Comprehensive Evaluation of Healthy Volunteers Using Multi-Modality Brain Injury Assessments: An Exploratory, Observational Study.
Identifieur interne : 000290 ( Main/Corpus ); précédent : 000289; suivant : 000291Comprehensive Evaluation of Healthy Volunteers Using Multi-Modality Brain Injury Assessments: An Exploratory, Observational Study.
Auteurs : Lindell K. Weaver ; Steffanie H. Wilson ; Anne S. Lindblad ; Susan Churchill ; Kayla Deru ; Robert Price ; Christopher S. Williams ; William W. Orrison ; Jigar B. Patel ; James M. Walker ; Anna Meehan ; Susan MirowSource :
- Frontiers in neurology [ 1664-2295 ] ; 2018.
Abstract
Introduction: Even though mild traumatic brain injury is common and can result in persistent symptoms, traditional measurement tools can be insensitive in detecting functional deficits after injury. Some newer assessments do not have well-established norms, and little is known about how these measures perform over time or how cross-domain assessments correlate with one another. We conducted an exploratory study to measure the distribution, stability, and correlation of results from assessments used in mild traumatic brain injury in healthy, community-dwelling adults. Materials and Methods: In this prospective cohort study, healthy adult men and women without a history of brain injury underwent a comprehensive brain injury evaluation that included self-report questionnaires and neurological, electroencephalography, sleep, audiology/vestibular, autonomic, visual, neuroimaging, and laboratory testing. Most testing was performed at 3 intervals over 6 months. Results: The study enrolled 83 participants, and 75 were included in the primary analysis. Mean age was 38 years, 58 were male, and 53 were civilians. Participants did not endorse symptoms of post-concussive syndrome, PTSD, or depression. Abnormal neurological examination findings were rare, and 6 had generalized slowing on electroencephalography. Actigraphy and sleep diary showed good sleep maintenance efficiency, but 21 reported poor sleep quality. Heart rate variability was most stable over time in the sleep segment. Dynavision performance was normal, but 41 participants had abnormal ocular torsion. On eye tracking, circular, horizontal ramp, and reading tasks were more likely to be abnormal than other tasks. Most participants had normal hearing, videonystagmography, and rotational chair testing, but computerized dynamic posturography was abnormal in up to 21% of participants. Twenty-two participants had greater than expected white matter changes for age by MRI. Most abnormal findings were dispersed across the population, though a few participants had clusters of abnormalities. Conclusions: Despite our efforts to enroll normal, healthy volunteers, abnormalities on some measures were surprisingly common. Trial Registration: This study was registered at www.clinicaltrials.gov, trial identifier NCT01925963.
DOI: 10.3389/fneur.2018.01030
PubMed: 30631299
PubMed Central: PMC6315163
Links to Exploration step
pubmed:30631299Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comprehensive Evaluation of Healthy Volunteers Using Multi-Modality Brain Injury Assessments: An Exploratory, Observational Study.</title><author><name sortKey="Weaver, Lindell K" sort="Weaver, Lindell K" uniqKey="Weaver L" first="Lindell K" last="Weaver">Lindell K. Weaver</name><affiliation><nlm:affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Wilson, Steffanie H" sort="Wilson, Steffanie H" uniqKey="Wilson S" first="Steffanie H" last="Wilson">Steffanie H. Wilson</name><affiliation><nlm:affiliation>The Emmes Corporation, Rockville, MD, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Lindblad, Anne S" sort="Lindblad, Anne S" uniqKey="Lindblad A" first="Anne S" last="Lindblad">Anne S. Lindblad</name><affiliation><nlm:affiliation>The Emmes Corporation, Rockville, MD, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Churchill, Susan" sort="Churchill, Susan" uniqKey="Churchill S" first="Susan" last="Churchill">Susan Churchill</name><affiliation><nlm:affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Deru, Kayla" sort="Deru, Kayla" uniqKey="Deru K" first="Kayla" last="Deru">Kayla Deru</name><affiliation><nlm:affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Price, Robert" sort="Price, Robert" uniqKey="Price R" first="Robert" last="Price">Robert Price</name><affiliation><nlm:affiliation>Evans Army Community Hospital, Fort Carson, CO, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Williams, Christopher S" sort="Williams, Christopher S" uniqKey="Williams C" first="Christopher S" last="Williams">Christopher S. Williams</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Orrison, William W" sort="Orrison, William W" uniqKey="Orrison W" first="William W" last="Orrison">William W. Orrison</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Jigar B" sort="Patel, Jigar B" uniqKey="Patel J" first="Jigar B" last="Patel">Jigar B. Patel</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Walker, James M" sort="Walker, James M" uniqKey="Walker J" first="James M" last="Walker">James M. 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Weaver</name><affiliation><nlm:affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Wilson, Steffanie H" sort="Wilson, Steffanie H" uniqKey="Wilson S" first="Steffanie H" last="Wilson">Steffanie H. Wilson</name><affiliation><nlm:affiliation>The Emmes Corporation, Rockville, MD, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Lindblad, Anne S" sort="Lindblad, Anne S" uniqKey="Lindblad A" first="Anne S" last="Lindblad">Anne S. Lindblad</name><affiliation><nlm:affiliation>The Emmes Corporation, Rockville, MD, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Churchill, Susan" sort="Churchill, Susan" uniqKey="Churchill S" first="Susan" last="Churchill">Susan Churchill</name><affiliation><nlm:affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Deru, Kayla" sort="Deru, Kayla" uniqKey="Deru K" first="Kayla" last="Deru">Kayla Deru</name><affiliation><nlm:affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Price, Robert" sort="Price, Robert" uniqKey="Price R" first="Robert" last="Price">Robert Price</name><affiliation><nlm:affiliation>Evans Army Community Hospital, Fort Carson, CO, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Williams, Christopher S" sort="Williams, Christopher S" uniqKey="Williams C" first="Christopher S" last="Williams">Christopher S. Williams</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Orrison, William W" sort="Orrison, William W" uniqKey="Orrison W" first="William W" last="Orrison">William W. Orrison</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Jigar B" sort="Patel, Jigar B" uniqKey="Patel J" first="Jigar B" last="Patel">Jigar B. Patel</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Walker, James M" sort="Walker, James M" uniqKey="Walker J" first="James M" last="Walker">James M. Walker</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Meehan, Anna" sort="Meehan, Anna" uniqKey="Meehan A" first="Anna" last="Meehan">Anna Meehan</name><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Mirow, Susan" sort="Mirow, Susan" uniqKey="Mirow S" first="Susan" last="Mirow">Susan Mirow</name><affiliation><nlm:affiliation>Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Frontiers in neurology</title><idno type="ISSN">1664-2295</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Introduction:</b> Even though mild traumatic brain injury is common and can result in persistent symptoms, traditional measurement tools can be insensitive in detecting functional deficits after injury. Some newer assessments do not have well-established norms, and little is known about how these measures perform over time or how cross-domain assessments correlate with one another. We conducted an exploratory study to measure the distribution, stability, and correlation of results from assessments used in mild traumatic brain injury in healthy, community-dwelling adults. <b>Materials and Methods:</b> In this prospective cohort study, healthy adult men and women without a history of brain injury underwent a comprehensive brain injury evaluation that included self-report questionnaires and neurological, electroencephalography, sleep, audiology/vestibular, autonomic, visual, neuroimaging, and laboratory testing. Most testing was performed at 3 intervals over 6 months. <b>Results:</b> The study enrolled 83 participants, and 75 were included in the primary analysis. Mean age was 38 years, 58 were male, and 53 were civilians. Participants did not endorse symptoms of post-concussive syndrome, PTSD, or depression. Abnormal neurological examination findings were rare, and 6 had generalized slowing on electroencephalography. Actigraphy and sleep diary showed good sleep maintenance efficiency, but 21 reported poor sleep quality. Heart rate variability was most stable over time in the sleep segment. Dynavision performance was normal, but 41 participants had abnormal ocular torsion. On eye tracking, circular, horizontal ramp, and reading tasks were more likely to be abnormal than other tasks. Most participants had normal hearing, videonystagmography, and rotational chair testing, but computerized dynamic posturography was abnormal in up to 21% of participants. Twenty-two participants had greater than expected white matter changes for age by MRI. Most abnormal findings were dispersed across the population, though a few participants had clusters of abnormalities. <b>Conclusions:</b> Despite our efforts to enroll normal, healthy volunteers, abnormalities on some measures were surprisingly common. <b>Trial Registration:</b> This study was registered at www.clinicaltrials.gov, trial identifier NCT01925963.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">30631299</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>01</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1664-2295</ISSN><JournalIssue CitedMedium="Print"><Volume>9</Volume><PubDate><Year>2018</Year></PubDate></JournalIssue><Title>Frontiers in neurology</Title><ISOAbbreviation>Front Neurol</ISOAbbreviation></Journal><ArticleTitle>Comprehensive Evaluation of Healthy Volunteers Using Multi-Modality Brain Injury Assessments: An Exploratory, Observational Study.</ArticleTitle><Pagination><MedlinePgn>1030</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fneur.2018.01030</ELocationID><Abstract><AbstractText><b>Introduction:</b> Even though mild traumatic brain injury is common and can result in persistent symptoms, traditional measurement tools can be insensitive in detecting functional deficits after injury. Some newer assessments do not have well-established norms, and little is known about how these measures perform over time or how cross-domain assessments correlate with one another. We conducted an exploratory study to measure the distribution, stability, and correlation of results from assessments used in mild traumatic brain injury in healthy, community-dwelling adults. <b>Materials and Methods:</b> In this prospective cohort study, healthy adult men and women without a history of brain injury underwent a comprehensive brain injury evaluation that included self-report questionnaires and neurological, electroencephalography, sleep, audiology/vestibular, autonomic, visual, neuroimaging, and laboratory testing. Most testing was performed at 3 intervals over 6 months. <b>Results:</b> The study enrolled 83 participants, and 75 were included in the primary analysis. Mean age was 38 years, 58 were male, and 53 were civilians. Participants did not endorse symptoms of post-concussive syndrome, PTSD, or depression. Abnormal neurological examination findings were rare, and 6 had generalized slowing on electroencephalography. Actigraphy and sleep diary showed good sleep maintenance efficiency, but 21 reported poor sleep quality. Heart rate variability was most stable over time in the sleep segment. Dynavision performance was normal, but 41 participants had abnormal ocular torsion. On eye tracking, circular, horizontal ramp, and reading tasks were more likely to be abnormal than other tasks. Most participants had normal hearing, videonystagmography, and rotational chair testing, but computerized dynamic posturography was abnormal in up to 21% of participants. Twenty-two participants had greater than expected white matter changes for age by MRI. Most abnormal findings were dispersed across the population, though a few participants had clusters of abnormalities. <b>Conclusions:</b> Despite our efforts to enroll normal, healthy volunteers, abnormalities on some measures were surprisingly common. <b>Trial Registration:</b> This study was registered at www.clinicaltrials.gov, trial identifier NCT01925963.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Weaver</LastName><ForeName>Lindell K</ForeName><Initials>LK</Initials><AffiliationInfo><Affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilson</LastName><ForeName>Steffanie H</ForeName><Initials>SH</Initials><AffiliationInfo><Affiliation>The Emmes Corporation, Rockville, MD, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lindblad</LastName><ForeName>Anne S</ForeName><Initials>AS</Initials><AffiliationInfo><Affiliation>The Emmes Corporation, Rockville, MD, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Churchill</LastName><ForeName>Susan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Deru</LastName><ForeName>Kayla</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Division of Hyperbaric Medicine Intermountain Medical Center, Murray, UT, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Intermountain LDS Hospital, Salt Lake City, UT, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Price</LastName><ForeName>Robert</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Evans Army Community Hospital, Fort Carson, CO, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Williams</LastName><ForeName>Christopher S</ForeName><Initials>CS</Initials><AffiliationInfo><Affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Orrison</LastName><ForeName>William W</ForeName><Initials>WW</Initials><AffiliationInfo><Affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Jigar B</ForeName><Initials>JB</Initials><AffiliationInfo><Affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walker</LastName><ForeName>James M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Meehan</LastName><ForeName>Anna</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mirow</LastName><ForeName>Susan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Lovelace Biomedical Research, Albuquerque, NM, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>NORMAL Study Team</CollectiveName></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT01925963</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>12</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Front Neurol</MedlineTA><NlmUniqueID>101546899</NlmUniqueID><ISSNLinking>1664-2295</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">brain imaging</Keyword><Keyword MajorTopicYN="N">healthy volunteers</Keyword><Keyword MajorTopicYN="N">mild traumatic brain injury</Keyword><Keyword MajorTopicYN="N">neuroepidemiology</Keyword><Keyword MajorTopicYN="N">neurological evaluation</Keyword><Keyword MajorTopicYN="N">white matter hyperintensities</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>08</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>11</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>1</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>1</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>1</Month><Day>12</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30631299</ArticleId><ArticleId IdType="doi">10.3389/fneur.2018.01030</ArticleId><ArticleId 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