partner violence (IPV) perpetration is highly prevalent among veterans. Suggested risk factors of IPV perpetration include combat exposure, post-traumatic stress disorder (PTSD), depression, alcohol use, and mild traumatic brain injury (mTBI). While the underlying brain pathophysiological characteristics associated with IPV perp...

Background and Purpose Sport-specific training may improve postural control, while repetitive head acceleration events (RHAEs) may compromise it. Understanding the neural mechanisms underlying postural control may contextualize changes due to training and RHAE. The goal of this study was to determine whether postural sway during the Balance Error S...

Resting state functional magnetic resonance imaging (rsfMRI) provides researchers and clinicians with a powerful tool to examine functional connectivity across large-scale brain networks, with ever-increasing applications to the study of neurological disorders, such as traumatic brain injury (TBI). While rsfMRI holds unparalleled promise in systems...

Importance: Blast-related mild traumatic brain injuries (bTBI), the 'signature injury' of post-9/11 conflicts, are associated with clinically-relevant long-term cognitive, psychological, and behavioral dysfunction and disability; however, the underlying neural mechanisms remain unclear. Objective: To investigate associations between a history of re...

Introduction MRI represents one of the clinical tools at the forefront of research efforts aimed at identifying diagnostic and prognostic biomarkers following traumatic brain injury (TBI). Both volumetric and diffusion MRI findings in mild TBI (mTBI) are mixed, making the findings difficult to interpret. As such, additional research is needed to co...

Objective To describe sex differences in non-sport related concussion (non-SRC). Design Descriptive epidemiology. Setting 30 colleges/universities and military service academies in the Concussion Assessment, Research and Education Consortium. Participants 1,036 cadets and athletes (n=555 females) with non-SRC (outside of competition/practice/tra...

Objective Identify sex- and sport-specific differences in recovery time after sport-related concussion (SRC). Design The Ivy League-Big Ten Epidemiology of Concussion Study entails a surveillance system and prospective cohort study of SRC of student-athletes. Setting 18 universities from two collegiate athletic conferences in the United States....

Objective Significant advances in the research of sport-related concussion (SRC) and repetitive head impacts (RHI) over the previous decade have translated to improved injury identification, diagnosis, and management. However, an objective gold standard for SRC/RHI treatment has remained elusive. SRC often result in heterogenous clinical outcomes,...

Introduction The relation between traumatic brain injury (TBI), its acute and chronic symptoms, and the potential for remote neurodegenerative disease is a priority for military research. Structural and functional connectivity (FC) of the basal ganglia, involved in motor tasks such as walking, are altered in some samples of Service Members and Vete...

This review appraises the existing literature to highlight the benefits, barriers, and role of rehabilitation in the early mobilization of patients in neurological critical care. While the benefits of early mobilization in patients with critical illness have become more widely acknowledged, there are benefits and challenges to the successful implem...

Importance Traumatic brain injury (TBI) is known to cause widespread neural disruption in the cerebrum. However, less is known about the association of TBI with cerebellar structure and how such changes may alter executive functioning. Objective To investigate alterations in subregional cerebellum volume and cerebral white matter microstructure af...

Concussion has been described in the United States (US) collegiate student–athlete population, but female-specific findings are often underrepresented and underreported. Our study aimed to describe female collegiate student–athletes’ initial injury characteristics and return to activity outcomes following concussion. Female collegiate student–athle...

Mild traumatic brain injury (mTBI) has been described in the United States (US) military service academy cadet population, but female-specific characteristics and recovery outcomes are poorly characterized despite sex being a confounder. Our objective was to describe female cadets’ initial characteristics, assessment performance, and return-to-acti...

Context: Concussion research has primarily focused on sport-related mechanisms and excluded non-sport related mechanisms. In adult populations, non-sport related concussions (non-SRC) demonstrate worse clinical outcomes relative to sport-related concussions (SRC); however, there is limited research examining non-SRC in college-aged patients. Obje...

An extensive library of symptom inventories has been developed over time to measure clinical symptoms, but this variety has led to several long standing issues. Most notably, results drawn from different settings and studies are not comparable, which limits reproducibility. Here, we present an artificial intelligence (AI) approach using semantic te...

Sport-related concussion (SRC) affects an estimated 1.6 to 3.8 million Americans each year. Sport-related concussion results from biomechanical forces to the head or neck that lead to a broad range of neurologic symptoms and impaired cognitive function. Although most individuals recover within weeks, some develop chronic symptoms. The heterogeneity...

Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substanc...

Investigators in neuroscience have turned to Big Data to address replication and reliability issues by increasing sample sizes, statistical power, and representativeness of data. These efforts unveil new questions about integrating data arising from distinct sources and instruments. We focus on the most frequently assessed cognitive domain - memory...

Objective: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine...

Traumatic brain injury (TBI) in military populations can cause disruptions in brain structure and function, along with cognitive and psychological dysfunction. Diffusion magnetic resonance imaging (dMRI) can detect alterations in white matter (WM) microstructure, but few studies have examined brain asymmetry. Examining asymmetry in large samples ma...

While traditionally ignored as a region purely responsible for motor function, the cerebellum is increasingly being appreciated for its contributions to higher-order functions through cerebro-cerebellar networks. Traumatic brain injury (TBI) research generally focuses on the cerebrum, in part because of the frequency of acute pathology. Acute patho...

Due to documented adverse events, understanding the prevalence of nutritional supplements commonly used by athletes is essential. This cross-sectional study used data from a web-based survey conducted in February-March 2022. Participants were Division I (DI) and Division III (DIII) student-athletes of the National Collegiate Athletic Association (N...

Purpose: The purpose of this study was to determine changes in neurocognitive, psychosocial, and balance functioning in collegiate male and female soccer players across three consecutive years of baseline testing compared to a control group of non-contact athletes. Methods: Generalized estimating equations were used to compare changes in annual,...

Background There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among wom...

Objective: In this position article, we highlight the importance of considering cultural and linguistic variables that influence neuropsychological test performance and the possible moderating impact on our understanding of brain/behavior relationships. Increasingly, neuropsychologists are realizing that cultural and language differences between c...

Traumatic brain injury (TBI), a significant concern in military populations, is associated with alterations in brain structure and function, cognition, as well as physical and psychological dysfunction. Diffusion magnetic resonance imaging (dMRI) is particularly sensitive to changes in brain structure following TBI, as alterations in white matter (...

Objective: To determine whether cognitive and psychological symptom profiles differentiate clinical diagnostic classifications (eg, history of mild traumatic brain injury [mTBI] and posttraumatic stress disorder [PTSD]) in military personnel. Methods: US Active-Duty Service Members (N = 209, 89% male) with a history of mTBI (n = 56), current PTS...

Soccer athletes experience repetitive head impacts (RHI) through purposeful heading and unintentional head impacts, which may be associated with acute and chronic brain injury. Previous soccer studies have sought to quantify and characterize RHI, but to-date no consistent, standardized methods exist. The Heads-Up Checklist (HUC), originally used fo...

Background: Measures of postural stability are useful in assisting the diagnosing and managing of athlete concussion. Error counting using the Balance Error Scoring System (BESS) is the clinical standard, but has notable limitations. New technologies offer the potential to increase precision and optimize testing protocols; however, whether these d...

Digital neuropsychological test batteries are popular in college athletics; however, well-validated digital tests that are short and portable are needed to expand the feasibility of performing cognitive testing quickly, reliably, and outside standard clinical settings. This study assessed performance on digital versions of Trail Making Test (dTMT)...

Introduction Impairments in cognitive performance after sport-related concussion (SRC) typically resolve within weeks of the injury, whereas alterations to white matter (WM) organization have been found to persist longer into the chronic injury stage. However, longer-term associations between cognition and WM organization following SRC have not bee...

Importance Myocarditis is a leading cause of sudden death in competitive athletes. Myocardial inflammation is known to occur with SARS-CoV-2. Different screening approaches for detection of myocarditis have been reported. The Big Ten Conference requires comprehensive cardiac testing including cardiac magnetic resonance (CMR) imaging for all athlete...

Aim: To examine whether neck strength and symmetry are associated with psychological function in athletes with exposure to repetitive head impacts. Methods: Collegiate soccer (n = 29) and limited/noncontact (n = 63) athletes without a history of concussion completed the Brief Symptom Inventory 18 and assessments of isometric neck strength. Neck...

Sport-related brain injury is very common, and the potential long-term effects include a wide range of neurological and psychiatric symptoms, and potentially neurodegeneration. Around the globe, researchers are conducting neuroimaging studies on primarily homogenous samples of athletes. However, neuroimaging studies are expensive and time consuming...

Intimate partner violence includes psychological aggression, physical violence, sexual violence, and stalking from a current or former intimate partner. Past research suggests that exposure to intimate partner violence can impact cognitive and psychological functioning, as well as neurological outcomes. These seem to be compounded in those who suff...

The aim of this cross-sectional study was to explore the effects of different ball types and characteristics on head acceleration during purposeful heading in youth football players. Experienced male and female players (n=61) aged between 12-17 years completed heading trials with 4 different balls (Ball 1 mass 192 grams(g), pressure 5.0 pounds per...

Context: Past work has identified sex differences in sport-related concussion (SRC) incidence and recovery time; however, few have examined sex differences in specific recovery trajectories: time to symptom resolution, return-to-academics, and return-to-athletic activity across collegiate sports. Objective: To examine sex differences in SRC recover...

Background: Individualized baseline testing is resource and time intensive. The use of normative data to approximate changes after a suspected concussion is thus an appealing alternative. Yet, few peer-reviewed, large-sample studies are available from which to develop accurate normative averages of balance using force-plate technology. Purpose:...

This article presents a brief history and literature review of chronic traumatic encephalopathy (CTE) in professional athletes that played contact sports. The hypothesis that CTE results from concussion or sub-concussive blows is based largely on several case series investigations with considerable bias. Evidence of CTE in its clinical presentation...

Introduction Menstrual irregularity (MI) is common in female athletes and is a component of the Female Athlete Triad (Triad). Many athletes with the Triad are started on hormonal contraceptives (HC) for MI, but this interferes with the ability to monitor menstrual cycle regularity and can mask other causes of MI. There are limited studies investiga...

Abstract This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci as...

Soccer athletes frequently experience repetitive head impacts (RHI) during games and practices, which may affect neural integrity over time and lead to altered brain structure. Neck strength is hypothesized to limit the transfer of force to the brain and decrease the effect of RHI on brain structure. The goal of our work was to examine whether grea...

Background Alterations in resting-state functional connectivity (rsFC) occur in the acute and chronic phases following traumatic brain injury (TBI); however, few studies have assessed long-term (>1 year) changes in rsFC. Methods Resting-state functional magnetic resonance imaging (rsfMRI) scans were obtained from the Federal Interagency Traumatic...

Participation in sport is associated with numerous physical and psychological health benefits, but also can have negative consequences, such as career ending injuries, which may have long-term effects on mental health. Recent research suggests that involuntary retirement, due to injury, illness, or being cut from a sport, can be particularly detrim...

Neck circumference is quick and simple to measure and thus an attractive proxy of neck strength, a putative mechanism underlying risk of sport-related concussion (SRC). Research, however, is limited on the relationship of neck circumference to SRC. Our study examined differences in neck circumference based on sex, concussion history, concussions ex...

Traumatic brain injury (TBI) is a major cause of disability worldwide, but the heterogeneous nature of TBI with respect to injury severity and health comorbidities make patient outcome difficult to predict. Injury severity accounts for only some of this variance, and a wide range of preinjury, injury‐related, and postinjury factors may influence ou...

Sports-related brain injury is very common, and the potential long-term effects include a widerange of neurological and psychiatric symptoms, and potentially neurodegeneration. Aroundthe globe, researchers are conducting neuroimaging studies on primarily homogenoussamples of athletes. However, neuroimaging studies are expensive and time consuming,...

Objective: To examine the association of multiple health behaviors to mental health functioning in male and female collegiate athletes. Participants: Prospective National Collegiate Athletic Association (NCAA) Division I athletes (n = 183) completed a health and wellness survey in the summer prior to joining the athletic program. Methods: Health b...

Intimate partner violence includes psychological aggression, physical violence, sexual violence, and stalking from a current or former intimate partner. Experiencing intimate partner violence is associated with impaired neurocognitive and psychosocial functioning, mental illness, as well as structural brain alterations. These impairments seem to be...

Intimate partner violence includes psychological aggression, physical violence, sexual violence, and stalking from a current or former intimate partner. Experiencing intimate partner violence is associated with impaired neurocognitive and psychosocial functioning, mental illness, as well as structural brain alterations. These impairments seem to be...

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics throughMeta Analysis) Consortium, a global alliance of over 1,400 scientists across 43 countries, studying the humanbrain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicatedgenetic loci associated wi...

Objective: To identify CSF biomarkers that are related to decreased white matter (WM) integrity and poor cognitive performance in former professional athletes with a history of multiple concussions. Methods: Concentrations of phosphorylated tau181, total tau (t-tau), and β-amyloid in the CSF were measured in 3 groups: 22 former professional athl...

Synopsis: Sports-related concussion (SRC) occurs due to biomechanical forces to the head or neck that can result in pathophysiological changes in the brain. The musculature of the cervical spine has been identified as one potential factor in reducing SRC risk as well as for underlying sex differences in SRC rates. Recent research has demonstrated...

Background and objective: The relationship between repeated concussions and neurodegenerative disease has received significant attention, particularly research in postmortem samples. Our objective was to characterise retired professional ice hockey players' cognitive and psychosocial functioning in relation to concussion exposure and apolipoprotei...

Traumatic brain injury (TBI) is associated with a range of neuropsychological deficits, including attention, memory, and executive functioning attributable to diffuse axonal injury with accompanying focal frontal and temporal damage. Although the memory deficit of TBI has been well characterized with laboratory tests, comparatively little research...

Traumatic brain injury (TBI) is a highly prevalent condition with significant effects on cognition and behavior. While the acute and sub-acute effects of TBI recover over time, relatively little is known about the long-term effects of TBI in relation to neurodegenerative disease. This issue has recently garnered a great deal of attention due to pub...

The theory of embodied cognition postulates that the brain represents semantic knowledge as a function of the interaction between the body and the environment. The goal of our research was to provide a neuroanatomical examination of embodied cognition using action-rela