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Our study compared the impact of administering Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs) in in-person versus remote formats and assessed different approaches to combining validity test results. Using the MMPI-2-RF, IOP-29, IOP-M, and FIT, we assessed 164 adults, with half instructed to feign mild traumatic brain injury (mTBI) and half to respond honestly. Within each subgroup, half completed the tests in person, and the other half completed them online via videoconferencing. Results from 2 ×2 analyses of variance showed no significant effects of administration format on SVT and PVT scores. When comparing feigners to controls, the MMPI-2-RF RBS exhibited the largest effect size (d = 3.05) among all examined measures. Accordingly, we conducted a series of two-step hierarchical logistic regression models by entering the MMPI-2-RF RBS first, followed by each other SVT and PVT individually. We found that the IOP-29 and IOP-M were the only measures that yielded incremental validity beyond the effects of the MMPI-2-RF RBS in predicting group membership. Taken together, these findings suggest that administering these SVTs and PVTs in-person or remotely yields similar results, and the combination of MMPI and IOP indexes might be particularly effective in identifying feigned mTBI. [ABSTRACT FROM AUTHOR]

Background: Injury prevention/reduction strategies are driven by data collected through injury surveillance systems. The aim of this review was to describe injury surveillance systems that are used for ongoing surveillance in either a professional or amateur sporting environment. This was an update to a review done in 2015 to determine the gaps in injury surveillance. Methods: A systematic search process of five databases (MEDLINE, CINAHL, EMBASE, SCOPUS and ProQuest) was used to discover published research that presented methodological data about the injury surveillance systems implemented by clubs and organisations for ongoing surveillance. Inclusion criteria centred on the population under surveillance and the ongoing nature of that activity. Data extracted and summarised included the level of athlete under surveillance, the data collection mechanism and the personnel involved, the injury definitions applied and the date and country of origin to provide a comprehensive picture of the systems. Results: A total of 21 systems were documented as being used in ongoing injury surveillance, with 57% of these exclusively in the professional/elite landscapes and 33% at the amateur level. Surveillance systems cater for one sport per athlete entry so there is a gap in research for multi-sport athletes at the amateur level, especially where there is no early specialisation in a multi-sport participation environment. Conclusions: Research in this area will lead to a better understanding of subsequent injury risk for multi-sport athletes who have a higher athlete exposure than single-sport athletes. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy SampleResultsConclusionsThe current study aimed to explore (1) school-aged children’s auditory and cognitive abilities and (2) their perceptions (self-reported and parents) of listening behaviours and symptoms following mild traumatic brain injury (mTBI).Prospective cohort study.Twenty-one children aged 8 to 12 participated in this study. Eleven children with mTBI were diagnosed in the emergency department, and 10 were matched controls. They were assessed twice, in the acute (≤14 days) and chronic (≥3 months) stages post-injury, using six central auditory behavioural tests, a cognitive screening battery, and questionnaires. ANOVA and correlation analysis were performed.Group differences were present in three auditory tests as children with mTBI obtained poorer scores than controls (Pitch Pattern Sequence Tests - PPST: p = 0.037; Gap In Noise test - GIN threshold: p = 0.046; Duration Pattern Test - DPT: p = 0.053), but not for perceived listening behaviours and cognitive abilities. Correlations were found only between perceived listening behaviours and reported mTBI symptoms for parents (p =0.014) and children (p =0.002).Auditory abilities, mostly those related to temporal processing, were affected following mTBI, independently of cognitive abilities. Better identification of auditory processing difficulties following mTBI will improve treatment and resource allocation for children. [ABSTRACT FROM AUTHOR]

Objective: Memory and affective processing were compared in young adults with a remote mild traumatic brain injury (mTBI), to healthy younger and older adults. We evaluated memory performance when encoding was done under multi-tasking (divided attention) conditions, likely to exacerbate cognitive and psychological symptoms in mTBI. Methods: Participants studied pairs of unrelated words under either full or divided attention conditions. Memory for single words (item memory) and for pairs of words (associative memory) was then assessed in sequential independent recognition tests, under full attention. Results: Associative memory was poorer than item memory, and worse when encoding was done under divided than full attention. The decline in recognition accuracy from full to divided attention conditions on the associative memory test was significantly greater in mTBI compared to young adults and was similar in magnitude to that observed in older adults under full attention. Self-reported mental and total fatigue increased significantly as performance on the memory tests, following the divided attention condition, decreased, but only in the mTBI group. Conclusions: Results show lingering memory deficits, and suggest that cognitive tasks may be experienced as psychologically more demanding in those with a mTBI, even months or years after injury. [ABSTRACT FROM AUTHOR]

Primary Objective: This is Part II of a four-part opinion review on traditional neuropsychological assessment methods and findings associated with mild traumatic brain injury (mTBI). This Part II review focuses on historical, psychometric and statistical issues involving traditional neuropsychological methods that have been used in neuropsychological outcome studies of mTBI, but demonstrates the critical limitations of traditional methods. Research Design: This is an opinion review. Methods and Procedures: Traditional neuropsychological tests are dated and lack specificity in evaluating such a heterogenous and complex injury as occurs with mTBI. Main Outcome and Results: In this review, we demonstrate traditional neuropsychological methods were never developed as standalone measures for detecting subtle changes in neurocognitive or neurobehavioral functioning and likewise, never designed to address the multifaceted issues related to underlying mTBI neuropathology symptom burden from having sustained a concussive brain injury. Conclusions: For neuropsychological assessment to continue to contribute to clinical practice and outcome literature involving mTBI, major innovative changes are needed that will likely require technological advances of novel assessment techniques more specifically directed to evaluating the mTBI patient. These will be discussed in Part IV. [ABSTRACT FROM AUTHOR]

Assessing the credibility of symptoms is critical to neuropsychological assessment in both clinical and forensic settings. To this end, the Inventory of Problems-29 (IOP-29) and its recently added memory module (Inventory of Problems-Memory; IOP-M) appear to be particularly useful, as they provide a rapid and cost-effective measure of both symptom and performance validity. While numerous studies have already supported the effectiveness of the IOP-29, research on its newly developed module, the IOP-M, is much sparser. To address this gap, we conducted a simulation study with a community sample (N = 307) from the United Kingdom. Participants were asked to either (a) respond honestly or (b) pretend to suffer from mTBI or (c) pretend to suffer from depression. Within each feigning group, half of the participants received a description of the symptoms of the disorder to be feigned, and the other half received both a description of the symptoms of the disorder to be feigned and a warning not to over-exaggerate their responses or their presentation would not be credible. Overall, the results confirmed the effectiveness of the two IOP components, both individually and in combination. [ABSTRACT FROM AUTHOR]

Sara Montemerani,1 Cosimo Fabrizi,1 Cecilia Sacchi,2 Antoine Belperio,3 Lorenzo Moriani,3 Samuele Pacchi,3 Cinzia Garofalo,4 Giovanni Sbrana,5 Duccio Venezia,6 Maurizio Zanobetti,1 Simone Nocentini3 1UOC Medicina d’Emergenza Urgenza e Pronto Soccorso Ospedale San Donato, Dipartimento Emergenza Urgenza, Azienda USL Toscana Sud Est, Arezzo, Italia; 2Scuola di specializzazione in Medicina d’Emergenza Urgenza, Università degli Studi di Siena, Siena, Italia; 3COES Arezzo, Dipartimento Emergenza Territoriale, Azienda USL Toscana Sud Est, Arezzo, Italia; 4UOC Direzione Infermieristica Emergenza e Urgenza Area provinciale Arezzo, Siena e Grosseto, Azienda USL Toscana Sud Est, Arezzo, Italia; 5UOC Elisoccorso ed Emergenza Territoriale 118 area provinciale grossetana, Dipartimento Emergenza Territoriale, Azienda USL Toscana Sud Est Grosseto, Arezzo, Italia; 6UOC Radiologia Ospedale San Donato, Azienda USL Toscana Sud Est, Arezzo, ItaliaCorrespondence: Sara Montemerani, UOC Medicina d’Emergenza Urgenza e Pronto Soccorso Ospedale San Donato, Dipartimento Emergenza Urgenza, Azienda USL Toscana Sud Est, Via Curtatone, Arezzo, 52100, Italia, Email sara.montemerani@uslsudest.toscana.itPurpose: Mild Traumatic brain injury is classified based on Glasgow Coma Scale (GCS 13– 15), it also involves transient alteration of brain function, which may lead to severe short- and long-term sequelae. When treating a patient with a mild head injury outside the hospital, it is of crucial importance to decide whether to transport him to a center without neurosurgery or to a center equipped with neurosurgery (primary centralization). Recent decades have seen exploration of portable, non-invasive devices for intracranial injury and stroke detection, with microwave frequency electromagnetic field technology showing promising clinical outcomes. This clinical investigation aims to assess the diagnostic accuracy of the TES HT100 medical device, utilizing electromagnetic fields for endocranial lesion screening.Patients and Methods: Patients with mild traumatic brain injury were randomly enrolled according to inclusion criteria. Twenty-three patients recruited from the Intensive Short-Term Observation (ISTO) unit at San Donato Hospital in Arezzo. The sensitivity and specificity of the TES HT were evaluated statistically against cranial computed tomography (CT), the gold standard.Results: A preliminary analysis shows a sensitivity of 100% and a specificity of 100%. Based on these results, there is maximum concordance between the two examinations, and the AUC is 1. No adverse events related to the use of TES HT100 or the examination.Conclusion: The device’s ability to differentiate patients with intracranial lesions from those without can streamline the diagnostic and therapeutic process, potentially leading to improved patient outcomes. If Temnography will maintain high standards of sensitivity and specificity with the expansion of the enrolled population, it could be considered as a stable screening tool in the Emergency Room (ER). We could think to apply this technology to reduce the length of stay that patients with mTBI have to spend in ER for observation. Temnography could also be useful in special categories of patients such as pregnant women or the pediatric population. Moreover, another front of future development of this technology could be extending the study to include Territorial Emergency. In this context, Temnography could aid centralized decision-making in patient care.Keywords: temnography, mild traumatic brain injury, mTBI, traumatic brain injury, TBI, emergency medicine, pre-hospital