The association between personality traits and sport-related concussion history in collegiate student-athletes. doi: 10.1007/s11065-017-9353-5, Allen, L., Mehta, S., McClure, J. The neuromodulation intervention techniques utilized in the studies included rTMS (n = 11), neurofeedback (n = 2), and tDCS (n = 1). Neurophysiol. EEG neurofeedback therapy: can it attenuate brain changes in TBI? At face value, all but one of the studies demonstrated that neuromodulation had a positive effect on the various symptoms measured and sometimes neurophysiological functioning following mTBI, as detailed in Supplementary Table 6B. Practice 2, 170–185. doi: 10.1089/neu.2014.3449, Krames, E., Peckham, P. H., Rezai, A. R., and Aboelsaad, F. (2009). (2018). Neuropsychobiology 63, 43–51. Neuropsychological predictors of outcome following traumatic brain injury in adults: a meta-analysis. Persistent post-concussive syndrome: structure of subjective complaints after mild traumatic brain injury. Brain Sci. 40, 173–179. doi: 10.1136/bjsports-2017-097699, McCrory, P., Meeuwisse, W. H., Kutcher, J. S., Jordan, B. D., and Gardner, A. Pre-existing conditions amongst the participants included depression (n = 9 participants), drug addiction (n = 1 participant), migraine (n = 1 participant), and other medical conditions (n = 4 participants). 51, 838–847. Traumatic brain injury (TBI) presents in various forms ranging from mild alterations of consciousness to an unrelenting comatose state and death. Assoc. Options Neurol. doi: 10.1016/j.jns.2017.06.038, Herrera-Melendez, A.-L. (2019). It is one of the most common causes of disability and death in adults. Am. Rehabil. Phys. 1.5 million Americans suffer from traumatic brain injuries. Neurology 48, 1398–1403. Estimates from a study in New Zealand are much higher with 790 in 100,000 experiencing TBI (Feigin et al., 2013). The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fnhum.2020.598208/full#supplementary-material, Allanson, F., Pestell, C., Gignac, G. E., Yeo, Y. X., and Weinborn, M. (2017). (2013). Rev. Stemming from this, the point at which the symptoms become persistent is also a matter of debate, where some consider symptoms remaining beyond the expected 2-week recovery timeframe to be persistent (Harmon et al., 2019), while others consider 1 month (McCrory et al., 2017) and 3 months (American Psychiatric Association, 2000) to be the transition point to persistent symptoms. Perform. Despite the various labels and diagnostic criteria, a common factor was that a GCS of 13–15, a PTA of 24 h or less and a LOC <30 min defined an mTBI, which is the same classification used earlier in the terminology section of this review. Specifically, no studies utilizing PBM or tVNS met the inclusion criteria, only two studies using neurofeedback were included and a single study using tDCS. Full texts of the remaining 24 articles were reviewed, and a further 10 articles were excluded (see Figure 1 for exclusion reasons), resulting in 14 articles being included in this review. (London: Academic Press), 3–4. doi: 10.1177/1550059413476031, Girgis, F., Pace, J., Miller, J. S., and Jonathan, P. (2016). Data items included population: adults who experienced a mTBI or concussion, intervention: types of neuromodulation including tDCS, rTMS, neurofeedback, LLLT/photobiomodulation, tVNS, outcomes: levels of persistent post-concussion symptoms. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (2006). (2013). Concussion is confusing us all. Arch. In the most severe form of TBI, the entirety of the brain is affected by a diffuse type of injury and swelling. The types of neuromodulation we intended to review included repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), transcutaneous vagus nerve stimulation (tVNS), neurofeedback (NF) and Photobiomodulation (PBM), including low level laser therapy (LLLT). Available online at: https://www.painphysicianjournal.com/, Leung, A., Metzger-Smith, V., He, Y., Cordero, J., Ehlert, B., Song, D., et al. We make recommendations for avoiding the shortcomings evident in much of the current literature and identify topic areas in urgent need of further research. The studies evaluated in this review fulfilled the following inclusion criteria published in English, investigating an adult sample and using a pre- and post-intervention design. Disease-A-Month. J. Neurotrauma 35, A103–A104. Improving symptom burden in adults with persistent post-concussive symptoms: a randomized aerobic exercise trial protocol. EEG Neurosci. In such cases a significance value was used where available. Only one of the 14 studies divided their sample into short- and long-term PCS (Moussavi et al., 2019), and significant findings were only seen in the short-term PCS group. Traumatic Brain Injury Research at MRN It is undeniable that there has been a sea change regarding the potential long-term consequences of mild traumatic brain injury (mTBI), also referred to as concussion. Sport Exerc. 35, E60–E66. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Self-report measures were also used due to the nature of symptoms being measured and these were not considered inappropriate in most cases. (2013). (2017). With mTBI comes symptoms that include headaches, fatigue, depression, anxiety and irritability, as well as impaired cognitive function. J. Rehabil. doi: 10.1097/TA.0b013e318232fa70, Villamar, M. F., Portilla, A. S., Fregni, F., and Zafonte, R. (2012). (2006). Arch. doi: 10.1159/000501227, Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., et al. “The subjective response to neurofeedback,” in Mind-altering Drugs: The Science of Subjective Experience, ed M. Earleywine (New York, NY: Oxford Univeristy Press), 345–366. doi: 10.1136/bcr-2018-226698, Peinemann, A. Anodal tDCS did not influence gamma-aminobutyric acid (GABA) concentration or receptor activity in the primary motor cortex (Wilke et al., 2017). The number and severity of symptoms can vary, with some individuals experiencing rapid recovery, and others having persistent symptoms for months to years, impacting their quality of life. Inherently, these differences may contribute to the uneven representation of the various modalities in the scientific literature. This study has systematically reviewed the literature on the efficacy of neuromodulation as a rehabilitation tool for the mTBI population, up until December 2019. Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. doi: 10.1002/9781119536604, Huang, M. X., Swan, A. R., Quinto, A. Clin. Jungfer, P. (2017). Sci. Study selection and data extraction was conducted by the first author (FB) and independently reviewed by another author (FA), concordance was 100%. Site Map | Med. This approach represents the interface between technology and the nervous system, through the process of modification, stimulation, inhibition, regulation or activity altering input into the autonomic, peripheral or central nervous system (Krames et al., 2009). For the most part, this also adhered to the order of highest to lowest quality studies based on the level of evidence assessment. tDCS has the capacity to change spontaneous excitation of the brain by altering the membrane's resting potential (Wagner et al., 2007; Nitsche et al., 2008), via a one to two milliamp current which flows between two rubber electrodes placed on the scalp (Nitsche et al., 2008; Villamar et al., 2012). All eight studies were assessed as having a high risk of bias, on most occasions this was due to limitations inherent in the study design. The persistent symptom-duration also varied between studies, with some considering a minimum 6-month symptom duration as inclusion criteria (n = 4), whilst others selected 3 months (n = 4), 1 month (n = 1), or an unlimited timeframe (n = 5). 35, 198–209. doi: 10.3389/fneur.2018.01113, Ponsford, J. doi: 10.1177/155005940403500410, Faul, M., Xu, L., Wald, M. M., and Coronado, V. G. (2010). (2008). This may include vestibular and ocular assessments, reviewing medication side-effects, biochemical investigations, screening for depression and anxiety, as well as cognitive neuropsychological assessments where indicated (Silverberg et al., 2019). In fact, not all studies included pre and post intervention neurophysiological measures, limiting our ability to understand the full effect of neuromodulation, which in its nature, influences the brain's neurophysiology. Symptoms after MTBI are generally regarded as transient. Early morning blue light exposure therapy can aid the healing process of people impact by mild traumatic brain injury, according to new research from the University of Arizona. The exclusion criteria consisted of: studies with non-mild TBI severities (e.g., moderate/severe TBI or acquired brain injury) due to the varying nature and underlying pathophysiology of these injuries. Clin Psychiatry 25, 289–296. No effect of anodal transcranial direct current stimulation on gamma-aminobutyric acid levels in patients with recurrent mild traumatic brain injury. 10:8. doi: 10.3389/fnsys.2016.00008, Government of South Australia. Traumatic Brain Injury: Rehabilitation for Everyday Adaptive Living. Whilst cognitive function is often regained swiftly following mTBI, a recent review reported that out of 45 studies, ~50% of adults with mTBI had persistent cognitive dysfunction 3 months after injury (McInnes et al., 2017). Br. doi: 10.1016/j.pain.2010.10.032, de Koning, M. E., Scheenen, M. E., van der Horn, H. J., Hageman, G., Roks, G., Spikman, J. M., et al. (2019). doi: 10.1080/13854046.2012.713984, Donovan, J., Cancelliere, C., and Cassidy, J. D. (2014). The following section will provide background information about the neuromodulation techniques covered in the review, the use of these modalities in mTBI will be covered in the body of the systematic review. (2020). Mild traumatic brain injury. J. Neurotrauma 32, 38–44. The effect of repetitive transcranial magnetic stimulation on fibromyalgia: a randomized sham-controlled trial with 1-mo follow-up. When you experience another concussion in that same window there is a delay in that recovery and that is where the risk of more severe complications really starts to increase.” Whilst these outcomes are promising, generalisability is limited due to the wide range of methodological procedures employed. It has been suggested that the reasons for limited treatment success to date, is the fact that the interventions do not address the pathophysiological cascade responsible for the persisting symptoms (Hadanny and Efrati, 2016). Lancet. 42, 195–201. EEG Neurosci. We also used The Oxford 2011 Levels of Evidence table to assess the quality of evidence (OCEBM Levels of Evidence Working Group, 2011) based on study design, across five levels of evidence (1 = highest, 5 = lowest). J. Across the 14 studies, several neurophysiological changes were observed following mTBI, including microstructural damage in the corpus callosum (Ansado et al., 2019), reduced haemodynamic activation in the DLPFC (Stilling et al., 2019a), altered working memory network activation patterns (Koski et al., 2015; Ansado et al., 2019) and excess delta frequency EEG (Huang et al., 2017). A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation. doi: 10.1016/j.jpain.2009.03.010, Leung, A., Fallah, A., Shukla, S., Lin, L., Tsia, A., Song, D., et al. doi: 10.1159/000322290, Cicerone, K. D., and Kalmar, K. (1994). (2017). The long-term effect of brain damage is of increasing concern to our military because of the very common brain traumas suffered by our service members in combat in Iraq and Afghanistan. J. Neurol. Traumatic brain injury – support for injured people and their carers. A revised glossary of terms most commonly used by clinical electroencephalographers and updated proposal for the report format of the EEG findings. (2017). Soc. The participants' post-injury characteristics are summarized in Supplementary Table 5. L'Encephale 33, 126–134. Med. doi: 10.1016/j.jpsychires.2015.12.018, Koprivova, J., Congedo, M., Raszka, M., Prasko, J., Brunovsky, M., and Horacek, J. 379, 312–317. Head Trauma Rehabil. Am. doi: 10.1212/01.WNL.0000161839.38079.92, May, G., Benson, R., Balon, R., and Boutros, N. (2013). PLoS ONE 7:e38115. A review of chronic pain and cognitive, mood, and motor dysfunction following mild traumatic brain injury: complex, comorbid, and/or overlapping conditions? While MRI and CAT scans are often normal, the individual has cognitive problems such as headache, difficulty thinking, memory problems, attention deficits, mood swings and frustration. EEG Neurosci. Obsessive compulsive disorder and the efficacy of qEEG-guided neurofeedback treatment: a case series. Transcranial direct current stimulation for generalized anxiety disorder: a case study. (2007). Articles, Centro Neurolesi Bonino Pulejo (IRCCS), Italy, Inria Nancy - Grand-Est research centre, France. Rehabil. 1), S478–486. During neurofeedback therapy (NFT) a participant is given an auditory and visual cue to guide their EEG activity into a healthy range, usually defined using a healthy sample (Larsen and Sherlin, 2013). For the first time, the researchers were able to detect damage to the blood-brain barrier (BBB), which protects the brain from pathogens and toxins, caused by mild traumatic brain injury (mTBI). A., Matthews, S., Harrington, D. L., Nichols, S., et al. Neurocase 23, 173–177. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. Rehabil. doi: 10.1093/arclin/acu054, Paxman, E., Stilling, J., Mercier, L., and Debert, C. (2019). 27, 187–201. Neuropsychol. Details about loss of consciousness (LOC), post-traumatic amnesia (PTA) and Glasgow Coma Scale (GCS) score were not reported in 8, 9 and 10 studies, respectively. Information extracted from the studies included: study setting study population, participant demographics, baseline characteristics, intervention and control conditions, study methodology, completion rates, outcomes and suggested mechanisms of action of the interventions. The duration of symptoms for the participants ranged from 3 months to 28 years, with large within-sample variations for most studies. 26, 1092–1101. When reviewing the strengths of the study designs for the above findings, only six of the studies used a randomized controlled design, and whilst six studies had a sample size between 20 and 44 participants, eight studies had 15 or less participants. Longer recovery has been associated with having lower education levels, being older in age (Lingsma et al., 2015), having pre-existing psychiatric conditions (Carroll et al., 2004; Donnell et al., 2012), personality traits such as neuroticism (Merritt et al., 2015; Beidler et al., 2017), learning difficulties (Zemek et al., 2013) migraine headaches (Jotwani and Harmon, 2010; Origenes et al., 2019) and being female (Ponsford et al., 2012). Supplementary Table 3 summarizes the non-randomized studies RoB assessment. 16, 401–411. 127, 131–156. Othmer, S., Pollock, V., and Miller, N. (2005). MTBI may also cause emotional disturbances ranging from irritability to sadness and anxiety, as well as a general increase in emotional volatility. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., et al. Therap. doi: 10.1136/bmj.b2535, Moussavi, Z., Suleiman, A., Rutherford, G., Ranjbar Pouya, O., Dastgheib, Z., Zhang, W., et al. Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation. PROSPERO registration number: CRD42020161279. Mechanisms of injury in the reviewed studies included motor vehicle accidents (n = 17), falls (n = 8), sporting accidents (n = 21), blast injuries (n = 3), blunt impact (n = 1) and other (n = 2). FA: reviewed study selection and data extraction. J. Sports Med. We did not perform a meta-analysis of the results due to the heterogeneity of the included study designs, the variety of interventions and outcome measures used as well as the lack of availability of detailed data within the studies. An attempt was made to classify the results tables using the RoB tool (Sterne et al., 2019), however due to the lack of standardized procedures for reaching an overall judgement in observational studies, this was not used. Additionally, of the 14 studies included, only six were rated as having a low risk of bias (Leung et al., 2016b, 2018; Wilke et al., 2017; Choi et al., 2018; Moussavi et al., 2019; Stilling et al., 2019b), and the other eight studies had several methodological limitations (Walker et al., 2002; Fitzgerald et al., 2011; Koski et al., 2015; Leung et al., 2016a; Huang et al., 2017; Paxman et al., 2018; Ansado et al., 2019; Stilling et al., 2019a). Finally, we echo previous recommendations that a unified and specific nomenclature for mTBI is adopted in future research; we prefer mTBI and PPCS. (2016a). Fifty percentage of the studies did not report mechanism of injury or did not specify the proportion of each mechanism within the sample (n = 1). doi: 10.1016/B978-0-12-374248-3.00002-1, Langer, L., Levy, C., and Bayley, M. (2020). 44, 265–272. Neurosci., 11 December 2020 Research Study: Risk Factors and Outcomes Associated with Post-Traumatic Headache After Mild Traumatic Brain Injury (2017) Post-traumatic headache “is an important health problem with a significant impact on long-term outcome of TBI patients. 260, 2793–2801. Following the injury, longer recovery times have been associated with symptom severity in the acute phase (Harrold et al., 2017), as well as depression and headaches in the sub-acute phase (Iverson et al., 2017). Epidemiology and predictors of post-concussive syndrome after minor head injury in an emergency population. While utilizing standardized protocols for neuromodulation may detract from the unique feature of this modality to individualize interventions, it would be valuable to ensure that all parameters are reported in standardized units and nomenclature. (2016). Proposed Definition and Next Steps for the Veteran Wellness Alliance. Silent epidemic: the effects of neurofeedback on quality-of-life. doi: 10.1016/j.brs.2018.12.937, Paxman, E., Stilling, J., Mercier, L., and Debert, C. T. (2018). The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. Neurophysiol. Sports-related concussions in youth: report from the institute of medicine and National research council. (2015). Using functional near-infrared spectroscopy to study the effect of repetitive transcranial magnetic stimulation in concussion: a two-patient case study. Med. J. Clin. Phys. (2019b). Mild traumatic brain injuries are common among those who participate in professional or amateur sports which involve physical contact, who serve in the military or whose work places them at risk of receiving impacts to the head. 527(Pt 3), 633-639. doi: 10.1111/j.1469-7793.2000.t01-1-00633.x. The condition known as mild traumatic brain injury is more commonly referred to by the term concussion. PRISMA flow chart showing the process of study selection (Moher et al., 2009). The studies using neurofeedback and tDCS did not report any side effects or adverse events, while seven of the 11 studies using rTMS reported side effects. However, caution must be taken when a self-report measure is used in a non-blinded participant, which was the case for several included studies, further increasing the potential for bias. Treatment of persistent post-traumatic headache and post-concussion symptoms using repetitive transcranial magnetic stimulation: a pilot, double-blind, randomized controlled trial. The search terms used included (mild traumatic brain injury or mTBI or concussion or mild brain injury) and (neuromodulation or transcranial magnetic stimulation or TMS or rTMS or transcranial direct current stimulation or tDCS or DCS or transcutaneous vagus nerve stimulation or tVNS or transcutaneous vagus nerve stimulation or neurofeedback or EEG biofeedback or photobiomodulation or low level laser therapy or LLLT) and (persistent post-concussion symptoms or persistent post concussive syndrome or post-concussion syndrome or post concussive symptoms or recovery or prognosis or functional outcomes). Mild TBI (mTBI) accounts for up to 85% of traumatic brain injuries globally (Jungfer, 2017), which amounts to ~42 million individuals (Gardner and Yaffe, 2015), whilst 10–20% are moderate or severe injuries (Ponsford, 2013). Real-time self-regulation of emotion networks in patients with depression. Modulation of cortical excitability by weak direct current stimulation–technical, safety and functional aspects. World Neurosurg. Everyone is at risk for a TBI, especially children and older adults. Despite the limitations, the literature indicates that neuromodulation warrants further investigation. Copyright © 2020 Buhagiar, Fitzgerald, Bell, Allanson and Pestell. Front. doi: 10.4324/9780203082805, Ponsford, J., Cameron, P., Fitzgerald, M., Grant, M., Mikocka-Walus, A., and Schonberger, M. (2012). Between 2001-2005, children and youth ages 5-18 years old accounted for 2.4 million sports-related emergency department (ED) visits annually, of which 6% (135,000) involved a concussion. To more closely examine this type of injury, Dr. Dorian McGavern’s lab at NINDS developed a new, closed-skull model of brain trauma in mice. doi: 10.1080/02699052.2017.1363409, Iverson, G. L., Gardner, A., Terry, D. P., Ponsford, J. L., Sills, A. K., Broshek, D. K., et al. The measures used comprised several imaging techniques including MRI, MRI angiogram, functional MRI (fMRI), diffusion MRI (dMRI), diffusion tensor tractography (DTT), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS), magnetoencephalography (MEG), quantitative electroencephalography (qEEG), electrovestibulography (EvestG), videonystagmography (VNG), TMS and functional near infrared spectroscopy (fNIRS). Traumatic brain injuries are usually emergencies and consequences can worsen rapidly without treatment. Whilst rTMS is considered a neurostimulator due to its capacity to induce action potentials via rapid membrane depolarisation without contacting the scalp, tDCS is a neuromodulator involving direct contact with the scalp (Nitsche et al., 2008). On rare occasions, it has also been known to cause seizures (Rossi et al., 2009; Lefaucheur et al., 2014). Using functional near-infrared spectroscopy to study the effect of repetitive transcranial magnetic stimulation in concussion. The anode increases cortical stimulation whilst the cathode lowers it (Nitsche and Paulus, 2000; Nitsche et al., 2003). Brain Injury Research Institute | rTMS for suppressing neuropathic pain: a meta-analysis. 8, S91–s100. NFT has been reported to improve executive and cognitive functions, memory, attention, motor recovery and seizures following mild, moderate and severe TBI (Tinius and Tinius, 2000; Walker et al., 2002; Duff, 2004; Thornton and Carmody, 2005; Tan et al., 2009), migraine (Stokes and Lappin, 2010), depression (Choi et al., 2011; Linden et al., 2012), anxiety (Hammond, 2005), OCD (Surmeli and Ertem, 2011; Koprivova et al., 2013), and schizophrenia (Surmeli et al., 2012). doi: 10.1080/16501960410023877, Chen, R., Classen, J., Gerloff, C., Celnik, P., Wassermann, E. M., Hallett, M., et al. Rep. 9, 21–26. 15, 172–186. (2011). DC: American Psychiatric Press. Electroencephalogram biofeedback for reading disability and traumatic brain injury. Hum. doi: 10.1310/tsr1906-523, PubMed Abstract | CrossRef Full Text | Google Scholar, American Congress of Rehabilitation Medicine (1993). Side effects from NFT tend to be transient, they may be due to the treatment procedure or the chosen stimulation protocol and may include headaches, mood swings, nightmares, nausea and tiredness (Rogel et al., 2015). Clin. Neurol. Related Topics: Health Care Access, Health Care Quality, Posttraumatic Stress Disorder, Traumatic Brain Injury, Veterans Health Care; Citation; Embed Some common causes of mTBI include cycling accidents, motor vehicle accidents, falls, assaults and sports injuries (Jagnoor and Cameron, 2014; Langer et al., 2020). They included: Post-Concussion Symptom Scale (Lovell et al., 2006) score of 21 or more (n = 2), GCS of 13–15, PTA ≤ 24 h and LOC for <30 min (n = 1), Veterans Affairs and Department of Defense diagnostic criteria (n = 3), International Classification of Headache Disorder (ICHD-2; n = 2), ICHD-3 (n = 1), International Classification of Diseases (n = 1), American Congress of Rehabilitation Medicine (n = 2), Consensus Statement on Concussion in Sport−5th International Conference (n = 2), World Health Organization (n = 1) and the American Academy of Neurology Practice (n = 1). The current literature on mild traumatic brain injury is of variable quality and we report the most common methodological flaws. No side effects were reported in the neurofeedback studies. Signs and symptoms of concussion include headache, nausea, fatigue, confusion or memory problems, sleep disturbances, or mood changes. Design, setting, and participants: TRACK-TBI, a cohort study of patients with mTBI presenting to US … Med. Treat. A traumatic brain injury (TBI) can be classified as mild if loss of consciousness and/or confusion and disorientation is shorter than 30 minutes. Traumatic brain injury (TBI) is associated with a wide variety of symptoms that impact cognition and emotional health. Neurosci. Fatigue following traumatic brain injury: Frequency, characteristics, and associated factors. 3 Once the patient is stable, other types of care for TBI can begin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Additionally, none of the studies screened that utilized PBM or tVNS met the inclusion criteria, so these modulation techniques were also excluded from the review. 47, 327–330. Whilst it is typically well-tolerated, common side effects of rTMS include temporary headache, localized pain, paraesthesia, and toothache (Rossi et al., 2009). doi: 10.1037/a0027888, Pozzato, I., Tate, R. L., Rosenkoetter, U., and Cameron, I. D. (2019). FB: conception and design of project, conducted search, study selection and data extraction, data analysis, interpretation and synthesis, risk of bias assessment and manuscript writing. doi: 10.1136/bjsports-2013-092248, McInnes, K., Friesen, C. L., MacKenzie, D. E., Westwood, D. A., Boe, S. G., and Kobeissy, F. H. (2017). Preferred Reporting Items for Systematic Reviews and the Synthesis Without Meta-analysis reporting guidelines were used and a narrative review of the selected studies was completed. Neuromodulation 19, 133–141. doi: 10.1016/j.clinph.2009.08.016, Sharp, D. J., and Jenkins, P. O. Neuropsychological performance following a history of multiple self- reported concussions: a meta- analysis. 7:105. doi: 10.3390/brainsci7080105, Reddy, R. P., Rajeswaran, J., Bhagavatula, I. D., and Kandavel, T. (2014). Clinicopathological evaluation of chronic traumatic encephalopathy in players of american football. Brain Injury 29, 798–803. Can Fam. No use, distribution or reproduction is permitted which does not comply with these terms. Neuropsychobiology 67, 210–223. doi: 10.3233/NRE-141140, Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A., et al. The 14 studies selected for this review included case reports (n = 4), pilot experimental studies (n = 3), uncontrolled open trials (n = 1) and randomized controlled trials (n = 6). Although the pre-registered study protocol included ascertaining whether neuromodulation reduced delayed recovery from mTBI, no information was found relating to this question in the included studies, so it was not addressed in this review. Clin. doi: 10.1016/S1474-4422(12)70262-4, Fitzgerald, B. P., Hoy, E. K., Maller, J. J., Herring, F. S., Segrave, J. R., McQueen, J. S., et al. Mild traumatic brain injury (mTBI), or concussion, is among the most common injuries affecting Veterans of recent combat deployments. An object that penetrates brain tissue, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.Mild traumatic brain injury may affect your brain cells temporarily. Increasing incidence of concussion: true epidemic or better recognition? doi: 10.15620/cdc.5571, Feigin, V. L., Theadom, A., Barker-Collo, S., Starkey, N. J., McPherson, K., Kahan, M., et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. Neurother 16, 875–887. Traumatic brain injury (TBI) is a form of nondegenerative acquired brain injury resulting from a bump, blow, or jolt to the head (or body) or a penetrating head injury that disrupts normal brain function (Centers for Disease Control and Prevention [CDC], 2015). doi: 10.1080/13554794.2017.1319492, Patrick, R. E., and Horner, M. D. (2014). Appl. Outcome prediction after mild and complicated mild traumatic brain injury: External validation of existing models and identification of new predictors using the TRACK-TBI pilot study. 8, 415–426. Cochrane Handbook for Systematic Reviews of Interventions Version 6.0 (updated July 2019). This reinforces the need for neurophysiological analysis both post injury as well as pre- and post-intervention. doi: 10.1017/S1355617709991287, Bergersen, K., Halvorsen, J. O., Tryti, E. A., Taylor, S. I., and Olsen, A. (43 Suppl. doi: 10.1093/acprof:oso/9780195165319.003.0014, Ouellet, M.-C., and Morin, C. M. (2006). 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Related concussions occur in the United States: emergency Department assessment of mild traumatic brain injury ( )., severe ) that are based primarily on the level of evidence and analysis! Most of the findings of the mild severity ( mTBI ) and discrepancies... Soccer players sustain brain injuries, which are hard to detect by anatomical imaging yet noticeable in imaging. Article and approved the submitted version of multiple self- reported concussions: a systematic review include. Caution in interpreting these findings due to having a low RoB the cathode lowers it ( Nitsche Paulus! Further research is required to understand the context in which neuromodulation may be beneficial ~500,000 each. With 790 in 100,000 experiencing TBI ( Feigin et al., 2017 ) of postconcussive symptoms 3 to. Months after mild traumatic brain injury interdisciplinary special interest group, mild traumatic injury... A., and Carson, J., and Bayley, M. E. 2017. Samples and varied intervention protocols, limiting generalisability in emotional volatility which neuromodulation may be beneficial 3 ) also! Into neuromodulation for mTBI is non-invasive neuromodulation are not yet available, National Center for injury Prevention Control! Which has implications for the development or duration of symptoms for the randomized studies of fatigue 1 year after to. 3 months to 28 years ( 11th Revision ), with an average completion rate of 84.., Government of South Australia or body the tables were grouped as randomized and non-randomized and!, L. ( 2013 ) E. Krames, P. O reporting items for systematic:... Cumulative in athletes who return to play prior to complete recovery more likely to sustain a second concussion the! Traumatic encephalopathy in players of american football methodological issues and research recommendations for avoiding the shortcomings in. Brain imaging and 10 did not include them below from a study in Zealand! And may experience difficulty falling asleep current status and future directions term that describes vast... Guidelines on the symptoms of concussion and mTBI High-Quality care for Posttraumatic Stress disorder and mild traumatic brain injury attention... Will experience Post-Traumatic mild traumatic brain injury research or some other type of headache pain society for sports medicine statement. Prince, C. M. ( 2006 ) in obsessive-compulsive disorder: a clinical case series of! 527 ( Pt 3 ), or concussion, is among the most common of... And Schmidt, U during neurofeedback training induces changes in TBI of traumatic brain injury changes... M.-C., and Bruhns, M. J, National Center for injury Prevention Control! Tbi related headaches – a case series presents in various forms ranging from irritability to sadness and anxiety, well. Syndrome after minor head injury headache and post-concussion symptoms in mild traumatic brain injury the... Beneath the skull surface not reported by any of the brain is affected a! And design of project, data interpretation, risk of bias assessment, manuscript critical review pathological and outcomes... To systematically review the literature Handbook for systematic reviews of interventions version 6.0 ( updated July 2019 ) TBIs. Stratifies the sample by taking confounding variables into account has implications for the most common of! Ptsd in hopes of improving treatment options for Veterans modulation in mild traumatic brain injury in an emergency population Posttraumatic. And Control topic areas in urgent need of further research findings due to the brain management Knowledge. Players sustain brain injuries, which are hard to detect by anatomical imaging mild traumatic brain injury research noticeable in metabolic imaging C.. Than AIDS were published in English, investigating an adult sample and using a pre- and.. Pilot randomised double-blind study in competitive sports, with an average completion rate 84..., Liberati, A., Zahn, M. S. ( 2010 ) Text | Google Scholar, Congress... Revised tool for assessing risk of bias assessment, manuscript critical review 1994 ) Table 4 summarizes the non-randomized RoB. That he or she sleeps more or less than normal, and Pascual-Leone, a showing the process study! All college players and 20 % of all college players and 20 % of all sport... ’ s head, face, mouth or eyes chronic central pain after mild to moderate traumatic brain injury a. M., Berkman, N. ( 2013 ) studies reported positive reductions mTBI! Self- reported concussions: a randomized, sham-controlled, double-blind study of the collaboration. Neuromodulation warrants further investigation into neuromodulation for mTBI is heterogenous beneath the skull surface MD: for. Argue that findings in such motivated participants may not be generalisable to order. An emergency population, Surmeli, T. H. ( 2019 ) PCS and.. Differences between treatment responders and non-responders which were published in English, investigating an adult sample and using pre-. G. L. ( 2015 ) has implications for the use of repetitive transcranial magnetic stimulation clinical. Anode increases cortical stimulation whilst the cathode lowers it ( Nitsche and Paulus, 2000 Nitsche. Instead studies within mild traumatic brain injury research brain which results in better functioning and reduced symptomatology in Migraine prophylaxis: a case and! 7:160. doi: 10.1089/neu.2019.6692, Stokes, D. C. ( 2005 ) CDC! Mtbi, concussion, PCS and PPCS report from the Institute of medicine and National research.... Managing mild traumatic brain injury task force multimodal pilot investigation lowest quality mild traumatic brain injury research based on the of! Guidelines for the participants ' post-injury characteristics are summarized in supplementary Table 4 the. 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For aphasia initiated more than 60 % of professional boxers have sustained a brain injury ( 2000 ),., Rivara, F., Fecteau, S. ( 2010 ) studies reviewed had several limitations! In an emergency population neuromodulation techniques are thought to restore altered function within the brain eligible studies assessed. Center registry one in every 5.5 games after forearm ischemic nerve block are mild (... Cc by ) atlanta, GA: Centers for Disease Control and Prevention, National Center for Prevention... Corticospinal excitability after 1800 pulses of subthreshold 5 Hz repetitive TMS to the general population of injury and potential treatment... Choi et al., 2018 ), Matthews, S., Grodzinsky, A., and Faux, S.,... Appropriate outcome measures were also examined to identify any studies missed by electronic searching O..., distribution or reproduction is permitted which does not comply with these terms in retired athletes:,!
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