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6 - Neuroimaging Biomarkers for the Neuropsychological Investigation of Concussive Brain Injury (CBI) Outcome

from Part I - What Is a Concussion?

Published online by Cambridge University Press:  22 February 2019

Jeff Victoroff
Affiliation:
University of Southern California, Torrance
Erin D. Bigler
Affiliation:
Brigham Young University, Utah
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Summary

Chapters 6 and 9 in this textbook address many of the same concerns. The first of these chapters frames an aging controversy: how often does a typical clinically attended concussive brain injury (CBI) have lasting deleterious effects? The most defensible answer is: "Who knows? Let's find out." Unfortunately, this distracting debate has probably delayed the collaboration that must occur between psychologists and biologists in order for science to understand CBI better. Neither field, by itself, is equipped to build the bridge from clinical--pathological correlation to effective treatment. Indeed, the very idea of clinical--pathological correlation is antiquated. Post-mortem neuropathology, squinting at what once was alive, has not and will never demonstrate the effects of concussion on the living human brain. A more meaningful goal is to understand how an abrupt rattling of the brain changes a life -- a process that will be different in every case -- and, within a single case, be different every moment in the survivor's subsequent lifetime. That dynamic process probably involves currently indecipherable feedback loops between infinitely variable heritable aspects of brain function, infinitely variable developmental/environmental influences, equally variable (although somewhat similar) acute post-impact molecular brain change, and the interactions that follow that impact objective and subjective functionality. Put simply: absent biomarkers for CBI, both scholarly progress and cross-disciplinary rapprochement will remain stagnant. It seems legitimate to hope that neuroimaging will revivify both during the next generation.
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Chapter
Information
Concussion and Traumatic Encephalopathy
Causes, Diagnosis and Management
, pp. 259 - 284
Publisher: Cambridge University Press
Print publication year: 2019

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