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Walter AE, Wilkes JR, Scaramuzzo M, Johns-Bostick T, Lynch S, Sebastianelli W, Seidenberg P, Bream T, Slobounov SM. Head acceleration event exposure and cognitive and functional outcomes: a comparison of multiple football seasons. Res Sports Med 2024; 32:122-131. [PMID: 35708219 DOI: 10.1080/15438627.2022.2090249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/11/2022] [Indexed: 10/18/2022]
Abstract
Athletes in contact sports are exposed to repetitive impacts as an inherent part of sport. There is concern over the accumulative effect; however, much is still unknown regarding their short-term effects. This study investigated impact accumulation and outcomes over three seasons (2015, 2017, 2019) in NCAA Football Bowl Subdivision players. Impacts were recorded using helmet accelerometers, and virtual reality testing (VR) was done across the season. Incidence rates for impacts (total; ≥25 G to <80 G; ≥80 G) all significantly differed by season (p < 0.05). VR scores changed across the seasons, specifically significant decreases in spatial memory (p < 0.05) in 2015, significant changes in balance and spatial memory (p < 0.05) in 2017, and no significant changes in 2019. Linear regressions predicting VR change score by impact incidence rate were nonsignificant. Monitoring exposure to impacts and changes in outcomes is useful; however, results are fluid, and many factors could indirectly have protective effects on athletes.
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Affiliation(s)
- Alexa E Walter
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA
| | - James R Wilkes
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Madeleine Scaramuzzo
- Intercollegiate Athletics, The Pennsylvania State University, University Park, PA, USA
- Intercollegiate Athletics, Southeastern Louisiana University, Hammond, LA, USA
| | - Tesa Johns-Bostick
- Intercollegiate Athletics, The Pennsylvania State University, University Park, PA, USA
| | - Scott Lynch
- Department of Orthopaedics, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Wayne Sebastianelli
- Department of Orthopaedics and Rehabilitation, the Pennsylvania State University, Penn State College of Medicine, State College, PA, USA
| | - Peter Seidenberg
- Department of Orthopaedics and Rehabilitation and Family and Community Medicine, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Family Medicine, Louisiana State University Health School of Medicine, Shreveport, LA, USA
| | - Tim Bream
- Intercollegiate Athletics, The Pennsylvania State University, University Park, PA, USA
- SAFR Sport Technologies, Chester Springs, PA, USA
| | - Semyon M Slobounov
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
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Meiling JB, Schulze DR, Hines E, Hassett LC, Esterov D. Traumatic Brain Injury After Music-Associated Head Banging: A Scoping Review. Arch Rehabil Res Clin Transl 2022; 4:100192. [PMID: 36123989 PMCID: PMC9482027 DOI: 10.1016/j.arrct.2022.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To examine the literature to understand the extent that music-associated head banging (MAHB), a common form of self-expression that involves rhythmically swinging one's head to music, is a risk factor for traumatic brain injury (TBI), to identify areas for further research, and to inform primary prevention strategies. Data Sources A comprehensive search of several databases from database inception to June 30, 2021, was designed and conducted by an experienced librarian with input from study investigators. Study Selection Study inclusion criteria encompassed all study designs evaluating TBI associated with MAHB. Two independent reviewers reviewed all titles, abstracts, and full texts. Data Extraction Data were extracted by 2 independent reviewers, and results were summarized descriptively. Data Synthesis Of 407 eligible studies, 13 met inclusion criteria. All included studies were case reports from multiple countries describing a case of moderate-severe TBI occurring as a direct consequence of MAHB. Of the individuals reported (n=13), they had 1 or more of the following: traumatic subdural hematoma (n=8), internal carotid artery dissection (n=2), basilar artery thrombosis (n=2), traumatic vertebral artery aneurism (n=1), or intracerebral hemorrhage (n=1). No studies were found involving mild TBI after MAHB. Conclusions This scoping review suggests that MAHB is a risk factor for moderate-severe TBI, although the incidence of mild TBI after MAHB remains unknown. Additional research is needed to understand the association of TBI after MAHB through the spectrum of injury severity, including the potential sequelae of multiple subconcussive injuries.
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DiFabio MS, Smith DR, Breedlove KM, Pohlig RT, Buckley TA, Johnson CL. Altered Brain Functional Connectivity in the Frontoparietal Network following an Ice Hockey Season. Eur J Sport Sci 2022; 23:684-692. [PMID: 35466861 DOI: 10.1080/17461391.2022.2069512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractSustaining sports-related head impacts has been reported to result in neurological changes that potentially lead to later-life neurological disease. Advanced neuroimaging techniques have been used to detect subtle neurological effects resulting from head impacts, even after a single competitive season. The current study used resting-state functional magnetic resonance imaging to assess changes in functional connectivity of the frontoparietal network, a brain network responsible for executive functioning, in collegiate club ice hockey players over one season. Each player was scanned before and after the season and wore accelerometers to measure head impacts at practices and home games throughout the season. We examined pre- to post-season differences in connectivity within the frontoparietal and default mode networks, as well as the relationship between the total number of head impacts sustained and changes in connectivity. We found a significant interaction between network region of interest and time point (p = 0.016), in which connectivity between the left and right posterior parietal cortex seed regions increased over the season (p < 0.01). Number of impacts had a significant effect on frontoparietal network connectivity, such that more impacts were related to greater connectivity differences over the season (p = 0.042). Overall, functional connectivity increased in ice hockey athletes over a season between regions involved in executive functioning, and sensory integration, in particular. Furthermore, those who sustained more impacts had the greatest changes in connectivity. Consistent with prior findings in resting-state sports-related head impact literature, these findings have been suggested to represent brain injury.
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Affiliation(s)
- Melissa S DiFabio
- Department of Biomedical Engineering, University of Delaware, Newark, DE.,Department of Child and Adolescent Psychiatry, Psychomatics, and Psychotherapy, Ludwig-Maximilans-Universität München - University of Munich, Munich, Germany
| | - Daniel R Smith
- Department of Biomedical Engineering, University of Delaware, Newark, DE
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, MA.,Department of Radiology, Harvard Medical School, Boston, MA
| | - Ryan T Pohlig
- Biostatistics Core Facility, College of Health Sciences, University of Delaware, Newark, DE
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Curtis L Johnson
- Department of Biomedical Engineering, University of Delaware, Newark, DE
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Espinoza TR, Hendershot KA, Liu B, Knezevic A, Jacobs BB, Gore RK, Guskiewicz KM, Bazarian JJ, Phelps SE, Wright DW, LaPlaca MC. A Novel Neuropsychological Tool for Immersive Assessment of Concussion and Correlation with Subclinical Head Impacts. Neurotrauma Rep 2021; 2:232-244. [PMID: 34223554 PMCID: PMC8240822 DOI: 10.1089/neur.2020.0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mild traumatic brain injury (mTBI) remains a diagnostic challenge and therefore strategies for objective assessment of neurological function are key to limiting long-term sequelae. Current assessment methods are not optimal in austere environments such as athletic fields; therefore, we developed an immersive tool, the Display Enhanced Testing for Cognitive Impairment and mTBI (DETECT) platform, for rapid objective neuropsychological (NP) testing. The objectives of this study were to assess the ability of DETECT to accurately identify neurocognitive deficits associated with concussion and evaluate the relationship between neurocognitive measures and subconcussive head impacts. DETECT was used over a single season of two high school and two college football teams. Study participants were instrumented with Riddell Head Impact Telemetry (HIT) sensors and a subset tested with DETECT immediately after confirmed impacts for different combinations of linear and rotational acceleration. A total of 123 athletes were enrolled and completed baseline testing. Twenty-one players were pulled from play for suspected concussion and tested with DETECT. DETECT was 86.7% sensitive (95% confidence interval [CI]: 59.5%, 98.3%) and 66.7% specific (95% CI: 22.3%, 95.7%) in correctly identifying athletes with concussions (15 of 21). Weak but significant correlations were found between complex choice response time (processing speed and divided attention) and both linear (Spearman rank correlation coefficient 0.262, p = 0.02) and rotational (Spearman coefficient 0.254, p = 0.03) acceleration on a subset of 76 players (113 DETECT tests) with no concussion symptoms. This study demonstrates that DETECT confers moderate to high sensitivity in identifying acute cognitive impairment and suggests that football impacts that do not result in concussion may negatively affect cognitive performance immediately following an impact. Specificity, however, was not optimal and points to the need for additional studies across multiple neurological domains. Given the need for more objective concussion screening in triage situations, DETECT may provide a solution for mTBI assessment.
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Affiliation(s)
- Tamara R Espinoza
- Department of Emergency Medicine, Division of Emergency Neurosciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kristopher A Hendershot
- Department of Emergency Medicine, Division of Emergency Neurosciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Brian Liu
- Georgia Tech Research Institute (GTRI), Advanced Human Integration Branch, Atlanta, Georgia, USA
| | - Andrea Knezevic
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Breanne B Jacobs
- Department of Emergency Medicine, Division of Emergency Neurosciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Russell K Gore
- Complex Concussion Clinic, Shepherd Center, Atlanta, Georgia, USA
| | - Kevin M Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina, North Carolina, USA
| | - Jeffery J Bazarian
- Department of Emergency Medicine, University of Rochester, Rochester, New York, USA
| | - Shean E Phelps
- Georgia Tech Research Institute (GTRI), Advanced Human Integration Branch, Atlanta, Georgia, USA
| | - David W Wright
- Department of Emergency Medicine, Division of Emergency Neurosciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michelle C LaPlaca
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, USA
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