Neuroimaging and Neuropsychological Studies in Sports-Related Concussions in Adolescents: Current State and Future Directions

Abstract

Sports-related concussion, is a serious neurological concern that many adolescent athletes will face during their athletic careers. In some instances, the effects of sports-related head injury are long-lasting. Due to their still-developing brains, adolescents appear to be more vulnerable to long-term repercussions of these injuries. As all sports-related concussions are mild traumatic brain injuries (mTBI), this review we will examine the pathophysiology of mTBI, its acute effects and long-term risks from sustaining injury, and current and needed advancements in the areas of neuropsychological testing, accelerometer telemetry, and neuroimaging. Current methods do not adequately measure the extent of an injury that an athlete may sustain, potentially putting these athletes at a much greater risk for long-term effects. To better understand mTBI, neuropsychological testing best practices need to be developed, standardized, and implemented based on sound scientific evidence in order to be propagated as clinical guidelines. Wearable accelerometers can be used to assess thresholds for mTBI and cumulative effects of concussive and subconcussive injuries. Novel neuroimaging methods that can detect anatomical abnormalities and functional deficits with more specificity and sensitivity should be developed. Young athletes are particularly a vulnerable population warranting immediate and significant research aimed at protecting them against sports related injury and mitigating their long-term deficits.

Altered white matter diffusivity and subtle motor function in a pilot cohort of adolescents with sports-related concussion

“…Recent systematic reviews focusing on pediatric SRC have noted the heterogeneity in DTI findings ( 54 , 55 ). In addition to differences in study methodology and participant characteristics, this variability is partly attributed to SRC being one of the mildest forms of brain injury with the greatest fluctuations of symptom presentations and mechanisms of injury ( 56 ).…”

Neuroimaging Markers for Determining Former American Football Players at Risk for Alzheimer's Disease

“…Assessing neuropsychological findings in relation to neuroimaging biomarkers in persons who show decline can be potentially useful in assessing the risk for neurodegenerative diseases such as AD. 67 , 68 Thus, we assessed the relationship between ANAM subtest scores and the number of atrophied brain regions in NFL players. Whereas all ANAM subtest scores correlated negatively with the number of atrophied brain regions, the ANAM subtests that showed a significant correlation ( p < 0.05) with the number of atrophied brain regions were M2S and CDS, with a Pearson's correlation coefficient ( r ) of −0.35 and −0.31, respectively ( Table 2 ).…”

Public Awareness of the Fencing Response as an Indicator of Traumatic Brain Injury: Quantitative Study of Twitter and Wikipedia Data

“…Persistent symptoms may linger for some individuals, particularly those who sustain repeated TBIs, for months to years after the injury, including increased risk for psychiatric disorders, drug abuse, and suicide [2,8,9]. Perhaps due to the potential for long-term symptoms and disability, considerable public interest focuses on sport-related TBI among adolescents (<19 years) [10,11]. The most common sport and recreational activities associated with TBI-related ED visits in adolescents are bicycling, American football, basketball, soccer, and playground activities [2].…”

“…Perhaps due to the potential for long-term symptoms and disability, considerable public interest focuses on sport-related TBI among adolescents (<19 years) [ 10 , 11 ]. The most common sport and recreational activities associated with TBI-related ED visits in adolescents are bicycling, American football, basketball, soccer, and playground activities [ 2 ].…”