Association of Sex With Adolescent Soccer Concussion Incidence and Characteristics

Bretzin, Abigail C.; Covassin, Tracey; Wiebe, Douglas J.; Stewart, William

doi:10.1001/jamanetworkopen.2021.8191

Cited by 52 publications

(32 citation statements)

References 40 publications

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“…There is emerging evidence to suggest women are more at risk of concussion than men, and that current gender-neutral return to play guidelines may not sufficiently consider gender differences 61. Additionally, women are believed to be more at risk of neurocognitive disease than men 62.…”

Section: Discussionmentioning

confidence: 99%

Health conditions among retired professional footballers: a scoping review

Carmody

Anemaat

Massey

et al. 2022

BMJ Open Sport Exerc Med

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ObjectiveTo conduct a scoping review providing an overview of the health conditions occuring in retired male and female professional footballers, with an emphasis on musculoskeletal, mental, neurocognitive, cardiovascular and reproductive health conditions.MethodsIn January 2022, a comprehensive systematic literature search in three databases (MEDLINE via PubMed, SPORTDiscus via EBSCOhost and EMBASE) was conducted for common health conditions among retired male and female professional footballers. Primary research studies (full text available online) which described the incidence or prevalence of a health condition (musculoskeletal, mental, neurocognitive, cardiovascular, reproductive) among retired male and female professional footballers were included for review. Case reports, qualitative research and grey literature were omitted.ResultsIn total, 917 eligible articles were identified from the databases, with 41 meeting the eligibility criteria. Osteoarthritis of the hip, knee and ankle were found to be common among retired professional footballers. Mental health symptoms (eg, anxiety, depression) are experienced by retired male and female professional footballers. The incidence of neurocognitive disease appears to be higher among retired male professional footballers than among matched controls. There is very limited evidence examining the presence of health conditions in retired female professional footballers.ConclusionOsteoarthritis of the lower limb, musculoskeletal pain and mental health symptoms are common among retired professional footballers. Knowledge about the occurrence and timing of musculoskeletal, mental health and neurocognitive conditions among retired professional footballers can be used by a wide range of stakeholders to proactively intervene during and after a player’s career to mitigate risk.

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Section: Discussionmentioning

confidence: 99%

Health conditions among retired professional footballers: a scoping review

Carmody

Anemaat

Massey

et al. 2022

BMJ Open Sport Exerc Med

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“…Most of the human studies involved only males, leaving a significant knowledge gap of how females respond long-term post msTBI. Future studies will need to address post-TBI tau pathology in females, who may have a higher susceptibility to TBI [ 10 , 14 , 17 , 85 ]. Additional factors, such as genetics, ethnicity, socioeconomic status, and educational level, will be important to assess for how they may influence tau pathology.…”

Section: Discussionmentioning

confidence: 99%

Association between single moderate to severe traumatic brain injury and long-term tauopathy in humans and preclinical animal models: a systematic narrative review of the literature

Walker

Chapin

Abisambra

et al. 2022

acta neuropathol commun

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Background The initiation, anatomic pattern, and extent of tau spread in traumatic brain injury (TBI), and the mechanism by which TBI leads to long-term tau pathology, remain controversial. Some studies suggest that moderate to severe TBI is sufficient to promote tau pathology; however, others suggest that it is simply a consequence of aging. We therefore conducted a systematic narrative review of the literature addressing whether a single moderate to severe head injury leads to long-term development of tauopathy in both humans and animal models. Methods Studies considered for inclusion in this review assessed a single moderate to severe TBI, assessed tau pathology at long-term timepoints post-injury, comprised experimental or observational studies, and were peer-reviewed and published in English. Databases searched included: PUBMED, NCBI-PMC, EMBASE, Web of Science, Academic Search Premiere, and APA Psychnet. Search results were uploaded to Covidence®, duplicates were removed, and articles underwent an abstract and full-text screening process. Data were then extracted and articles assessed for risk of bias. Findings Of 4,150 studies screened, 26 were eligible for inclusion, of which 17 were human studies, 8 were preclinical animal studies, and 1 included both human and preclinical animal studies. Most studies had low to moderate risk of bias. Most human and animal studies (n = 12 and 9, respectively) suggested that a single moderate to severe TBI resulted in greater development of long-term tauopathy compared to no history of head injury. This conclusion should be interpreted with caution, however, due to several limitations: small sample sizes; inconsistencies in controlling for confounding factors that may have affected tau pathology (e.g., family history of dementia or neurological illnesses, apolipoprotein E genotype, etc.), inclusion of mostly males, and variation in reporting injury parameters. Interpretation Results indicate that a single moderate to severe TBI leads to greater chronic development of tauopathy compared to no history of head injury. This implies that tau pathology induced may not be transient, but can progressively develop over time in both humans and animal models. Targeting these tau changes for therapeutic intervention should be further explored to elucidate if disease progression can be reversed or mitigated.

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“…These results reflect previous findings that identify sex differences in overall clinical recovery timelines. [6][7][8]48 Importantly, contrasting findings suggest recovery differences do not exist when controlling for injury severity, 22 the level of contact and division of play, 31 sport, 19 faster initial evaluation, 36 earlier presentation to specialized care, 20 or clearance from a medical provider. 9 This may highlight differences in concussion management between women and men (or even a need in women) at earlier stages and warrants further attention, as both displayed seemingly similar time in their RTP progression (median, 6 days) in the present study.…”

Section: Discussionmentioning

confidence: 99%

The Role of Reported Affective Symptoms and Anxiety in Recovery Trajectories After Sport-Related Concussion

et al. 2022

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Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited. Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery. Study Design: Cohort study; Level of evidence, 3. Methods: Using SRC data from the Ivy League–Big Ten Epidemiology of Concussion Study among varsity athletes through February 2020, we identified the 4 affective symptoms from the Sport Concussion Assessment Tool symptom inventory. We modeled the relationship between a 4-category affective symptom variable and time to symptom resolution, RTP, and RTP progression, adjusting for nonaffective symptom prevalence and concussion history. Cox regressions were used to estimate hazard ratios for time to event outcomes, and linear regressions were used to evaluate mean differences for continuous outcomes. Results: Among 2077 student-athletes (men, 63.5%) with SRC symptoms, affective symptom prevalence was 47.6% and 44.3% in women and men, respectively, and nervous-anxious prevalence was 24.2% and 22.5%, respectively. When comparing women with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with affective symptoms, and women with nervous-anxious symptoms spent significantly longer in RTP progression. When comparing men with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with co-occurring affective symptoms, and affective symptoms were not associated with time in RTP progression. Conclusion: Student-athletes with affective symptoms and nervous-anxious symptoms exhibited delayed clinical recovery and RTP timelines, particularly for time in RTP. Symptom prevalence and concussion history contributed to this; however, unmeasured confounding remains, as indicated by the poor model fit. This study motivates future work to explore affective symptoms and RTP timelines, considering anxiety and risk/protective factors over time.

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Association of Sex With Adolescent Soccer Concussion Incidence and Characteristics

Cited by 52 publications

References 40 publications

Health conditions among retired professional footballers: a scoping review

Health conditions among retired professional footballers: a scoping review

Association between single moderate to severe traumatic brain injury and long-term tauopathy in humans and preclinical animal models: a systematic narrative review of the literature

The Role of Reported Affective Symptoms and Anxiety in Recovery Trajectories After Sport-Related Concussion

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