300,000 individuals sustain sports concussions each year in the U.S. The short and long-term effects of sports concussions and sub-concussive impacts are not known, nor are the cumulative effects of repeated injuries understood. What is clear is that there is enormous variability in outcome, although the reasons for this variability are not understood. The overarching theme of this proposal is that an individual's exposure to biomechanical forces is a critical factor influencing outcome. This has two broad components: the characteristics of a single impact (e.g. linear acceleration, rotational acceleration, direction etc.), and the history of exposure to biomechanical forces (e.g. measures of frequency and intensity of impacts over the preceding days and weeks). We propose to use technological advances in on-field head impact monitoring, cognitive testing, and functional brain imaging to learn for the first time what types of head impacts, under what circumstances, in which individuals, cause what effects in brain function. Both acute (post-concussive) and cumulative (pre to one-month post season) monitoring of biomechanical forces are of interest and will be assessed. Three groups of student athletes (football/hockey players with concussion, teammates without concussion, matched non-impact sport athletes) will be studied at three time points (preseason, postseason, and within one week of a concussion) using a standardized cognitive battery and functional MRI (fMRI). Impact parameters will be directly measured using helmet-based accelerometer units. Results of this study should yield important information on the biomechanics and genetics of sports-related traumatic brain injury, lead to more informed return-to-play guidelines, and provide objective information regarding the effects of cumulative minor head injuries.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS055020-05
Application #
8090299
Study Section
Clinical Neuroscience and Disease Study Section (CND)
Program Officer
Hicks, Ramona R
Project Start
2007-08-01
Project End
2014-06-30
Budget Start
2011-07-01
Budget End
2014-06-30
Support Year
5
Fiscal Year
2011
Total Cost
$420,451
Indirect Cost
Name
Dartmouth College
Department
Psychiatry
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Maerlender, Arthur C; Masterson, Caitlin J; James, Tiffany D et al. (2016) Test-retest, retest, and retest: Growth curve models of repeat testing with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). J Clin Exp Neuropsychol 38:869-74
Ji, Songbai; Zhao, Wei; Ford, James C et al. (2015) Group-wise evaluation and comparison of white matter fiber strain and maximum principal strain in sports-related concussion. J Neurotrauma 32:441-54
Wilcox, Bethany J; Beckwith, Jonathan G; Greenwald, Richard M et al. (2015) Biomechanics of head impacts associated with diagnosed concussion in female collegiate ice hockey players. J Biomech 48:2201-4
McAllister, Thomas W (2015) Genetic factors in traumatic brain injury. Handb Clin Neurol 128:723-39
McAllister, Thomas W; Ford, James C; Flashman, Laura A et al. (2014) Effect of head impacts on diffusivity measures in a cohort of collegiate contact sport athletes. Neurology 82:63-9
Rowson, Steven; Duma, Stefan M; Greenwald, Richard M et al. (2014) Can helmet design reduce the risk of concussion in football? J Neurosurg 120:919-22
Beckwith, Jonathan G; Greenwald, Richard M; Chu, Jeffrey J et al. (2013) Timing of concussion diagnosis is related to head impact exposure prior to injury. Med Sci Sports Exerc 45:747-54
Maerlender, A; Flashman, L; Kessler, A et al. (2013) Discriminant construct validity of ImPACTâ„¢: a companion study. Clin Neuropsychol 27:290-9
Beckwith, Jonathan G; Greenwald, Richard M; Chu, Jeffrey J et al. (2013) Head impact exposure sustained by football players on days of diagnosed concussion. Med Sci Sports Exerc 45:737-46
McAllister, Thomas W; Tyler, Anna L; Flashman, Laura A et al. (2012) Polymorphisms in the brain-derived neurotrophic factor gene influence memory and processing speed one month after brain injury. J Neurotrauma 29:1111-8

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