Skip to main content
SpringerLink
Log in

The Relationship Between Subconcussive Impacts and Concussion History on Clinical Measures of Neurologic Function in Collegiate Football Players

  • Published:
Annals of Biomedical Engineering Aims and scope Submit manuscript

Abstract

Concussions sustained during college and professional football careers have been associated with both acute and chronic neurologic impairment. The contribution of subconcussive impacts to this impairment has not been adequately studied. Therefore, we investigated the relationship between subconcussive impacts and concussion history on clinical measures of neurologic function. Forty-six collegiate football players completed five clinical measures of neurologic function commonly employed in the evaluation of concussion before and after a single season. These tests included the Automated Neuropsychological Assessment Metrics, Sensory Organization Test, Standardized Assessment of Concussion, Balance Error Scoring System, and Graded Symptom Checklist. The Head Impact Telemetry (HIT) System recorded head impact data including the frequency, magnitude, and location of impacts. College football players sustain approximately 1,000 subconcussive impacts to the head over the course of a season, but for the most part, do not demonstrate any clinically meaningful changes from preseason to postseason on measures of neurologic function. Changes in performance were mostly independent of prior concussion history, and the total number, magnitude and location of sustained impacts over one season as observed R 2 values ranged between 0.30 and 0.35. Repetitive subconcussive head impacts over a single season do not appear to result in short-term neurologic impairment, but these relationships should be further investigated for a potential dose–response over a player’s career.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bailey, C. M., R. J. Echemendia, and P. A. Arnett. The impact of motivation on neuropsychological performance in sports-related mild traumatic brain injury. J. Int. Neuropsychol. Soc. 12:475–484, 2006.

    Article  PubMed  Google Scholar 

  2. Bleiberg, J., A. N. Cernich, K. Cameron, W. Sun, K. Peck, P. J. Ecklund, D. Reeves, J. Uhorchak, M. B. Sparling, and D. L. Warden. Duration of cognitive impairment after sports concussion. Neurosurgery 54:1073–1078, 2004.

    Article  PubMed  Google Scholar 

  3. Bleiberg, J., R. L. Kane, D. L. Reeves, W. S. Garmoe, and E. Halpern. Factor analysis of computerized and traditional tests used in mild brain injury research. Clin. Neuropsychol. 14:287–294, 2000.

    Article  PubMed  CAS  Google Scholar 

  4. Broglio, S. P., and T. W. Puetz. The effect of sport concussion on neurocognitive function, self-report symptoms and postural control: a meta-analysis. Sports Med. 38:53–67, 2008.

    Article  PubMed  Google Scholar 

  5. Cantu, R. C. Recurrent athletic head injury: risks and when to retire. Clin. Sports Med. 22:593–603, x, 2003.

    Google Scholar 

  6. Cernich, A. N., D. Reeves, W. Sun, and J. Bleiberg. Automated neuropsychological assessment metrics sports medicine battery. Arch. Clin. Neuropsychol. 22S:S101–S114, 2007.

    Article  Google Scholar 

  7. Crisco, J. J., R. Fiore, J. G. Beckwith, J. J. Chu, P. G. Brolinson, S. Duma, T. W. McAllister, A. C. Duhaime, and R. M. Greenwald. Frequency and location of head impact exposures in individual collegiate football players. J. Athl. Train. 45:549–559, 2010.

    Article  PubMed  Google Scholar 

  8. De Beaumont, L., H. Theoret, D. Mongeon, J. Messier, S. Leclerc, S. Tremblay, D. Ellemberg, and M. Lassonde. Brain function decline in healthy retired athletes who sustained their last sports concussion in early adulthood. Brain 132:695–708, 2009.

    Article  PubMed  Google Scholar 

  9. Delaney, J. S., and R. Frankovich. Head injuries and concussions in soccer. Clin. J. Sport Med. 15:216–219, 2005; discussion 212-3.

    Article  PubMed  Google Scholar 

  10. Duma, S. M., S. J. Manoogian, W. R. Bussone, P. G. Brolinson, M. W. Goforth, J. J. Donnenwerth, R. M. Greenwald, J. J. Chu, and J. J. Crisco. Analysis of real-time head accelerations in collegiate football players. Clin. J. Sport Med. 15:3–8, 2005.

    Article  PubMed  Google Scholar 

  11. Gessel, L. M., S. K. Fields, C. L. Collins, R. W. Dick, and R. D. Comstock. Concussions among United States high school and collegiate athletes. J. Athl. Train 42:495–503, 2007.

    PubMed  Google Scholar 

  12. Guskiewicz, K. M., M. McCrea, S. W. Marshall, R. C. Cantu, C. Randolph, W. Barr, J. A. Onate, and J. P. Kelly. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA 290:2549–2555, 2003.

    Article  PubMed  CAS  Google Scholar 

  13. Guskiewicz, K. M., J. P. Mihalik, V. Shankar, S. W. Marshall, D. H. Crowell, S. M. Oliaro, M. F. Ciocca, and D. N. Hooker. Measurement of head impacts in collegiate football players: relationship between head impact biomechanics and acute clinical outcome after concussion. Neurosurgery 61:1244–1252, 2007.

    Article  PubMed  Google Scholar 

  14. Guskiewicz, K. M., N. L. Weaver, D. A. Padua, and W. E. Garrett, Jr. Epidemiology of concussion in collegiate and high school football players. Am. J. Sports Med. 28:643–650, 2000.

    PubMed  CAS  Google Scholar 

  15. Iverson, G. L., M. Gaetz, M. R. Lovell, and M. W. Collins. Cumulative effects of concussion in amateur athletes. Brain Inj. 18:433–443, 2004.

    Article  PubMed  Google Scholar 

  16. Lincoln, A. E., S. V. Caswell, J. L. Almquist, R. E. Dunn, J. B. Norris, and R. Y. Hinton. Trends in concussion incidence in high school sports: a prospective 11-year study. Am. J. Sports Med. 39:958–963, 2011.

    Article  PubMed  Google Scholar 

  17. McCrea, M. Standardized mental status testing on the sideline after sport-related concussion. J. Athl. Train. 36:274–279, 2001.

    PubMed  Google Scholar 

  18. McCrea, M., K. M. Guskiewicz, S. W. Marshall, W. Barr, C. Randolph, R. C. Cantu, J. A. Onate, J. Yang, and J. P. Kelly. Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study. JAMA 290:2556–2563, 2003.

    Article  PubMed  CAS  Google Scholar 

  19. McCrea, M., J. P. Kelly, J. Kluge, B. Ackley, and C. Randolph. Standardized assessment of concussion in football players. Neurology 48:586–588, 1997.

    PubMed  CAS  Google Scholar 

  20. McCrory, P. R. Brain injury and heading in soccer. BMJ 327:351–352, 2003.

    Article  PubMed  Google Scholar 

  21. McKee, A. C., R. C. Cantu, C. J. Nowinski, E. T. Hedley-Whyte, B. E. Gavett, A. E. Budson, V. E. Santini, H. S. Lee, C. A. Kubilus, and R. A. Stern. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J. Neuropathol. Exp. Neurol. 68:709–735, 2009.

    Article  PubMed  Google Scholar 

  22. Mihalik, J. P., D. R. Bell, S. W. Marshall, and K. M. Guskiewicz. Measurement of head impacts in collegiate football players: an investigation of positional and event-type differences. Neurosurgery 61:1229–1235, 2007.

    Article  PubMed  Google Scholar 

  23. Miller, J. R., G. J. Adamson, M. M. Pink, and J. C. Sweet. Comparison of preseason, midseason, and postseason neurocognitive scores in uninjured collegiate football players. Am. J. Sports Med. 35:1284–1288, 2007.

    Article  PubMed  Google Scholar 

  24. Pellman, E. J., J. W. Powell, D. C. Viano, I. R. Casson, A. M. Tucker, H. Feuer, M. Lovell, J. F. Waeckerle, and D. W. Robertson. Concussion in professional football: epidemiological features of game injuries and review of the literature—part 3. Neurosurgery 54:81–94, 2004.

    Article  PubMed  Google Scholar 

  25. Pellman, E. J., D. C. Viano, A. M. Tucker, and I. R. Casson. Concussion in professional football: location and direction of helmet impacts-Part 2. Neurosurgery 53:1328–1340, 2003; discussion 1340-1.

    Article  PubMed  Google Scholar 

  26. Peterson, C. L., M. S. Ferrara, M. Mrazik, S. Piland, and R. Elliott. Evaluation of neuropsychological domain scores and postural stability following cerebral concussion in sports. Clin. J. Sport Med. 13:230–237, 2003.

    Article  PubMed  Google Scholar 

  27. Piland, S. G., R. W. Motl, K. M. Guskiewicz, M. McCrea, and M. S. Ferrara. Structural validity of a self-report concussion-related symptom scale. Med. Sci. Sports Exerc. 38:27–32, 2006.

    Article  PubMed  Google Scholar 

  28. Rabadi, M. H., and B. D. Jordan. The cumulative effect of repetitive concussion in sports. Clin. J. Sport Med. 11:194–198, 2001.

    Article  PubMed  CAS  Google Scholar 

  29. Riemann, B. L., N. A. Caggiano, and S. M. Lephart. Examination of a clinical method of assessing postural control during a functional performance task. J. Sport Rehabil. 8:171–183, 1999.

    Google Scholar 

  30. Schnebel, B., J. T. Gwin, S. Anderson, and R. Gatlin. In vivo study of head impacts in football: a comparison of National Collegiate Athletic Association Division I versus high school impacts. Neurosurgery 60:490–495, 2007; discussion 495-6.

    Article  PubMed  Google Scholar 

  31. Shankar, P. R., S. K. Fields, C. L. Collins, R. W. Dick, and R. D. Comstock. Epidemiology of high school, collegiate football injuries in the United States, 2005–2006. Am. J. Sports Med. 35:1295–1303, 2007.

    Article  PubMed  Google Scholar 

  32. Talavage, T. M., E. Nauman, E. L. Breedlove, U. Yoruk, A. E. Dye, K. Morigaki, H. Feuer, and L. J. Leverenz. Functionally-detected cognitive impairment in high school football players without clinically-diagnosed concussion. J. Neurotrauma, 2010.

  33. Valovich McLeod, T. C., D. H. Perrin, K. M. Guskiewicz, S. J. Shultz, R. Diamond, and B. M. Gansneder. Serial administration of clinical concussion assessments and learning effects in healthy young athletes. Clin. J. Sport Med. 14:287–295, 2004.

    Article  PubMed  Google Scholar 

  34. Valovich, T. C., D. H. Perrin, and B. M. Gansneder. Repeat administration elicits a practice effect with the balance error scoring system but not with the standardized assessment of concussion in high school athletes. J. Athl. Train. 38:51–56, 2003.

    PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported in part by the Centers for Disease Control and Prevention and the National Operating Committee on Standards for Athletic Equipment.

Author information

Authors and Affiliations

  1. Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina, 2207 Stallings-Evans Sports Medicine Complex, Campus Box 8700, Chapel Hill, NC, 27599-8700, USA

    Sonia M. Gysland, Jason P. Mihalik, Johna K. Register-Mihalik & Kevin M. Guskiewicz

  2. Campus Health Services, University of North Carolina, Chapel Hill, NC, USA

    Scott C. Trulock

  3. Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA

    Edgar W. Shields

Authors
  1. Sonia M. Gysland
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason P. Mihalik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johna K. Register-Mihalik
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Scott C. Trulock
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edgar W. Shields
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kevin M. Guskiewicz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin M. Guskiewicz.

Additional information

Associate Editor Stefan M. Duma oversaw the review of this article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gysland, S.M., Mihalik, J.P., Register-Mihalik, J.K. et al. The Relationship Between Subconcussive Impacts and Concussion History on Clinical Measures of Neurologic Function in Collegiate Football Players. Ann Biomed Eng 40, 14–22 (2012). https://doi.org/10.1007/s10439-011-0421-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10439-011-0421-3

Keywords

Search

Navigation