Neuropsychological Change After a Single Season of Head Impact Exposure in Youth Football

Maerlender, Arthur C.; Smith, Eric P.; Brolinson, P. Gunnar; Crisco, Joseph J.; Urban, Jillian E.; Ajamil, Amaris; Rowson, Steven; Campolettano, Eamon T.; Gellner, Ryan A.; Bellamkonda, Srinidhi; Kieffer, Emily; Kelley, Mireille E.; Jones, Derek A.; Powers, Alex; Beckwith, Jonathan G.; Stitzel, Joel D.; Greenwald, Richard M.; Duma, Stefan M.

doi:10.1017/s1355617720000685

Cited by 12 publications

(8 citation statements)

References 51 publications

(63 reference statements)

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“…In a separate investigation using a battery of neuropsychological tests, head impact metrics were significantly associated with impaired performance on a list-learning task among 9- to 10-year-old football players, but no significant relationships were discovered among HIE and the other tests used. 29 That study also found no significant associations between HIE and any measure of neuropsychological function in players aged 11–13 years.…”

Section: Discussionmentioning

confidence: 67%

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Fickling

Poel

Dorman

et al. 2021

Brain Communications

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Brain vital signs, measured by electroencephalography (EEG), were used for portable, objective, neurophysiological evaluation of cognitive function in youth tackle football players. Specifically, we investigated whether previously reported pre- and post-season subconcussive changes detected in youth ice hockey players were comparably detected in football. The two objectives were to: 1) replicate previously published results showing subconcussive cognitive deficits; and 2) the relationship between brain vital sign changes and head-impact exposure. Using a longitudinal design, 15 male football players (age 12.89 ± 0.35 years) were tested pre- and post-season, with none having a concussion diagnosis during the season. Peak latencies and amplitudes were quantified for Auditory sensation (N100), Basic attention (P300) and Cognitive processing (N400). Regression analyses tested the relationships between these brain vital signs and exposure to head impacts through both number of impacts sustained, and total sessions (practices and games) participated. The results demonstrated significant pre/post differences in N400 latencies, with a ∼70ms delay (p < 0.01), replicating prior findings. Regression analysis also showed significant linear relationships between brain vital signs changes and head impact exposure based on accelerometer data and games/practices played (highest R = 0.863, p < 0.001 for overall sessions). Number of head impacts in youth football (age 12–14 years) findings corresponded most closely with prior Junior-A ice hockey (age 16–21 years) findings, suggesting comparable contact levels at younger ages in football. The predictive relationship of brain vital signs provided a notable complement to instrumented accelerometers, with a direct physiological measure of potential individual exposure to subconcussive impacts.

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Section: Discussionmentioning

confidence: 67%

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Fickling

Poel

Dorman

et al. 2021

Brain Communications

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“…However, there is also evidence that HIE can be associated with de cits in both cognitive and behavioral performance following increased levels of HIE. For example, impairments in reaction time, processing speed, memory and learning, balance, impulse control, and attention have been observed in contact sport athletes after one or two seasons, with effects seen across youth, high school, and college level athletes [20,22,23]. Similar results in cognitive measures were also identi ed following exposure to headers performed by soccer players [24,25].…”

Section: Introductionmentioning

confidence: 75%

Change in Head Impact Exposure following Return to Play in Concussed Football Athletes

Muench

Sinson

Harezlak

et al. 2022

Preprint

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Background Following sport-related concussion, early head impact exposure and premature return to play is known to increase risk of repeat concussion in football athletes, yet athletes’ true post-injury head impact exposure profiles and biomechanical progression have not been explored. Accordingly, this study explored how American college football athletes alter playing style during their return from concussion, particularly within the same athletic season. Methods Using head impact exposure profiles of fifty-two collegiate football athletes from six NCAA Division I programs, this analysis compared daily volume of head impacts following concussion with pre-injury levels and further compared these athletes to team- and position-matched controls to minimize season- or team-related factors. Additionally, this study provided an analysis of the possible association between length of recovery time and change in head impact exposure following concussion using continuous linear regression. Results Over 40% of concussed athletes did not reach their pre-injury level of head impact exposure at any point during the remainder of the season segment that the concussion occurred. Furthermore, concussed athletes showed significantly larger decreases than non-concussed athletes over the same time period. Finally, longer recovery times after concussion were associated with larger decreases in head impact exposure over the remaining contact days within the season segment. Conclusions This study provide evidence for a shift in playing style after returning from concussion, both in the immediate days after return to play as well as over extended periods of time within the season. These findings will help to better inform the management of athletes returning from concussion.

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“…Three players were excluded from statistical analyses at the corresponding assessment time point In previous reports, 9,11,12 we found several outcome measures suggesting a potential association with cumulative impact. On the basis of these results and associations found in other studies, 8,16 we narrowed the list of outcome measures in the current analysis to the 10 most likely to be affected by repetitive head impacts (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Repetitive subconcussive head impacts during childhood have been implicated in the development of chronic cognitive and behavioral problems. However, both retrospective 1 , 2 , 3 , 4 , 5 , 6 , 7 and prospective 8 , 9 , 10 , 11 , 12 research studies have yielded conflicting results regarding the association between repetitive head impacts and cognitive and behavioral outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Exposure to Head Impacts and Cognitive and Behavioral Outcomes in Youth Tackle Football Players Across 4 Seasons

Rose

Yeates

Nguyen³

et al. 2021

JAMA Netw Open

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IMPORTANCERepetitive head impacts have been posited to contribute to neurocognitive and behavioral difficulties in contact sport athletes. OBJECTIVE To identify associations between cognitive and behavioral outcomes and head impacts measured in youth tackle football players over 4 seasons of play. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from July 2016 through January 2020, spanning 4 football seasons. The setting was a youth tackle football program and outpatient medical clinic. Players were recruited from 4 football teams composed of fifth and sixth graders, and all interested players who volunteered to participate were enrolled. Data analysis was performed from March 2020 to June 2021. EXPOSURES Impacts were measured using helmet-based sensors during practices and games throughout 4 consecutive seasons of play. Impacts were summed to yield cumulative head impact gravitational force equivalents per season. MAIN OUTCOMES AND MEASURES Ten cognitive and behavioral measures were completed before and after each football season. RESULTS There were 70 male participants aged 9 to 12 years (mean [SD] age, 10.6 [0.64] years),with 18 completing all 4 years of the study. At the post-season 1 time point, higher cumulative impacts were associated with lower self-reported symptom burden (β = −0.6; 95% CI, −1.0 to −0.2; P = .004). After correcting for multiple comparisons, no other associations were found between impacts and outcome measures. At multiple times throughout the study, premorbid attentiondeficit/hyperactivity disorder, anxiety, and depression were associated with worse cognitive or behavioral scores, whereas a premorbid headache disorder or history of concussion was less often associated with outcomes. CONCLUSIONS AND RELEVANCEIn this cohort of youth tackle football players, premorbid conditions, including attention-deficit/hyperactivity disorder, anxiety, and depression, were associated with cognitive and behavioral outcomes more often than cumulative impact.

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Neuropsychological Change After a Single Season of Head Impact Exposure in Youth Football

Cited by 12 publications

References 51 publications

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers

Change in Head Impact Exposure following Return to Play in Concussed Football Athletes

Exposure to Head Impacts and Cognitive and Behavioral Outcomes in Youth Tackle Football Players Across 4 Seasons

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