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PubMed1982

Is chronic brain damage in boxing a hazard of the past?

Of fourteen boxers with a mean age of 31 years who had been Finnish, Scandinavian, or European champions, only one showed deficits in neurological status and he and one other had had episodes of inappropriate behaviour which were attributed to boxing. However, computed tomography revealed pathological findings attributable to brain injury in four of six professional and one of eight amateur boxers. Two of the professionals and four of the amateurs had electroencephalographic abnormalities which may have been caused by brain injury. Twelve of the boxers had psychological test results which suggested brain injury, although only two professionals had definite deviation from normal. The results indicate that modern medical control of boxing cannot prevent chronic brain injuries but may create a dangerous illusion of safety. The only way to prevent brain injuries is to disqualify blows to the head.

Adolescent↗
PubMed2000

Does endogenous progesterone promote recovery of chronic sensorimotor deficits following contusion to the forelimb representation of the sensorimotor cortex?

We studied sensorimotor recovery in male, normal-cycling and pseudopregnant female rats following unilateral FL-SMC contusions. Forelimb use (push off before a rear, support against the walls, and landing after a rear) and the foot fault test (foot misplacements during locomotion on an elevated grid) were analyzed from videotapes taken before surgery, and then again on post-surgical days 2 and 36. High endogenous progesterone levels in females at the time of injury did not affect recovery as there were no differences between males, pseudopregnant females and normal-cycling female rats on these behaviors. None of the brain-injured rats recovered symmetrical forelimb use between 2 and 36 days after injury (P>0.05) and they also showed foot misplacements (P>0.05) in the foot fault test. Male and female rats with contusions had fewer mean foot misplacements on day 36 than 2 days after injury (P<0.001), indicating that there was partial recovery on this task. These results were taken to show that there were no sex differences in motor deficits caused by unilateral FL-SMC injury. In addition, higher endogenous progesterone levels in females did not protect them from the chronic sensorimotor deficits caused by unilateral FL-SMC contusions.

Animals↗
PubMed1998

Are brain injuries a significant problem in soccer?

This article examines the types of forces that the brain is subjected to in soccer, secondary to both acute brain injury and repetitive heading of the ball. The incidence of acute brain injury is reviewed, as well as studies documenting the effects of heading the ball. Finally, 10 actions are proposed that would make soccer a safer sport with respect to brain injuries and provide avenues for further study in this area.

Athletic Injuries↗
PubMed1999

Immediate in vivo response of the cortex and the blood-brain barrier following dynamic cortical deformation in the rat.

Although it is known that the brain can be injured by mechanical forces initiated at the moment of impact during trauma, it is not clear how the physical response of the brain dictates the injury patterns that occur in experimental models of traumatic brain injury. In this study, we investigated the mechanical response of the brain to a technique that creates a focal injury in the rat brain. Using a transient vacuum pulse applied to the exposed cortical surface, we found that the displacement of the cortex and the extent of in vivo blood-brain barrier breakdown were related significantly to the vacuum pressure level. The relationship between the response of the cortex and injury pattern points towards a new opportunity for control of the distribution and extent of injury patterns in animal models through a precise understanding of the model biomechanics, as well as potential improvements in means of preventing traumatic brain injury.

Animals↗
PubMed1984

Directional preponderance of optokinetic nystagmus. Study of 30 cases of unilateral cerebral lesions.

Analysis of the optokinetic nystagmus has been one of the most important means to examine the function of the vestibulo-oculomotor system. Especially in Japan, it has been used as a mean to analyze the function of the brain stem. We investigated directional preponderance of the optokinetic nystagmus in supratentorial lesions especially unilateral lesions, in the cerebral hemisphere which had been nearly neglected as an object for investigation of the vestibular system. We examined 30 cases of unilateral lesion in the cerebral hemisphere. In all cases CT-scan confirmed that these lesions have no mass effect which might affect the function of the surrounding brain. It was also confirmed that these cases had no spontaneous nystagmus. These cases consisted of 11 cerebral infarctions, 9 cerebral thrombosis, 6 cerebral hemorrhages and 4 cerebral contusions. In the result, 27 cases showed directional preponderance of the optokinetic nystagmus to the ipsilateral side, while there was none to the contralateral side. Three cases showed no directional preponderance. Some cases showed marked inhibition of optokinetic nystagmus of the contralateral side. These markedly inhibited cases are very similar to cases of pontine lesion which usually manifest marked inhibition of the optokinetic nystagmus to the ipsilateral side.

Aged↗
PubMed1999

Life-long history of injuries related to seizures.

There is meager information in the literature regarding the characteristics and risk factors for injuries caused during epileptic seizures in adults. Previous studies focused mainly on specific types of injuries incurred, and only few explored associated risk factors. A questionnaire regarding lifetime seizures and their traumatic consequences was administered to 298 consecutive epileptic patients and their caretakers or relatives. Ninety-one of them (30%) have reported trauma: 185 events (age 39.8+/-18 years, 54 males), of which 61 were severe. This translates to one seizure-related injury every 21 patient-years, and a serious injury once every 64 patient-years. The most common site of injury was the head (55% of the events). Blunt injuries occurred most frequently (40%), followed by cuts (28%). Severe injuries included fractures and dislocations (17%), burns (6%), brain concussion (6%), subdural hematoma (3%) and intracerebral hematoma (1%). Most injuries occurred at home. The 91 patients with traumatic events were compared with the 207 epileptic patients without previous trauma (age 37.8+/-14.7 years, 112 males). Patients with seizure-related trauma had significantly earlier onset age of epilepsy. They more commonly had generalized from onset tonic-clonic, complex partial, myoclonic or absence seizures but fewer had partial seizures with secondary generalization. The risk of trauma was mostly related to seizure type (generalized tonic clonic from onset and myoclonic seizures). This information may be helpful for better management of epileptic patients.

Adolescent↗
PubMed1991

The psychobiology of minor head injury.

Twenty-six consecutive admissions to an accident and emergency unit with minor head injury were examined. This was defined as a head injury warranting brief in-patient overnight stay but with a post-traumatic amnesia of less than 12 hours. Each patient had a neurological examination, a post-traumatic symptom check list completed, EEG power spectra analysis and auditory brain stem-evoked potential recordings, and a four-choice reaction-time measurement. These assessments were repeated six weeks later. Six months after the head injury a symptom check list was completed and four-choice reaction time measured again. Post-traumatic symptoms are persistent in half of all patients at six weeks and six months follow-up. The EEG power spectra showed a significant change in theta power between the first recording and the second one at six weeks, with relative reduction being noted. Approximately half of all patients had significant delays in brain stem conduction time at day 0. There was a trend towards a decrease in brain stem conduction time at six weeks, though in almost half the brain stem conduction time still remained abnormal at six weeks. Head-injured patients had prolonged choice reaction times at day 0 with serial improvement between then and six months, though the values at six weeks were still significantly longer than healthy controls. It is suggested that these findings reflect both cortical and brain stem damage following minor head injury, the brain stem damage being more persistent. There appear to be three patterns of recovery, half recovering within six weeks, a minority persisting over six months with persisting brain stem dysfunction and less than a third showing an exacerbation of symptoms with no evidence of brain stem dysfunction, the exacerbation being possibly a consequence of psychological and social factors.

Adolescent↗
PubMed1996

Motor dysfunction profiles in traumatic brain injury and postconcussion syndrome.

Motor measures are sensitive to central lesions, but they are also affected by peripheral injury and motivation. The motor skills profiles of proven brain injury clients were compared with the profiles of healthy postconcussion patients. The chief result was a double dissociation: The traumatic brain injury (TBI) group produced a motor dysfunction gradient consistent with upper motor neuron disease, while the compensation-seeking postconcussion group produced a nonphysiologic pattern. Objective measures of behavioral pain and emotional distress did not correlate with the findings. Motor skill deficiencies in postconcussion syndrome (PCS) are probably functional in nature.

Adult↗
PubMed2001

Patterns of verbal learning and memory in traumatic brain injury.

CVLT and WMS-R Digit Span variables were used to calculate indexes of seven specific short- and long-term memory processes: working memory span and central executive functions, and long-term memory encoding, consolidation, retention, retrieval, control abilities. Scores on these indexes were then cluster-analyzed to determine whether subtypes of memory performance exist that correspond to deficits in these theoretical memory constructs. Parallel analyses were conducted with two large samples (N = 150 and N = 151) of individuals who had sustained a traumatic brain injury (TBI). Findings showed that TBI results in subgroups of memory disorders with specific deficits in consolidation, retention, and retrieval processes. Control problems (keeping track of list versus non-list items) only appeared in conjunction with retrieval deficits. Working memory span and central executive functioning (i.e., the ability to manipulate information in working memory) do not appear to be deficits characteristic of TBI as no such clusters emerged in the analyses. By using specific indexes of memory processes, and in contrast to previous studies, patterns of memory dysfunction were found that correspond to deficits in theoretically meaningful memory constructs.

Adult↗
PubMed2001

Acquisition of skilled visual search performance following severe closed-head injury.

This study used a semantic-category visual search task to investigate skill acquisition and automatic process development in a severe closed-head injured (CHI) population. Eighteen severe CHI participants (> I year post injury) and 18 matched controls completed over 3600 trials of training in both consistent mapping (CM) and varied mapping (VM) training situations. Transfer conditions were also used to test for development of an automatic attention response (AAR) that was independent of general, task-related learning. For both the severe CHI and control group, CM training, where individuals always responded in the same way to a specific class of stimuli, resulted in dramatic performance improvements and the development of an AAR. In the VM training condition, where individuals could not respond in the same way to a class of stimuli from one stimulus exposure to the next, there was little performance improvement and continued reliance on controlled processes. The visual search rates of the CHI participants also remained slower than those of controls following extended VM but not extended CM practice. These results indicate that skill acquisition training guidelines can be used to teach severe CHI patients to develop a new automatic skill.

Adult↗