Neary J Patrick, Singh Jyotpal, Bishop Scott A, Dech Ryan T, Butz Matthew J A, Len Trevor K
Faculty of Kinesiology & Health Studies, University of Regina, Regina, SK S4S 0A2, Canada.
Methods Protoc. 2019 Mar 6;2(1):23. doi: 10.3390/mps2010023.
The prevalence and incidence of sport-related concussion have continued to increase over the past decade, and researchers from various backgrounds strive for evidenced-based clinical assessment and management. When diagnosing and managing a concussion, a battery of tests from several domains (e.g., symptom reporting, neurocognitive, physiology) must be used. In this study, we propose and develop an objective, evidence-based protocol to assess the pathophysiology of the brain by using non-invasive methods.
Contact sport athletes ( = 300) will be assessed at the beginning of the season in a healthy state to establish baseline values, and then prospectively followed if a mild traumatic brain injury (mTBI) occurs on approximately days 1-2, 3-5, 7-10, 21, 30, and subsequently thereafter, depending on the severity of injury. The protocol includes spontaneous measurements at rest, during head postural change, controlled breathing maneuvers for cerebrovascular reactivity, a neurovascular coupling stimuli, and a baroreflex/autoregulation maneuver. Physiological data collection will include cerebral blood flow velocity, cerebral oxygenation, respiratory gases for end-tidal oxygen and carbon dioxide, finger photoplethysmography for blood pressure, seismocardiography for cardiac mechanics, and electrocardiography. Conclusion, Limitations, and Ethics: The protocol will provide an objective, physiological evidence-based approach in an attempt to better diagnose concussion to aid in return-to-play or -learn. Ethics approval has been granted by the University Research Ethics Board.
在过去十年中，与运动相关的脑震荡的患病率和发病率持续上升，来自不同背景的研究人员致力于基于证据的临床评估和管理。在诊断和管理脑震荡时，必须使用来自多个领域（例如症状报告、神经认知、生理学）的一系列测试。在本研究中，我们提出并开发了一种基于证据的客观方案，通过使用非侵入性方法来评估大脑的病理生理学。
接触性运动运动员（n = 300）将在赛季开始时处于健康状态下进行评估，以建立基线值，然后，如果在大约第1 - 2天、3 - 5天、7 - 10天、21天、30天发生轻度创伤性脑损伤（mTBI），随后根据损伤的严重程度进行前瞻性随访。该方案包括在休息时、头部姿势改变期间的自发测量、用于脑血管反应性的控制性呼吸动作、神经血管耦合刺激以及压力反射/自动调节动作。生理数据收集将包括脑血流速度、脑氧合、呼气末氧和二氧化碳的呼吸气体、用于血压的手指光电容积描记法、用于心脏力学的地震心音图以及心电图。结论、局限性和伦理学：该方案将提供一种基于生理证据的客观方法，试图更好地诊断脑震荡，以帮助运动员恢复比赛或学习。该大学研究伦理委员会已批准伦理许可。
