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Neuropsychological Impairment from Concussions

Mild traumatic brain injury (MTBI, often used interchangeably with "concussion") is common among athletes. A study in the Journal of the American Medical Association found that over a three-year period, 5.5 percent of all reported injuries to high school athletes in 10 sports were MTBIs. Two other studies in the same issue report that these injuries may have serious and permanent consequences.

In the first study, researchers collected neurologic histories and performed neuropsychological tests on 393 football players from four U.S. Division IA college football programs. Thirty-four percent of the players suffered one previous MTBI, and another 20 percent experienced two or more. Two or more MTBIs were significantly and independently associated with long-term deficits involving the ability to plan and execute a nonverbal behavior and the speed of processing information. Among athletes with multiple MTBIs, a history of learning disability conferred a significant additional risk for impairment.

In the second study, 33 amateur soccer players from the Netherlands were compared with a control group of swimmers and runners. Half of the soccer players had suffered at least one soccer-related MTBI, and nearly all had received repeated subconcussive blows to the head from soccer balls. Compared with controls, the soccer players were significantly impaired in the neurocognitive domains of planning and memory. Impairment was inversely related to the number of MTBIs.

Comment: MTBI is common and should not be shrugged off as a trivial event. An editorialist calls this a major public health problem to which physicians, coaches, trainers, athletes, and the public need to pay greater attention.

— RA Dershewitz

Published in Journal Watch General Medicine September 14, 1999

Citation(s):

Powell JW and Barber-Foss KD. Traumatic brain injury in high school athletes. JAMA 1999 Sep 8 282 958-963.

• Original article (Subscription may be required)
• Medline abstract (Free)

Collins MW et al. Relationship between concussion and neuropsychological performance in college football players. JAMA 1999 Sep 8 282 964-970.

• Original article (Subscription may be required)
• Medline abstract (Free)

Matser EJT et al. Neuropsychological impairment in amateur soccer players. JAMA 1999 Sep 8 282 971-973.

• Original article (Subscription may be required)
• Medline abstract (Free)

Kelly JP. Traumatic brain injury and concussion in sports. JAMA 1999 Sep 8 282 989-991.

• Original article (Subscription may be required)
• Medline abstract (Free)

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