About this Research Topic
Recent interest in concussion and mild traumatic brain injury (mTBI), spurred by the recognition of the chronic, debilitating effects in football players and returning combat veterans, has culminated in important insights regarding symptoms, pathophysiology, and treatment, which has had downstream benefits for all persons suffering with concussions and head injury. Recent advances in diagnostics, greater understanding of biomechanics, and appreciation of injury to neuroendocrine and neurosensory networks in chronic, debilitated individuals has provided the opportunity for unprecedented recovery of quality of life.
Mild, unlike more severe brain injury, is typically lacking objective findings to confirm diagnosis. While symptoms may abound across cognitive, affective and physical domains, particularly early following trauma, controversy exists regarding the natural history of mTBI, with some patients recovering well and others doing poorly.
This Research topic will present some of the advances in brain injury medicine that have informed our understanding of the variability in symptomatology and clinical outcomes between patients. More specifically, we will describe the advances in brain injury biomechanics, neuroimaging, traumatically-induced pituitary dysfunction and altered neurosensory functioning that have provided unprecedented insights and opportunities to reverse symptoms. This topic will also use these advances to explain the higher rate of degenerative dementia observed in TBI, including mTBI.
• Diagnosis, epidemiology, natural history of mTBI — discuss evolution of symptoms and prognosis;
• General biomechanics and Biomechanical models —inertial vs. blast, basis of diffuse axonal injury using models to explain;
• Neuroimaging techniques and the information they provide —advanced MRI including FLAIR, SWI, DTI, MRS, fcMRI, MEG, QEEG, SPECT/PET;
• Clinical syndromes of mTBI — Neuropsychological, Neurometabolic and Neurosensory
1. Neuropsychological — Cognitive, psychological and motor system abnormalities
2. Neurometabolic — Hypothalamic-pituitary dysfunction resulting in gonadotropic, corticotropic, somatotropic deficiencies
3. Neurosensory — disordered sensory function including visual, auditory and balance systems
• Chronic effects of mTBI — TBI as a systemic disease; TBI and risk of dementia.
Keywords: Concussion, Postconcussive Syndrome, mild TBI, Neuroimaging, Hypopituitarism
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