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A semi-quantitative sport-specific assessment of recurrent traumatic brain injury: the TraQ questionnaire and its application in American football

Abstract

Chronic traumatic encephalopathy (CTE) is very frequent and studied among contact sport players, above all American Football. Now, the defined diagnosis is only post-mortem and, consequently, more detailed diagnostic in-vivo instruments are needed to facilitate diagnosis and to allow a follow up. This clinical questionnaire (Trauma Questionnaire-TraQ) has been designed to investigate in parallel the traumatic load and clinical and cognitive subjective symptoms. It evaluates 4 anamnestic fields (specific sport activity, all previous pathological events, clinical manifestations compatible with TBI (traumatic brain injury) or CTE and subjective perception of personal memory efficacy with PRMQ questionnaire). The aim of TraQ questionnaire is to allow a standardized follow-up of active players and to identify subclinical disturbances that may become warnings. A pilot comparative study with TraQ on 105 subjects (75 AF players and 30 comparable people without a history of contact-sports activity) revealed that AF players have an increased amount of severe head trauma, an amplified level of subjective aggressiveness, more olfactory deficits but also more speech subjective problems, previously never related with CTE. In view of the obtained results, the TraQ seems to be useful (1) to obtain a better quantification of the traumatic load; (2) to differentiate the risk of long-term neurological consequences, allowing better management of different athletes right from the pre-symptomatic phases; (3) to manage prevention strategies if regularly applied to periodic visits to sports fitness; and (4) to identify the predisposing factors for the development of CTE and other neurological consequences of TBI with follow-up studies.

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Acknowledgments

Mr. Andrea Ibba provided language help.

Author information

Correspondence to Giacomo Querzola.

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The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Highlights

–The TraQ (Trauma Questionnaire) is manageable, detailed, and easily administrable.

–The TraQ confirms the importance of semiquantitative evaluation of TBIs (traumatic brain injury) for diagnoses, prevention, and follow-up

–Higher number of TBIs among athletes

–Athletes reported greater aggressiveness, olfactory problems, and problems of verbal expression

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Querzola, G., Lovati, C., Mariani, C. et al. A semi-quantitative sport-specific assessment of recurrent traumatic brain injury: the TraQ questionnaire and its application in American football. Neurol Sci 40, 1909–1915 (2019). https://doi.org/10.1007/s10072-019-03853-z

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Keywords

  • Traumatic brain injury
  • TBI
  • American football
  • Trauma questionnaire
  • TraQ
  • Chronic traumatic encephalopathy
  • CTE