Rehab Centers: Examining the Neural Impact of Pediatric Concussion: A Scoping Review of Multimodal and Integrative Approaches Using Functional and Structural MRI Techniques.

Examining the neural impact of pediatric concussion: a scoping review of multimodal and integrative approaches using functional and structural MRI techniques.

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Curr Opin Pediatr. 2012 Oct 17;
Keightley ML, Chen JK, Ptito A

PURPOSE OF REVIEW: This study presents the findings from a scoping review of recent, original research investigating changes in brain structure and/or function following pediatric concussion or mild traumatic brain injury (mTBI) using MRI and functional MRI techniques. RECENT FINDINGS: Our scoping review identified only five studies, two of which were focused specifically on sports-related concussion. A common finding across studies was that traditional structural methods such as anatomical T1, T2, and even susceptibility-weighted MRI failed to reveal abnormalities in brain structure following pediatric concussion/mTBI. Although data suggest alterations in brain function associated with concussion, correlation with changes in performance is inconsistently found, possibly because of the use of compensatory cerebral mechanisms or alternate pathways while the brain is still dysfunctional. SUMMARY: In conclusion, the literature describing neuroimaging investigations of pediatric concussion is too scarce to allow the formulation of definitive conclusions regarding the impact of concussion on the developing brain. There is a dire need for longitudinal, multisite investigations focused on a wider age range and recovery period.
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Weak detrusor contractility correlates with motor disorders in Parkinson’s disease.

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Mov Disord. 2012 Oct 18;
Terayama K, Sakakibara R, Ogawa A, Haruta H, Akiba T, Nagao T, Takahashi O, Sugiyama M, Tateno A, Tateno F, Yano M, Kishi M, Tsuyusaki Y, Uchiyama T, Yamamoto T

Limited attention has been paid to the relationship between urinary symptoms or urodynamic findings and motor disorders in Parkinson’s disease (PD). We aimed to correlate pressure-flow urodynamic parameters with video-gait analysis parameters in PD. We recruited 41 patients with PD (25 men and 16 women; age, 70.6 ± 8.5 years; H & Y motor grading: 2 [range, 1-3]; disease duration: 4 years [range, 1-7]; taking levodopa 300 mg/day [range, 100-400]). All patients underwent pressure-flow urodynamics (parameters: first sensation, bladder capacity, detrusor overactivity [noted in 24 patients], and Watts factor [WF]) and video-gait analysis (parameters: time and number of strides for 5-m gait [simple task] and time for timed up and go [complex task]). Statistical analysis was made by Mann-Whitney’s U-test for analyzing the relation between detrusor overactivity and gait as well as Spearman’s rank-correlation coefficient test for analyzing the relation between the remaining parameters and gait. We found no relation between filling-phase urodynamics (detrusor overactivity, first sensation, and bladder capacity) and video-gait analysis parameters. By contrast, we found a significant relation between voiding-phase urodynamics (WF, reflecting detrusor power) and all three video-gait analysis parameters (reflecting lower-half bradykinesia and loss of postural reflex) in our PD patients (P < 0.01). The close relation between the WF and motor disorders in the present study suggests that, though clinically mild, a weak detrusor in PD might have a central origin. We should follow postvoid residual volume carefully in PD patients with advanced gait disorder, because postvoid residual volume might increase in such patients. © 2012 Movement Disorder Society. HubMed – rehab


December 3-international day of persons with disabilities: an opportunity to advocate for equal opportunities.

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Am J Phys Med Rehabil. 2012 Nov; 91(11): 999-1001
Delisa JA

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