TY - JOUR
T1 - The dynamics of concussion
T2 - Mapping pathophysiology, persistence, and recovery with causal-loop diagramming
AU - Kenzie, Erin S.
AU - Parks, Elle L.
AU - Bigler, Erin D.
AU - Wright, David W.
AU - Lim, Miranda M.
AU - Chesnutt, James C.
AU - Hawryluk, Gregory W.J.
AU - Gordon, Wayne
AU - Wakeland, Wayne
N1 - Publisher Copyright:
© 2018 Kenzie, Parks, Bigler, Wright, Lim, Chesnutt, Hawryluk, Gordon and Wakeland.
PY - 2018/4/4
Y1 - 2018/4/4
N2 - Despite increasing public awareness and a growing body of literature on the subject of concussion, or mild traumatic brain injury, an urgent need still exists for reliable diagnostic measures, clinical care guidelines, and effective treatments for the condition. Complexity and heterogeneity complicate research efforts and indicate the need for innovative approaches to synthesize current knowledge in order to improve clinical outcomes. Methods from the interdisciplinary field of systems science, including models of complex systems, have been increasingly applied to biomedical applications and show promise for generating insight for traumatic brain injury. The current study uses causal-loop diagramming to visualize relationships between factors influencing the pathophysiology and recovery trajectories of concussive injury, including persistence of symptoms and deficits. The primary output is a series of preliminary systems maps detailing feedback loops, intrinsic dynamics, exogenous drivers, and hubs across several scales, from micro-level cellular processes to social influences. Key system features, such as the role of specific restorative feedback processes and cross-scale connections, are examined and discussed in the context of recovery trajectories. This systems approach integrates research findings across disciplines and allows components to be considered in relation to larger system influences, which enables the identification of research gaps, supports classification efforts, and provides a framework for interdisciplinary collaboration and communication-all strides that would benefit diagnosis, prognosis, and treatment in the clinic.
AB - Despite increasing public awareness and a growing body of literature on the subject of concussion, or mild traumatic brain injury, an urgent need still exists for reliable diagnostic measures, clinical care guidelines, and effective treatments for the condition. Complexity and heterogeneity complicate research efforts and indicate the need for innovative approaches to synthesize current knowledge in order to improve clinical outcomes. Methods from the interdisciplinary field of systems science, including models of complex systems, have been increasingly applied to biomedical applications and show promise for generating insight for traumatic brain injury. The current study uses causal-loop diagramming to visualize relationships between factors influencing the pathophysiology and recovery trajectories of concussive injury, including persistence of symptoms and deficits. The primary output is a series of preliminary systems maps detailing feedback loops, intrinsic dynamics, exogenous drivers, and hubs across several scales, from micro-level cellular processes to social influences. Key system features, such as the role of specific restorative feedback processes and cross-scale connections, are examined and discussed in the context of recovery trajectories. This systems approach integrates research findings across disciplines and allows components to be considered in relation to larger system influences, which enables the identification of research gaps, supports classification efforts, and provides a framework for interdisciplinary collaboration and communication-all strides that would benefit diagnosis, prognosis, and treatment in the clinic.
KW - Causal-loop diagram
KW - Complexity
KW - Concussion
KW - Models of injury
KW - Recovery
KW - Systems medicine
KW - Systems science
KW - Traumatic brain injury
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UR - http://www.scopus.com/inward/citedby.url?scp=85045059824&partnerID=8YFLogxK
U2 - 10.3389/fneur.2018.00203
DO - 10.3389/fneur.2018.00203
M3 - Article
AN - SCOPUS:85045059824
SN - 1664-2295
VL - 9
JO - Frontiers in Neurology
JF - Frontiers in Neurology
IS - APR
M1 - 203
ER -