Concussion studies in the news

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Concussion studies in the news

Category : Information , Research , Safety

Study validates concussion assessment tools for children (published 7/26/17): http://www.aappublications.org/news/2017/07/26/Concussion072617

  • Woodinville Pediatrics uses the updated version of these tools, SCAT5 and Child SCAT5

General advice regarding concussion from the AAP: https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Concussions.aspx

Study of football players’ brains, including a majority of ex-NFL players (published 7/25/17):

  • NY Times article about this study:  https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-cte.html 
    • “It is no longer debatable whether or not there is a problem in football — there is a problem,” Dr. McKee said.
  • Source article: http://jamanetwork.com/journals/jama/fullarticle/2645104
    • Relevant comments from the study: “There is substantial evidence that CTE is a progressive, neurodegenerative disease. In this study, 107 participants (96%) had a progressive clinical course based on informant report. In addition, pathological severity of CTE was correlated with age at death (Table 3). However, a postmortem study evaluates brain pathology at only 1 time point and is by definition cross-sectional. In addition, the participants were not observed longitudinally during life. Although associations with age in cross-sectional samples can result from age-related progression within individuals, they can also arise from birth cohort effects, differential survival, or age-related differences in how individuals were selected into the study. Population-based prospective studies are needed to address the issue of progression of CTE pathology and age at symptom onset.The strengths of this study are that this is the largest CTE case series ever described to our knowledge, more than doubling the size of the 2013 report,6 and that all participants were exposed to a relatively similar type of repetitive head trauma while playing the same sport. In addition, the comprehensive neuropathological evaluation and retrospective clinical data collection were independently performed while blinded to the findings of the other investigators.This study had several limitations. First, a major limitation is ascertainment bias associated with participation in this brain donation program. Although the criteria for participation were based on exposure to repetitive head trauma rather than on clinical signs of brain trauma, public awareness of a possible link between repetitive head trauma and CTE may have motivated players and their families with symptoms and signs of brain injury to participate in this research. Therefore, caution must be used in interpreting the high frequency of CTE in this sample, and estimates of prevalence cannot be concluded or implied from this sample. Second, the VA-BU-CLF brain bank is not representative of the overall population of former players of American football; most players of American football have played only on youth or high school teams, but the majority of the brain bank donors in this study played at the college or professional level. Additionally, selection into brain banks is associated with dementia status, depression status, marital status, age, sex, race, and education.36 Third, this study lacked a comparison group that is representative of all individuals exposed to American football at the college or professional level, precluding estimation of the risk of participation in football and neuropathological outcomes.”

Association of Playing High School Football With Cognition and Mental Health Later in Life (published 7/3/2017)

http://jamanetwork.com/journals/jamaneurology/article-abstract/2635831

  • “For men who attended high school in the late 1950s, playing high school football did not appear to be a major risk factor for later-life cognitive impairment or depression”

Reassuring News About Football and Cognitive Decline? Not So Fast (published 7/3/2017)

http://jamanetwork.com/journals/jamaneurology/article-abstract/2635828

  • “Although the Wisconsin Longitudinal Study provides a rich data set, there is no information on concussion history per se. The study evaluates the overall effect on long-term outcomes of playing football vs not playing football, but it does not directly evaluate the association of football-related exposure to concussion or subconcussion injury…”

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