Effect of Head Impact Exposures on Changes in Cognitive Testing

Abstract

Background:Gaining a better understanding of head impact exposures may lead to better comprehension of the possible effects of repeated impact exposures not associated with clinical concussion.Purpose:To assess the correlation between head impacts and any differences associated with cognitive testing measurements pre- and postseason.Study Design:Case-control study; Level of evidence, 3.Methods:A total of 34 National Collegiate Athletic Association Division I men’s lacrosse players wore lacrosse helmets instrumented with an accelerometer during the 2014 competitive season and were tested pre- and postseason with the Sport Concussion Assessment Tool (SCAT 3) and Concussion Vital Signs (CVS) computer-based neurocognitive tests. The number of head impacts >20g and results from the 2 cognitive tests were analyzed for differences and correlation.Results:There was no significant difference between pre- and postseason SCAT 3 scores, although a significant correlation between pre- and postseason cognitive scores on the SCAT 3 and total number of impacts sustained was noted (r = –0.362, P = .035). Statistically significant improvements on half of the CVS testing components included visual reaction time (P = .037, d = 0.37), reaction time (P = .001, d = 0.65), and simple reaction time (P = .043, d = 0.37), but no correlation with head impacts was noted.Conclusion:This study did not find declines in SCAT 3 or CVS scores over the course of a season among athletes who sustained multiple head impacts but no clinical concussion. Thus, it could not be determined whether there was no cognitive decline among these athletes or whether there may have been subtle declines that could not be measured by the SCAT 3 or CVS.

Longitudinal Alterations of Cerebral Blood Flow in High‐Contact Sports

“…Our within‐FB data similarly support this pattern, with rCBF decreasing over time in those at high‐impact risk and those with lower baseline SCAT scores. SCAT is widely used in the clinical assessment of sport‐related concussions, and the SCAT cognitive score has been shown to correlate with the number of head impacts sustained (>20 g) during a season of high‐impact sports 37 . Other studies correlating SCAT with imaging have shown reduction in CBF 1 year after return to play negatively correlating with SCAT symptom severity, 15 and impaired SCAT cognitive performance 1 day after concussion with elevated CBF compared with day 8 after concussion 13 .…”

“…SCAT is widely used in the clinical assessment of sport-related concussions, and the SCAT cognitive score has been shown to correlate with the number of head impacts sustained (>20 g) during a season of high-impact sports. 37 Other studies correlating SCAT with imaging have shown reduction in CBF 1 year after return to play negatively correlating with SCAT symptom severity, 15 and impaired SCAT cognitive performance 1 day after concussion with elevated CBF compared with day 8 after concussion. 13 None of these studies tracked athletes for multiple years, so given the lack of longitudinal studies in athletes, there is a need for future longitudinal research in athletes correlating CBF changes with neurobehavioral measures, such as SCAT and beyond in this age range.…”

Differential Change in Oculomotor Performance among Female Collegiate Soccer Players versus Non-Contact Athletes from Pre- to Post-Season

“…9,[11][12][13]15,[54][55][56] However, prospective investigations of behavioral and/or cognitive functioning from pre-to post-season have produced mixed results. 16,[18][19][20][22][23][24][25][26] The results of this study suggest that oculomotor testing may possess adequate sensitivity to distinguish differential patterns of change in sensorimotor and cognitive functioning following variable exposure to impacts over the course of a female collegiate soccer season. Further, our findings were on tasks of executive functioning, which is consistent with neuroimaging literature citing alterations in neurometabolism, functional activation, and connectivity in the dorsolateral prefrontal cortex (DLPFC) as a result of subconcussive impacts.…”

“…[8][9][10][11][12][13][14][15] Prospective studies examining the relationship between subconcussive impacts and cognitive functioning have yielded mixed findings, with some reporting decline following impact exposure (in domains such as working memory, processing speed, and verbal learning and memory), [15][16][17][18][19] and others observing no change. [20][21][22][23][24][25][26] Given that cognitive change is seen variably, 7 it is possible a more sensitive measure is needed to reliably detect subtle changes associated with subconcussive impacts. Saccadic oculomotor testing demonstrates promising sensitivity and specificity for distinguishing individuals with and without exposure to head trauma.…”

The Hammer and the Nail: Biomechanics of Striking and Struck Canadian University Football Players

“…2 ; 3M™ Dual Lock™ Recloseable Fastener SJ3551 400 Black, St. Paul, MN). Previous studies have used 4 , 7 , 9 , 12 , 17 and validated 9 this location and mounting. The GFT triggered when the helmet linear acceleration exceeded the user-defined threshold.…”