The neuropsychological impact of sports-related concussion: A meta-analysis

James A. Haley Veterans Hospital, Tampa, Florida, United States
Journal of the International Neuropsychological Society (Impact Factor: 2.96). 08/2005; 11(4):345-57. DOI: 10.1017/S1355617705050411
Source: PubMed


There is increasing interest in the potential neuropsychological impact of sports-related concussion. A meta-analysis of the relevant literature was conducted to determine the impact of sports-related concussion across six cognitive domains. The analysis was based on 21 studies involving 790 cases of concussion and 2014 control cases. The overall effect of concussion (d = 0.49) was comparable to the effect found in the non-sports-related mild traumatic brain injury population (d = 0.54; Belanger et al., 2005). Using sports-concussed participants with a history of prior head injury appears to inflate the effect sizes associated with the current sports-related concussion. Acute effects (within 24 hr of injury) of concussion were greatest for delayed memory, memory acquisition, and global cognitive functioning (d = 1.00, 1.03, and 1.42, respectively). However, no residual neuropsychological impairments were found when testing was completed beyond 7 days postinjury. These findings were moderated by cognitive domain and comparison group (control group versus preconcussion self-control). Specifically, delayed memory in studies utilizing a control group remained problematic at 7 days. The implications and limitations of these findings are discussed.

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Available from: Rodney Vanderploeg, Aug 05, 2014
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    • "Although the neurologic and cognitive effects of acute TBIs have been extensively studied (Belanger and Vanderploeg, 2005; Kokmen et al., 1996; Nemetz et al., 1999; Schofield et al., 1997), causal relationships between TBIs and delayed sequelae have been less studied because of the variable latency period before overt neurologic dysfunction. Neurocognitive effects of repetitive mild head injury were initially recognized in boxers for many years, with a syndrome that was distinct from the clinical and pathologic sequelae of single-incident severe TBI (Martland, 1928). "
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    ABSTRACT: A number of small studies and anecdotal reports have been suggested that sports involving repeated head trauma may have long-term risks of neurodegenerative disease. There are now plausible mechanisms for these effects, and a recognition that these problems do not just occur in former boxers, but in a variety of sports involving repeated concussions, and possibly also in sports in which low-level head trauma is common. These neurodegenerative effects potentially include increased risks of impaired cognitive function and dementia, Parkinson's disease, and amyotrophic lateral sclerosis. Many would argue for taking a precautionary approach and immediately banning or restricting sports such as boxing. However, there are important public health issues in terms of how wide the net should be cast in terms of other sports, and what remedial measures could be taken? This in turn requires a major research effort involving both clinical and basic research to understand the underlying mechanisms, leading from head trauma to neurodegenerative disease and epidemiologic studies to assess the long-term consequences. Copyright © 2015 Elsevier Inc. All rights reserved.
    Neurobiology of Aging 03/2015; 36(3). DOI:10.1016/j.neurobiolaging.2014.12.024 · 5.01 Impact Factor
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    • "In conclusion, most athletes require about 7–10 days for return to their baseline performance postconcussion (Belanger & Vanderploeg, 2005; Constantinidou & Zimmerman, 2005; Majerske et al., 2008; McCrea et al., 2013). However, as demonstrated in our second case study, some athletes with a history of repeated concussions require a longer recovery period (Covassin et al., 2013). "
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    ABSTRACT: Purpose: The Miami University Concussion Management Program was established in 1999 to assess, manage, and monitor athletes who sustain concussions and experience neurobehavioral and neurocognitive symptoms secondary to their injury. The purpose of this article is to describe the established procedures of one of the oldest university-based interdisciplinary concussion management programs that is coordinated by speech-language pathologists (SLP). Method: The theoretical and clinical underpinnings of baseline and postconcussion neurocognitive assessment and management procedures are discussed. Additionally, 2 illustrative case studies are presented to demonstrate the evolution and implementation of the interdisciplinary concussion management protocol and to present different patterns of concussion symptoms and recovery. Paper and computer-based neurocognitive assessment protocols are discussed and integrated in the case studies. Results/conclusions: Successful management of sport-related concussion requires an interdisciplinary team that understands the unique neurobehavioral and neurocognitive symptoms associated with sports concussions. SLPs can play a valuable role on the interdisciplinary team in the prompt and appropriate management of postconcussion symptoms so that athletes can successfully return to their athletic, academic, and social activities.
    American Journal of Speech-Language Pathology 08/2014; 23(4). DOI:10.1044/2014_AJSLP-13-0126 · 1.59 Impact Factor
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    • "There was no evidence of symptoms, cognitive impairment , or balance problems in the concussion group at day 90. A subsequent meta-analysis of the neurocognitive effects of SRC conducted by Belanger and Vanderploeg (2005) aggregated data from 21 studies totaling 790 concussed players and 2,014 controls and reported a similar conclusion, finding a moderate effect (d =.49) of concussion on neuropsychological functioning acutely (within 24 h of injury) but virtually no residual impairments by 7 days post-injury. A more recent meta-analysis by Broglio and Puetz (2008) similarly found large acute effects of concussion (i.e., change from baseline or control group performance) on neurocognitive functioning (Hedge's g =−.81) and, as an extension, also documented robust changes in symptoms (g =−3.31) and postural stability (g =−2.65), lending support to these three domains as useful components of multimodal concussion assessment. "
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    ABSTRACT: Concussion is a highly prevalent injury in contact and collision sports that has historically been poorly understood. An influx of sport-concussion research in recent years has led to a dramatic improvement in our understanding of the injury's defining characteristics and natural history of recovery. In this review, we discuss the current state of knowledge regarding the characteristic features of concussion and typical acute course of recovery, with an emphasis on the aspects of functioning most commonly assessed by clinicians and researchers (e.g., symptoms, cognitive deficits, postural stability). While prototypical clinical recovery is becoming better understood, questions remain regarding what factors (e.g., injury severity, demographic variables, history of prior concussions, psychological factors) may explain individual variability in recovery. Although research concerning individual differences in response to concussion is relatively new, and in many cases limited methodologically, we discuss the evidence about several potential moderators of concussion recovery and point out areas for future research. Finally, we describe how increased knowledge about the negative effects of and recovery following concussion has been translated into clinical guidelines for managing concussed athletes.
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