Publications by authors named "Jennifer V Wethe"

Former American football players are at risk for developing traumatic encephalopathy syndrome (TES), the clinical disorder associated with neuropathologically diagnosed chronic traumatic encephalopathy (CTE). The objective of this study was to determine whether hyposmia is present in traumatic encephalopathy syndrome. The study included 119 former professional American football players, 60 former college football players, and 58 same-age asymptomatic unexposed men from the DIAGNOSE CTE Research Project.

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Article Synopsis
  • - Blood-based biomarkers are being explored to detect brain injuries from repetitive head impacts, specifically in former football players, by analyzing plasma levels of various proteins like tau and amyloid.
  • - A study involving 180 former football players and 60 control participants found that specific biomarkers (p-tau181 and p-tau231) were significantly elevated in the football players, indicating potential brain damage linked to their sport.
  • - The findings suggest that certain plasma proteins (p-tau, GFAP, NfL) could help in understanding and identifying neurological issues related to head impacts, with younger players showing more severe biomarker changes.
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Tools used for the identification, evaluation, and monitoring of concussion have not been sufficiently studied in youth or real-world settings. Normative and reliability data on sideline concussion assessment measures in the youth athlete population is needed. Pre-season normative data for 515 athletes (93.

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Article Synopsis
  • The study investigates neurobehavioral dysregulation (NBD), which includes neuropsychiatric symptoms linked to repetitive head impacts, particularly in former contact sport athletes.
  • Through analyses involving questionnaires from 178 former football players, researchers identified four subconstructs of NBD: explosivity, emotional dyscontrol, impulsivity, and affective lability.
  • The results revealed four symptom profiles among participants, highlighting the complexity of NBD and serving as a basis for future research on its diagnostic criteria and neurobiological aspects.
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Background And Objectives: Obstructive sleep apnea (SA) is common in older men and a contributor to negative cognitive, psychiatric, and brain health outcomes. Little is known about SA in those who played contact sports and are at increased risk of neurodegenerative disease(s) and other neuropathologies associated with repetitive head impacts (RHI). In this study, we investigated the frequency of diagnosed and witnessed SA and its contribution to clinical symptoms and tau pathology using PET imaging among male former college and former professional American football players.

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Article Synopsis
  • Traumatic encephalopathy syndrome (TES) is linked to chronic traumatic encephalopathy (CTE) and is characterized by neurobehavioral dysregulation (NBD), impacting emotional and behavioral regulation in individuals exposed to repetitive head impacts, like former American football players.
  • The study involved 104 former players diagnosed with NBD, 76 without the diagnosis, and 55 unexposed individuals, using self-report measures to assess NBD symptoms and cerebrospinal fluid (CSF) biomarkers associated with inflammation.
  • Results indicated that levels of the pro-inflammatory cytokine IL-6 were significantly higher in former players, suggesting a connection between these inflammation markers and NBD symptoms linked to past head impacts.
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Background And Objectives: Recent data link exposure to repetitive head impacts (RHIs) from American football with increased white matter hyperintensity (WMH) burden. WMH might have unique characteristics in the context of RHI beyond vascular risk and normal aging processes. We evaluated biological correlates of WMH in former American football players, including markers of amyloid, tau, inflammation, axonal injury, neurodegeneration, and vascular health.

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Article Synopsis
  • - The study investigates tau pathology in chronic traumatic encephalopathy (CTE) using tau PET imaging from 218 participants, including former professional and college football players, and a control group of individuals without head impact exposure.
  • - Elevated tau levels were found in former football players compared to controls, especially in older players over 60 with cumulative head impact exposure, but PET imaging didn't effectively distinguish between individuals with and without traumatic encephalopathy syndrome.
  • - The authors emphasize the need for further research to better understand the link between tau pathology and chronic traumatic brain injuries, as current findings only partially clarify these relationships.
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  • Former football players are at risk for chronic traumatic encephalopathy (CTE), which can include parkinsonism as a clinical feature.
  • A study assessed 120 former professional and 58 college football players, comparing them to 60 similar-aged men without repetitive head impacts, to investigate rates of parkinsonism.
  • Results showed that 12.4% of football players met parkinsonism criteria, with a higher prevalence in professional players, but overall rates were low and inconclusive regarding the effects of football exposure on parkinsonism.
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Objective: To develop new diagnostic criteria for mild traumatic brain injury (TBI) that are appropriate for use across the lifespan and in sports, civilian trauma, and military settings.

Design: Rapid evidence reviews on 12 clinical questions and Delphi method for expert consensus.

Participants: The Mild Traumatic Brain Injury Task Force of the American Congress of Rehabilitation Medicine Brain Injury Special Interest Group convened a Working Group of 17 members and an external interdisciplinary expert panel of 32 clinician-scientists.

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Background: Patterns of cognitive impairment in former American football players are uncertain because objective neuropsychological data are lacking. This study characterized the neuropsychological test performance of former college and professional football players.

Methods: One hundred seventy male former football players (n=111 professional, n=59 college; 45-74 years) completed a neuropsychological test battery.

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Introduction: The presentation, risk factors, and etiologies of white matter hyperintensities (WMH) in people exposed to repetitive head impacts are unknown. We examined the burden and distribution of WMH, and their association with years of play, age of first exposure, and clinical function in former American football players.

Methods: A total of 149 former football players and 53 asymptomatic unexposed participants (all men, 45-74 years) completed fluid-attenuated inversion recovery magnetic resonance imaging, neuropsychological testing, and self-report neuropsychiatric measures.

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Article Synopsis
  • Chronic traumatic encephalopathy (CTE) is a serious brain disease caused by repeated head impacts and can only be diagnosed after death; the DIAGNOSE CTE Research Project aims to develop diagnostic methods for this condition.
  • Funded by the National Institute of Neurological Disorders and Stroke, the project includes 240 male participants, focusing on former football players and asymptomatic individuals, to study various risk factors and biomarkers related to CTE.
  • The research involves extensive evaluations such as neurological exams, brain imaging, and biological sample collection, with a focus on refining clinical criteria and sharing data with the broader research community.
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Objective: To develop evidence-informed, expert consensus research diagnostic criteria for traumatic encephalopathy syndrome (TES), the clinical disorder associated with neuropathologically diagnosed chronic traumatic encephalopathy (CTE).

Methods: A panel of 20 expert clinician-scientists in neurology, neuropsychology, psychiatry, neurosurgery, and physical medicine and rehabilitation, from 11 academic institutions, participated in a modified Delphi procedure to achieve consensus, initiated at the First National Institute of Neurological Disorders and Stroke Consensus Workshop to Define the Diagnostic Criteria for TES April, 2019. Before consensus, panelists reviewed evidence from all published cases of CTE with neuropathologic confirmation, and they examined the predictive validity data on clinical features in relation to CTE pathology from a large clinicopathologic study (n = 298).

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Objectives: To conduct an updated, systematic review of the clinical literature, classify studies based on the strength of research design, and derive consensual, evidence-based clinical recommendations for cognitive rehabilitation of people with traumatic brain injury (TBI) or stroke.

Data Sources: Online PubMed and print journal searches identified citations for 250 articles published from 2009 through 2014.

Study Selection: Selected for inclusion were 186 articles after initial screening.

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Many patients with epilepsy caused by hypothalamic hamartomas (HHs) have cognitive impairments during the course of the disease or following neurosurgical treatment. The purpose of this study was to assess cognitive function in these patients, as well as factors influencing preoperative cognitive performance and cognitive outcome after neurosurgical treatment. Using the two largest and most detailed neuropsychology datasets on HH and epilepsy from two centers, we retrospectively report on cognitive functions in 48 patients with structural epilepsy due to HH (mean age ± standard deviation [SD] 20 ± 12 years, range 5-53 years, median 16 years; disease duration mean 17 ± 11 years).

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Objective: To determine whether patients with hypothalamic hamartoma (HH) improve in their cognitive functioning after neurosurgical resection of their HH and explore what variables correlate with cognitive outcome.

Methods: Thirty-two patients underwent preoperative and postoperative neuropsychological testing. The age range of patients was between 3.

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We evaluated health-related quality of life in patients with hypothalamic hamartoma, to see how it differs from that of children with more common neurologic disorders. We used the PedsQL 4.0, along with the Child Behavior Checklist, Hague Seizure Severity Scale, and Side Effects Scale, to evaluate presurgical patients with hypothalamic hamartoma and epilepsy (n = 21).

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Objective: The goal of the work described here was to examine the relationship between intellectual test performance in patients with hypothalamic hamartoma (HH) with refractory epilepsy and their seizure histories, as well as the size and neuroradiographic anatomical features of the HH. It was predicted that the level of estimated intelligence and the pattern of intellectual test performance would significantly correlate with the size of the HH and neuroanatomical features.

Method: In this cross-sectional design study, 49 patients with HH between the ages of 5 and 55 years were classified by age at time of examination, as well as pattern of performance on the Wechsler intelligence scales.

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Primary Objective: To explore pre-injury variables related to post-discharge psychosocial status and identify factors related to work and driving outcomes.

Methods And Procedures: Ninety-three brain-injured patients attended a holistic milieu-oriented neurorehabilitation program and were contacted 1-7 years post-discharge.

Experimental Interventions: Questionnaire data addressing pre-injury and post-injury work, driving, income, marital status and living situation.

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Objective: To determine whether patients with traumatic brain injury (TBI) report higher levels of fatigue than do normal controls and to identify demographic and cognitive correlates of self-reported fatigue.

Design: Prospective study.

Setting: Inpatient neurorehabilitation unit in a medical center and neurological institute.

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