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Neuropsychological Change After a Single Season of Head Impact Exposure in Youth Football

Published online by Cambridge University Press:  07 August 2020

Arthur Maerlender Open the ORCID record for Arthur Maerlender [Opens in a new window] ,
Eric Smith ,
P. Gunnar Brolinson ,
Joseph Crisco ,
Jillian Urban ,
Amaris Ajamil ,
Steven Rowson ,
Eamon T. Campolettano ,
Ryan A. Gellner  and
Srinidhi Bellamkonda
...Show all authors
Arthur Maerlender*
Affiliation:
University of Nebraska-Lincoln, Lincoln, NE68588, USA
Eric Smith
Affiliation:
Virginia Polytechnic Institute and State University, Center for Injury Biomechanics, Blacksburg, VA24060, USA
P. Gunnar Brolinson
Affiliation:
Virginia Polytechnic Institute and State University, Center for Injury Biomechanics, Blacksburg, VA24060, USA Department of Family and Sports Medicine, Edward Via College of Osteopathic Medicine, Blacksburg, VA24060, USA
Joseph Crisco
Affiliation:
Department of Orthopedics, Brown University, Providence, RI02912, USA
Jillian Urban
Affiliation:
School of Biomedical Engineering and Sciences, Wake Forest University, Winston-Salem, NC27109, USA
Amaris Ajamil
Affiliation:
Simbex, Inc., Lebanon, NH03766, USA
Steven Rowson
Affiliation:
Virginia Polytechnic Institute and State University, Center for Injury Biomechanics, Blacksburg, VA24060, USA
Eamon T. Campolettano
Affiliation:
Virginia Polytechnic Institute and State University, Center for Injury Biomechanics, Blacksburg, VA24060, USA
Ryan A. Gellner
Affiliation:
Virginia Polytechnic Institute and State University, Center for Injury Biomechanics, Blacksburg, VA24060, USA
Srinidhi Bellamkonda
Affiliation:
Department of Orthopedics, Brown University, Providence, RI02912, USA
Emily Kieffer
Affiliation:
Virginia Polytechnic Institute and State University, Center for Injury Biomechanics, Blacksburg, VA24060, USA
Mireille E. Kelley
Affiliation:
School of Biomedical Engineering and Sciences, Wake Forest University, Winston-Salem, NC27109, USA
Derek Jones
Affiliation:
School of Biomedical Engineering and Sciences, Wake Forest University, Winston-Salem, NC27109, USA
Alex Powers
Affiliation:
Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, NC27157, USA
Jonathan Beckwith
Affiliation:
Simbex, Inc., Lebanon, NH03766, USA
Joel Stitzel
Affiliation:
School of Biomedical Engineering and Sciences, Wake Forest University, Winston-Salem, NC27109, USA
Richard M. Greenwald
Affiliation:
Simbex, Inc., Lebanon, NH03766, USA
Stefan Duma
Affiliation:
Virginia Polytechnic Institute and State University, Center for Injury Biomechanics, Blacksburg, VA24060, USA
*
*Correspondence and reprint requests to: Arthur Maerlender, Center for Brain, Biology and Behavior, University of Nebraska, LincolnEast Stadium, Lincoln, NE68588, USA. E-mail: [email protected]
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Abstract

Objectives:

Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes.

Method:

Over 200 participants (ages 9–13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes.

Results:

For the full sample, a small effect was found with season average rotational values predicting changes in list-learning such that HIE was related to negative score change: standardized beta (β) = -.147, t(205) = -2.12, and p = .035. When analyzed by age clusters (9–10, 11–13) and adding participant weight to models, the R2 values increased. Splitting groups by weight (median split), found heavier members of the 9–10 cohort with significantly greater change than lighter members. Additionaly, significantly more participants had clinically meaningful negative changes: X2 = 10.343, p = .001.

Conclusion:

These findings suggest that in the 9–10 age cluster, the average seasonal level of HIE had inverse, negative relationships with cognitive change over one season that was not found in the older group. The mediation effects of age and weight have not been explored previously and appear to contribute to the effects of HIE on cognition in youth football players.

Keywords

Youth footballHead impact exposureNeuropsychological testCognitionNIH ToolboxReliable change
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 27 , Issue 2 , February 2021 , pp. 113 - 123
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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