Sport-Related Concussion: Evaluation, Treatment, and Future Directions

Abstract

Sport-related concussion (SRC) is a highly prevalent injury predominantly affecting millions of youth through high school athletes every year. In recent years, SRC has received a significant amount of attention due to potential for long-term neurologic sequelae. However, the acute symptoms and possibility of prolonged recovery account for the vast majority of morbidity from SRC. Modifying factors have been identified and may allow for improved prediction of a protracted course. Potential novel modifying factors may include genetic determinants of recovery, as well as radiographic biomarkers, which represent burgeoning subfields in SRC research. Helmet design and understanding the biomechanical stressors on the brain that lead to concussion also represent active areas of research. This narrative review provides a general synopsis of SRC, including relevant definitions, current treatment paradigms, and modifying factors for recovery, in addition to novel areas of research and future directions for SRC research.

Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches?

“…Both TBI patients and rSRC athletes performed significantly worse in the memory domain. This result agrees with other studies demonstrating impaired neuropsychological outcome in TBI patients and rSRC athletes during the subacute/chronic stage [2,4,5,7,20,23,39,56]. In patients with evidence of structural and functional abnormalities after TBI, effective cognitive rehabilitation interventions initiated post TBI enhance the recovery process and minimize the functional disability [57].…”

“…Sport-related concussion (SRC), defined as a mild TBI, affects millions of athletes each year [6,7]. While most SRC-induced symptoms resolve within 2-3 weeks, headache, dizziness, confusion, and nausea may be long-lasting.…”

Executive Dysfunction after a Sport-Related Concussion Is Independent of Task-Based Symptom Burden

“…It is, however, important to recognize that the tool's utility decreases significantly three to five days post-concussive eventa critical limitation given that many sport venues do not provide the opportunity for the timely administration of the SCAT-5 (McCrory et al, 2017;Torres et al, 2013). Similarly, the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) is a brief computer-administered neuropsychological test battery that has been employed among several professional sports organizations for concussion management (Covassin & Elbin, 2010;McKeithan, Hibshman, Yengo-Kahn, Solomon, & Zuckerman, 2019). The test battery consists of six individual modules (e.g., Colour Trails, Symbol Matching) that provide global measures of attention, memory, response variability, RT, and processing speed (Iverson, Lovell, & Collins, 2005).…”

Neurotrauma Prevention Review: Improving Helmet Design and Implementation

“…50 Consequently, helmet designs in sports and combat have historically neglected to consider rotational acceleration and the resultant more mild traumatic brain injuries (mTBI) such as concussion and subconcusion. 7,51 Rotational acceleration produces axonal shearing, obstructing axonal function, and causing an accumulation of amyloid-beta precursor protein that peaks after 24-48 hours. [52][53][54] In addition, shearing and mechanical forces produce plasma membrane instability resulting in potassium leakage and neuronal depolarization.…”