Analysis and Evolution of Head Injury in Football

Levy, Michael L.; Ozgur, Burak M.; Berry, Cherisse; Aryan, Henry E.; Apuzzo, Michael L.J.

doi:10.1227/01.neu.0000134598.06114.89

Cited by 54 publications

(50 citation statements)

References 54 publications

(42 reference statements)

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“…These included the classical or standard Morris water maze (sMWM) and reversal Morris water maze (rMWM) tests, novel object recognition (NOR), passive avoidance (PA), tail suspension (TS), beam walk (BW), and open-field locomotor activity. The goals were to examine the following questions: (1) whether more detailed behavioral assessment than is usually employed is feasible in experimental TBI; (2) to what degree the various behavioral tasks reflect lesion changes and loss of cells in specific anatomical regions; (3) whether the use of multiple behavioral outcomes enhances the ability to discriminate across levels of injury severity; and (4) whether a combined assessment ''neuroscore'' could be developed that increases predictive value in distinguishing injury severity.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence data likely represent underestimates, as these figures do not adequately reflect concussion, which appears to be under-reported and is often not seen in emergency departments. There is increasing recognition of the consequences of concussion and repeated mild TBI in both contact sports, [1][2][3] and in the military setting. 4 TBI causes tissue damage and associated neurological dysfunction through both primary and secondary injury mechanisms.…”

Section: Introductionmentioning

confidence: 99%

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Comparing the Predictive Value of Multiple Cognitive, Affective, and Motor Tasks after Rodent Traumatic Brain Injury

Zhao

Loane

Murray

et al. 2012

Journal of Neurotrauma

140

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Controlled cortical impact injury (CCI) is a widely-used, clinically-relevant model of traumatic brain injury (TBI). Although functional outcomes have been used for years in this model, little work has been done to compare the predictive value of various cognitive and sensorimotor assessment tests, singly or in combination. Such information would be particularly useful for assessing mechanisms of injury or therapeutic interventions. Following isoflurane anesthesia, C57BL/6 mice were subjected to sham, mild (5.0 m/sec), moderate (6.0 m/sec), or severe (7.5 m/sec) CCI. A battery of behavioral tests were evaluated and compared, including the standard Morris water maze (sMWM), reversal Morris water maze (rMWM), novel object recognition (NOR), passive avoidance (PA), tail-suspension (TS), beam walk (BW), and open-field locomotor activity. The BW task, performed at post-injury days (PID) 0, 1, 3, 7, 14, 21, and 28, showed good discrimination as a function of injury severity. The sMWM and rMWM tests (PID 14-23), as well as NOR (PID 24 and 25), effectively discriminated spatial and novel object learning and memory across injury severity levels. Notably, the rMWM showed the greatest separation between mild and moderate/severe injury. PA (PID 27 and 28) and TS (PID 24) also reflected differences across injury levels, but to a lesser degree. We also compared individual functional measures with histological outcomes such as lesion volume and neuronal cell loss across anatomical regions. In addition, we created a novel composite behavioral score index from individual complementary behavioral scores, and it provided superior discrimination across injury severities compared to individual tests. In summary, this study demonstrates the feasibility of using a larger number of complementary functional outcome behavioral tests than those traditionally employed to follow post-traumatic recovery after TBI, and suggests that the composite score may be a helpful tool for screening new neuroprotective agents or for addressing injury mechanisms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing the Predictive Value of Multiple Cognitive, Affective, and Motor Tasks after Rodent Traumatic Brain Injury

Zhao

Loane

Murray

et al. 2012

Journal of Neurotrauma

140

View full text Add to dashboard Cite

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“…With the adoption of NOCSAE standards, fatalities decreased by 74% and head injuries decreased from 4.25 per 100,000 to 0.69 per 100,000. 21 In summary, the evolution of better helmet technology, together with further rule changes and head injury management guidelines, has further reduced football head injuries. 22 For this analysis to be valid, adequate follow-up is necessary.…”

Section: Discussionmentioning

confidence: 99%

High School Football and Risk of Neurodegeneration: A Community-Based Study

Savica

Parisi

Wold

et al. 2012

Mayo Clinic Proceedings

141

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Objective: To assess whether high school football played between 1946 and 1956, when headgear was less protective than today, was associated with development of neurodegenerative diseases later in life. Methods: All male students who played football from 1946 to 1956 in the high schools of Rochester, Minnesota, plus a non-football-playing referent group of male students in the band, glee club, or choir were identified. Using the records-linkage system of the Rochester Epidemiology Project, we reviewed (from October 31, 2010, to March 30, 2011 all available medical records to assess later development of dementia, Parkinson disease (PD), or amyotrophic lateral sclerosis (ALS). We also compared the frequency of dementia, PD, or ALS with incidence data from the general population of Olmsted County, Minnesota. Results: We found no increased risk of dementia, PD, or ALS among the 438 football players compared with the 140 non-football-playing male classmates. Parkinson disease and ALS were slightly less frequent in the football group, whereas dementia was slightly more frequent, but not significantly so. When we compared these results with the expected incidence rates in the general population, only PD was significantly increased; however, this was true for both groups, with a larger risk ratio in the non-football group. Conclusion: Our findings suggest that high school students who played American football from 1946 to 1956 did not have an increased risk of later developing dementia, PD, or ALS compared with non-football-playing high school males, despite poorer equipment and less regard for concussions compared with today and no rules prohibiting head-first tackling (spearing). M ultiple concussive head injuries incurred in sporting activities previously have been associated with progressive neurodegenerative disease later in life. Initially, it was reported in boxers (dementia pugilistica), 1 but an evolving literature now suggests that this risk extends to other sports in which concussions are common. The term chronic traumatic encephalopathy (CTE) has been used to define this condition, with dementia being the primary delayed outcome.2 Besides fighting sports, American football, soccer, and hockey predispose players to head trauma and have been implicated in the later development of CTE. 3,4 Moreover, head trauma and sport-related trauma have been reported as risk factors for development of Parkinson disease (PD), 5 dementia, 6 and amyotrophic lateral sclerosis (ALS). 7,8 Although repeated concussive head trauma is a purported risk factor for later neurodegenerative disease, few studies have evaluated long-term risks in a cohort of athletes participating in a sport that is often associated with concussions.9 American football as played several decades ago often put participants at risk for concussion, which at the time was commonly disregarded ("bell rung"); moreover, the protective headgear of that era was marginally protective against concussions (Figure 1). We chose to analyze the long-term medical ou...

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“…67,90,91 Therefore, athletes participating in football should wear undamaged, properly fitted helmets with secured chin straps. By protecting the scalp from the discomfort of blows to the vertex of the head, however, helmets are considered, in part, to have led to an increase in the number of cases of quadriplegia by encouraging the use of the head as the point of impact.…”

Section: Rule Changesmentioning

confidence: 99%

Tackling in Youth Football

Brenner¹,

LaBella²,

Brooks³

et al. 2015

Pediatrics

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American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for longterm sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk.

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Analysis and Evolution of Head Injury in Football

Cited by 54 publications

References 54 publications

Comparing the Predictive Value of Multiple Cognitive, Affective, and Motor Tasks after Rodent Traumatic Brain Injury

Comparing the Predictive Value of Multiple Cognitive, Affective, and Motor Tasks after Rodent Traumatic Brain Injury

High School Football and Risk of Neurodegeneration: A Community-Based Study

Tackling in Youth Football

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