In an investigation of head impact burden and change in neurocognitive function during a season of youth football, researchers find that sub-concussive impacts are not correlated with worsening performance in neurocognitive function.
Each year, more than 3 million children in primary and high school play tackle football in the United States. Growing concern about the possible negative effects of repetitive sub-concussive head impacts led to an increased number of physicians and parents who counsel against youth participation in full-contact sports.
A research team, led by Sean Rose, MD, pediatric sports neurologist and co-director of the Complex Concussion Clinic at Nationwide Children’s Hospital, followed 112 youth football players age 9-18 during the 2016 season in a prospective study.
“When trying to determine the chronic effects of repetitive sub-concussive head impacts, prospective outcomes studies are an important complement to the existing retrospective studies,” says Dr. Rose. “In this study of primary school and high school football players, a battery of neurocognitive outcomes tests did not detect any worsening of performance associated with cumulative head impacts.”
The pre- and post-season assessments used to measure outcomes included:
- Neuropsychological testing
- Symptoms assessment
- Vestibular and ocular-motor screening
- Balance testing
- Parent-reported ADHD symptoms
- Self-reported behavioral adjustment
Sensors placed in the helmets recorded sub-concussive head impacts during practices and games. Researchers added the impact g-forces to yield a cumulative impact measure. According to the study, cumulative impact did not predict changes (from pre-season to post-season) in any of the outcome measures.
Additionally, Dr. Rose notes, having sustained one or more concussions prior to entering the study was not associated with worse pre-season testing.
In their secondary analysis, they found that younger age and reported history of attention deficit hyperactivity disorder (ADHD) predicted score changes on several cognitive testing measures and parent-reported ADHD symptoms. Additionally, a reported history of anxiety or depression predicted changes in scores of symptom reporting.
“We expected repetitive impacts to correlate with worsening neurocognitive function, but we found that sub-concussive head impacts sustained over the course of a single season were not associated with neurocognitive functional outcomes. And also surprising, sustaining isolated high g-force impacts was also not associated with worse outcome,” says Dr. Rose. “The lack of a significant association may reflect the need for longer follow up — so we are continuing to follow kids across multiple seasons.”
This publication is the first analysis in a four-year prospective cohort study. Dr. Rose will be presenting data from the second year of the study at the upcoming Child Neurology Society meeting in mid-October. The team is currently collecting data for a third year.
Reference: Rose SC, Yeates KO, Fuerst DR, Ercole PM, Nguyen JT, Pizzimenti NM. Head impact burden and change in neurocognitive function during a season of youth football. The Journal of Head Trauma Rehabilitation.
Nationwide Children’s Hospital earned a spot as a BlackDoctor.org (BDO) 2018 Top Hospital For Diversity
“This recognition serves as an external validation of our efforts to achieve the highest standards of inclusiveness and create a culture that respects individual differences in diverse teams where every person is vital to improving children’s lives everywhere,” said Olivia W. Thomas, MD, Chief Diversity and Health Equity Officer at Nationwide Children’s Hospital. “We strive to treat all staff, physicians, patients, and families equitably and hold ourselves accountable to create an environment that fosters diversity and inclusion to maximize best outcomes.”
Featured hospitals represent all regions of the United States. Each hospital on this distinguished list delivers quality care at the highest level, while promoting equity and inclusion in their operations, programs services and staffing. Nationwide Children’s is joined by world-renowned institutions such as Johns Hopkins, Mayo Clinic and Cedars-Sinai. In highlighting the significance of the top hospitals list, BDO CEO Reginald Ware exclaims, “Our 30 million plus audience places a great importance upon cultural competency and sensitivity when it comes to the entire healthcare delivery system. Our users have expressed a strong desire for us to point them in the right direction to providers and companies who excel in these areas. Organizations who are working hard to see that everyone is treated fairly, regardless of race or creed, are highlighted here. This important list is our means of recognizing the best institutions, while also paying homage to those values.”
Among the determining critical areas of assessment that led to this distinction by BDO experts, executives and editors are:
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- Inclusive and diverse clinical and administrative staff
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