Contributions of neuroimaging, balance testing, electrophysiology and blood markers to the assessment of sport-related concussion

Guskiewicz, Kevin M.; Ptito, Alain; Johnston, Karen

doi:10.1136/bjsm.2009.058123

Cited by 95 publications

(51 citation statements)

References 112 publications

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“…However, the few studies conducted on younger athletes have not demonstrated significant differences in head injury characteristics or outcomes of athletes who possess these genetic markers. [127][128][129] At this time, genetic testing is not recommended for evaluating young athletes with concussion.…”

Section: Genetic Testingmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

581

445

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Sport-related concussion is a "hot topic" in the media and in medicine. It is a common injury that is likely underreported by pediatric and adolescent athletes. Football has the highest incidence of concussion, but girls have higher concussion rates than boys do in similar sports. A clear understanding of the definition, signs, and symptoms of concussion is necessary to recognize it and rule out more severe intracranial injury. Concussion can cause symptoms that interfere with school, social and family relationships, and participation in sports. Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them. Appropriate management is essential for reducing the risk of long-term symptoms and complications. Cognitive and physical rest is the mainstay of management after diagnosis, and neuropsychological testing is a helpful tool in the management of concussion. Return to sport should be accomplished by using a progressive exercise program while evaluating for any return of signs or symptoms. This report serves as a basis for understanding the diagnosis and management of concussion in children and adolescent athletes.

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Section: Genetic Testingmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

581

445

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“…27,28 Electrophysiological measures (i.e., electroencephalography [EEG] and event-related potential [ERP]) have revealed functional effects of concussion as much as 3 years post-injury, 29 even in the absence of behavioral effects. 30 In addition, a number of recent studies have used functional magnetic resonance imaging (fMRI) to examine functional abnormalities in recently concussed athletes.…”

Section: Introductionmentioning

confidence: 99%

Episodic Memory in Former Professional Football Players with a History of Concussion: An Event-Related Functional Neuroimaging Study

Ford

Giovanello

Guskiewicz

2013

Journal of Neurotrauma

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Previous research has demonstrated that sport-related concussions can have short-term effects on cognitive processes, but the long-term consequences are less understood and warrant more research. This study was the first to use event-related functional magnetic resonance imaging (fMRI) to examine long-term differences in neural activity during memory tasks in former athletes who have sustained multiple sport-related concussions. In an event-related fMRI study, former football players reporting multiple sport-related concussions (i.e., three or more) were compared with players who reported fewer than three concussions during a memory paradigm examining item memory (i.e., memory for the particular elements of an event) and relational memory (i.e., memory for the relationships between elements). Behaviorally, we observed that concussion history did not significantly affect behavioral performance, because persons in the low and high concussion groups had equivalent performance on both memory tasks, and in addition, that concussion history was not associated with any behavioral memory measures. Despite demonstrating equivalent behavioral performance, the two groups of former players demonstrated different neural recruitment patterns during relational memory retrieval, suggesting that multiple concussions may be associated with functional inefficiencies in the relational memory network. In addition, the number of previous concussions significantly correlated with functional activity in a number of brain regions, including the medial temporal lobe and inferior parietal lobe. Our results provide important insights in understanding the long-term functional consequences of sustaining multiple sports-related concussions.

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“…Researchers have investigated more objective measures for concussion diagnosis, including balance testing, 20 neuropsychological testing, 21 and advanced imaging. 22 Whereas these measures assess the clinical symptoms of concussion, no measure can identify the concussed athlete while on the field or be used as a preventive tool. Head-impact biomechanics have been investigated to determine the kinematic signature of a concussion.…”

mentioning

confidence: 99%

Head-Impact–Measurement Devices: A Systematic Review

O’Connor

Rowson

Duma

et al. 2017

Journal of Athletic Training

154

117

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Context: With an estimated 3.8 million sport-and recreation-related concussions occurring annually, targeted prevention and diagnostic methods are needed. Biomechanical analysis of head impacts may provide quantitative information that can inform both prevention and diagnostic strategies.Objective: To assess available head-impact devices and their clinical utility.Data Sources: We performed a systematic search of the electronic database PubMed for peer-reviewed publications, using the following phrases: accelerometer and concussion, head impact telemetry, head impacts and concussion and sensor, head impacts and sensor, impact sensor and concussion, linear acceleration and concussion, rotational acceleration and concussion, and xpatch concussion. In addition to the literature review, a Google search for head impact monitor and concussion monitor yielded 15 more devices.Study Selection: Included studies were performed in vivo, used commercially available devices, and focused on sportrelated concussion.Data Extraction: One author reviewed the title and abstract of each study for inclusion and exclusion criteria and then reviewed each full-text article to confirm inclusion criteria. Controversial articles were reviewed by all authors to reach consensus.Data Synthesis: In total, 61 peer-reviewed articles involving 4 head-impact devices were included. Participants in boxing, football, ice hockey, soccer, or snow sports ranged in age from 6 to 24 years; 18% (n ¼ 11) of the studies included female athletes. The Head Impact Telemetry System was the most widely used device (n ¼ 53). Fourteen additional commercially available devices were presented.Conclusions: Measurements collected by impact monitors provided real-time data to estimate player exposure but did not have the requisite sensitivity to concussion. Proper interpretation of previously reported head-impact kinematics across age, sport, and position may inform future research and enable staff clinicians working on the sidelines to monitor athletes. However, head-impact-monitoring systems have limited clinical utility due to error rates, designs, and low specificity in predicting concussive injury.

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Contributions of neuroimaging, balance testing, electrophysiology and blood markers to the assessment of sport-related concussion

Cited by 95 publications

References 112 publications

Sport-Related Concussion in Children and Adolescents

Sport-Related Concussion in Children and Adolescents

Episodic Memory in Former Professional Football Players with a History of Concussion: An Event-Related Functional Neuroimaging Study

Head-Impact–Measurement Devices: A Systematic Review

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