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Article ; Online: Stress fractures of the hand and wrist in athletes.

Koslosky, Ezekial / Elder, Gregory / Heath, David / Brady, Christina / Dutta, Anil

2023 Volume 55, Issue 2, Page(s) 111218

Abstract: Stress fractures of the upper extremity are reported less often than their lower extremity counterpart. This review aims to provide a comprehensive overview of an important and often missed diagnosis in pediatric athletes: hand and wrist stress fractures. ...

Abstract	Stress fractures of the upper extremity are reported less often than their lower extremity counterpart. This review aims to provide a comprehensive overview of an important and often missed diagnosis in pediatric athletes: hand and wrist stress fractures.
MeSH term(s)	Humans ; Child ; Wrist ; Fractures, Bone/diagnosis ; Fractures, Stress/diagnostic imaging ; Wrist Injuries/diagnostic imaging ; Wrist Joint ; Upper Extremity
Language	English
Publishing date	2023-11-17
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2023.111218
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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Apathy in Lewy body disease and its effects on functional impairment over time.

Zhu, Carolyn W / Grossman, Hillel T / Elder, Gregory A / Rosen, Howie / Sano, Mary

Frontiers in neurology

2024 Volume 15, Page(s) 1339190

Abstract: Background and objectives: Apathy strongly affects function in Alzheimer's disease and frontotemporal dementia, however its effect on function in Lewy Body Disease (LBD) has not been well-described. This study aims to (1) examine the prevalence and ... ...

Abstract	Background and objectives: Apathy strongly affects function in Alzheimer's disease and frontotemporal dementia, however its effect on function in Lewy Body Disease (LBD) has not been well-described. This study aims to (1) examine the prevalence and persistence of apathy in a large, national cohort of well-characterized patients with LBD, and (2) estimate the effect of apathy on function over time. Methods: Study included 676 participants with mild cognitive impairment (MCI) or dementia in the National Alzheimer's Coordinating Center Uniform Data Set. Participants were followed for an average of 3.4 ± 1.7 years and consistently had a primary diagnosis of LBD. Apathy was defined by clinician judgment, categorized into four mutually exclusive profiles: (1) never apathetic across all visits, (2) at least one but <50% of visits with apathy ( Results: Baseline characteristics of the sample were: average age = 72.9 ± 6.9, years of education = 15.6 ± 3.4, Mini Mental State Exam (MMSE) = 24.4 ± 5.4, Geriatric Depression Scale (GDS) = 3.8 ± 3.2, FAQ = 12.0 ± 9.1. 78.8% were male and 89% were non-Hispanic white. Prevalence of apathy increased from 54.4% at baseline to 65.5% in year 4. 77% of participants had apathy at some point during follow-up. Independent of cognitive status and parkinsonian features, FAQ was significantly higher in participants with intermittent/persistent and always apathetic than never apathetic. Annual rate of decline in FAQ was faster in participants who were always apathetic than never apathy. Discussion: In this large national longitudinal cohort of LBD patients with cognitive impairment, apathy was strongly associated with greater functional impairment at baseline and faster rate of decline over time. The magnitude of these effects were clinically important and were observed beyond the effects on function from participants' cognitive status and parkinsonism, highlighting the importance of specifically assessing for apathy in LBD.
Language	English
Publishing date	2024-01-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2024.1339190
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Article ; Online: Update on TBI and Cognitive Impairment in Military Veterans.

Elder, Gregory A

Current neurology and neuroscience reports

2015 Volume 15, Issue 10, Page(s) 68

Abstract: Traumatic brain injury (TBI) is a common cause of morbidity and mortality in military life. Interest in military TBI has increased recently due to the conflicts in Iraq and Afghanistan. Certain types of TBI are relatively unique to the military, the most ...

Abstract	Traumatic brain injury (TBI) is a common cause of morbidity and mortality in military life. Interest in military TBI has increased recently due to the conflicts in Iraq and Afghanistan. Certain types of TBI are relatively unique to the military, the most prominent being blast-related TBI. Blast-related mild TBI has been of particular concern in veterans from the most recent conflicts although controversy remains concerning its separation from post-traumatic stress disorder. TBI is also a risk factor for the later development of neurodegenerative diseases in which cognitive impairment is prominent putting veterans at risk for disorders including Alzheimer's disease and chronic traumatic encephalopathy. Recent evidence associating TBI with chronic cognitive impairment is reviewed in the context of its relevance to military veterans.
MeSH term(s)	Blast Injuries/complications ; Blast Injuries/physiopathology ; Brain Injuries/complications ; Brain Injuries/physiopathology ; Cognition Disorders/etiology ; Cognition Disorders/physiopathology ; Humans ; Risk Factors ; Stress Disorders, Post-Traumatic/physiopathology ; Veterans
Language	English
Publishing date	2015-10
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	2057363-7
ISSN	1534-6293 ; 1528-4042
ISSN (online)	1534-6293
ISSN	1528-4042
DOI	10.1007/s11910-015-0591-8
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Zs.A 5549: Show issues

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Article ; Online: Sagittal Spinal Deformity in Patients with Idiopathic Normal Pressure Hydrocephalus.

Lenartowicz, Karina A / Naylor, Ryan M / Mikula, Anthony L / Graff-Radford, Jonathan / Jones, David T / Cutsforth-Gregory, Jeremy K / Graff-Radford, Neill R / Fogelson, Jeremy L / Cogswell, Petrice M / Elder, Benjamin D

Turkish neurosurgery

2023 Volume 33, Issue 3, Page(s) 471–476

Abstract: Aim: To measure the baseline spinopelvic parameters and characterize the sagittal, and coronal plane deformities in patients with idiopathic normal pressure hydrocephalus (iNPH).: Material and methods: We analyzed a series of patients at one academic ...

Abstract	Aim: To measure the baseline spinopelvic parameters and characterize the sagittal, and coronal plane deformities in patients with idiopathic normal pressure hydrocephalus (iNPH). Material and methods: We analyzed a series of patients at one academic institution who underwent ventriculoperitoneal shunting for iNPH with pre-shunt standing full length x-rays. The series of patients was enrolled consecutively to minimize selection bias. We quantified comorbid sagittal plane spinal deformity based on the Scoliosis Research Society-Schwab classification system by assessing pelvic incidence and lumbar lordosis mismatch (PI-LL), pelvic tilt (PT), and sagittal vertical axis (SVA). Results: Seventeen patients (59% male) were included in this study. Mean (± standard deviation) age was 74 ± 5.3 years with a body mass index (BMI) of 30 ± 4.5 kg/m < sup > 2< sup > . Six patients (35%) had marked sagittal plane spinal deformity by at least one parameter: five (29%) had greater than 20˚ PI-LL mismatch, three (18%) had > 9.5 cm SVA, and one (6%) had PT greater than 30˚. Additionally, the thoracic kyphosis exceeded the lumbar lordosis in nine patients (53%). Conclusion: Positive sagittal balance, with thoracic kyphosis exceeding lumbar lordosis, is common in iNPH patients. This may lead to postural instability, especially in patients whose gait does not improve following shunting. These patients may warrant further investigation and workup, including full length standing x-rays. Future studies should assess for improvement in the sagittal plane parameters following shunt placement.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Hydrocephalus, Normal Pressure ; Kyphosis ; Lordosis ; Lumbar Vertebrae ; Quality of Life ; Retrospective Studies ; Scoliosis ; Spine/abnormalities
Language	English
Publishing date	2023-03-13
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	1203779-5
ISSN	2651-5032 ; 1019-5149
ISSN (online)	2651-5032
ISSN	1019-5149
DOI	10.5137/1019-5149.JTN.36555-22.3
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Article ; Online: Relationship of traumatic brain injury to chronic mental health problems and dementia in military veterans.

Elder, Gregory A / Ehrlich, Michelle E / Gandy, Sam

Neuroscience letters

2019 Volume 707, Page(s) 134294

Abstract: Traumatic brain injury (TBI) is an unfortunately common event in military life. The conflicts in Iraq and Afghanistan have increased public awareness of TBI in the military. Certain injury mechanisms are relatively unique to the military, the most ... ...

Abstract	Traumatic brain injury (TBI) is an unfortunately common event in military life. The conflicts in Iraq and Afghanistan have increased public awareness of TBI in the military. Certain injury mechanisms are relatively unique to the military, the most prominent being blast exposure. Blast-related mild TBI (mTBI) has been of particular concern in the most recent veterans although controversy remains concerning separation of the postconcussion syndrome associated with mTBI from post-traumatic stress disorder. TBI is also a risk factor for the development of neurodegenerative diseases including chronic traumatic encephalopathy (CTE) and Alzheimer's disease (AD). AD, TBI, and CTE are all associated with chronic inflammation. Genome wide association studies (GWAS) have identified multiple genetic loci associated with AD that implicate inflammation and - in particular microglia - as key modulators of the AD- and TBI-related degenerative processes. At the molecular level, recent studies have identified TREM2 and TYROBP/DAP12 as components of a key molecular hub linking inflammation and microglia to the pathophysiology of AD and possibly TBI. Evidence concerning the relationship of TBI to chronic mental health problems and dementia is reviewed in the context of its relevance to military veterans.
MeSH term(s)	Animals ; Blast Injuries/complications ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/genetics ; Brain Injuries, Traumatic/psychology ; Chronic Disease ; Dementia/complications ; Dementia/genetics ; Dementia/psychology ; Humans ; Inflammation/genetics ; Inflammation/metabolism ; Inflammation/pathology ; Mental Disorders/complications ; Mental Disorders/genetics ; Mental Disorders/psychology ; Microglia/physiology ; Military Personnel ; Veterans
Language	English
Publishing date	2019-05-26
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	194929-9
ISSN	1872-7972 ; 0304-3940
ISSN (online)	1872-7972
ISSN	0304-3940
DOI	10.1016/j.neulet.2019.134294
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Zs.A 1166: Show issues

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Article ; Online: Field strength difference in extent of artifacts induced by CERTAS Plus valves in patients with idiopathic normal pressure hydrocephalus.

Camerucci, Emanuele / Elder, Benjamin D / Shu, Yunhong / Messina, Steven A / Gunter, Jeffrey L / Graff-Radford, Jonathan / Jones, David T / Botha, Hugo / Cutsforth-Gregory, Jeremy K / Jack, Clifford R / Huston, John / Cogswell, Petrice M

The neuroradiology journal

2023 Volume 36, Issue 6, Page(s) 665–673

Abstract: Background and purpose: : Post-shunt MRI is usually performed at 1.5T under the general assumption that shunt-related susceptibility artifacts would be greater at higher field strengths.: Purpose: The purpose is to show that imaging post-shunt ... ...

Abstract	Background and purpose: : Post-shunt MRI is usually performed at 1.5T under the general assumption that shunt-related susceptibility artifacts would be greater at higher field strengths. Purpose: The purpose is to show that imaging post-shunt idiopathic normal pressure hydrocephalus (iNPH) patients at 3T is feasible and with reduced artifacts as compared to 1.5T. Methods: We manually measured transverse dimensions of artifact at the levels of lateral ventricles, cerebral aqueduct, and cerebellar hemisphere. Areas/volumes of artifacts were calculated assuming an elliptic/ellipsoid shape. Relative extent of shunt-related artifact between field strengths was rated by 3 readers on a 5-point Likert scale. A Wilcoxon Signed Rank Test was used to compare artifact at 1.5T vs 3T for each sequence, with a significance level set at Results: Artifact areas were calculated in 22 iNPH patients; artifacts were on average smaller at 3T vs 1.5T on MPRAGE, DWI, and GRE sequences. On T2 FLAIR and T2 FSE, artifacts at 3T were larger than 1.5T. On the qualitative analysis, artifact effects were less at 3T vs 1.5T on DWI, greater at 3T on T2 FSE, and had mixed results on GRE. Conclusion: Our results indicate feasibility of post-shunt imaging with the CERTAS Plus valve at 3T based on shunt-related artifact that is less than or equal in extent to that on 1.5T on most standard clinical imaging sequences. Our findings, corroborated by the qualitative image review, suggest that dedicated clinical imaging sequences for devices may allow for reduction in artifact extent at both 1.5T and 3T.
MeSH term(s)	Humans ; Artifacts ; Hydrocephalus, Normal Pressure/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Image Interpretation, Computer-Assisted/methods
Language	English
Publishing date	2023-04-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2257770-1
ISSN	2385-1996 ; 1971-4009 ; 1120-9976
ISSN (online)	2385-1996
ISSN	1971-4009 ; 1120-9976
DOI	10.1177/19714009231173099
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Zs.A 2823: Show issues

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Article ; Online: Objective assessment of patients with idiopathic normal pressure hydrocephalus following ventriculoperitoneal shunt placement using activity-monitoring data: pilot study.

Jusue-Torres, Ignacio / Brown, Desmond A / Pennington, Zach / Cogswell, Petrice M / Ali, Farwa / Graff-Radford, Neill / Jones, David T / Cutsforth-Gregory, Jeremy K / Graff-Radford, Jonathan / Kaufman, Kenton R / Elder, Benjamin D

Neurosurgical focus

2023 Volume 54, Issue 4, Page(s) E6

Abstract: Objective: Idiopathic normal pressure hydrocephalus (iNPH) results in significant morbidity in the elderly with symptoms of dementia, gait instability, and urinary incontinence. In well-selected patients, ventriculoperitoneal shunt (VPS) placement often ...

Abstract	Objective: Idiopathic normal pressure hydrocephalus (iNPH) results in significant morbidity in the elderly with symptoms of dementia, gait instability, and urinary incontinence. In well-selected patients, ventriculoperitoneal shunt (VPS) placement often results in clinical improvement. Most postshunt assessments of patients rely on subjective scales. The goal of this study was to assess the utility of remote activity monitoring to provide objective evidence of gait improvement following VPS placement for iNPH. Methods: Patients with iNPH were prospectively enrolled and fitted with 5 activity monitors (on the hip and bilateral thighs and ankles) that they wore for 4 days preoperatively within 30 days of surgery and for 4 days within 30 days postoperatively. Monitors collected continuous data for number of steps, cadence, body position (upright, prone, supine, and lateral decubitus), gait entropy, and the proportion of each day spent active or static. Data were retrieved from the devices and a comparison of pre- and postoperative movement assessment was performed. The gait data were also correlated with formal clinical gait assessments before and after lumbar puncture and with motion analysis laboratory testing at baseline and 1 month and 1 year after VPS placement. Results: Twenty patients fulfilled the inclusion and exclusion criteria (median age 76 years). The baseline median number of daily steps was 1929, the median percentage of the day spent inactive was 70%, the median percentage of the day with a static posture was 95%, the median gait velocity was 0.49 m/sec, and the median number of steps required to turn was 8. There was objective improvement in median entropy from pre- to postoperatively, increasing from 0.6 to 0.8 (p = 0.002). There were no statistically significant differences for any of the remaining variables measured by the activity monitors when comparing the preoperative to the 1-month postoperative time point. All variables from motion analysis testing showed statistically significant differences or a trend toward significance at 1 year after VPS placement. Among the significantly correlated variables at baseline, cadence was inversely correlated with percentage of gait cycle spent in the support phase (contact with ground vs swing phase). Conclusions: This pilot study suggests that activity monitoring provides an early objective measure of improvement in gait entropy after VPS placement among patients with iNPH, although a more significant improvement was noted on the detailed clinical gait assessments. Further long-term studies are needed to determine the utility of remote monitoring for assessing gait improvement following VPS placement.
MeSH term(s)	Humans ; Aged ; Ventriculoperitoneal Shunt/methods ; Hydrocephalus, Normal Pressure/surgery ; Hydrocephalus, Normal Pressure/diagnosis ; Pilot Projects ; Treatment Outcome ; Longitudinal Studies
Language	English
Publishing date	2023-02-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2023.1.FOCUS22640
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Article ; Online: Response to "Letter to the editor concerning "High prevalence of cervical myelopathy in patients with idiopathic normal pressure hydrocephalus" by Naylor et al. (Clinical Neurology and Neurosurgery 2020; 197. /doi:10.1016/j.clineuro.2020.106099. e-pub: 2020 July 17)".

Naylor, Ryan M / Lenartowicz, Karina A / Graff-Radford, Jonathan / Jones, David T / Cutsforth-Gregory, Jeremy K / Graff-Radford, Neill R / Elder, Benjamin D

Clinical neurology and neurosurgery

2021 Volume 208, Page(s) 106820

MeSH term(s)	Humans ; Hydrocephalus, Normal Pressure ; Neurology ; Neurosurgery ; Prevalence ; Spinal Cord Diseases
Language	English
Publishing date	2021-07-22
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2021.106820
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Article: Prevalent, persistent, and impairing: Longitudinal course and impact of apathy in Alzheimer's disease.

Grossman, Hillel T / Sano, Mary / Aloysi, Amy / Elder, Gregory A / Neugroschl, Judith / Schimming, Corbett / Soleimani, Laili / Zhu, Carolyn W

Alzheimer's & dementia (Amsterdam, Netherlands)

2022 Volume 13, Issue 1, Page(s) e12169

Abstract: Introduction: Understanding of the natural history of apathy and its impact on patient function is limited. This study examines, in a large, national sample of Alzheimer's disease (AD) patients with long follow-ups: (1) prevalence, incidence, and ... ...

Abstract	Introduction: Understanding of the natural history of apathy and its impact on patient function is limited. This study examines, in a large, national sample of Alzheimer's disease (AD) patients with long follow-ups: (1) prevalence, incidence, and persistence of apathy, and (2) impact of apathy on function across dementia severity. Methods: A longitudinal study of 9823 well-characterized AD patients in the National Alzheimer's Coordinating Center Uniform Data Set. Results: Apathy was highly prevalent across disease severity with cumulative prevalence of 48%, 74%, and 82% in Clinical Dementia Rating (CDR) 0.5, 1.0, and 2.0, respectively. Persistence of apathy from clinician judgment varied from visit to visit at earlier disease stages but remained high at moderate dementia. Independent of cognition, persistent apathy was strongly associated with accelerated rate of functional decline. Discussion: Findings point to important targets for the treatment and management of apathy, include functional outcomes, and study designs that account for variable persistence of the apathy syndrome.
Language	English
Publishing date	2022-02-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2832898-X
ISSN	2352-8729
ISSN	2352-8729
DOI	10.1002/dad2.12169
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Article ; Online: The Neurovascular Unit as a Locus of Injury in Low-Level Blast-Induced Neurotrauma.

Elder, Gregory A / Gama Sosa, Miguel A / De Gasperi, Rita / Perez Garcia, Georgina / Perez, Gissel M / Abutarboush, Rania / Kawoos, Usmah / Zhu, Carolyn W / Janssen, William G M / Stone, James R / Hof, Patrick R / Cook, David G / Ahlers, Stephen T

International journal of molecular sciences

2024 Volume 25, Issue 2

Abstract: Blast-induced neurotrauma has received much attention over the past decade. Vascular injury occurs early following blast exposure. Indeed, in animal models that approximate human mild traumatic brain injury or subclinical blast exposure, vascular ... ...

Abstract	Blast-induced neurotrauma has received much attention over the past decade. Vascular injury occurs early following blast exposure. Indeed, in animal models that approximate human mild traumatic brain injury or subclinical blast exposure, vascular pathology can occur in the presence of a normal neuropil, suggesting that the vasculature is particularly vulnerable. Brain endothelial cells and their supporting glial and neuronal elements constitute a neurovascular unit (NVU). Blast injury disrupts gliovascular and neurovascular connections in addition to damaging endothelial cells, basal laminae, smooth muscle cells, and pericytes as well as causing extracellular matrix reorganization. Perivascular pathology becomes associated with phospho-tau accumulation and chronic perivascular inflammation. Disruption of the NVU should impact activity-dependent regulation of cerebral blood flow, blood-brain barrier permeability, and glymphatic flow. Here, we review work in an animal model of low-level blast injury that we have been studying for over a decade. We review work supporting the NVU as a locus of low-level blast injury. We integrate our findings with those from other laboratories studying similar models that collectively suggest that damage to astrocytes and other perivascular cells as well as chronic immune activation play a role in the persistent neurobehavioral changes that follow blast injury.
MeSH term(s)	Animals ; Humans ; Blast Injuries ; Endothelial Cells ; Brain Concussion ; Vascular System Injuries ; Astrocytes ; Inflammation
Language	English
Publishing date	2024-01-17
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms25021150
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