Update: Don’t ignore concussions

20 May

Moi discussed concussions in Don’t ignore concussions:

Lindsey Tanner of AP reports on a new study about concussions in the article, Even mild concussions can cause lingering symptoms:

Children with even relatively mild concussions can have persistent attention and memory problems a year after their injuries, according to a study that helps identify which kids may be most at risk for lingering symptoms.

In most kids with these injuries, symptoms resolve within a few months but the study results suggest that problems may linger for up to about 20 percent, said study author Keith Owen Yeates, a neuropsychologist at Ohio State University’s Center for Biobehaviorial Health.

http://www.seattlepi.com/news/article/Even-mild-concussions-can-cause-lingering-symptoms-3383079.php#ixzz1oMUeQVuu

Citation:

Concussion

Time to Start Paying Attention

Frederick P. Rivara, MD, MPH

Arch Pediatr Adolesc Med. Published online March 5, 2012. doi:10.1001/archpediatrics.2011.1602

Coaches and parents must be alert to signs of concussion.  WebMD has a good description of what a concussion is and the signs of concussion https://drwilda.wordpress.com/2012/03/06/dont-ignore-concussions/

Bryan Toporek is reporting in the Education Week article, Head Impacts in Sports May Reduce Student-Athletes’ Learning Ability:

Certain contact sports, such as football and ice hockey, may hinder some student-athletes’ ability to learn and remember new information, suggests a study published online Wednesday in the journal Neurology.

However, at a group level, repetitive head impacts over the course of a single season don’t appear to have detrimental short-term effects on cognitive function for contact-sport athletes, the study found.

Researchers examined a mostly male group of 214 contact-sport athletes and 45 noncontact-sport athletes from three Division 1 schools who completed both preseason and postseason ImPACT tests. In addition, 55 noncontact-sport athletes and 45 contact-sport athletes completed a neuropsychological test battery along with the pre- and postseason ImPACT tests.

Of the 45 contact-sport athletes who completed the neuropsychological test, 22 percent finished more than 1.5 standard deviations below their expected score. Of the 55 noncontact-sport athletes who took the same test, only 4 percent finished more than 1.5 standard deviations lower. This discrepancy was deemed statistically significant by the researchers.

These findings suggest that “there may be a subgroup of athletes for whom repetitive head impacts affect learning and memory at least on a temporary basis,” the study authors wrote.

“The good news is that overall there were few differences in the test results between the athletes in contact sports and the athletes in noncontact sports,” said study author Dr. Thomas McAllister of the New Hampshire-based Geisel School of Medicine at Dartmouth, in a statement. “But we did find that a higher percentage of the contact-sport athletes had lower scores than would have been predicted after the season on a measure of new learning than the noncontact-sport athletes.”

The contact-sport athletes were exposed to an average of 469 separate head impacts over the course of a season, according to the study. No athlete who endured a concussion during the season was included in the study.

On a potentially positive note, the researchers didn’t find any association between accumulated head impacts over previous seasons and reduced cognitive performance when comparing contact- and noncontact-sport athletes….

http://blogs.edweek.org/edweek/schooled_in_sports/2012/05/head_impacts_in_sports_may_reduce_student-athletes_learning_ability.html?intc=es

Here is the citation for the study:

Cognitive effects of one season of head impacts in a cohort of collegiate contact sport athletes

  1. 1.     T.W. McAllister, MD,
  2. 2.     L.A. Flashman, PhD,
  3. 3.     A. Maerlender, PhD,
  4. 4.     R.M. Greenwald, PhD,
  5. 5.     J.G. Beckwith, MS,
  6. 6.     T.D. Tosteson, ScD,
  7. 7.     J.J. Crisco, PhD,
  8. 8.     P.G. Brolinson, DO,
  9. 9.     S.M. Duma, PhD,
  10. 10.  A.-C. Duhaime, MD,
  11. 11.  M.R. Grove, MS and
  12. 12.  J.H. Turco, MD

+ Author Affiliations

1.     From the Departments of Psychiatry (T.W.M., L.A.F., A.M., M.R.G.), Community and Family Medicine (T.D.T.), and Medicine (J.H.T.), Dartmouth Medical School, Lebanon; Simbex (R.M.G., J.G.B.), Lebanon; Thayer School of Engineering (R.M.G.), Dartmouth College, Hanover, NH; Bioengineering Laboratory, Department of Orthopaedics (J.J.C.), The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI; Edward Via Virginia College of Osteopathic Medicine (P.G.B.), Blacksburg; Virginia Tech-Wake Forest (S.M.D.), Center for Injury Biomechanics, Blacksburg; Pediatric Neurosurgery (A.-C.D.), Children’s Hospital at Dartmouth, Dartmouth Hitchcock Medical Center, Hanover, NH; and Pediatric Neurosurgery (A.-C.D.), Massachusetts General Hospital, Boston.
  1. Correspondence & reprint requests to Dr. McAllister:thomas.w.mcallister@dartmouth.edu

View Complete Disclosures

Abstract

Objective: To determine whether exposure to repetitive head impacts over a single season negatively affects cognitive performance in collegiate contact sport athletes.

Methods: This is a prospective cohort study at 3 Division I National Collegiate Athletic Association athletic programs. Participants were 214 Division I college varsity football and ice hockey players who wore instrumented helmets that recorded the acceleration-time history of the head following impact, and 45 noncontact sport athletes. All athletes were assessed prior to and shortly after the season with a cognitive screening battery (ImPACT) and a subgroup of athletes also were assessed with 7 measures from a neuropsychological test battery.

Results: Few cognitive differences were found between the athlete groups at the preseason or postseason assessments. However, a higher percentage of the contact sport athletes performed more poorly than predicted postseason on a measure of new learning (California Verbal Learning Test) compared to the noncontact athletes (24% vs 3.6%; p < 0.006). On 2 postseason cognitive measures (ImPACT Reaction Time and Trails 4/B), poorer performance was significantly associated with higher scores on several head impact exposure metrics.

Conclusion: Repetitive head impacts over the course of a single season may negatively impact learning in some collegiate athletes. Further work is needed to assess whether such effects are short term or persistent.

Received July 14, 2011.

Accepted January 25, 2012.

Copyright © 2012 by AAN Enterprises, Inc.

Parents must be alert to what is happening with the children when they participate in athletic events and activities.

Resources:

Concussions http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Concussion                                                                                                                         http://www.emedicinehealth.com/concussion/article_em.htm

Concussion-Overview

http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

Dr. Wilda says this about that ©

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