Age at First Concussion Influences the Number of Subsequent Concussions

Schmidt, Julianne D.; Rizzone, Katherine; Hoffman, Nicole L.; Weber, Melanie; Jones, Courtney Marie Cora; Bazarian, Jeff; Broglio, Steven P.; McCrea, Michael; McAllister, Thomas W.; Hoy, April; Hazzard, Joseph B; Kelly, Louise A.; Ortega, Justus D.; Port, Nicholas; Putukian, Margot; Langford, Dianne; O’Donnell, Patrick; Giza, Christopher C.; Benjamin, Holly J.; Buckley, Thomas A.; Kaminski, Thomas W.; Clugston, James R.; Feigenbaum, Luis A.; Mihalik, Jason P.; Miles, Jessica Dysart; Anderson, Scott; Collins, Michael James; Kontos, Anthony P.; Chrisman, Sara P D; Miles, Christopher M.; Dykhuizen, Brian H; Brooks, M. Alison; Svoboda, Steven J.

doi:10.1016/j.pediatrneurol.2017.12.017

Cited by 29 publications

(19 citation statements)

References 27 publications

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“…The median age of first concussion in this sample of private high school student athletes was 9.5. A study conducted by Schmidt et al reported individuals who reported their first concussion during childhood (less than 10 years old) doubled the risk of sustaining a subsequent concussion compared to individuals who reported their first concussion during adolescence (10–18 years old). Due to an increased susceptibility for subsequent concussions, and often more severe outcomes after one has sustained an initial concussion, it is important that any youth with a suspected concussion be removed from play and evaluated by a health care provider and then follow return‐to‐learn and return‐to‐play protocols.…”

Section: Discussionmentioning

confidence: 99%

Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities

Daugherty

Waltzman

Snedaker³

et al. 2020

Journal of School Health

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BACKGROUND Sports‐ and recreation‐related (SRR) activities are a major cause of adolescent concussions. Most adolescent SRR concussion research has been conducted among public school students. As private schools are qualitatively different from public schools (eg, location, socioeconomic status, sports played), this study explores the concussion experiences of a large group of private high school students. METHODS We surveyed 2047 New England private preparatory high school students who played sports or engaged in a recreational activity in 2018 about the sports they played, and their self‐reported concussion experiences (eg, age at first concussion, if concussions were sports‐ or recreation‐related). Descriptive, bivariate, and multivariate statistics are presented. RESULTS One‐third (33.0%) of students who reported engaging in sport‐ or recreation‐related activities self‐reported experiencing a concussion in their lifetime. A higher percentage of boys, students who played contact sports, and those who played multiple seasons of school sports reported a concussion. Sex, contact level of primary sport played, and age of first concussion were also significantly associated with reporting a sports‐ or recreation‐related concussion. CONCLUSIONS A sizeable proportion of private preparatory high school students reported experiencing a concussion, with some students at higher risk. Private preparatory high school‐specific concussion prevention strategies may be needed.

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Section: Discussionmentioning

confidence: 99%

Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities

Daugherty

Waltzman

Snedaker³

et al. 2020

Journal of School Health

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“…We also did not compare age of first concussion because of low sample sizes among our concussion cohorts. Schmidt and colleagues reported that participants self-reporting their first concussion during childhood had an increased risk of sustaining subsequent concussions (RR = 2.19) compared to participants self-reporting their first concussion during adolescence [39]. Future research should examine the association between age of first concussion and later-life outcomes.…”

Section: Afe < 10 Yearsmentioning

confidence: 99%

Age of First Exposure to Soccer Heading and Sensory Reweighting for Upright Stance

et al. 2020

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US Soccer eliminated soccer heading for youth players ages 10 years and younger and limited soccer heading for children ages 11–13 years. Limited empirical evidence associates soccer heading during early adolescence with medium-to-long-term behavioral deficits. The purpose of this study was to compare sensory reweighting for upright stance between college-aged soccer players who began soccer heading ages 10 years and younger (AFE ≤ 10) and those who began soccer heading after age 10 (AFE > 10). Thirty soccer players self-reported age of first exposure (AFE) to soccer heading. Sensory reweighting was compared between AFE ≤ 10 and AFE > 10. To evaluate sensory reweighting, we simultaneously perturbed upright stance with visual, vestibular, and proprioceptive stimulation. The visual stimulus was presented at two different amplitudes to measure the change in gain to vision, an intra-modal effect; and change in gain to galvanic vestibular stimulus (GVS) and vibration, both inter-modal effects. There were no differences in gain to vision (p=0.857, η2=0.001), GVS (p=0.971, η2=0.000), or vibration (p=0.974, η2=0.000) between groups. There were no differences in sensory reweighting for upright stance between AFE ≤ 10 and AFE > 10, suggesting that soccer heading during early adolescence is not associated with balance deficits in college-aged soccer players, notwithstanding potential deficits in other markers of neurological function

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“…Health care providers often have to make difficult decisions regarding when an athlete is fit to safely return to sport/activity based on self-reporting of symptoms and their severity, and clinical testing. Self-reports, however, are highly subjective and also influenced by socio-cultural factors [70,71]. Moreover, emerging literature is showing that neurophysiological changes persist well after clinical recovery [15][16][17][18][19][20][21][22][23], suggesting that athletes may be returning to activity before their brains have fully recovered and may therefore be at increased risk of additional brain injury [66].…”

Section: Stage 3: Assessing Concnet's Performancementioning

confidence: 99%

“…Moreover, emerging literature is showing that neurophysiological changes persist well after clinical recovery [15][16][17][18][19][20][21][22][23], suggesting that athletes may be returning to activity before their brains have fully recovered and may therefore be at increased risk of additional brain injury [66]. In fact, a history of prior concussions is one of the strongest predictors of future concussions [71][72][73]. Specifically, high school athletes with prior concussions have >2× higher risk of suffering subsequent concussions [72,73] and with each successive injury, have a growing risk for sustaining long term neurological and mental health complications.…”

Section: Stage 3: Assessing Concnet's Performancementioning

confidence: 99%

“…We suspect that our misclassified "healthy" may be one of these individuals who may have suffered one or more concussions previously and are exhibiting persistent changes. We did not request our subjects' concussion history since there is considerable evidence showing that self-reported histories are prone to errors [70,71]. Ultimately, the resolution of this puzzle requires growing our relatively shallow dataset with a larger sample that encompasses the full range of diversity present during the acute post concussion phase.…”

Section: Stage 3: Assessing Concnet's Performancementioning

confidence: 99%

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Recurrent Neural Network-based Acute Concussion Classifier using Raw Resting State EEG Data

Thanjavur

Babul

Foran

et al. 2020

Preprint

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ABSTRACTConcussion is a global health concern. Despite its high prevalence, a sound understanding of the mechanisms underlying this type of diffuse brain injury remains elusive. It is, however, well established that concussions cause significant functional deficits; that children and youths are disproportionately affected and have longer recovery time than adults; and recovering individuals are more prone to suffer additional concussions, with each successive injury increasing the risk of long term neurological and mental health complications. Currently, concussion management faces two significant challenges: there are no objective, clinically accepted, brain-based approaches for determining (i) whether an athlete has suffered a concussion, and (ii) when the athlete has recovered. Diagnosis is based on clinical testing and self-reporting of symptoms and their severity. Self-reporting is highly subjective and symptoms only indirectly reflect the underlying brain injury. Here, we introduce a deep learning Long Short Term Memory (LSTM)-based recurrent neural network that is able to distinguish between healthy and acute post-concussed adolescent athletes using only a short (i.e. 90 seconds long) sample of resting state EEG data as input. The athletes were neither required to perform a specific task nor subjected to a stimulus during data collection, and the acquired EEG data was neither filtered, cleaned of artefacts, nor subjected to explicit feature extraction. The LSTM network was trained and tested on data from 27 male, adolescent athletes with sports related concussion, bench marked against 35 healthy, adolescent athletes. During rigorous testing, the classifier consistently identified concussions with an accuracy of >90% and its ensemble-median Area Under the Curve (AUC) corresponds to 0.971. This is the first instance of a high-performing classifier that relies only on easy-to-acquire resting state EEG data. It represents a key step towards the development of an easy-to-use, brain-based, automatic classification of concussion at an individual level.

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Age at First Concussion Influences the Number of Subsequent Concussions

Abstract: Individuals self-reporting a concussion at a young age sustained a higher number of concussions before age 18. Concussion prevention, recognition, and reporting strategies are of particular need at the youth level.

Cited by 29 publications

References 27 publications

Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities

Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities

Age of First Exposure to Soccer Heading and Sensory Reweighting for Upright Stance

Recurrent Neural Network-based Acute Concussion Classifier using Raw Resting State EEG Data

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