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MTBI Overview

Delivered August 14th, 2019. Contributors: Michelle, George, Kathryn, SHRUTI, Leslie and

Research Outline: mTBI Overview
Part
01
of five
Part
01

MTBI Diagnostic Methods

Several methods currently in use or in development to treat mild traumatic brain injury (mTBI), also known as a concussion, include the Banyan Brain Traumatic Indicator; the Glasgow Coma Scale; CT and MRI imaging tests; neuropsychological evaluations; blood tests conducted on mHealth platforms; and long noncoding RNAs.

current diagnostic methods

Banyan Brain Traumatic Indicator (BTI)

  • In February 2018, the Food & Drug Administration (FDA) approved a blood test called the Banyan BTI to be used for the diagnosis of mTBI. Within 12 hours of a concussion, two proteins, ubiquitin carboxy-terminal hydrolase-L1 and glial fibrillary acidic protein, are released into the blood and the Banyan test is looking for those proteins. The test can be used to predict which patients would benefit from receiving a CT scan.
  • In a clinical study for the test, the Banyan BTI accurately predicted the presence of intracranial lesions 97.5% of the time, and correctly predicted no lesions 99.6% of the time. Therefore, the test can be used to reduce the number of CT scans that are done.

Glasgow Coma Scale

  • According to the FDA, the Glasgow Coma Scale is used with most patients that have a suspected head injury. The test uses a 6-level scale for motor response, a 5-level scale for verbal response, and a 4-level scale for eye-opening. The results are added together and the patient is then categorized into Mild (a score of 13-15), Moderate (a score of 9-12), Severe (a score of 3-8), or Vegetative (a score of less than 3).
  • The areas looked at on the Glasgow Scale are designed to determine the social capability of the patient as well as their dependence on others.
  • The scale was first published in 1974 and began being widely used during the 1980s.

Imaging Tests

  • Both computerized tomography (CT) scans and magnetic resonance imaging (MRI) are used when there is a suspected brain injury. A CT scan is usually done first, and MRIs are more often used as a secondary test if symptoms don't improve.
  • A CT scan is a series of x-rays that allow for a detailed look at the brain. This test can detect issues such as bleeding in the brain, fractures, brain contusions, and swelling.
  • An MRI uses radio waves and magnets to view the brain. However, a study published in 2019 found that MRIs are not generally helpful in diagnosing concussions in children.

Neuropsychological Evaluation

  • A neuropsychological evaluation allows a doctor to evaluate any cognitive or functional deficits that are presented after an injury. This evaluation is typically an interview of the patient and others who know the patient, if possible. The evaluation considers symptoms, behavioral changes pre and post-injury, and patient reported complaints.
  • Some areas of cognitive function that are examined during the evaluation include "attention, processing speed, executive functions, and/or memory."

IN-DEVELOPMENT TESTING METHODS

Blood Testing

  • Abbott and the United States Defense Department are beginning the process of conducting clinical trials on a blood test that can be done on an mHealth platform within minutes of an injury. The test would be looking for proteins that are released into the blood following an injury that causes a concussion. The hope is that the clinical trial will lead to developing a mobile device that could scan a blood sample wherever needed in order to diagnose a potential concussion.
  • This test is designed to improve on the Banyan BTI test by allowing for testing to happen anywhere. The results of this trial will be compared to the other assessments used for detecting mTBIs, such as CT scans and MRIs.

Long noncoding RNAs (lncRNAs)

  •  lncRNAs are molecules that are specific to various tissue, and may "leak out of a cell when it is injured."
  •  Daniel Lim and Geoffrey Manley are researchers at the University of California San Francisco who are researching how a blood test can be used to identify the lncRNAs specific to the brain in order to identify brain injuries immediately after they happen.
  • The researchers are hoping that the lncRNA markers will be more sensitive than proteins that are currently being tested for, which would allow for the diagnosis of even mild concussions that may currently be missed.
Part
02
of five
Part
02

MTBI Treatments

There is no professional consensus on the treatment of mTBI because treatment should "account for multiple factors including cognitive, emotional, and somatic symptoms" due to the variability and complexity of the symptoms after mTBI. However, the NCBI states that existing research supports the "efficacy of neuropsychological evaluations and interventions" while the International Brain Injury Association recommends interventions such as patient/family education, symptoms recognition, and customized cognitive therapy. Below is an explanation of the methodology as well as available findings.

USEFUL INFORMATION

  • According to the NCBI, research on effective interventions for mTBI has produced mixed results despite several decades of research establishing a clearer picture of its typical symptoms.
  • The available research has provided "preliminary support for a number of behavioral interventions for the management and amelioration of symptoms following mTBI,"
  • Proper treatment of mTBI has proven to be a challenge due to lack of consensus regarding the management and diagnosis of symptoms and the "complexity of symptom presentations and comorbidities."
  • However, the existing research supports the "efficacy of neuropsychological evaluations and interventions across stages of recovery from mTBI."
  • The NCBI recommends that rehabilitation psychologists and neuropsychologists can be useful in the care for mTBI patients.
  • A study by the International Brain Injury Association agrees that there is no standardized treatment for mTBI due to lack of consistent evidence. Regardless, certain interventions have proven to be helpful in the treatment for mTBI including patient/family education, symptoms recognition, and customized cognitive therapy.
  • In November 2018, the CDC released the "CDC Pediatric mTBI Guideline" which recommends rest, support, symptom management, and family/patient education for the treatment of mTBI.
  • The CDC's set of guideline identifies what it considers the best practices based on the available evidence. The organization will provide updates as more evidence is acquired.
RESEARCH STRATEGY
Our research for current and in-development treatments for mTBI began with searching for any information provided by international/multilateral healthcare resources/bodies such as the World Health Organization and the Pan American Health Organization. Our initial research also entailed scouring through bilateral healthcare resources such as the UK's NHS and the U.S.' CDC and NCBI. From these resources, we learned that mTBI treatment is still a gray area since there is no professional consensus.

Still, we explored other strategies to ensure that our research is thorough and conclusive. Our second strategy was to search through medical media resources such as The Lancet and NIH MedlinePlus. We also searched through respected medical journals such as the Harvard Health Journal, the Annual Review Of Public Health, and the Journal of Psychopharmacology. However, there was no information on the subject.

Our third strategy was to search for any current or ongoing medical research on the subject on medical research sites such as Research Match, Medical News Today, and ClinicalTrials.gov. At this point, we looked for any communications by pharma stakeholders regarding any successful or ongoing research being carried out on the treatment of mTBI. We also searched for any academic studies/journals and international media resources in the hope that we would find some that contained any information on the subject. Again, our research was fruitless.

It is our conclusion that the required information is missing because there is no professional consensus on the treatment of mTBI. This is because the mTBI treatment should "account for multiple factors including cognitive, emotional, and somatic symptoms" due to the variability and complexity of the symptoms after mTBI.
Part
03
of five
Part
03

Economic Impact/Opportunity-mTBI

Evidence exists suggesting that some large enterprises are willing to pay for an employee's recovery and others are not willing to pay. Ultimately insufficient information was available to conclude how much large enterprises would pay to get their personnel back faster following an mTBI.

EVIDENCE THAT ENTERPRISES WOULD PAY

  • In some cases businesses may receive financial incentives for hiring a person with an mTBI.
  • It typically does not cost much for a workplace to make accommodations for an employee who has sustained an mTBI.
  • A Return to Work (RTW) program is a common way that businesses facilitate their employees' RTW, businesses can reduce worker's compensation costs, retain experience workers, and reduce turnover.
  • The longer a worker is recovering from an injury, the more expensive the insurance claim becomes, which would motivate businesses to facilitate their employee's recovery.

EVIDENCE THAT ENTERPRISES WOULD NOT PAY

  • In a study of Danish workers who sustained mTBIs, most had their long term employment prospects damaged by the injury, suggesting that businesses are not interested in facilitating an employee's return to work (RTW).
  • A Canadian study demonstrated that there was no difference between the recuperation process of people who had sustained mTBIs in the workplace and not in the workplace. In Canada, employers can be required to pay workers injured in the workplace lost income, treatment expenses, disability accommodation, and more. So, even though employers would benefit from a quicker RTW, this study suggests that they do not facilitate their employee's recovery.
  • An RTW program can be expensive because it requires businesses to pay a full salary for an employee who is giving a reduced contribution, plus the salary of a replacement employee. One estimate says RTW programs can cost employers $184,614.
  • Furthermore, brain injuries are already expensive injuries without speeding up the process of recovery; estimates put the annual direct cost burden of brain injuries between $98 million and $2.8 billion.

RESEARCH STRATEGY

Although we were ultimately unable to arrive at an answer to how much large enterprises pay to get their personnel back faster following an mTBI, your research team employed several strategies in attempts to find relevant information.

First, we searched news outlets, management and human resources publications, and academic journals for examples of businesses paying to speed up the process of recovery for employees after an mTBI. When this search failed to reveal any examples of this happening, we widened the search to include any kind of injury and not just mTBIs. Still, this strategy failed to reveal any relevant information. We also tried searching for examples of specific universities and large businesses to see if searching an organization by name revealed any evidence of this kind of occurrence. Still, we found nothing.

Next, we tried triangulating an answer by identifying the average cost incurred by a business when an employee sustains an mTBI. If we found this number, we could assume that the business would be willing to pay any amount less than this cost to facilitate an employee's RTW. While we were unable to find an exact number for this, the information we did find is included above.

Finally, we tried examining RTW programs to see if any programs included provisions about speeding up the recovery process of employees, and if so, what the costs associated with this were. While we did find some cost projections for RTW programs, we did not find any programs that discussed speeding up the recovery process for employees.

Part
04
of five
Part
04

MTBI Key Players/Organizations

Key persons who are leading the market in mTBI treatment or diagnosis are Dr. David Tate, Dr. Michael Esser, Dr. Angela Lumba-Brown, Dr. Keith Owen Yeates, and Dr. Kelly Sarmiento while the key organizations which are leading the market in mTBI treatment or diagnosis are The Virginia Tech Carilion Research Institute and BrainBox Solutions.

KEY PERSONS OR ORGANISATIONS WHO ARE LEADING THE MARKET IN mTBI TREATMENT OR DIAGNOSIS

1. VIRGINIA TECH CARILION RESEARCH INSTITUTE (VTCRI)

  • The Virginia Tech Carilion Research Institute (VTCRI) conducts translational and interdisciplinary and research within the medical sciences to continually improve patient care through discovery and research.
  • The Virginia Tech Carilion Research Institute is considered as a key institute as it has Won an Award to develop tests for mild traumatic brain injury and raised money to diagnose mild traumatic brain injury.
  • Scientists at Virginia Tech Carilion Research Institute (VTCRI) have teamed up to address an important medical challenge to diagnose a mild traumatic brain injury that has subtle or no physical signs but can cause long-term damage.
  • Virginia Tech Carilion Research Institute (VTCRI) has raised $500,000 from Virginia Catalyst to develop and commercialize a multi-modality system approach to aid in the diagnosis and management of mild traumatic brain injury, known as mTBI. An additional fund of $500,000 was invested in the program by the project’s industry partner, BrainBox Solutions Inc.
  • The VTCRI is served as the first anchor research and demonstration site for the blood-based tests.

2. BRAINBOX SOLUTIONS

  • BrainBox Solutions aims to develop a “multi-modality product” combining point-of-care measurement of protein biomarkers linked to mTBI with additional tests like cognitive assessments to diagnose and monitor mTBI cases as well as to determine a patient’s risk of longer-term effects.
  • BrainBox Solutions is considered as a key institute as it focuses on the post-CT space in mTBI after TRACK-TBI initiative that was launched in 2014 by the National Institutes of Health.
  • BrainBox Solutions develops tests to identify patients with negative CT findings. Those patients who are at high risk of mTBI symptoms are identified and enabled to access services and therapies that can improve their recoveries.
  • The institute plans to target the acute setting with its first test that is going to be launched in the 4th quarter of 2019, which will be used to identify CT-negative mTBI patients who may benefit from additional outpatient intervention.
  • Additionally, the company plans to develop tests covering the post-acute periods, monitoring patient recovery over a period of months.

3. DR.DAVID TATE PHD

  • Dr. David Tate PhD is the associate Professor, Research, and Director of the Brain Imaging and Behavior Laboratory.
  • David Tate is also the Principal Investigator at The Chronic Effects of Neurotrauma Consortium (CENC) which is a coordinated, multicenter collaboration linking basic science, translational and clinical neuroscience researchers from the VA, military, and academia to effectively address the long-term effects of mild traumatic brain injury (mTBI) and its diagnosis and treatment among members and veterans of the military.
  • Dr. David Tate is a key leader in the market because he has contributed the most research in mild traumatic brain injury including its long-term effects of mild traumatic brain injury among US service members and veterans.
  • He has a specialty in traumatic brain injury, brain imaging, neuroimaging, and Neuropsychology.
  • He is heavily involved in medical imaging research used to examine a number of developmental, clinical, and medical disorders mild traumatic brain injury (mTBI) and HIV.
  • Dr. Tate runs an active funded research program that explores the biological and cognitive benefits of cognitive rehabilitation treatments for service members with a traumatic brain injury.
  • He also supports the Neuroimaging Core for the Chronic Effects of Neurotrauma Consortium (CENC) which is a multicenter DoD/VA funded collaborative effort to study the long-term effects of mild traumatic brain injury among US service members and veterans.
  • In addition, he has begun working with researchers examining the imaging and cognitive effects high altitude flying has on pilots working in decompressed environments.

4. DR. MICHAEL ESSER

  • Dr. Michael Esser is a Pediatric Neurologist and Basic Science Researcher at the Alberta Children's Hospital and Alberta Children's Hospital Resarch Institute. He is exploring the cellular mechanisms involved in symptom persistence following mild traumatic brain injury.
  • Dr. Michael Esser is considered as a Key person as his main area of research is pediatric brain injury whereby he explores symptoms that persists following mild traumatic brain injury.
  • He is also involved in pediatric neurology brain injury clinical program at Alberta Children Hospital, developing a translational program linking the bedside and the bench.
  • He has recently published Research Papers on mild traumatic brain injury including: Sex-dependent and chronic alterations in behavior and mitochondrial function in a rat model of pediatric mild traumatic brain injury; Cortical excitability after pediatric mild traumatic brain injury; The direction of the acceleration and rotational forces associated with mild traumatic brain injury in rodents effect behavioural and molecular outcomes; A mild traumatic brain injury (mTBI) induces secondary attention-deficit hyperactivity disorder-like symptomology in young rats; A novel model of mild traumatic brain injury for juvenile rats and many more.

5. ANGELA LUMBA-BROWN, MD

  • Dr. Angela Lumba-Brown is an Assistant Professor in Emergency Medicine and Pediatrics at Stanford University, where she practices clinically in the pediatric emergency department. She is also the co-director of the Stanford Concussion (Mild Traumatic Brain Injury) and Brain Performance Center.
  • Dr. Angela Lumba-Brown is considered as a key person as she is the first-author on the 2018 Center for Disease Control and Prevention’s Guidelines for the Diagnosis and Management of Mild Traumatic Brain Injury Among Children.
  • She has been a member of the CDC’s expert workgroup panel on pediatric mTBI for over 7 years.
  • Her research work is focused on evidence-based management of mild TBI, inclusive of concussion, in all pediatric age groups, regardless of mechanism of injury.
  • Dr. Lumba-Brown’s current work includes Mild Traumatic Brain Injury sub types and examines targeted treatments through the Stanford Brain Trauma Evidence-Based Consortium (Mild Traumatic Brain Injury).
  • Her work has been published in the Journal of Trauma, JAMA Pediatrics, Annals of Emergency Medicine, Neurosurgery, and the Journal of Neurotrauma. She has also been highlighted on NPR and in the New York Times.
  • Dr. Lumba-Brown's passion is in injury prevention and the application of personalized medicine to Mild Traumatic Brain Injury’s rehabilitation strategies.

6. DR KEITH OWEN YEATES

  • Dr. Keith Owen Yeates is a Professor at the University of Calgary. His research aims to understand the outcomes of childhood brain injury and influences on recovery, and thereby foster more effective treatment and management.
  • Dr. Keith Owen Yeates is considered as a key person as his focus is on concussion and mild traumatic brain injury (TBI), in terms of both assessment and treatment.
  • He has done extreme research in understanding the interplay of neurobiological and psychosocial factors in determining the outcomes of children after mild TBI.
  • He works with several groups that investigate social outcomes in childhood brain tumors, neurofibromatosis, and stroke.
  • He has published a variety of research papers including:
--CDC Guideline on Mild Traumatic Brain Injury in Children: Important Practice Takeaways for Sports Medicine Providers.
--Practice Patterns in Pharmacological and Non-Pharmacological Therapies for Children with Mild Traumatic Brain Injury: A Survey of 15 Canadian and United States Centers.
--Diagnosis and Management of Mild Traumatic Brain Injury in Children: A Systematic Review.
--Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children.

7. KELLY SARMIENTO, MPH

  • Dr. Kelly Sarmiento, MPH, serves as a public health advisor in the Division of Unintentional Injury Prevention’s Traumatic Brain Injury Team. She has expertise in pediatric mild traumatic brain injury.
  • Dr. Kelly Sarmiento is considered as a Key person in Mild Traumatic Brain Injury as she has expertise is in pediatric mild traumatic brain injury.
  • She is a leader in operating "Heads Up" campaign which includes a series of educational initiatives to protect kids and teens by raising awareness and informing action to improve prevention, recognition, and response to concussion and other serious brain injuries.
  • She had been a part of CDC in the National Center for Injury Prevention and Control’s Division of Injury Response where she has lead several educational campaigns on mild traumatic brain injury.
  • She has developed more than 60 educational products and tools, as well as authored over 20 presentations, abstracts, and chapters specific to traumatic brain injury. She has also received many awards for her work in public health and innovation in health communication.
  • She has published various Research Paper on mild traumatic brain injury including:
--Healthcare providers' attitudes and behaviours related to pediatric mild traumatic brain injury: results from the 2014 DocStyles survey.
--Emergency Department Implementation of the Centers for Disease Control and Prevention Pediatric Mild Traumatic --Brain Injury Guideline Recommendations.
--Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children.
-- Diagnosis and Management of Mild Traumatic Brain Injury in Children: A Systematic Review.
--CDC Guideline on Mild Traumatic Brain Injury in Children: Important Practice Takeaways for Sports Medicine Providers.
--Considerations for Athletic Trainers: A Review of Guidance on Mild Traumatic Brain Injury Among Children From the ----Centers for Disease Control and Prevention and the National Athletic Trainers' Association.
-- Considerations for neurosurgeons: recommendations from the CDC Pediatric Mild Traumatic Brain Injury Guideline.
--Strengthening the Evidence Base: Recommendations for Future Research Identified Through the Development of CDC's Pediatric Mild TBI Guideline.
--CDC's guideline on pediatric mild traumatic brain injury: Recommendations for neurologists.

RESEARCH STRATEGY

We started off our research by looking at the key persons or organizations who are leading the market in mTBI treatment or diagnosis in HealthCare Reports from PRNewswire, AbNews, and Reuters. The idea was to check for the information on Mild Traumatic Brain Injury Market and identify the organizations that are taking leading roles in the treatment or diagnosis of Mild Traumatic Brain Injury. We found a pre-compiled list of Key players in the industry including ALSP, Inc., Amarantus Bioscience Holdings, Inc., Athersys, Inc., BHR Pharma, LLC, Cognosci, Inc., Euroscreen S.A. among others. We then checked the information for each player one by one but could not find any relevant result or metrics that could define them as key players. All the information we found was on the general services provided by these players in Mild Traumatic Brain Injury.

Next, we scoured for the information in Healthcare Reports and Surveys in sources such as MayoClinic, Missouri Institute of Mental Health, and University of Calgary. The idea was to check if any key person or organization could be located who lead in this field and have made some contribution towards the mTBI treatment or diagnosis. The sources mentioned the Information for Dr. David Tate contribution to mTBI Industry, Virginia Tech Carilion Research Institute (VTCRI) wins award to develop test for mild traumatic brain injury, BrainBox Solutions is a Key Organization that raises money for the diagnosis and treatment of Mild Traumatic Brain Injury.


Part
05
of five
Part
05

MTBI Diagnosis and Treatment Developments

The developments on the diagnosis and treatment of mTBI are geared towards accuracy and accessibility. It has been determined that movement is better than prolonged rest for treating mTBI, and several drugs are also being developed to address the long-term symptoms and chronic pain. More information on the topic has been presented below.

DIAGNOSIS

  • Currently, healthcare practitioners examine a patient for cognitive and neurological clues to diagnose mTBI. CT Scan and other imaging tests are specifically used to detect if there is bleeding in the brain.
  • The identification of biomarkers also helps in determining if an individual who has sustained a concussion can safely return to physical activities.
  • The mTBI biomarkers that are being studied currently include the following alterations:
— Local pathophysiological changes
— Blood-brain barrier disruption
— Cerebral blood flow disturbance
— Axonal and neuronal cell body damage
— Neuroinflammatory response
  • According to an article on ABC News, a quicker, less expensive, and more accurate way of diagnosing mTBI is being developed.

EXAMPLES OF NEWLY-DEVELOPED DIAGNOSIS TOOLS

  •  BRAINBox Solutions has designed a blood test that can determine if an individual has mTBI immediately after an injury. According to the FDA, this is a breakthrough device that provides a quick and precise way of determining mTBI.
  • On December 28, 2018, FDA granted authorization to Oculogica to market the EyeBox device. It is a non-invasive eye-tracking device used for the diagnosis of concussions.
  • The EyeBox device is considered to be a milestone that provides an objective assessment to healthcare providers.
  • In partnership with Neuro Kinetics, UHealth has developed the concussion-detection goggles that have been reported to give a 95% accuracy in diagnosing mTBI.
  • A method of using vital brain signs to detect physiological impairment in individuals was developed by a group of scientists. Healthcare providers can now check whether a treatment is effective or not using electroencephalography.
  • Healthcare providers can also check if it is safe for athletes to return to the playing field.

TREATMENT

  • Vestibular and cervical spine rehabilitation is a good treatment method and a faster way of recovering from a concussion. It was recommended in the 2017 International Consensus Statement on Concussion in Sport.
  • Resting for a long period of time is no longer the recommended treatment for mTBI.
  • It was found out in several studies that exercising leads to faster recovery from concussions than resting.
  • Mental health now plays a vital role in mTBI treatment and recovery. Cognitive Behavioral Therapy (CBT) was recommended as the best treatment for persistent mood or behavioral disorders resulting from a concussion in the 2017 International Consensus Statement on Concussion in Sport.
  • While there are no concussion-specific medications currently, there are many clinical trials being conducted for this purpose.

CLINICAL TRIALS AND STUDIES FOR CONCUSSIONS

  • A combination of cannabidiol (CBD) and another chemical is being used by the University of Miami to address the long-term symptoms.
  • A medication developed from synthetic human ghrelin (OXE-103) is being used by Oxeia Biopharmaceuticals to address the metabolic energy crisis.
  • A few companies are testing neurosteroids on animals by administering the neurosteroids nasally right after a brain impact.
  •  UHealth is studying the use of a cannabinoid compound for treating the chronic discomfort that arises from headaches due to concussions.

Did this report spark your curiosity?

Sources
Sources
From Part 01

Abbott, Military To Test mHealth Platform for Concussion Diagnosis

mhealthintelligence.com
Publication Year: 2019
Quotes
  • "In Late 2017, Harvard University researchers announced plans to field test the Tbit, a diagnostic device about the size of a loaf of bread that analyzes a blood sample for proteins released when the brain experiences a hard hit."

FDA Approves Blood Test to Aid Concussion Evaluation

aafp.org
Publication Year: 2018
Quotes
  • "The FDA reviewed and approved Banyan's de novo request in fewer than six months through the agency's Breakthrough Devices Program.(www.fda.gov) The de novo premarket review pathway is used for some novel low- to moderate-risk devices for which there is no previous legally marketed device. The Breakthrough Devices Program is intended to give patients more timely access to certain medical devices by expediting their development, assessment and review."
t

Glasgow Coma Scale

traumaticbraininjury.com
Publication Year: 2019

Glasgow Coma Scale - StatPearls - NCBI Bookshelf

ncbi.nlm.nih.gov
Publication Year: 2019
Quotes
  • "The use of the Glasgow Coma Scale became widespread in the 1980s when the first edition of the Advanced Trauma and Life Support recommended its use in all trauma patients. Additionally, the World Federation of Neurosurgical Societies (WFNS) used it in its scale for grading patients with subarachnoid hemorrhage in 1988, The Glasgow Coma Scale and its total score have since been incorporated in numerous clinical guidelines and scoring systems for victims of trauma or critical illness."

Traumatic brain injury - Diagnosis and treatment - Mayo Clinic

mayoclinic.org
Publication Year: 2019

Brain MRI in Children with Mild Traumatic Brain Injury and Persistent Symptoms in Both Sports- and Non-sports-related Concussion

ncbi.nlm.nih.gov
Publication Year: 2019

Evaluation and Treatment of Mild Traumatic Brain Injury: The Role of Neuropsychology

ncbi.nlm.nih.gov
Publication Year: 2017
Quotes
  • "They found that less than half of the centers had a standardized protocol in place for evaluating all patients with suspected mTBI. Foks and colleagues found a similar lack of consistency in mTBI evaluation and management when they surveyed 71 neurotrauma centers in Europe and Israel. Powell and colleagues found that over half of the 197 patients identified as having a mTBI by study personnel were not documented with that diagnosis by medical personnel in the ED."

With Dangers of Everyday Concussions Revealed, Scientists Race to Find Solutions

ucsf.edu
Publication Year: 2018
Quotes
  • "In the United States, nearly three million people every year visit the emergency room for traumatic brain injuries, with 70 percent to 90 percent sustaining so-called mild traumatic brain injuries (mTBI), more commonly known as concussions. These numbers don’t account for the many people who suffer concussions but do not seek medical attention."
  • "Currently, head injuries that show up on a CT scan can be diagnosed by protein biomarkers such as GFAP and UCH-L1, but those may not be sensitive enough to pick up concussions, according to Lim. "
From Part 02

Evaluation and Treatment of Mild Traumatic Brain Injury: The Role of Neuropsychology

ncbi.nlm.nih.gov
Publication Year: 2017

Mild Traumatic Brain Injuries were previously undiagnosable, and therefore treatment uncertain, and damages speculative International Brain Injury Association - IBIA

internationalbrain.org
Publication Year: 2018

CDC Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children

jamanetwork.com
Publication Year: 2018

Treatment of MTBI | CNS Traumatic Brain Injury Rehabilitation

neuroskills.com
Publication Year: 2018

New Guidelines for Mild Traumatic Brain Injuries

aap.org
Publication Year: 2018
From Part 03
b

Employment after Traumatic Brain Injury

bianys.org
Publication Year: 2004

Study: Can Mild Traumatic Brain Injury Affect Employment Status? - Docwire News

docwirenews.com
Publication Year: 2019

Employee Rights in the Workplace

brainline.org
Publication Year: 2018

Workers’ Compensation for Workplace Injuries and Illness

monster.ca
Publication Year: 2019

Workplace and non-workplace mild traumatic brain injuries in an outpatient clinic sample: A case-control study

journals.plos.org
Publication Year: 2018

Why You Should Consider a Return to Work Program

thebalancesmb.com
Publication Year: 2018

Workers Compensation Return-to-Work Programs: Cost Savers?

irmi.com
Publication Year: 2019
d

Assessing the Costs and Benefits of Return-to-Work Programs

dol.gov
Publication Year: 2015

Return to Work Programs – Why You Need One

cavignac.com
Publication Year: 2019

The costs of traumatic brain injury: a literature review

ncbi.nlm.nih.gov
Publication Year: 2013

Adults & Brain Injury: Returning to Work

biausa.org
Publication Year: 2019
From Part 04
t

Mild TBI Symptoms

traumaticbraininjury.com
Publication Year: 2019

Traumatic brain injury - Doctors and departments - Mayo Clinic

mayoclinic.org
Publication Year: 2019

Tate, David

mimh.edu

VTCRI wins award to develop test for mild traumatic brain injury, working with industry partners, University of Virginia

vtnews.vt.edu
Publication Year: 2018

Virginia Tech Carilion Research Institute

research.vt.edu

Immunarray Spins Off Brainbox Solutions To Develop Traumatic Brain Injury Tests - BRAINBox Solutions, Inc.

brainboxinc.com
Publication Year: 2019

Our research team | Traumatic Brain Injury Research Program

ucalgary.ca
Publication Year: 2019

Michael Esser | ACHRI | University of Calgary

research4kids.ucalgary.ca
Publication Year: 2019

Esser MJ - PubMed - NCBI

ncbi.nlm.nih.gov
Publication Year: 2019

Angela Lumba-Brown — Pink Concussions

pinkconcussions.com

Diagnosis and Management of Mild Traumatic Brain Injury in Children: A Systematic Review

jhu.pure.elsevier.com
Publication Year: 2018

Dr. Keith Owen Yeates | Hotchkiss Brain Institute

hbi.ucalgary.ca
Publication Year: 2018

yeates ko - PubMed - NCBI

ncbi.nlm.nih.gov
Publication Year: 2019

Expert Bio - Kelly Sarmiento | CDC

cdc.gov
Publication Year: 2019

Error encountered - PubMed - NCBI

ncbi.nlm.nih.gov
Publication Year: 2019
r

Kelly Sarmiento

researchgate.net
Publication Year: 2019
From Part 05

The current state of biomarkers of mild traumatic brain injury

ncbi.nlm.nih.gov
Publication Year: 2018
Quotes
  • "The development of a suite of biomarkers that indicate the pathogenicity of mTBI could lead to clinically useful tools for establishing both diagnosis and prognosis."
  • "The long-term goal of these studies should be to better design personalized therapy for concussed individuals and, especially, to address concerns about when it is safe for injured athletes to return to play as well as concerns of any individual who has sustained a concussion."

Oculogica Receives FDA Marketing Authorization for EyeBOX® Device, the First Non-Invasive, Baseline-Free Test for Concussion - Oculogica

oculogica.com
Publication Year: 2019
Quotes
  • "Eye-tracking will change the practice of emergency care for concussion and will greatly assist a large number of patients. The result will be more consistent and objective diagnoses of concussion in the emergency room and clinic, and eventually on the field,” stated Dr. Robert Spinner, Chair of the Department of Neurological surgery at Mayo Clinic."
h

New Concussion Frontiers

health.usnews.com
Publication Year: 2018
Quotes
  • "...it's looking more and more like concussion itself isn't the only potential danger. Sub-concussive events (forces and blows to the head that don't cause concussion symptoms, but may still contribute to long-term effects) are now considered potentially just as important. "
  • "The old recommendation for concussion treatment was complete bed rest with no bothersome stimuli to overexcite a healing brain"
  • "treatment today usually includes a period of initial rest, with a gradual return to activity in the shorter term because newer research has demonstrated that the brain heals better with physical activity and movement – particularly for athletes."

Cannabis, concussion, and chronic pain

n.neurology.org
Publication Year: 2018
Quotes
  • "results support MC as an option for treatment of concussion-related chronic pain. While prospective studies are required, these preliminary results lay the foundation for investigating MC as a valid treatment for concussion and chronic pain."

Cannabis and goggles: the latest in concussion treatments and research

medicalxpress.com
Publication Year: 2017

Top five concussion breakthroughs of the past five years: #4 - Complete Concussion Management Inc.

completeconcussions.com
Publication Year: 2019

Top five concussion breakthroughs of the past five years: #3 - Complete Concussion Management Inc.

completeconcussions.com
Publication Year: 2019
Quotes
  • "In 2017, the most recent International Consensus Statement on Concussion in Sport2 suggested that vestibular and cervical spine rehabilitation be incorporated in patients with persistent concussion symptoms (i.e., lasting longer than 10-14 days)."

Top five concussion breakthroughs of the past five years: #1 - Complete Concussion Management Inc.

completeconcussions.com
Publication Year: 2019
Quotes
  • "What we are starting to learn however, is that exercise may actually be beneficial in the acute stages of concussion recovery."

Brain vital signs detect concussion-related neurophysiological impairments in ice hockey

academic.oup.com
Publication Year: 2019
Quotes
  • "The results demonstrate the importance of an objective physiological evaluation of potential concussion effects over time. They address a major challenge faced by practitioners—the lack of practical, objective, evidence-based approaches deployed at the point of care to inform critical decisions for concussion management on sports."
  • "This emphasizes the need for continued implementation of the brain vital signs framework, as deployable at the point-of-care to better enable the evaluations of concussive and subconcussive impacts on brain function."

Medications for a concussion — Concussion Alliance

concussionalliance.org
Publication Year: 2019

Concussion test that could help minimize long-term effects designated as breakthrough

abcnews.go.com
Publication Year: 2019
Quotes
  • "The device, made by the company BRAINBox Solutions, is a blood test to determine if they’ve had a concussion and will be compared with both computerized imaging of a patient’s brain function and clinical diagnosis tools to test its accuracy."
  • "The real goal is [for this to be] an accurate and quick test that can be accessed by trained professionals right at the moment of injury or later on,” said Kuehl, who will be working on a trial of the new test."

Concussion tests and diagnosis

qbi.uq.edu.au
Publication Year: 2018