Sport-related concussions: A review of epidemiology, challenges in diagnosis, and potential risk factors

Neuropsychology Review

Volumn 23, Issue 4, 2013, Pages 273-284

  Noble, James M ^a,c   Hesdorffer, Dale C ^b  

^a Och Spine at New York Presbyterian Hospitals   (United States)

^b Taub Institute for Research on Alzheimer's Disease and the Aging Brain and the Gertrude H Sergievsky Center   (United States)

^c NEUROLOGICAL INSTITUTE   (United States)

Author keywords

Chronic traumatic encephalopathy; Cognitive impairment; Concussion; Epidemiology; Neuroepidemiology; Sport related concussion; Sport related injury; Traumatic brain injury

Indexed keywords

AGE; BRAIN CONCUSSION; HUMAN; INCIDENCE; REVIEW; RISK FACTOR; SPORT INJURY;

AGE FACTORS; ATHLETIC INJURIES; BRAIN CONCUSSION; HUMANS; INCIDENCE; RISK FACTORS;

EID: 84891163481     PISSN: 10407308     EISSN: 15736660     Source Type: Journal    
DOI: 10.1007/s11065-013-9239-0     Document Type: Review

References (98)

1. Agel, J., & Harvey, E. J. (2010). A 7-year review of men's and women's ice hockey injuries in the NCAA. Canadian Journal of Surgery. Journal Canadien de Chirurgie, 53(5), 319-323.
2. Beghi, E. (2013). Are professional soccer players at higher risk for ALS? Amyotrophic Lateral Sclerosis Frontotemporal Degeneration, 14(7-8), 501-506. doi: 10.3109/21678421.2013.809764.
3. Benson, B. W., Meeuwisse, W. H., Rizos, J., Kang, J., & Burke, C. J. (2011). A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program. CMAJ, 183(8), 905-911. doi: 10.1503/cmaj.092190.
4. Bigler, E. D. (2013). Neuroimaging Biomarkers in Mild Traumatic Brain Injury (mTBI). Neuropsychology Review, 23(3), 169-209.
5. Boden, B. P., Kirkendall, D. T., & Garrett, W. E., Jr. (1998). Concussion incidence in elite college soccer players. The American Journal of Sports Medicine, 26(2), 238-241.
6. Bot, A., van Amerongen, I. A., Groot, R. D., Hoekstra, N. L., & Agterof, W. G. (1996). Large deformation rheology of gelatin gels. Polymer Gels and Networks, 4(3), 189-227.
7. Bradley, B. (2013). NFL owners approve crown-of-helmet rule, abolish Tuck Rule. NFL.com. Published March 20,! 2013, Accessed October 29, 2013. Retrieved from http://www.nflevolution.com/article/NFL-owners-approve-crown-of-helmet- rule-change?ref=7317
8. Breedlove, E. L., Robinson, M., Talavage, T. M., Morigaki, K. E., Yoruk, U., O'Keefe, K., et al. (2012). Biomechanical correlates of symptomatic and asymptomatic neurophysiological impairment in high school football. Journal of Biomechanics, 45(7), 1265-1272. doi: 10.1016/j.jbiomech.2012.01.034.
9. Broglio, S. P., Sosnoff, J. J., Shin, S., He, X., Alcaraz, C., & Zimmerman, J. (2009). Head impacts during high school football: a biomechanical assessment. Journal of Athletic Training, 44(4), 342-349. doi: 10.4085/1062-6050-44.4.342.
10. Bruns, J., Jr., & Hauser, W. A. (2003). The epidemiology of traumatic brain injury: a review. [Review]. Epilepsia, 44(Suppl 10), 2-10.
11. Brust, J. C. M. (1984). On banning boxing. Neurology, 34(11), 1526-1527.
12. Casson, I. R., Viano, D. C., Powell, J. W., & Pellman, E. J. (2010). Twelve years of national football league concussion data. Sports Health, 2(6), 471-483. doi: 10.1177/1941738110383963.
13. CDC. (2011). Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged
14. Chang, S. K., Tominaga, G. T., Wong, J. H., Weldon, E. J., & Kaan, K. T. (2006). Risk factors for water sports-related cervical spine injuries. The Journal of Trauma, 60(5), 1041-1046. doi: 10.1097/01.ta.0000218256.39295.8f.
15. Chen, J. K., Johnston, K. M., Petrides, M., & Ptito, A. (2008). Neural substrates of symptoms of depression following concussion in male athletes with persisting postconcussion symptoms. [Research Support, Non-U.S. Gov't]. Archives of General Psychiatry, 65(1), 81-89. doi: 10.1001/ archgenpsychiatry.2007.8.
16. Covassin, T., Swanik, C. B., & Sachs, M. L. (2003). Epidemiological considerations of concussions among intercollegiate athletes. [Comparative Study]. Applied Neuropsychology, 10(1), 12-22. doi: 10.1207/S15324826AN1001-3.
17. Covassin, T., Elbin, R. J., & Sarmiento, K. (2012). Educating coaches about concussion in sports: evaluation of the CDC's "Heads Up: concussion in youth sports" initiative. [Comparative Study Evaluation Studies]. The Journal of School Health, 82(5), 233-238. doi: 10.1111/j.1746-1561.2012.00692.x.
18. Crisco, J. J., & Greenwald, R. M. (2011). Let's get the head further out of the game: a proposal for reducing brain injuries in helmeted contact sports. [Editorial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]. Current Sports Medicine Reports, 10(1), 7-9. doi: 10.1249/JSR.0b013e318205e063.
19. Crisco, J. J., Fiore, R., Beckwith, J. G., Chu, J. J., Brolinson, P. G., Duma, S., et al. (2010). Frequency and location of head impact exposures in individual collegiate football players. Journal of Athletic Training, 45(6), 549-559. doi: 10.4085/1062-6050-45.6.549.
20. Cubon, V. A., Putukian, M., Boyer, C., & Dettwiler, A. (2011). A diffusion tensor imaging study on the white matter skeleton in individuals with sports-related concussion. Journal of Neurotrauma, 28(2), 189-201. doi: 10.1089/neu.2010.1430.
21. Daneshvar, D. H., Baugh, C. M., Nowinski, C. J., McKee, A. C., Stern, R. A., & Cantu, R. C. (2011). Helmets and mouth guards: the role of personal equipment in preventing sport-related concussions. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review]. Clinics in Sports Medicine, 30(1), 145-163. doi: 10.1016/j.csm.2010.09.006. x.
22. Daniel, R. W., Rowson, S., & Duma, S. M. (2012). Head impact exposure in youth football. [Clinical Trial Research Support, Non-U.S. Gov't]. Annals of Biomedical Engineering, 40(4), 976-981. doi: 10.1007/s10439-012-0530-7.
23. DeVivo, M. J., & Sekar, P. (1997). Prevention of spinal cord injuries that occur in swimming pools. [Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S.]. Spinal Cord, 35(8), 509-515.
24. Donnell, A. J., Kim, M. S., Silva, M. A., & Vanderploeg, R. D. (2012). Incidence of postconcussion symptoms in psychiatric diagnostic groups, mild traumatic brain injury, and comorbid conditions. [Research Support, U.S. Gov't, Non-P.H.S.]. The Clinical Neuropsychologist, 26(7), 1092-1101. doi: 10.1080/13854046.2012.713984.
25. Echemendia, R. J., Putukian, M., Mackin, R. S., Julian, L., & Shoss, N. (2001). Neuropsychological test performance prior to and following sports-related mild traumatic brain injury. Clinical Journal of Sport Medicine, 11(1), 23-31.
26. Eisenberg, M. A., Andrea, J., Meehan, W., & Mannix, R. (2013). Time interval between concussions and symptom duration. Pediatrics, 132(1), 8-17. doi: 10.1542/peds.2013-0432.
27. Elkin, B. S., Ilankova, A., & Morrison, B. (2011a). Dynamic, regional mechanical properties of the porcine brain: indentation in the coronal plane. [Research Support, Non-U.S. Gov't]. Journal of Biomechanical Engineering, 133(7), 071009. doi: 10.1115/1.4004494.
28. Elkin, B. S., Ilankovan, A. I., & Morrison, B., III. (2011b). A detailed viscoelastic characterization of the P17 and adult rat brain. Journal of Neurotrauma, 28(11), 2235-2244.
29. Ellenbogen, R. G., Berger, M. S., & Batjer, H. H. (2010). The National Football League and concussion: leading a culture change in contact sports. World Neurosurgery, 74(6), 560-565. doi: 10.1016/j.wneu.2010.11.016.
30. Engebretsen, L., Steffen, K., Alonso, J. M., Aubry, M., Dvorak, J., Junge, A., et al. (2010). Sports injuries and illnesses during the Winter Olympic Games 2010. [Research Support, Non-U.S. Gov't]. British Journal of Sports Medicine, 44(11), 772-780. doi: 10.1136/bjsm.2010.076992.
31. Ferguson, R. J., Mittenberg, W., Barone, D. F., & Schneider, B. (1999). Postconcussion syndrome following sports-related head injury: expectation as etiology. [Comparative Study]. Neuropsychology, 13(4), 582-589.
32. Ferguson, R. W., Green, A., & Hansen, L. M. (2013). Game Changers: Stats, Stories and What Communities are Doing to Protect Young Athletes. Washington, DC: Safe Kids Worldwide.
33. Finan, J. D., Elkin, B. S., Pearson, E. M., Kalbian, I. L., & Morrison, B., III. (2012). Viscoelastic properties of the rat brain in the sagittal plane: effects of anatomical structure and age. Annals of Biomedical Engineering, 40(1), 70-78.
34. Finnoff, J. T., Jelsing, E. J., & Smith, J. (2011). Biomarkers, genetics, and risk factors for concussion. [Review]. PM & R: the Journal of Injury, Function, and Rehabilitation, 3(10 Suppl 2), S452-S459. doi: 10.1016/j.pmrj.2011.07.014.
35. Frommer, L. J., Gurka, K. K., Cross, K. M., Ingersoll, C. D., Comstock, R. D., & Saliba, S. A. (2011). Sex differences in concussion symptoms of high school athletes. [Research Support, U.S. Gov't, P.H.S.]. Journal of Athletic Training, 46(1), 76-84. doi: 10.4085/1062-6050-46.1.76.
36. Gajawelli, N., Lao, Y., Apuzzo, M. L., Romano, R., Liu, C., Tsao, S., et al. (2013). Neuroimaging changes in the brain in contact versus noncontact sport athletes using diffusion tensor imaging. World Neurosurgery. doi: 10.1016/j.wneu.2013.10.020.
37. Gardner, A., Shores, E. A., & Batchelor, J. (2010). Reduced processing speed in rugby union players reporting three or more previous concussions. Archives of Clinical Neuropsychology, 25(3), 174-181. doi: 10.1093/arclin/acq007.
38. Gardner, A., Kay-Lambkin, F., Stanwell, P., Donnelly, J., Williams, W. H., Hiles, A., et al. (2012). A systematic review of diffusion tensor imaging findings in sports-related concussion. Journal of Neurotrauma, 29(16), 2521-2538.
39. Gerberich, S. G., Priest, J. D., Boen, J. R., Straub, C. P., & Maxwell, R. E. (1983). Concussion incidences and severity in secondary school varsity football players. [Research Support, Non-U.S. Gov't]. American Journal of Public Health, 73(12), 1370-1375.
40. Gessel, L. M., Fields, S. K., Collins, C. L., Dick, R. W., & Comstock, R. D. (2007). Concussions among United States high school and collegiate athletes. [Research Support, U.S. Gov't, P.H.S.]. Journal of Athletic Training, 42(4), 495-503.
41. Giza, E., Mithofer, K., Farrell, L., Zarins, B., & Gill, T. (2005). Injuries in women's professional soccer. British Journal of Sports Medicine, 39(4), 212-216. doi: 10.1136/bjsm.2004.011973. discussion 212-216.
42. Giza, C. C., Kutcher, J. S., Ashwal, S., Barth, J., Getchius, T. S., Gioia, G. A., et al. (2013). Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. [Research Support, Non-U.S. Gov't Review]. Neurology, 80(24), 2250-2257. doi: 10.1212/WNL.0b013e31828d57dd.
43. Guskiewicz, K. M., Weaver, N. L., Padua, D. A., & Garrett, W. E., Jr. (2000). Epidemiology of concussion in collegiate and high school football players. American Journal of Sports Medicine, 28(5), 643-650.
44. Guskiewicz, K. M., McCrea, M., Marshall, S. W., Cantu, R. C., Randolph, C., Barr, W., et al. (2003). Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA, 290(19), 2549-2555. doi: 10.1001/jama.290.19.2549.
45. Guskiewicz, K. M., Marshall, S. W., Bailes, J., McCrea, M., Cantu, R. C., Randolph, C., et al. (2005). Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery, 57(4), 719-726. discussion 719-726.
46. Guskiewicz, K. M., Marshall, S. W., Bailes, J., McCrea, M., Harding, H. P., Jr., Matthews, A., et al. (2007). Recurrent concussion and risk of depression in retired professional football players. Medicine and Science in Sports and Exercise, 39(6), 903-909. doi: 10.1249/mss.0b013e3180383da5.
47. Guskiewicz, K. M., Register-Mihalik, J., McCrory, P., McCrea, M., Johnston, K., Makdissi, M., et al. (2013). Evidence-based approach to revising the SCAT2: introducing the SCAT3. [Review]. British Journal of Sports Medicine, 47(5), 289-293. doi: 10.1136/bjsports-2013-092225.
48. Halpin, T. (2013). Rules committee recommends ejection for targeting defenseless players, NCAA.com. Published February 13, 2013. Accessed October 29, 2013. Retrieved from http://www.ncaa.com/news/football/article/2013-02-13/ rules-committee-recommendsejection-targeting-defenseless-players.
49. Hendrickson, B. (2012), Concussion rate remains steady. NCAA.org. Published Sep 21, 2012, Accessed October 23, 2013. Retrieved from http://www.ncaa.org/wps/wcm/connect/public/NCAA/Resources/Latest+News/2012/ September/Concussion+rate+remains+steady.
50. Henry, L. C., Tremblay, J., Tremblay, S., Lee, A., Brun, C., Lepore, N., et al. (2011). Acute and chronic changes in diffusivity measures after sports concussion. Journal of Neurotrauma, 28(10), 2049-2059.
51. Holbourn, A. H. S. (1943). Mechanics of head injuries. The Lancet, 242(6267), 438-441.
52. Hootman, J. M., Dick, R., & Agel, J. (2007). Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. [Review]. Journal of Athletic Training, 42(2), 311-319.
53. Institute of Medicine (IOM) and National Research Council (NRC). (2013). Sports-related concussions in youth: Improving the science, changing the culture. Washington DC: The National Academies Press.
54. Johnson, M., & Etienne, M. (2013). From Army-Navy to the NFL: the evolution of the football helmet [ABSTRACT]. Neurology, 80(Meeting Abstracts 1), P01.268.
55. Johnson, B., Zhang, K., Gay, M., Horovitz, S., Hallett, M., Sebastianelli, W., et al. (2011). Alteration of brain default network in subacute phase of injury in concussed individuals: resting-state fMRI study. NeuroImage. doi: 10.1016/j.neuroimage.2011.07.081.
56. Kimpara, H., & Iwamoto, M. (2012). Mild traumatic brain injury predictors based on angular accelerations during impacts. Annals of Biomedical Engineering, 40(1), 114-126. doi: 10.1007/s10439-011-0414-2.
57. Koerte, I. K., Kaufmann, D., Hartl, E., Bouix, S., Pasternak, O., Kubicki, M., et al. (2012). A prospective study of physician-observed concussion during a varsity university hockey season: white matter integrity in ice hockey players. Part 3 of 4. Neurosurgical Focus, 33(6), E3.
58. Kontos, A. P., Elbin, R. J., Fazio-Sumrock, V. C., Burkhart, S., Swindell, H., Maroon, J., et al. (2013). Incidence of sports-related concussion among youth football players aged 8-12 years. [Research Support, Non-U.S. Gov't]. The Journal of Pediatrics, 163(3), 717-720. doi: 10.1016/j.jpeds.2013. 04.011.
59. Kroshus, E., Daneshvar, D. H., Baugh, C. M., Nowinski, C. J., & Cantu, R. C. (2013). NCAA concussion education in ice hockey: an ineffective mandate. British Journal of Sports Medicine. doi: 10.1136/bjsports-2013-092498.
60. Langlois, J. A., Rutland-Brown, W., & Wald, M. M. (2006). The epidemiology and impact of traumatic brain injury: a brief overview. The Journal of Head Trauma Rehabilitation, 21(5), 375-378.
61. Lehman, E. J., Hein, M. J., Baron, S. L., & Gersic, C. M. (2012). Neurodegenerative causes of death among retired National Football League players. Neurology, 79(19), 1970-1974. doi: 10.1212/WNL.0b013e31826daf50.
62. Lincoln, A. E., Caswell, S. V., Almquist, J. L., Dunn, R. E., Norris, J. B., & Hinton, R. Y. (2011). Trends in concussion incidence in high school sports: a prospective 11-year study. American Journal of Sports Medicine, 39(5), 958-963. doi: 10.1177/0363546510392326.
63. Lipton, M. L., Kim, N., Zimmerman, M. E., Kim, M., Stewart, W. F., Branch, C. A., et al. (2013). Soccer heading is associated with white matter microstructural and cognitive abnormalities. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]. Radiology, 268(3), 850-857. doi: 10.1148/radiol.13130545.
64. Marar, M., McIlvain, N. M., Fields, S. K., & Comstock, R. D. (2012). Epidemiology of concussions among United States high school athletes in 20 sports. [Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.]. The American Journal of Sports Medicine, 40(4), 747-755. doi: 10.1177/0363546511435626.
65. Marchi, N., Bazarian, J. J., Puvenna, V., Janigro, M., Ghosh, C., Zhong, J., et al. (2013). Consequences of repeated blood-brain barrier disruption in football players. PloS One, 8(3), e56805.
66. McAllister, T. W., Ford, J. C., Ji, S., Beckwith, J. G., Flashman, L. A., Paulsen, K., et al. (2012). Maximum principal strain and strain rate associated with concussion diagnosis correlates with changes in corpus callosum white matter indices. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.]. Annals of Biomedical Engineering, 40(1), 127-140. doi: 10.1007/s10439-011-0402-6.
67. McCarthy, M. M., Voos, J. E., Nguyen, J. T., Callahan, L., & Hannafin, J. A. (2013). Injury profile in elite female basketball athletes at the Women's National Basketball Association combine. The American Journal of Sports Medicine, 41(3), 645-651. doi: 10.1177/0363546512474223.
68. McCrea, M., Guskiewicz, K., Randolph, C., Barr, W. B., Hammeke, T. A., Marshall, S. W., et al. (2009). Effects of a symptom-free waiting period on clinical outcome and risk of reinjury after sport-related concussion. Neurosurgery, 65(5), 876-882. doi: 10.1227/01.NEU.0000350155.89800.00. discussion 882-873.
69. McCrea, M., Guskiewicz, K., Randolph, C., Barr, W. B., Hammeke, T. A., Marshall, S. W., et al. (2013). Incidence, clinical course, and predictors of prolonged recovery time following sport-related concussion in high school and college athletes. Journal of the International Neuropsychological Society, 19(1), 22-33. doi: 10.1017/S1355617712000872.
70. McCrory, P., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvorak, J., Echemendia, R. J., et al. (2013). Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. [Consensus Development Conference]. British Journal of Sports Medicine, 47(5), 250-258. doi: 10.1136/bjsports-2013-092313.
71. McKee, A. C., Cantu, R. C., Nowinski, C. J., Hedley-Whyte, E. T., Gavett, B. E., Budson, A. E., et al. (2009). Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. Journal of Neuropathology and Experimental Neurology, 68(7), 709-735. doi: 10.1097/NEN.0b013e3181a9d503.
72. McKee, A. C., Stern, R. A., Nowinski, C. J., Stein, T. D., Alvarez, V. E., Daneshvar, D. H., et al. (2013). The spectrum of disease in chronic traumatic encephalopathy. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.]. Brain: A Journal of Neurology, 136(Pt 1), 43-64. doi: 10.1093/brain/aws307.
73. Mills, B. J. (2001). Football helmets and products liability. Sports Law Journal, 8, 153-180.
74. Moeller, J. J., Tu, B., & Bazil, C. W. (2011). Quantitative and qualitative analysis of ambulatory electroencephalography during mild traumatic brain injury. [Case Reports Comparative Study]. Archives of Neurology, 68(12), 1595-1598. doi: 10.1001/archneurol.2011.1080.
75. Mooney, G., & Speed, J. (2001). The association between mild traumatic brain injury and psychiatric conditions. Brain Injury: [BI], 15(10), 865-877. doi: 10.1080/02699050110065286.
76. Mrazik, M., Naidu, D., Lebrun, C., Game, A., & Matthews-White, J. (2013). Does an Individual's fitness level affect baseline concussion symptoms? Journal of Athletic Training, 48(5), 654-658. doi: 10.4085/1062-6050-48.3.19.
77. National Sporting Goods Association. (2012). 2011 vs 2001 Youth Sports Participation. Survey performed January 2012. Report published December 19, 2012. Accessed October 24, 2013. Retrieved from http://www.nsga.org/files/ public/2011vs2001-Youth-Participation-website.pdf.
78. Neselius, S., Zetterberg, H., Blennow, K., Randall, J., Wilson, D., Marcusson, J., et al. (2013). Olympic boxing is associated with elevated levels of the neuronal protein tau in plasma. [Research Support, Non-U.S. Gov't]. Brain Injury: [BI], 27(4), 425-433. doi: 10.3109/02699052.2012.750752.
79. Nilsson, M., Hagglund, M., Ekstrand, J., & Walden, M. (2013). Head and neck injuries in professional soccer. [Research Support, Non-U.S. Gov't]. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine, 23(4), 255-260. doi: 10.1097/JSM.0b013e31827ee6f8.
80. Rigg, J. L., & Mooney, S. R. (2011). Concussions and the military: issues specific to service members. [Review]. PM & R: the Journal of Injury, Function, and Rehabilitation, 3(10 Suppl 2), S380-S386. doi: 10.1016/j.pmrj.2011.08.005.
81. Ruhe, A., Gansslen, A., & Klein, W. (2013). The incidence of concussion in professional and collegiate ice hockey: are we making progress? A systematic review of the literature. British Journal of Sports Medicine. doi: 10.1136/bjsports-2012-091609.
82. Schofield, P. W., Tang, M., Marder, K., Bell, K., Dooneief, G., Chun, M., et al. (1997). Alzheimer's disease after remote head injury: an incidence study. Journal of Neurology, Neurosurgery, and Psychiatry, 62(2), 119-124.
83. Schulz, M. R., Marshall, S. W., Mueller, F. O., Yang, J., Weaver, N. L., Kalsbeek, W. D., et al. (2004). Incidence and risk factors for concussion in high school athletes, North Carolina, 1996-1999. [Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.]. American Journal of Epidemiology, 160(10), 937-944. doi: 10.1093/aje/kwh304.
84. Shams, T., Brickman, A. M., Gossett, J., Levine, W., & Noble, J. M. (2013). Subtle Post-Concussion Cognitive Impairment Is Under-Recognized, and yet Identifiable: Findings from the Concussion in Columbia University Sports Student (ConCUSS) Study [ABSTRACT]. LA: New Orleans. Paper presented at the American Neurological Association.
85. Shenouda, C., Hendrickson, P., Davenport, K., Barber, J., & Bell, K. R. (2012). The effects of concussion legislation one year later-what have we learned: a descriptive pilot survey of youth soccer player associates. [Comparative Study Research Support, U.S. Gov't, Non-P.H.S.]. PM R, 4(6), 427-435. doi: 10.1016/j.pmrj.2012.02.016.
86. Shenton, M. E., Hamoda, H. M., Schneiderman, J. S., Bouix, S., Pasternak, O., Rathi, Y., et al. (2012). A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review]. Brain Imaging and Behavior, 6(2), 137-192. doi: 10.1007/s11682-012-9156-5.
87. Shields, B. J., Fernandez, S. A., & Smith, G. A. (2009). Epidemiology of cheerleading stunt-related injuries in the United States. [Comparative Study Research Support, Non-U.S. Gov't]. Journal of Athletic Training, 44(6), 586-594. doi: 10.4085/1062-6050-44.6.586.
88. Signoretti, S., Lazzarino, G., Tavazzi, B., & Vagnozzi, R. (2011). The pathophysiology of concussion. PM R, 3(10 Suppl 2), S359-S368. doi: 10.1016/j.pmrj.2011.07.018.
89. Stone, J., Carson, A., Aditya, H., Prescott, R., Zaubi, M., Warlow, C., et al. (2009). The role of physical injury in motor and sensory conversion symptoms: a systematic and narrative review. [Research Support, Non-U.S. Gov't Review]. Journal of Psychosomatic Research, 66(5), 383-390. doi: 10.1016/j.jpsychores.2008.07.010.
90. Talavage, T. M., Nauman, E. A., Breedlove, E. L., Yoruk, U., Dye, A. E., Morigaki, K. E., et al. (2013). Functionally-detected cognitive impairment in high school football players without clinically-diagnosed concussion. Journal of Neurotrauma. doi: 10.1089/neu.2010.1512.
91. Thurman, D. J., Branche, C. M., & Sniezek, J. E. (1998). The epidemiology of sports-related traumatic brain injuries in the United States: recent developments. The Journal of Head Trauma Rehabilitation, 13(2), 1-8.
92. Torg, J. S., Vegso, J. J., Sennett, B., & Das, M. (1985). The National Football Head and Neck Injury Registry. 14-year report on cervical quadriplegia, 1971 through 1984. JAMA, 254(24), 3439-3443.
93. Valovich McLeod, T. C., Bay, R. C., Heil, J., & McVeigh, S. D. (2008). Identification of sport and recreational activity concussion history through the preparticipation screening and a symptom survey in young athletes. Clinical Journal of Sport Medicine, 18(3), 235-240. doi: 10.1097/JSM. 0b013e3181705756.
94. Vanderploeg, R. D., Belanger, H. G., & Curtiss, G. (2009). Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms. [Research Support, U.S. Gov't, Non-P.H.S.]. Archives of Physical Medicine and Rehabilitation, 90(7), 1084-1093. doi: 10.1016/j.apmr.2009.01.023.
95. Wennberg, R. A., & Tator, C. H. (2008). Concussion incidence and time lost from play in the NHL during the past ten years. The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques, 35(5), 647-651.
96. Zhang, L., Yang, K. H., & King, A. I. (2004). A proposed injury threshold for mild traumatic brain injury. [Comparative Study Evaluation Studies Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Validation Studies]. Journal of Biomechanical Engineering, 126(2), 226-236.
97. Zhou, Y., & Lui, Y. W. (2013). Changes in brain organization after. Evidence from functional MRI findings. TBI: Neurology. doi: 10.1212/WNL. 0b013e318292a37d.
98. Zillmer, E. A. (2003). The neuropsychology of repeated 1-and 3-meter springboard diving among college athletes. [Comparative Study]. Applied Neuropsychology, 10(1), 23-30. doi: 10.1207/S15324826AN1001-4.