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Consensus statement for the management of incidentally found brain white matter hyperintensities in general medical practice
Med J Aust. 2023 Aug 21. doi: 10.5694/mja2.52079. Online ahead of print.ABSTRACTINTRODUCTION: There is a paradigm shift in our understanding of white matter hyperintensities (WMH) found on brain imaging. They were once thought to be a normal phenomenon of ageing and, therefore, warranted no further investigation. However, evidence now suggests these lesions are markers of poor brain and cardiovascular health, portending an increased risk of stroke, cognitive decline, depression and death. Nevertheless, no specific guidelines exist for the management of incidentally found WMH for general medical practitioners and other clin...
Source: Medical Journal of Australia - August 21, 2023 Category: General Medicine Authors: Thomas P Ottavi Elizabeth Pepper Grant Bateman Mark Fiorentino Amy Brodtmann Source Type: research

Harnessing the Four Elements for Mental Health
DiscussionAs detailed above, the “elements” in both a classical and a contemporary sense have effects on our mental health and are potentially modifiable aspects that can be harnessed as therapeutic interventions. The most robust interventional evidence currently available shows tentative support for several use of the elements via horticultural and nature-exposure therapy, green exercise/physical activity, sauna and heat therapy, balneotherapy, and breathing exercises. It should be noted that, in many cases, these interventions were not studied in definitive diagnosed psychiatric disorders and thus it is pre...
Source: Frontiers in Psychiatry - April 23, 2019 Category: Psychiatry Source Type: research

The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents
Conclusion This study found that the ΔHR (HRt minus resting HR) correlated with duration of clinical recovery in participants who were prescribed relative rest or a placebo-stretching program but not for participants prescribed sub-threshold aerobic exercise. A ΔHR of ≤50 bpm on the BCTT was 73% sensitive and 78% specific for predicting delayed recovery in concussed adolescents prescribed the current standard of care (i.e., cognitive and physical rest). This has implications for planning team and school activities in adolescents who sustain SRC. Ethics Statement This study was carried out in acco...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

The Young Male Syndrome —An Analysis of Sex, Age, Risk Taking and Mortality in Patients With Severe Traumatic Brain Injuries
Conclusion The willingness of young males to engage in dangerous situations might be adaptive in terms of fitness maximization. Nonetheless, for some individuals this intense sexual competition can be detrimental to health. The correspondence between the age distribution of the reproductively most active population and those suffering sTBI only partially supports the evolutionary hypothesis about risk-taking behavior. The prevalence of higher external mortality rates of young males, on the other hand, was not present in our data at all, nor did we find any support for the assumption that sTBI acquired from riskier behavio...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Pre-injury Comorbidities Are Associated With Functional Impairment and Post-concussive Symptoms at 3- and 6-Months After Mild Traumatic Brain Injury: A TRACK-TBI Study
Conclusions: Pre-injury psychiatric and pre-injury headache/migraine symptoms are risk factors for worse functional and post-concussive outcomes at 3- and 6-months post-mTBI. mTBI patients presenting to acute care should be evaluated for psychiatric and headache/migraine history, with lower thresholds for providing TBI education/resources, surveillance, and follow-up/referrals. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01565551. Introduction Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality worldwide. In 2013 ~2.8 million TBI cases were recorded an...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Modafinil for the Improvement of Patient Outcomes Following Traumatic Brain Injury
Conclusion. Modafinil is a central nervous system stimulant with well-established effectiveness in the treatment of narcolepsy and shift-work sleep disorder. There is conflicting evidence about the benefits of modafinil in the treatment of fatigue and EDS secondary to TBI. One randomized, controlled study states that modafinil does not significantly improve patient wakefulness, while another concludes that modafinil corrects EDS but not fatigue. An observational study provides evidence that modafinil increases alertness in fatigued patients with past medical history of brainstem diencephalic stroke or multiple sclerosis. ...
Source: Innovations in Clinical Neuroscience - April 1, 2018 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Review excessive daytime sleep fatigue head injury modafinil stroke TBI traumatic brain injury Source Type: research