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Sport-Related Concussion

  • Grant L. Iverson
Chapter

Abstract

Concussions in sports typically arise from a hard blow to the head. In soccer, for example, head-to-head impacts carry a high risk for concussion (Withnall et al., Br J Sports Med 39(Suppl 1):i49–i57, 2005). In the National Football League (NFL), an injury reconstruction study revealed that a striking player often lines up his head, neck, and torso to deliver maximum force to the other player in helmet-to-helmet impacts that result in concussive injuries to the player being struck (Viano and Pellman, Neurosurgery 56(2):266–280, 2005). Fortunately, most injuries in sports fall on the milder end of the spectrum of mild traumatic brain injuries (MTBI). Occasionally, however, athletes experience complicated mild, moderate, or severe traumatic brain injuries. In equestrian and auto racing, for example, accidents can result in much more serious injuries to the brain.

Keywords

Impact Syndrome National Football League Active Rehabilitation Traumatic Axonal Injury National Hockey League 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. American Academy of Neurology. (1997). Practice parameter: The management of concussion in sports (summary statement). Report of the Quality Standards Subcommittee. Neurology, 48(3), 581–585.CrossRefGoogle Scholar
  2. Aubry, M., Cantu, R., Dvorak, J., Graf-Baumann, T., Johnston, K., Kelly, J., et al. (2002). Summary and agreement statement of the First International Conference on Concussion in Sport, Vienna 2001. Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries. British Journal of Sports Medicine, 36(1), 6–10.PubMedCrossRefGoogle Scholar
  3. Barr, W. B., & McCrea, M. (2001). Sensitivity and specificity of standardized neurocognitive testing immediately following sports concussion. Journal of the International Neuropsychological Society, 7(6), 693–702.PubMedCrossRefGoogle Scholar
  4. Barth, J. T., Alves, W., Ryan, T., Macciocchi, S., Rimel, R. W., Jane, J. J., et al. (1989). Mild head injury in sports: Neuropsychological sequelae and recovery of function. In H. Levin, J. Eisenberg, & A. Benton (Eds.), Mild head injury (pp. 257–275). New York: Oxford University Press.Google Scholar
  5. Belanger, H. G., & Vanderploeg, R. D. (2005). The neuropsychological impact of sports-related concussion: A meta-analysis. Journal of the International Neuropsychological Society, 11(4), 345–357.PubMedGoogle Scholar
  6. Bleiberg, J., Cernich, A. N., Cameron, K., Sun, W., Peck, K., Ecklund, P. J., et al. (2004). Duration of cognitive impairment after sports concussion. Neurosurgery, 54(5), 1073–1078. discussion 1078–1080.PubMedCrossRefGoogle Scholar
  7. Broglio, S. P., Ferrara, M. S., Piland, S. G., Anderson, R. B., & Collie, A. (2006). Concussion history is not a predictor of computerised neurocognitive performance. British Journal of Sports Medicine, 40(9), 802–805. discussion 802–805.PubMedCrossRefGoogle Scholar
  8. Broglio, S. P., Macciocchi, S. N., & Ferrara, M. S. (2007a). Neurocognitive performance of concussed athletes when symptom free. Journal of Athletic Training, 42(4), 504–508.PubMedGoogle Scholar
  9. Broglio, S. P., Macciocchi, S. N., & Ferrara, M. S. (2007b). Sensitivity of the concussion assessment battery. Neurosurgery, 60(6), 1050–1057. discussion 1057–1058.PubMedCrossRefGoogle Scholar
  10. Broshek, D. K., Kaushik, T., Freeman, J. R., Erlanger, D., Webbe, F., & Barth, J. T. (2005). Sex differences in outcome following sports-related concussion. Journal of Neurosurgery, 102(5), 856–863.PubMedCrossRefGoogle Scholar
  11. Brown, C. N., Guskiewicz, K. M., & Bleiberg, J. (2007). Athlete characteristics and outcome scores for computerized neuropsychological assessment: A preliminary analysis. Journal of Athletic Training, 42(4), 515–523.PubMedGoogle Scholar
  12. Buki, A., & Povlishock, J. T. (2006). All roads lead to disconnection? – Traumatic axonal injury revisited. Acta Neurochirurgica (Wien), 148(2), 181–193. discussion 184–193.CrossRefGoogle Scholar
  13. Cantu, R. C. (1998). Second-impact syndrome. Clinical Sports Medicine, 17(1), 37–44.CrossRefGoogle Scholar
  14. Cantu, R. C. (2001). Posttraumatic retrograde and anterograde amnesia: Pathophysiology and implications in grading and safe return to play. Journal of Athletic Training, 36(3), 244–248.PubMedGoogle Scholar
  15. Collie, A., Makdissi, M., Maruff, P., Bennell, K., & McCrory, P. (2006). Cognition in the days following concussion: Comparison of symptomatic versus asymptomatic athletes. Journal of Neurology, Neurosurgery and Psychiatry, 77(2), 241–245.CrossRefGoogle Scholar
  16. Collie, A., Maruff, P., Darby, D., Makdissi, M., McCrory, P., & McStephen, M. (2006). CogSport. In R. Echemendia (Ed.), Sports neuropsychology: Assessment and management of traumatic brain injury (pp. 240–262). New York: The Guilford.Google Scholar
  17. Collie, A., McCrory, P., & Makdissi, M. (2006). Does history of concussion affect current cognitive status? British Journal of Sports Medicine, 40(6), 550–551.PubMedCrossRefGoogle Scholar
  18. Collins, M. W., Field, M., Lovell, M. R., Iverson, G., Johnston, K. M., Maroon, J., et al. (2003). Relationship between postconcussion headache and neuropsychological test performance in high school athletes. The American Journal of Sports Medicine, 31(2), 168–173.PubMedGoogle Scholar
  19. Collins, M. W., Grindel, S. H., Lovell, M. R., Dede, D. E., Moser, D. J., Phalin, B. R., et al. (1999). Relationship between concussion and neuropsychological performance in college football players. Journal of the American Medical Association, 282(10), 964–970.PubMedCrossRefGoogle Scholar
  20. Collins, M. W., Iverson, G. L., Lovell, M. R., McKeag, D. B., Norwig, J., & Maroon, J. (2003). On-field predictors of neuropsychological and symptom deficit following sports-related concussion. Clinical Journal of Sport Medicine, 13(4), 222–229.PubMedCrossRefGoogle Scholar
  21. Collins, M. W., Lovell, M. R., Iverson, G. L., Ide, T., & Maroon, J. (2006). Examining concussion rates and return to play in high school football players wearing newer helmet technology: A three year prospective cohort study. Neurosurgery, 58(2), 275–286.PubMedCrossRefGoogle Scholar
  22. Covassin, T., Schatz, P., & Swanik, C. B. (2007). Sex differences in neuropsychological function and post-concussion symptoms of concussed collegiate athletes. Neurosurgery, 61(2), 345–350. discussion 341–350.PubMedCrossRefGoogle Scholar
  23. Covassin, T., Stearne, D., & Elbin, R. (2008). Concussion history and postconcussion neurocognitive performance and symptoms in collegiate athletes. Journal of Athletic Training, 43(2), 119–124.PubMedCrossRefGoogle Scholar
  24. De Beaumont, L., Brisson, B., Lassonde, M., & Jolicoeur, P. (2007). Long-term electrophysiological changes in athletes with a history of multiple concussions. Brain Injury, 21(6), 631–644.PubMedCrossRefGoogle Scholar
  25. Delaney, J. S., Lacroix, V. J., Gagne, C., & Antoniou, J. (2001). Concussions among university football and soccer players: A pilot study. Clinical Journal of Sport Medicine, 11(4), 234–240.PubMedCrossRefGoogle Scholar
  26. Delaney, J. S., Lacroix, V. J., Leclerc, S., & Johnston, K. M. (2000). Concussions during the 1997 Canadian Football League season. Clinical Journal of Sport Medicine, 10(1), 9–14.PubMedCrossRefGoogle Scholar
  27. Duman, R. S. (2005). Neurotrophic factors and regulation of mood: Role of exercise, diet and metabolism. Neurobiology of Aging, 26 (Suppl 1), 88–93.PubMedCrossRefGoogle Scholar
  28. Dunn, A. L., Trivedi, M. H., Kampert, J. B., Clark, C. G., & Chambliss, H. O. (2005). Exercise treatment for depression: Efficacy and dose response. American Journal of Preventive Medicine, 28(1), 1–8.PubMedCrossRefGoogle Scholar
  29. Echemendia, R. J. (2006). Sports neuropsychology: Assessment and management of traumatic brain injury. New York: The Guilford.Google Scholar
  30. Echemendia, R. J., & Cantu, R. C. (2003). Return to play following sports-related mild traumatic brain injury: The role for neuropsychology. Applied Neuropsychology, 10(1), 48–55.PubMedCrossRefGoogle Scholar
  31. Erlanger, D., Feldman, D., Kutner, K., Kaushik, T., Kroger, H., Festa, J., et al. (2003). Development and validation of a web-based neuropsychological test protocol for sports-related return-to-play decision-making. Archives of Clinical Neuropsychology, 18(3), 293–316.PubMedGoogle Scholar
  32. Erlanger, D., Kaushik, T., Cantu, R., Barth, J. T., Broshek, D. K., Freeman, J. R., et al. (2003). Symptom-based assessment of the severity of a concussion. Journal of Neurosurgery, 98(3), 477–484.PubMedCrossRefGoogle Scholar
  33. Erlanger, D., Saliba, E., Barth, J., Almquist, J., Webright, W., & Freeman, J. (2001). Monitoring resolution of postconcussion symptoms in athletes: Preliminary results of a web-based neuropsychological test protocol. Journal of Athletic Training, 36(3), 280–287.PubMedGoogle Scholar
  34. Fazio, V. C., Lovell, M. R., Pardini, J. E., & Collins, M. W. (2007). The relation between post concussion symptoms and neurocognitive performance in concussed athletes. NeuroRehabilitation, 22(3), 207–216.PubMedGoogle Scholar
  35. Gaetz, M., Goodman, D., & Weinberg, H. (2000). Electrophysiological evidence for the cumulative effects of concussion. Brain Injury, 14(12), 1077–1088.PubMedCrossRefGoogle Scholar
  36. Gaetz, M., & Iverson, G. L. (2005). The British Columbia Concussion Rehabilitation Program (BC-CRP).Google Scholar
  37. Gaetz, M., & Iverson, G. L. (2009). Sex differences in self-reported symptoms following aerobic exercise in non-injured athletes: Implications for concussion management programs. British Journal of Sports Medicine, 43, 508–513.PubMedCrossRefGoogle Scholar
  38. Gaetz, M., Parrott, H., & Iverson, G. L. (2006). The British Columbia Concussion Rehabilitation Program (BC-CRP): Normative and case data. Poster presented at the Brain Injury of the Americas Conference (North American Brain INjury Society – NABIS), Maimi, FL, September 14–16.Google Scholar
  39. Gagnon, I., Galli, C., Friedman, D., Grilli, L., & Iverson, G. L. (2009). Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Injury, 23(12), 956–964.PubMedCrossRefGoogle Scholar
  40. 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. American Journal of Public Health, 73(12), 1370–1375.PubMedCrossRefGoogle Scholar
  41. Giza, C. C., & Hovda, D. A. (2001). The neurometabolic cascade of concussion. Journal of Athletic Training, 36(3), 228–235.PubMedGoogle Scholar
  42. Giza, C. C., & Hovda, D. A. (2004). The pathophysiology of traumatic brain injury. In M. R. Lovell, R. J. Echemendia, J. T. Barth, & M. W. Collins (Eds.), Traumatic brain injury in sports (pp. 45–70). Lisse: Swets & Zeitlinger.Google Scholar
  43. Griesbach, G. S., Gomez-Pinilla, F., & Hovda, D. A. (2007). Time window for voluntary exercise-induced increases in hippocampal neuroplasticity molecules after traumatic brain injury is severity dependent. Journal of Neurotrauma, 24(7), 1161–1171.PubMedCrossRefGoogle Scholar
  44. Griesbach, G. S., Hovda, D. A., Gomez-Pinilla, F., & Sutton, R. L. (2008). Voluntary exercise or amphetamine treatment, but not the combination, increases hippocampal brain-derived neurotrophic factor and synapsin I following cortical contusion injury in rats. Neuroscience, 154(2), 530–540.PubMedCrossRefGoogle Scholar
  45. Griesbach, G. S., Hovda, D. A., Molteni, R., Wu, A., & Gomez-Pinilla, F. (2004). Voluntary exercise following traumatic brain injury: Brain-derived neurotrophic factor upregulation and recovery of function. Neuroscience, 125(1), 129–139.PubMedCrossRefGoogle Scholar
  46. 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. Journal of the American Medical Association, 290(19), 2549–2555.PubMedCrossRefGoogle Scholar
  47. Guskiewicz, K. M., Ross, S. E., & Marshall, S. W. (2001). Postural stability and neuropsychological deficits after concussion in collegiate athletes. Journal of Athletic Training, 36(3), 263–273.PubMedGoogle Scholar
  48. Iverson, G. L. (2005). Outcome from mild traumatic brain injury. Current Opinion in Psychiatry, 18, 301–317.PubMedCrossRefGoogle Scholar
  49. Iverson, G. L. (2007). Predicting slow recovery from sport-related concussion: The new simple-complex distinction. Clinical Journal of Sport Medicine, 17, 31–37.PubMedCrossRefGoogle Scholar
  50. Iverson, G. L., Brooks, B. L., Azevedo, A., & Gaetz, M. (2006a). Modifying the British Columbia Concussion Recovery Program for use with injured adults with postconcussion syndrome. Poster presented at the Brain Injury of the Americas Conference (North American Brain Injury Society – NABIS), Maimi, FL, September 14–16.Google Scholar
  51. Iverson, G. L., Brooks, B. L., Collins, M. W., & Lovell, M. R. (2006). Tracking neuropsychological recovery following concussion in sport. Brain Injury, 20(3), 245–252.PubMedCrossRefGoogle Scholar
  52. Iverson, G. L., Gaetz, M., Lovell, M. R., & Collins, M. W. (2002). Relation between fogginess and outcome following concussion. Archives of Clinical Neuropsychology, 17, 769–770.Google Scholar
  53. Iverson, G. L., Gaetz, M., Lovell, M. R., & Collins, M. W. (2004a). Cumulative effects of concussion in amateur athletes. Brain Injury, 18(5), 433–443.PubMedCrossRefGoogle Scholar
  54. Iverson, G. L., Gaetz, M., Lovell, M. R., & Collins, M. W. (2004b). Relation between subjective fogginess and neuropsychological testing following concussion. Journal of the International Neuropsychological Society, 10, 904–906.PubMedCrossRefGoogle Scholar
  55. Iverson, G. L., Lovell, M. R., & Collins, M. W. (2003). Interpreting change on ImPACT following sport concussion. The Clinical Neuropsychologist, 17(4), 460–467.PubMedCrossRefGoogle Scholar
  56. Iverson, G. L., Lovell, M. R., & Collins, M. W. (2005). Validity of ImPACT for measuring processing speed following sports-related concussion. Journal of Clinical and Experimental Neuropsychology, 27(6), 683–689.PubMedCrossRefGoogle Scholar
  57. Kaushik, T., & Erlanger, D. M. (2006). The headminder concussion resolution index. In R. Echemendia (Ed.), Sports neuropsychology: Assessment and management of traumatic brain injury (pp. 216–239). New York: The Guildford.Google Scholar
  58. Laurer, H. L., Bareyre, F. M., Lee, V. M., Trojanowski, J. Q., Longhi, L., Hoover, R., et al. (2001). Mild head injury increasing the brain’s vulnerability to a second concussive impact. Journal of Neurosurgery, 95(5), 859–870.PubMedCrossRefGoogle Scholar
  59. Longhi, L., Saatman, K. E., Fujimoto, S., Raghupathi, R., Meaney, D. F., Davis, J., et al. (2005). Temporal window of vulnerability to repetitive experimental concussive brain injury. Neurosurgery, 56(2), 364–374. discussion 364–374.PubMedCrossRefGoogle Scholar
  60. Lovell, M. R. (1996). Evaluation of the professional athlete. Poster presented at the New Developments in Sports-Related Concussion Conference, Pittsburgh, PA.Google Scholar
  61. Lovell, M. R. (1999). Evaluation of the professional athlete. In J. E. Bailes, M. R. Lovell, & J. C. Maroon (Eds.), Sports-related concussion. St. Louis: Quality Medical.Google Scholar
  62. Lovell, M. R. (2006). Neuropsychological assessment of the professional athlete. In R. J. Echemendia (Ed.), Sports neuropsychology: Assessment and management of traumatic brain injury (pp. 176–190). New York: The Guilford.Google Scholar
  63. Lovell, M. R., & Burke, C. J. (2002). The NHL concussion program. In R. Cantu (Ed.), Neurologic athletic head and spine injury (pp. 32–45). Phildelphia: WB Saunders.Google Scholar
  64. Lovell, M. R., & Collins, M. W. (1998). Neuropsychological assessment of the college football player. The Journal of Head Trauma Rehabilitation, 13(2), 9–26.PubMedCrossRefGoogle Scholar
  65. Lovell, M. R., Collins, M. W., Iverson, G. L., Field, M., Maroon, J. C., Cantu, R., et al. (2003). Recovery from mild concussion in high school athletes. Journal of Neurosurgery, 98(2), 296–301.PubMedCrossRefGoogle Scholar
  66. Lovell, M. R., Collins, M. W., Iverson, G. L., Johnston, K. M., & Bradley, J. P. (2004). Grade 1 or “ding” concussions in high school athletes. The American Journal of Sports Medicine, 32(1), 47–54.PubMedCrossRefGoogle Scholar
  67. Lovell, M. R., Echemendia, R. J., Barth, J. T., & Collins, M. W. (Eds.). (2004). Traumatic brain injury in sports. Lisse: Swets & Zeitlinger.Google Scholar
  68. Lovell, M. R., Echemendia, R. J., & Burke, C. J. (2004). Traumatic brain injury in professional hockey. In M. R. Lovell, R. J. Echemendia, J. Barth, & M. W. Collins (Eds.), Traumatic brain injury in sports: An international neuropsychological perspective (pp. 221–231). Amsterdam: Swets-Zietlinger.Google Scholar
  69. Lovell, M. R., & Fazio, V. (2008). Concussion management in the child and adolescent athlete. Current Sports Medicine Reports, 7(1), 12–15.PubMedGoogle Scholar
  70. Lovell, M. R., Iverson, G. L., Collins, M. W., Podell, K., Johnston, K. M., Pardini, D., et al. (2006). Measurement of symptoms following sports-related concussion: Reliability and normative data for the post-concussion scale. Applied Neuropsychology, 13(3), 166–174.PubMedCrossRefGoogle Scholar
  71. Macciocchi, S. N., Barth, J. T., Alves, W., Rimel, R. W., & Jane, J. A. (1996). Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery, 39(3), 510–514.PubMedGoogle Scholar
  72. Makdissi, M., Collie, A., Maruff, P., Darby, D. G., Bush, A., McCrory, P., et al. (2001). Computerised cognitive assessment of concussed Australian Rules footballers. British Journal of Sports Medicine, 35(5), 354–360.PubMedCrossRefGoogle Scholar
  73. Matser, J. T., Kessels, A. G., Lezak, M. D., & Troost, J. (2001). A dose-response relation of headers and concussions with cognitive impairment in professional soccer players. Journal of Clinical and Experimental Neuropsychology, 23(6), 770–774.PubMedCrossRefGoogle Scholar
  74. McClincy, M. P., Lovell, M. R., Pardini, J., Collins, M. W., & Spore, M. K. (2006). Recovery from sports concussion in high school and collegiate athletes. Brain Injury, 20(1), 33–39.PubMedCrossRefGoogle Scholar
  75. McCrea, M., Guskiewicz, K. M., Marshall, S. W., Barr, W., Randolph, C., Cantu, R. C., et al. (2003). Acute effects and recovery time following concussion in collegiate football players: The NCAA Concussion Study. Journal of the American Medical Association, 290(19), 2556–2563.PubMedCrossRefGoogle Scholar
  76. McCrea, M., Kelly, J. P., Randolph, C., Cisler, R., & Berger, L. (2002). Immediate neurocognitive effects of concussion. Neurosurgery, 50(5), 1032–1040.PubMedGoogle Scholar
  77. McCrory, P. (2001). Does second impact syndrome exist? Clinical Journal of Sport Medicine, 11(3), 144–149.PubMedCrossRefGoogle Scholar
  78. McCrory, P., & Berkovic, S. F. (1998). Second impact syndrome. Neurology, 50(3), 677–683.PubMedCrossRefGoogle Scholar
  79. McCrory, P., Collie, A., Anderson, V., & Davis, G. (2004). Can we manage sport related concussion in children the same as in adults? British Journal of Sports Medicine, 38(5), 516–519.PubMedCrossRefGoogle Scholar
  80. McCrory, P., Johnston, K., Meeuwisse, W., Aubry, M., Cantu, R., Dvorak, J., et al. (2005). Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. British Journal of Sports Medicine, 39(4), 196–204.PubMedGoogle Scholar
  81. McCrory, P., Meeuwisse, W., Johnston, K., Dvorak, J., Aubry, M., Molloy, M., et al. (2009). Consensus Statement on Concussion in Sport: The 3rd International Conference on Concussion in Sport held in Zurich, November 2008. British Journal of Sports Medicine, 43 (Suppl 1), i76–90.PubMedCrossRefGoogle Scholar
  82. Mead, G. E., Morley, W., Campbell, P., Greig, C. A., McMurdo, M., & Lawlor, D. A. (2008). Exercise for depression. Cochrane Database of Systematic Reviews (4), CD004366.Google Scholar
  83. Mihalik, J. P., McCaffrey, M. A., Rivera, E. M., Pardini, J. E., Guskiewicz, K. M., Collins, M. W., et al. (2007). Effectiveness of mouthguards in reducing neurocognitive deficits following sports-related cerebral concussion. Dental Traumatology, 23(1), 14–20.PubMedCrossRefGoogle Scholar
  84. Mori, T., Katayama, Y., & Kawamata, T. (2006). Acute hemispheric swelling associated with thin subdural hematomas: Pathophysiology of repetitive head injury in sports. Acta Neurochirurgica. Supplementum, 96, 40–43.CrossRefGoogle Scholar
  85. Moser, R. S., Iverson, G. L., Echemendia, R. J., Lovell, M. R., Schatz, P., Webbe, F. M., et al. (2007). Neuropsychological evaluation in the diagnosis and management of sports-related concussion. Archives of Clinical Neuropsychology, 22(8), 909–916.PubMedCrossRefGoogle Scholar
  86. Pellman, E. J., Lovell, M. R., Viano, D. C., & Casson, I. R. (2006). Concussion in professional football: Recovery of NFL and high school athletes assessed by computerized neuropsychological testing-part 12. Neurosurgery, 58(2), 263–274. discussion 263–274.PubMedCrossRefGoogle Scholar
  87. Pellman, E. J., Lovell, M. R., Viano, D. C., Casson, I. R., & Tucker, A. M. (2004). Concussion in professional football: Neuropsychological testing-part 6. Neurosurgery, 55(6), 1290–1305.PubMedCrossRefGoogle Scholar
  88. Pellman, E. J., Viano, D. C., Casson, I. R., Arfken, C., & Powell, J. (2004). Concussion in professional football: Injuries involving 7 or more days out-part 5. Neurosurgery, 55(5), 1100–1119.PubMedCrossRefGoogle Scholar
  89. Penninx, B. W., Rejeski, W. J., Pandya, J., Miller, M. E., Di Bari, M., Applegate, W. B., et al. (2002). Exercise and depressive symptoms: A comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. The Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 57(2), P124–132.CrossRefGoogle Scholar
  90. Peterson, C. L., Ferrara, M. S., Mrazik, M., Piland, S., & Elliott, R. (2003). Evaluation of neuropsychological domain scores and postural stability following cerebral concussion in sports. Clinical Journal of Sport Medicine, 13(4), 230–237.PubMedCrossRefGoogle Scholar
  91. Pietropaolo, S., Sun, Y., Li, R., Brana, C., Feldon, J., & Yee, B. K. (2008). The impact of voluntary exercise on mental health in rodents: A neuroplasticity perspective. Behavioural Brain Research, 192(1), 42–60.PubMedCrossRefGoogle Scholar
  92. Riemann, B. L., & Guskiewicz, K. M. (2000). Effects of mild head injury on postural stability as measured through clinical balance testing. Journal of Athletic Training, 35(1), 19–25.PubMedGoogle Scholar
  93. Schatz, P., Pardini, J. E., Lovell, M. R., Collins, M. W., & Podell, K. (2006). Sensitivity and specificity of the ImPACT test battery for concussion in athletes. Archives of Clinical Neuropsychology, 21(1), 91–99.PubMedCrossRefGoogle Scholar
  94. Shuttleworth-Rdwards, A. B., & Radloff, S. E. (2008). Compromised visuomotor processing speed in players of Rugby Union from school through to the national adult level. Archives of Clinical Neuropsychology, 23(5), 511–520.PubMedCrossRefGoogle Scholar
  95. Sosnoff, J. J., Broglio, S. P., Hillman, C. H., & Ferrara, M. S. (2007). Concussion does not impact intraindividual response time variability. Neuropsychology, 21(6), 796–802.PubMedCrossRefGoogle Scholar
  96. The Psychological Corporation. (2002). Updated WAIS-III/WMS-III technical manual. San Antonio: Author.Google Scholar
  97. Thornton, A. E., Cox, D. N., Whitfield, K., & Fouladi, R. T. (2007). Cumulative concussion exposure in rugby players: Neurocognitive and symptomatic outcomes. Journal of Clinical and Experimental Neuropsychology, 27, 1–12.Google Scholar
  98. Tsushima, W. T., Oshiro, R., & Zimbra, D. (2008). Neuropsychological test performance of Hawai’i high school athletes: Hawai’i ImPACT normative data. Hawaii Medical Journal, 67(4), 93–95.PubMedGoogle Scholar
  99. Vagnozzi, R., Tavazzi, B., Signoretti, S., Amorini, A. M., Belli, A., Cimatti, M., et al. (2007). Temporal window of metabolic brain vulnerability to concussions: Mitochondrial-related impairment – Part I. Neurosurgery, 61(2), 379–388. discussion 379–388.PubMedCrossRefGoogle Scholar
  100. Van Kampen, D. A., Lovell, M. R., Pardini, J. E., Collins, M. W., & Fu, F. H. (2006). The “value added” of neurocognitive testing after sports-related concussion. The American Journal of Sports Medicine, 34(10), 1630–1635.PubMedCrossRefGoogle Scholar
  101. Viano, D. C., & Pellman, E. J. (2005). Concussion in professional football: Biomechanics of the striking player – Part 8. Neurosurgery, 56(2), 266–280. discussion 266–280.PubMedCrossRefGoogle Scholar
  102. Wall, S. E., Williams, W. H., Cartwright-Hatton, S., Kelly, T. P., Murray, J., Murray, M., et al. (2006). Neuropsychological dysfunction following repeat concussions in jockeys. Journal of Neurology, Neurosurgery and Psychiatry, 77(4), 518–520.CrossRefGoogle Scholar
  103. Warden, D. L., Bleiberg, J., Cameron, K. L., Ecklund, J., Walter, J., Sparling, M. B., et al. (2001). Persistent prolongation of simple reaction time in sports concussion. Neurology, 57(3), 524–526.PubMedCrossRefGoogle Scholar
  104. Withnall, C., Shewchenko, N., Gittens, R., & Dvorak, J. (2005). Biomechanical investigation of head impacts in football. British Journal of Sports Medicine, 39 (Suppl 1), i49–57.PubMedCrossRefGoogle Scholar
  105. Zemper, E. D. (2003). Two-year prospective study of relative risk of a second cerebral concussion. American Journal of Physical Medicine & Rehabilitation, 82(9), 653–659.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.University of British Columbia & British Columbia Mental Health and Addiction ServicesVancouverCanada

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