1. Highlights in UF Concussion Research
Michael S. Jaffee, M.D., Medical Director
Russell M. Bauer, Ph.D., ABPP, Neuropsychologist
Breton Asken, M.S., ATC
Neurology Research Day
January 22, 2017
University of Florida

2. “Science, Practice, and Collaboration for Recovery”
The Team
RESEARCH COLLABORATORS
Jay Clugston, MD, UF Team Physician
Steven T. DeKosky, MD
Jon Boone, MS, ATC, LAT, FMSC, NCPT
Dewayne DuBose, PhD, ATC, LAT, NCPT
Zachary Houck, MS
Joseph Gullett, MS
David FitzGerald, MD
Thomas Mareci, PhD
Michael McCrea, PhD
BRAIN CLINIC
Michael S. Jaffee, MD, Medical Director
Russell M. Bauer, PhD, ABPP, Neuropsychologist
Zach Sutton, PT, DPT, Physical Therapist
Kyle Platek, DRS, OTR/L
Breton Asken, MS, ATC
Molly Sullan, MS
Gabrielle Altomare, MS
Sarah Greif, BS
“Science, Practice, and Collaboration for Recovery”

4. UF BRAIN Clinic:  Brain Injury Rehabilitation and Assessment INterdisciplinary Clinic
Patient
Neurology
Occupational Therapy
Physical Therapy
Neuro-
psychology
Opportunities for Shared Trans-Disciplinary Research
Sharing Measures and Techniques from Partner Disciplines
National Collaborations
On-Field / Acute Injury
Factors Affecting Symptom Recovery vs. Persistence
Factors Affecting Long-term Complications
“Science, Practice, and Collaboration for Recovery”

6. Typical = 7-14 days Acute Rest Athlete Reports Immediately
Diagnose and Remove from Play
Unrestricted Return to Play
Concussion
Cognitive and Physical Exertion as Tolerated

7. Typical = ???? Acute Rest Athlete Delays Reporting
Diagnose and Remove from Play
Concussion
Unrestricted Return to Play
Continued Physical Exertion
Additional Blows to Head?
Cognitive and Physical Exertion as Tolerated

8. Methods
97 athletes dichotomized as “Immediate Removal From Activity” (I-RFA) or “Delayed Removal From Activity” (D-RFA)
Analyzed differences in days missed from athletic activity controlling for other recovery modifying factors
Sex, concussion history, LD/ADHD dx, psychiatric dx, and acute symptom severity
Findings
Delayed reporting athletes missed ~5 more days from athletic activity compared to immediate reporting
2.2x more likely to have 8+ day recovery
First demonstration in humans of acute “window of vulnerability”

9. (Neuro)Psychology
Neurology
Physical Therapy
Occupational Therapy
Pain Management
Social Work

10. Trans-Disciplinary Model NeuroBioPsychoSocial Approach

11. Current Key Questions
Predictors of persistent TBI-related symptomatology
Does TB-induced sleep disturbance aid and abet chronic post-injury symptoms?
Mechanisms and clinical manifestations of neurodegeneration after TBI.
Can we improve neuropsychological characterization of post-injury cognitive status
Using helmet sensor data to monitor and characterize impact history in NCAA athletes (Clugston)

12. Segmentation of LC using FLOCS
Collaboration with Tom Mareci, Ph.D.
Sullan MJ, Bohsali AA, Gullett JM, Goldstein J, Bauer RM, et al. (2014) The Locus Coeruleus and Sleep-Wake Disturbances in Veterans with mTBI. J Sleep Med Disord1(1): 1004.
Resolution of LC-Hypothalamic tracts using MOW Tractography

13. The Vision: Genome-to-Syndrome Model for TBI

14. Delayed reporting athletes missed ~5 more days from athletic activity compared to immediate reporting
2.2x more likely to have 8+ day recovery
First demonstartion in humans of “window of vulnerability”