Concussions & Head Injuries: Athletes Are Not Alone

Concussion and Head Injuries Lecture Series posterResearch, Assessment and Treatment of Traumatic Brain Injury

a lecture series sponsored by the Department of Psychology and the Wellness Center at Hampden-Sydney College

"The Journey from Mild TBI and Sports Concussion to Chronic Traumatic Encephalopathy"  

Wednesday, September 24, 7:00 pm, Crawley Forum
Dr. Jeffrey T. Barth, John Edward Fowler Professor; Director, Brain Injury and Sports Concussion Institute, University of Virginia, School of Medicine

Dr. Barth presently holds the position of Professor and Co-Director of the Neurocognitive Assessment Laboratory, and Section Head, Neurocognitive Studies in the Department of Psychiatry and Neurobehavioral Sciences, with joint appointments in the Department of Neurological Surgery and the Department of Electrical and Computer Engineering at the University of Virginia.  He is also one of the Founders of the UVA Brain Injury and Sports Concussion Institute, and he has been the PI and Senior Scientist for the Defense and Veterans Brain Injury Center: Charlottesville. He is a Fellow of the American Psychological Association and the National Academy of Neuropsychology and is past president of the National Academy of Neuropsychology, current president of the National Academy of Neuropsychology Foundation Board of Trustees, past president of the Virginia Psychological Association, and holds the emeritus distinction of the Virginia Psychological Foundation.  He is on the editorial board of 10 scientific journals, has co-authored or edited three books, and is an author of over 200 scholarly articles and book chapters. He is a member of the NFL Players Association Mackey White Concussion Committee and has worked with the Department of Defense and the American Academy of Neurology on the development of concussion management guidelines. In 1992 he was awarded the John Edward Fowler Professorship in Clinical Psychology, an endowed chair in the UVA Eminent Scholars Program.  He is the recipient of the National Academy of Neuropsychology's 2005 Distinguished Neuropsychologist Award for lifetime achievements in the field of Neuropsychology, the 2006 Virginia Academy of Clinical Psychology's Distinguished Scientific Contributions in Clinical Psychology Award, and the 2012 Distinguished Service Award of the National Academy of Neuropsychology. In 2013 he received the "Toggle" Award from the Virginia Department of Aging and Rehabilitative Services for his dedication and leadership in serving veterans with brain injuries.  

It has been more than three decades since the term "Silent Epidemic" was coined and applied to the issue of mild closed head injury.  Since that time, the medical and neuropsychological communities have struggled to make sense of a condition which, in most people, leaves them with no permanent morbidity, yet clearly does result in complicated and poor recovery in others.  This presentation will focus on the historical underpinnings and early controversies surrounding the study of mild closed head injury, neuropsychological assessment and outcome studies, and individual vulnerability and recovery curves. Specific discussions will focus on sports concussions and return to play criteria, as well as the similarities and differences between sports concussions and combat blast injuries. The emerging controversy over chronic traumatic encephalopathy will be discussed.

"Advances in Diagnostic Imaging of Traumatic Brain Injury and Neuropsychiatric Disorders"  

Tuesday, September 30, 4:00 pm, Parents and Friends Lounge
J. Stephen Levkoff, DBA, Visiting Assistant Professor, Hampden-Sydney College

Stephen Levkoff is a Visiting Assistant Professor in the Economics and Business Department at Hampden Sydney College.  He previously taught at the Mason School of Business at the College of William and Mary from 1979 until 1983.   He holds a Doctor of Business Administration degree (Finance) from the Darden School of Business at the University of Virginia. After leaving academia in 1983, Levkoff was a partner and senior executive at three major financial services firms including Smith Barney, Inc., where he had global responsibilities for the firm's Quantitative Research, Trading Room Systems, Structured Finance and Non-Dollar Arbitrage groups.  He also headed the firm's global Fixed Income Policy group.  After leaving Smith Barney, he was a serial entrepreneur, leading global technology ventures as both CEO and CTO. In 2004, Levkoff chose to pursue a personal passion for research into the diagnosis and treatment of mild Traumatic Brain Injury (mTBI) and Neuropsychiatric Disorders.  After a year of intensive study of magnetic resonance imaging (MRI), he founded one of the most advanced medical imaging facilities in the US.  As CEO, he led clinical research activities and established clinical imaging protocols for diagnosis of mTBI and Neuropsychiatric Disorders.  After selling his imaging facility, Levkoff continued his research and clinical neuroimaging as Executive Vice President for Research and Clinical Activities for the largest privately held imaging company in the US.  During that period, Levkoff also served as Chairman and CEO of the North Florida Brain Health Foundation, a research affiliate of the North Florida Psychiatric Association.  He has been an invited speaker on imaging mTBI and Neuropsychiatric Disorders at national medical meetings.  He has also presented Grand Rounds on the topic to groups of academic and private physicians and has also trained over 40 psychiatrists in the use of imaging to diagnose and treat mTBI and Neuropsychiatric Disorders.  

Mild Traumatic Brain Injury has become a focal point in discussions of safety in sports - large part because of the NFL Players Association lawsuit against the NFL.  Over 500,000 cases of mTBI occur annually.  Those injured are primarily adolescents and young adults.  Advanced diagnostic imaging has dramatically changed the ability of physicians to diagnose the severity, persistence and prognosis of the injury.  However, the practice of medicine lags the best evidence based research by at least 10 years.  Likewise, there is little discussion among practitioners of a known sequale:  Neuropsychiatric disorders that persist for a lifetime.  

The modern history of anatomical pathology as the etiology of psychiatric disorders dates to Kraepelin's work at the turn of the last century. Although this theory / model of psychiatric disorders fell out of favor for most of the 20th century, it is now the basis for the most advanced theoretical and clinical research. For the last two decades of the 20th century, the focus was on gray matter / structural pathology due to the exquisite in vivo images generated by high field MRI. Over the past 10 years, with the introduction of MRI Diffusion Tensor Imaging (DTI), the focus shifted first to white matter/ connectivity issues and later to a systems approach which embraces both gray and white matter. Newer MRI techniques for observing brain function e.g. fMRI (Blood Oxygen Level Dependent Stimulus - Response) and MRI Spectroscopy (metabolic activity - chemical shift analysis) combined with structural MRI provide an extremely robust diagnostic tool to be used in conjunction with clinical observation. Likewise, post-treatment imaging provides an objective assessment of treatment efficacy.

"Assessment and Treatment of Prolonged Post-concussive Symptoms Following Mild TBI: Imagine Sisyphus Happy"  

Thursday, October 2, 7:00 pm, Parents and Friends Lounge
Dr. Thomas A. Campbell, Director, Rehabilitation Psychology Postdoctoral Fellowship; Neuropsychologist, Polytrauma Rehabilitation Center, McGuire VA Medical Center, Richmond

Thomas Campbell, Ph.D. is a neuropsychologist at the Richmond V.A. Medical Center's Polytrauma Rehabilitation Center and the director of the hospital's Postdoctoral Fellowship in Rehabilitation Psychology. He provides psychological assessment and treatment to with Veterans with mild, moderate, and severe traumatic brain injuries, PTSD, and post-deployment readjustment concerns. He is also an adjunct professor in VCU's department of psychology and teaches Neuropsychological Assessment in their graduate psychology program.  

Concussion, or mild traumatic brain injury (mTBI), is a relatively common occurrence. The vast majority of individuals who sustain a mTBI recover fully with no reportable long-term functional deficits. However, there is a subset of individuals that do not recover fully either due to poor post-concussion management, multiple prior head injuries, or unknown reasons. This presentation will explore potential reasons for prolonged post-concussive symptoms, how to assess for potential causes, and discuss different treatment options.