Utility of Providing a Concussion Definition in the Assessment of Concussion History in Former NFL Players

Overview

Journal Brain Inj

Publisher Informa Healthcare

Specialty Neurology

Date 2017 May 5

PMID 28471243

Citations 16

Authors

Michael L Alosco

Johnny Jarnagin

Yorghos Tripodis

Brett Martin

Christine Chaisson

Christine M Baugh

Alcy Torres

Christopher J Nowinski

Robert C Cantu

Robert A Stern

Affiliations

Soon will be listed here.

Abstract

Objective: Former National Football League (NFL) players' working knowledge of concussion has not yet been evaluated, despite this population being a major clinical research target due to the association between repetitive head impacts (RHI) and long-term clinical impairments. This study examined former NFL players' understanding of the current concussion definition, and the association between number of concussions with clinical function.

Methods: 95 former NFL players (mean age = 55.29; mean NFL year = 8.10) self-reported number of concussions before being provided with a concussion definition and after being read a modern definition of concussion. Subjects reported number of concussions with loss of consciousness (LOC). Principal Component Analysis of a battery of tests generated behaviour/mood, psychomotor speed/executive function, and verbal and visual memory factor scores.

Results: Post-definition number of concussions (median = 50) was five times the pre-definition (median = 10; p < 0.001). Greater pre- (p = 0.019) and post-definition concussions (p = 0.036) correlated with worse behaviour/mood scores, after controlling for years of football played, with specific effects for depressive symptoms and impulsivity. LOC did not account for variance beyond number of concussions.

Conclusions: Practitioners and clinical researchers should provide a definition of concussion in the assessment of concussion history in former football players to facilitate accuracy and standardization.

Citing Articles

Effects of mTBI with loss of consciousness on neurobehavioral symptoms, depression, and insomnia in former collegiate and NFL football athletes.

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American Football Play and Parkinson Disease Among Men.

Bruce H, Tripodis Y, McClean M, Korell M, Tanner C, Contreras B JAMA Netw Open. 2023; 6(8):e2328644.

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Neuropsychological test performance of former American football players.

Alosco M, Barr W, Banks S, Wethe J, Miller J, Pulukuri S Alzheimers Res Ther. 2023; 15(1):1.

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White matter hyperintensities in former American football players.

Alosco M, Tripodis Y, Baucom Z, Adler C, Balcer L, Bernick C Alzheimers Dement. 2022; 19(4):1260-1273.

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Towards defining biomarkers to evaluate concussions using virtual reality and a moving platform (BioVRSea).

Jacob D, Unnsteinsdottir Kristensen I, Aubonnet R, Recenti M, Donisi L, Ricciardi C Sci Rep. 2022; 12(1):8996.

PMID: 35637235 PMC: 9151646. DOI: 10.1038/s41598-022-12822-0.

References

Peng H, Zheng H, Li L, Liu J, Zhang Y, Shan B . High-frequency rTMS treatment increases white matter FA in the left middle frontal gyrus in young patients with treatment-resistant depression. J Affect Disord. 2012; 136(3):249-57. DOI: 10.1016/j.jad.2011.12.006. View

Kelly J, Nichols J, Filley C, Lillehei K, Rubinstein D, Kleinschmidt-DeMasters B . Concussion in sports. Guidelines for the prevention of catastrophic outcome. JAMA. 1991; 266(20):2867-9. DOI: 10.1001/jama.266.20.2867. View

Lovell M, Iverson G, Collins M, McKeag D, Maroon J . Does loss of consciousness predict neuropsychological decrements after concussion?. Clin J Sport Med. 1999; 9(4):193-8. DOI: 10.1097/00042752-199910000-00002. View

Baugh C, Kroshus E . Concussion management in US college football: progress and pitfalls. Concussion. 2016; 1(1). PMC: 4825689. DOI: 10.2217/cnc.15.6. View

Kroshus E, Daneshvar D, Baugh C, Nowinski C, Cantu R . NCAA concussion education in ice hockey: an ineffective mandate. Br J Sports Med. 2013; 48(2):135-40. DOI: 10.1136/bjsports-2013-092498. View

Pietrosimone B, Golightly Y, Mihalik J, Guskiewicz K . Concussion Frequency Associates with Musculoskeletal Injury in Retired NFL Players. Med Sci Sports Exerc. 2015; 47(11):2366-72. DOI: 10.1249/MSS.0000000000000684. View

Cantu R . Posttraumatic Retrograde and Anterograde Amnesia: Pathophysiology and Implications in Grading and Safe Return to Play. J Athl Train. 2003; 36(3):244-248. PMC: 155413. View

Mannings C, Kalynych C, Joseph M, Smotherman C, Kraemer D . Knowledge assessment of sports-related concussion among parents of children aged 5 years to 15 years enrolled in recreational tackle football. J Trauma Acute Care Surg. 2014; 77(3 Suppl 1):S18-22. DOI: 10.1097/TA.0000000000000371. View

Denny-Brown D . The Principles of Treatment of Closed Head Injury. Bull N Y Acad Med. 2009; 19(1):3-16. PMC: 1933941. View

10.

Kerr Z, Marshall S, Guskiewicz K . Reliability of concussion history in former professional football players. Med Sci Sports Exerc. 2011; 44(3):377-82. DOI: 10.1249/MSS.0b013e31823240f2. View

11.

Alosco M, Jarnagin J, Tripodis Y, Platt M, Martin B, Chaisson C . Olfactory Function and Associated Clinical Correlates in Former National Football League Players. J Neurotrauma. 2016; 34(4):772-780. PMC: 5314992. DOI: 10.1089/neu.2016.4536. View

12.

Bieniek K, Ross O, Cormier K, Walton R, Soto-Ortolaza A, Johnston A . Chronic traumatic encephalopathy pathology in a neurodegenerative disorders brain bank. Acta Neuropathol. 2015; 130(6):877-89. PMC: 4655127. DOI: 10.1007/s00401-015-1502-4. View

13.

Strain J, Didehbani N, Cullum C, Mansinghani S, Conover H, Kraut M . Depressive symptoms and white matter dysfunction in retired NFL players with concussion history. Neurology. 2013; 81(1):25-32. PMC: 3770203. DOI: 10.1212/WNL.0b013e318299ccf8. View

14.

Guskiewicz K, Marshall S, Bailes J, McCrea M, Harding Jr H, Matthews A . Recurrent concussion and risk of depression in retired professional football players. Med Sci Sports Exerc. 2007; 39(6):903-9. DOI: 10.1249/mss.0b013e3180383da5. View

15.

Goswami R, Dufort P, Tartaglia M, Green R, Crawley A, Tator C . Frontotemporal correlates of impulsivity and machine learning in retired professional athletes with a history of multiple concussions. Brain Struct Funct. 2015; 221(4):1911-25. PMC: 4853456. DOI: 10.1007/s00429-015-1012-0. View

16.

Montenigro P, Alosco M, Martin B, Daneshvar D, Mez J, Chaisson C . Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players. J Neurotrauma. 2016; 34(2):328-340. PMC: 5220530. DOI: 10.1089/neu.2016.4413. View

17.

Wright M, Woo E, Birath J, Siders C, Kelly D, Wang C . An index predictive of cognitive outcome in retired professional American Football players with a history of sports concussion. J Clin Exp Neuropsychol. 2016; 38(5):561-71. DOI: 10.1080/13803395.2016.1139057. View

18.

Cheng G, Lee T . Altering risky decision-making: Influence of impulsivity on the neuromodulation of prefrontal cortex. Soc Neurosci. 2015; 11(4):353-64. DOI: 10.1080/17470919.2015.1085895. View

19.

Guskiewicz K, Marshall S, Bailes J, McCrea M, Cantu R, Randolph C . Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery. 2005; 57(4):719-26. DOI: 10.1093/neurosurgery/57.4.719. View

20.

Broglio S, Eckner J, Martini D, Sosnoff J, Kutcher J, Randolph C . Cumulative head impact burden in high school football. J Neurotrauma. 2011; 28(10):2069-78. PMC: 4346237. DOI: 10.1089/neu.2011.1825. View