The approach to sports concussion diagnosis and management has been evolving at an unprecedented rate over the last several years. So much so, that committees at all level of sports have implemented concussion protocols and made adjustments to certain league rules in an effort to minimize the risk of head injury. With this newfound attention has come an even greater push by the scientific community to address the many questions that remain. The aim of this review article is to present the topic of sports concussion by means of discreet eras. It begins by introducing the very first mentions of concussion, dating back to ancient Greece, to present day, highlighting important periods along the way. It then goes on to review emerging scientific data, from biomarkers and serum studies, to imaging modalities, and brain networking. All of which will hopefully contribute to both the diagnostic and therapeutic approach to sports concussion.
ObjectiveWhile the approach to concussion and post-concussion syndrome management remains largely clinical, significant advancements have been made in identifying potential biomarkers to aid in the diagnosis and management of head injures. One such potential biomarker is Brain Network Activation (BNA) analysis. BNA is a multi-channel, EEG-ERP based platform that involves algorithmic analysis to provide a network map of cortical activity and quantitative data during specific tasks.DesignCase Series.SettingOutpatient, clinic-based.ParticipantsThree (3) athletes.Outcome measuresAnalysis of the subject’s BNA performance yieldsa BNA score,which reflects the degree of similarity between the performance of the subject and the normative data. BNA scores are further placed into one of three subcategories: Working Memory and Attention (Target Stimuli), Automatic Attention Orienting (Novel Stimuli), and Sensory (Frequent Stimuli). Each subject underwent a BNA analysis while symptomatic, followed by repeat analyses once subjects were identified as clinically asymptomatic.Main resultsIn each of the three studies, there were improvements in BNA scores identified in one, or several, subcategories. More importantly, improvements in BNA scores directly correlated with clinical improvement in the post-concussive setting.ConclusionsApproach to concussion management, in both the short-term and long-term setting, remains largely clinical. Current research seeks a more objective means of assessing not only potential structural abnormalities following a concussion, but also an improved means of assessing a patient’s neurocognitive status. BNA has proven to be an effective, supportive tool in allowing clinicians and patients to objectify one’s progress following a concussive injury.Competing interestsNone.
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