Mild cognitive impairment and dementia reported by former professional football players over 50 years of age: an NFL-LONG study

Summary: The authors analyzed self-report questionnaire data from over 900 former NFL players (ages 50+). Their results revealed higher prevalence of self-reported MCI and dementia compared to the general population, with self-reported impairment associated with various health-related (reported concussions, depression, anxiety, recent pain, sleep apnea) and demographics-related (age, race) factors. https://pubmed.ncbi.nlm.nih.gov/34593716/ Walton, S. R., Brett,…

Longitudinal trajectory of depression symptom severity and the influence of concussion history and physical function over a 19-year period among former NFL players

Summary: The authors studied 333 former NFL players over a 19-year period to determine factors associated with severity and trajectory of depressive symptoms. Their data revealed an association between concussion history and severity of depression, as well as showed that declining physical functioning was associated with increases in depressive symptoms longitudinally. https://jnnp.bmj.com/content/early/2021/10/17/jnnp-2021-326602 Brett B. L., Kerr Z. Y., Walton S.…

Diagnosis, Management, and Long-Term Risk – Virtual Workshop

Registration is now open for our August 26th Virtual Workshop – Sports Concussion: Diagnosis, Management, and Long-Term Risk! 3.5 CE CreditsThursday, August 26, 2021 (US) | Friday, August, 27, 2021 (AUS)5:00 PM – 8:30 PM ET (US) | 7:00 AM – 10:30 AM (AUS) View or download the full information flyer : http://www.sportsneuropsychologysociety.com/wp-content/uploads/2021/08/CCN_NAN_SNS_EventFlyer2021-1.pdf Please see…

Selected issues in sport-related concussion for the team physician: a consensus statement

This is the latest update to the Team Physician consensus statement on sport-related concussion developed by the Team Physician Consensus Conference (previous drafts published in 2006 and 2011).  The article delineates “essential” information that a team physician must understand and implement and “desirable” information that are considered best-practice in ideal settings.  The article then briefly…

A third of kids develop a mental health problem after concussion.

A third of children and adolescents develop a mental health problem after a concussion, which could persist for several years post-injury, according to a new literature review. The research, led by the Murdoch Children’s Research Institute (MCRI) and published in the British Journal of Sports Medicine, found mental health should be evaluated as part of standard…

After a concussion: No more sitting in the dark?

This is the first study to objectively document self-paced physical and cognitive activity post-concussion among youth suggests they may be able to engage in physical and cognitive activity as soon as tolerated post-concussion. The study, published in the Journal of Head Trauma Rehabilitation, found that self-paced physical and cognitive activity during the first week after sustaining…

Rates of Incidental Findings in Brain Magnetic Resonance Imaging in Children

This study explores the number of incidental findings in a large (N= 11,810) multi-site brain MRI study (Adolescent Brain Cognitive Development).  3T baseline scans were reviewed by board-certified neuroradiologists for incidental findings.  Approximately 21% of the scans had incidental findings with 3.7% warranting non-urgent clinical referrals and 0.2% warranting urgent clinical referrals.  The remaining 17%…

Association Between Previous Concussion Education and Concussion Care-Seeking Outcomes among NCAA Division I Student-Athletes

The authors of this article documented that concussion education increased concussion care seeking behaviors in NCAA Division I student athletes.  Student athletes who had sustained a concussion previously and/or participated in athletic programs with multi-format concussion education were more likely to engage in concussion care seeking than those athletes that had not had those experiences.…

Adolescents With ADHD Do Not Take Longer to Recover From Concussion

The authors presented research data to indicate that high school student athletes with ADHD did not require more recovery time than neurotypical student athletes.  Student athletes with ADHD were able to return to school, and to play, within the same recovery times as their neurotypical pee Cook, N. E., Iverson, G. L., Maxwell, B., Zafonte,…

Distinct latent profiles based on neurobehavioural, physical and psychosocial functioning of former NFL players

In the linked article, Brett and colleagues (including other SNS members Drs. Echemendia and McCrea) performed latent profile analysis to identify distinct groups across a range of functional outcomes in a sample of 686 former NFL players ages 50-70. Measures from the Quality of Life in Neurological Disorders and Patient Reported Outcomes Measurement Information System…

SNS Comment on recent press release regarding “blood test for concussions.”

The Sports Neuropsychology Society (SNS) previously issued a statement in 2018 following the FDA’s 2-13-2018 announcement regarding a blood test that allows for the detection of bleeding into the brain in cases of traumatic brain injury (“FDA authorizes marketing of first blood test to aid in the evaluation of concussion in adults” https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-first-blood-test-aid-evaluation-concussion-adults). The SNS pointed…

A Prospective Study of Concussions and Health Outcomes in High School Football Players

The authors prospectively examined the relationship between sport-related concussions (SRC) and self-reported SRC symptoms, symptom severity, depression, and health-related quality of life (HRQoL) in high school football players from 31 Wisconsin schools. The Post-concussion Symptom Scale (PCSS), the SCAT-3, the PHQ-9, and the Pediatric Quality of Life Inventory 4.0 (PedsQL) were administered at study entry.…

Aerobic Exercise for Sport-related Concussion: A Systematic Review and Meta-analysis.

This is a systematic review and meta-analysis examining the benefits of symptom-limited aerobic exercise on persistent concussion symptoms following sport-related concussion in adolescents. Seven RCT studies, representing 326 participants were included in the meta-analysis (Cochrane Collaboration Handbook methodology utilized). When compared to control interventions, results revealed that aerobic exercise was effective (low level of evidence)…

Age of First Exposure to Football is not Associated with Midlife Brain Health Problems

Is age of first exposure (AFE) to football associated with brain health problems in midlife (ages 35-55)? Results from the study showed that those participating in football before the age of 12 (AFE <12) did not significantly differ from those starting football at or after the age of 12 (AFE >12) in mental health treatment…

Return to sport for North American professional sport leagues in the context of COVID-19

There are important considerations around when and how to return to phased-in operations for 5 North American professional sports leagues (Major League Baseball, Major League Soccer, National Basketball Association, National Football League and National Hockey league) in the context of COVID-19. With a fundamental prioritization on the health and safety of all stakeholders (players, coaches,…

Neurorehabilitation of persistent sport-related post-concussion syndrome

Conder, A., Conder, R., & Friesen, C. (2020). Neurorehabilitation of persistent sport-related post-concussion syndrome. NeuroRehabilitation, 46, 167-180. This review article describes the benefit of applying a biopsychosocial diagnostic framework to guide diagnosis and treatment of sport-related concussion. https://pubmed.ncbi.nlm.nih.gov/32083597/

Use of the SCAT5 in professional hockey: Which components differentiate concussed and non-concussed players?

Bruce, J. M., Thelen, J., Meeuwisse, W., Hutchison, M. G., Rizos, J., Comper, P., & Echemendia, R. J. (2020). Use of the Sport Concussion Assessment Tool 5 (SCAT5) in professional hockey, part 2: Which components differentiate concussed and non-concussed players? British Journal of Sports Medicine. Subcomponents of the Sport Concussion Assessment Tool 5 (SCAT5): Symptom report,…

Use of the SCAT5 in professional hockey: Cross-cultural normative data

Echemendia, R. J., Thelen, J., Meeuwisse, W., Hutchison, M. G., Comper, P., Rizos, J., & Bruce, J. M. (2020). Use of the Sport Concussion Assessment Tool 5 (SCAT5) in professional hockey, part 1: Cross-cultural normative data. British Journal of Sports Medicine. New  normative data for NHL athlete performance on the SCAT5 provides information regarding consideration of language…

Mild cognitive impairment in retired professional football players with a history of mild traumatic brain injury: A pilot investigation.

This study compared cognitive profiles of individuals with mild cognitive impairment (MCI), finding that retired athletes with history of concussion and non-athletes without history of concussion performed similarly on many cognitive domains (verbal memory, verbal fluency, and processing speed), with athletes demonstrating somewhat lower scores on naming and speeded visual attention measures. Results suggest overall…

Affective distress explains discrepancy between objective and subjective cognitive functioning after mild traumatic brain injury.

This study examined factors that relate to level of cognitive symptoms among individuals seen in an interdisciplinary concussion clinic. These results highlight the importance of considering sleep, affective symptoms, time since injury, and age in concussion care and management. Hromas, G. A., Houck, Z. M., Asken, B. M., Svingos, A. M., Greif, S. M., Heaton,…

If you’ve been asked about using EEG as part of concussion diagnosis…

If you’ve been asked about using EEG as part of concussion diagnosis or management, Neuropsychology Review published a review article you should read: The Use of Electroencephalography as an Informative Tool in Assisting Early Clinical Management after Sport-Related Concussion: a Systematic Review The publication is linked below: https://pubmed.ncbi.nlm.nih.gov/32577950/

Testing the hybrid battery approach to evaluating sports-related concussion in the NHL

Separate factor structures for pencil-and-paper assessment vs. computerized assessment of concussion support a hybrid assessment model. Echemendia, R.J., Thelen,J., Meeuwisse, W., Comper,P., Hutchison, M.G.,  & Bruce, J.M.  (2019). Testing the hybrid battery approach to evaluating sports-related concussion in the National Hockey League: A factor analytic study. The Clinical Neuropsychologist. Click for full article – doi.org/10.1080/13854046.2019.1690051

Preliminary evidence of a dose-response for continuing to play on recovery time after concussion.

This article discusses recovery from sports-related concussion in adolescents and provides support for immediate removal from play following a concussion. Charek, D. B., Elbin, R. J., Sufrinko, A., Schatz, P., D’Amico, N. R., Collins, M. W., & Kontos, A. P. (2020). Preliminary evidence of a dose-response for continuing to play on recovery time after concussion. The…

Return to play and risk of repeat concussion in collegiate football players

Return to play and risk of repeat concussion in collegiate football players: comparative analysis from the NCAA Concussion Study (1999–2001) and CARE Consortium (2014–2017). British Journal of Sports Medicine, 54, 102-109. McCrea, M., Broglio, S., McAllister, T., … et al. (2020).  Description: This article examines how sports concussion management and recovery have evolved over a period of 15+ years, reducing athlete risk…

Mental Health Issues and Psychological Factors in Athletes Detection, Management, Effect on Performance, and Prevention

The American Medical Society for Sports Medicine published a position statement on mental health issues and psychological factors in athletes. The statement addresses a range of factors impacting athletes and emphasizes a need for the multi-disciplinary sports medicine team to work together to best provide comprehensive care to athletes. https://journals.lww.com/cjsportsmed/Abstract/publishahead/American_Medical_Society_for_Sports_Medicine.98999.aspx

The Importance Of The Role Of Neuropsychologists In The Healing Process Of Concussion Recovery

This study by Lichtenstein and Merz highlighted the importance of the role of neuropsychologists in the healing process of concussion recovery,  Their data supported a team approach to treating sports related concussions, as well as the value of neuropsychological testing in measuring recovery. Lichtenstein, J.D., Merz, Z.C. Post-Exertion Neuropsychological Testing in the Management of Sport-Related…

A Cross-Cultural Examination Of Baseline Data Across Language Groups In The NHL

Echemendia and colleagues (2020) recently published comprehensive traditional and computerized (i.e. ImPACT) baseline normative data for approximately 8,000 NHL players (3,145 traditional tests; 4,780 ImPACT; 604 both) across 7 language groups (English, French, Swedish, German, Russian, Czech, Finnish). Analyses of those data revealed that symptom reporting, concussion history and cognitive functioning varied significantly across language…

Concussion Legislation Should Be Based On Scientific Evidence

Concussion legislation should be based on scientific evidence: Dr. Mark Herceg speaks out on proposed youth football legislation. Brain injuries and concussions: Legislation must draw from science | Opinion [lohud.com]

Suicidality As A Manifestation Of CTE

Iverson (2019) provides a well-written summary and critique of suicidality as a manifestation of CTE:  https://academic.oup.com/acn/advance-article/doi/10.1093/arclin/acz023/5607499

Evidence for Concussion Subtype Classification

Supporting evidence for 5 concussion subtypes – a reminder to conduct comprehensive acute concussion evaluations:  https://academic.oup.com/neurosurgery/advance-article/doi/10.1093/neuros/nyz332/5552009

NHL New Concussion Video

The National Hockey League and NHLPA released a new video to educate athletes, families, coaches, and medical staff about sports concussion.  Narrated by Pat LaFontaine and featuring SNS members Dr. Paul Comper and Dr. Ruben Echemendia, the video discusses concussion signs and symptoms, diagnosis, and management.   https://www.nhl.com/video/2019-concussion-education-video/t-277350912/c-68701003

Is Football Bad For The Brain?

SNS President-Elect, Dr. Munro Cullum, talks about the importance of sports participation and clarifies misconceptions about the long term effects of playing football in this article for the popular press: https://www.statnews.com/2019/09/27/concussions-football-uncertain-long-term-effects/

Understanding What Tests Measure

Using confirmatory factor analysis in a sample of college athletes Dr. Art Maerlander and colleagues revealed the lack of a pure memory factor in C3 Logix, which may limit its utility in measuring the effects of SRC. Find more information at DOI: https://digitalcommons.unl.edu/cbbbpapers/47/

Predictors of Concussion Recovery

What are some predictors of longer recovery in adolescent athletes? To find out read this article by Summer Ott and colleagues. https://www.tandfonline.com/doi/full/10.1080/21622965.2017.1381099#.XMsOraYUChs.twitter

Symptom Reporting by Gender and Age

Study shows that females show greater emotional endorsement across the age span but seems greater during adolescence. Read this new article examining gender differences in symptom reporting at baseline across the lifespan by Rosemarie Moser, Lauren Olek, and Phil Schatz. https://academic.oup.com/acn/article/34/1/50/4840582

NFL players are Not all impaired

New finding on retired professional NFL players shows no linear association between concussion and cognitive impairment. Read this recent article by Lindy Fields, Nyaz Didehbani, John Hart, and Munro Cullum. https://www.researchgate.net/profile/Nyaz_Didehbani/publication/331607981_No_Linear_Association_Between_Number_of_Concussions_or_Years_Played_and_Cognitive_Outcomes_in_Retired_NFL_Players/links/5c895f60a6fdcc3817526125/No-Linear-Association-Between-Number-of-Concussions-or-Years-Played-and-Cognitive-Outcomes-in-Retired-NFL-Players.pdf

CTE reporting: Do no harm

In the spirit of do no harm, The Lancet publishes a call for balance when reporting on CTE.  The correspondence by a lengthy list of respected clinicians and researchers emphasizes the importance of balanced reporting and notes that misinformation about CTE can cause real harm to patients.  Read the statement here.

Supervised test administration in sports

Consistent with the Standards for Educational and Psychological Testing, SNS issues a Position Statement on Supervised Administration of Neuropsychological Tests in Sports.  Supervised test administration by qualified individuals greatly increases the likelihood of accurate and reliable test results, which is essential to support clinical decisions to return an athlete to play. http://www.sportsneuropsychologysociety.com/wp-content/uploads/2019/02/SNS-Statement-on-Supervised-Test-Administration-2019-FINAL.pdf

Biomarkers are not – and cannot – be the Holy Grail for concussion

Much work is being done in the search for blood-based markers that can be used to diagnose concussion.  Is this even a realistic aim?  To learn more about important caveats to consider read the recent series of articles by Asken, et al. Asken B, et al “Concussion Biomarkers Assessed in Collegiate Student-Athletes (BASICS) I” Neurology…

K-D use in professional football

Is the K-D a useful diagnostic tool in adult professional sports?  How are test findings best used in clinical situations?  Read the recent publication from Martin Mrazik, Ph.D. and his colleagues: https://www.liebertpub.com/doi/pdf/10.1089/neu.2017.5490 Dhiren Naidu et al. Sideline Concussion Assessment: The King-Devick Test in Canadian Professional Football, Journal of Neurotrauma (2018). DOI: 10.1089/neu.2017.5490

Impact of ATC’s on high school sports injuries

What is the importance of having athletic trainers on the sideline? Can their presence reduce overall injuries and improve identification of concussions? Read this article by Lauren Pierpoint, Cynthia LaBella, Christy Collins, Sarah Fields, & Dawn Comstock. https://injepijournal.springeropen.com/articles/10.1186/s40621-018-0159-6 Pierpoint, L .A., LaBella, C.R., Collins, C. L., Fields, S.K., & Comstock, D. (2018).  Injuries in girls’ soccer…

Media Headlines of concussion and CTE versus Good Science

Can science compete with media headlines to inform concussion policies? How can we can more accurately inform public policy that impacts sports participation? Take a look at this JAMA Pediatrics article from Chris Giza, William Stewart, & Mayumi Prins.   https://jamanetwork.com/journals/jamapediatrics/fullarticle/2686729 Giza, C. C., Stewart, W., & Prins, M. L. (2018). Building good policy from good science-The case for concussion…

Gender differences in symptom reporting across the youth age span

Do males and females report symptoms differently across the youth age span? Does gender or age matter more? Review this article by our very own Rosemarie Moser and Phil Schatz and Lauren Olek.   https://academic.oup.com/acn/advance-article-abstract/doi/10.1093/arclin/acy007/4840582?redirectedFrom=fulltext Moser, R.S., Olen, L., & Schatz, P. (2018). Gender differences in symptom reporting on baseline sports concussion testing across the youth…

Hockey players’ secrets to resilience

Do professional hockey players respond differently to concussions than non-athletes? Can our thinking change how we recover from a concussion? Check out this recent Forbes article from our own Dr. Sonia Mosch for a professional hockey perspective. Read the full article here – https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm596531.htm

Not a “Concussion Test”

An FDA press release issued on 2/14 announced, “FDA authorizes marketing of first blood test to aid in the evaluation of concussion in adults.”  Unfortunately, this headline does not accurately represent the approval, which is best captured by the release’s subtitle, “New quick testing option to help reduce need for CT scans, radiation exposure for patients.”  According…

Why do some athletes recover more quickly than others?

Why do some athletes recover more quickly than others? Are there any predictors to clinical recovery from concussion? Take a look at this review paper by SNS members Grant Iverson, Gary Solomon, and SNS president Donna Broshek. https://www.ncbi.nlm.nih.gov/pubmed/28566342

Should neuropsychologists use performance validity tests when evaluating student athletes?

Should neuropsychologists use performance validity tests when evaluating student athletes? If a student athlete produces optimal effort at one time of testing, does s/he produce optimal effort at all times of testing? What may be unique to measuring performance validity in student athletes? Take a look at this article by SNS members, Danielle Chase, Phil…

What role do sports neuropsychologists have in the evaluation and management of sports concussions?

What role do sports neuropsychologists have in the evaluation and management of sports concussions?  How do they work with other disciplines in caring for athletes?  What are unique challenges faced by sports neuropsychologists? Take a look at this article by SNS Board members, Summer Ott and Chris Bailey, and SNS President, Donna Broshek for a review of integrated care…

With computerized testing on the rise in youth sports, close examination of normative data becomes more important.

With computerized testing on the rise in youth sports, close examination of normative data becomes more important. Check out this paper by SNS members Erin Reynolds, Phil Schatz and Luke Henry presenting normative data from the ImPACT in 10-12 year old athletes. http://dx.doi.org/10.1080/21622965.2015.1057637