Neuropsychology of sports-related head injury: Dementia Pugilistica to Post Concussion Syndrome.

This article reviews the existing literature in the following areas of sports neuropsychology: Dementia Pugilistica, concussion and Post Concussion Syndrome, Second Impact Syndrome, and the emerging role of the sports neuropsychologist regarding return to play decisions. Dementia Pugilistica is discussed as a condition that exists along a continuum: Although many boxers will develop mild neurocognitive deficits, it is not yet known what percent of these mild presentations will progress to diagnosable Dementia Pugilistica. Factors contributing to both increased and reduced risk are detailed. The role of neuropsychological assessment in research and clinical management is reviewed. Existing studies of concussion incurred during contact sports provide evidence of an important role for neuropsychology in assessment and management of mild head injuries. Issues in clinical assessment of concussion are reviewed. The importance of grading of concussions, monitoring of postconcussive symptom resolution, and the use of neuropsychological test results in return to play decisions is detailed. The Second Impact Syndrome is discussed with regard to return to play decisions. Recommendations are proposed for research and for clinical application of findings in sports neuropsychology.

[1]  E. Zemper Analysis of cerebral concussion frequency with the most commonly used models of football helmets. , 1994, Journal of athletic training.

[2]  R. Tusa,et al.  Prospective study of central nervous system function in amateur boxers in the United States. , 1994, American journal of epidemiology.

[3]  C. Mawdsley,et al.  NEUROLOGICAL DISEASE IN BOXERS. , 1963, Lancet.

[4]  John A. Jane,et al.  Mild head injury in sports: Neuropsychological sequelae and recovery of function. , 1989 .

[5]  A. Tysvaer,et al.  Soccer injuries to the brain. A neurologic and electroencephalographic study of former players , 1989, Acta neurologica Scandinavica.

[6]  M R Lovell,et al.  Neuropsychological Assessment of the College Football Player , 1998, The Journal of head trauma rehabilitation.

[7]  D. Hovda,et al.  Massive increases in extracellular potassium and the indiscriminate release of glutamate following concussive brain injury. , 1990, Journal of neurosurgery.

[8]  J. Hardman,et al.  Morphological changes in brains of boxers. , 1984, JAMA.

[9]  C. Bruton,et al.  The aftermath of boxing , 1973, Psychological Medicine.

[10]  J. Haines,et al.  Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families. , 1993, Science.

[11]  H. Wainwright,et al.  Axonal injury in falls. , 1997, Journal of neurotrauma.

[12]  J R Boen,et al.  Concussion incidences and severity in secondary school varsity football players. , 1983, American journal of public health.

[13]  A. J. McLean,et al.  Stalning af amyloid percursor protein to study axonal damage in mild head Injury , 1994, The Lancet.

[14]  D. Gronwall,et al.  Duration of post-traumatic amnesia after mild head injury , 1980 .

[15]  R. Reitan,et al.  Clinical neuropsychology: Current status and applications. , 1974 .

[16]  C. M. van Duijn,et al.  Epidemiology of the dementias: recent developments and new approaches. , 1996 .

[17]  B. Giordani,et al.  Disability caused by minor head injury. , 1981, Neurosurgery.

[18]  D. Gronwall,et al.  CUMULATIVE EFFECT OF CONCUSSION , 1975, The Lancet.

[19]  R. Cantu,et al.  Second-impact syndrome. , 1998, Clinics in sports medicine.

[20]  J. Fisher,et al.  Neuropsychological Assessment, 2nd Ed , 1985 .

[21]  M. Sperling,et al.  The Electroencephalogram in Minor Brain Injury , 1993 .

[22]  M S Buchsbaum,et al.  Selected cases of poor outcome following a minor brain trauma: comparing neuropsychological and positron emission tomography assessment. , 1994, Brain injury.

[23]  G. Geffen,et al.  Mild head injury and speed of information processing: a prospective study of professional rugby league players. , 1997, Journal of clinical and experimental neuropsychology.

[24]  M. Pericak-Vance,et al.  Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[25]  R. Cantu Emergencies in sports. , 1992, The Physician and sportsmedicine.

[26]  J. Bleiberg,et al.  Future Directions for the Neuropsychological Assessment of Sports Concussion , 1998, The Journal of head trauma rehabilitation.

[27]  Thomas A. Gennarelli,et al.  Diffuse Axonal Injury: An Important Form of Traumatic Brain Damage , 1998 .

[28]  S. Dikmen,et al.  Neuropsychological and psychosocial consequences of minor head injury. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[29]  B. Giordani,et al.  Neuropsychological sequelae of minor head injury. , 1983, Neurosurgery.

[30]  Thomas A Gennarelli,et al.  Mechanisms and pathophysiology of cerebral concussion , 1986 .

[31]  B. Schuyler,et al.  Neuropsychological assessment of soccer players. , 1990 .

[32]  G. Larrabee,et al.  A review of mild head trauma. Part I: Meta-analytic review of neuropsychological studies. , 1997, Journal of clinical and experimental neuropsychology.

[33]  J. Adams,et al.  Diffuse axonal injury caused by assault. , 1992, Journal of clinical pathology.

[34]  R. Harbaugh,et al.  The second impact in catastrophic contact-sports head trauma. , 1984, JAMA.

[35]  J E Sniezek,et al.  Incidence of mild and moderate brain injury in the United States, 1991. , 1996, Brain injury.

[36]  L. Binder,et al.  A review of mild head trauma. Part II: Clinical implications. , 1997, Journal of clinical and experimental neuropsychology.

[37]  E. Bigler,et al.  Neuropsychological outcome and quantitative neuroimaging in mild head injury. , 1995, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[38]  J. Brandt The Hopkins Verbal Learning Test: Development of a new memory test with six equivalent forms. , 1991 .

[39]  J. Kelly,et al.  Standardized Assessment of Concussion (SAC): On-Site Mental Status Evaluation of the Athlete , 1998, The Journal of head trauma rehabilitation.

[40]  K. Svärdsudd,et al.  Long-term effects of head injuries sustained during life in three male populations. , 1987, Journal of neurosurgery.

[41]  J. Kelly,et al.  Concussion in Sports , 1999 .

[42]  R. Cantu Head injuries in sport. , 1996, British journal of sports medicine.

[43]  D. Hovda,et al.  Concussive brain injury is associated with a prolonged accumulation of calcium: a45Ca autoradiographic study , 1993, Brain Research.

[44]  J. DeLuca,et al.  Sequelae of minor traumatic brain injury. , 1992, American family physician.

[45]  M. Šercl,et al.  The mechanisms of cerebral concussion in boxing and their consequences. , 1962, World neurology.