Quantifying the Diagnostic Utility of Baseline Testing in Concussion Management: An Analysis of Collegiate Athletes From the NCAA-DoD CARE Consortium Dataset.

Background: Although preseason baseline testing is a commonly recommended part of the concussion management process, its "value-added" contribution to the diagnosis of acute concussion compared with normative reference values remains in question.

Purpose: This research aimed to evaluate the diagnostic benefits of baseline testing in acute concussion assessment compared with normative reference values and characterize the athletes who receive the most diagnostic utility from baseline testing.

Study Design: Cohort study (Diagnosis); Level of evidence, 2.

Factors Associated With Return to Activity After Concussion Among Female Service Academy Members: Findings From the NCAA-DoD CARE Consortium.

Introduction: Service academy members are at high risk for concussions as a result of participation in both sports and military-specific training activities. Approximately 17% of active duty service members are female, and they face unique challenges in achieving timely recovery from concussions. Understanding the unique characteristics affecting return to unrestricted activity (RTA) among female service academy members is imperative for the ever-growing proportion of females across the U.

Demonstration of magnetically silent optically pumped magnetometers for the TUCAN electric dipole moment experiment.

We report the performance of a magnetically silent optically pumped cesium magnetometer with a statistical sensitivity of 3.5 pT/ at 1 Hz and a stability of 90 fT over 150 s of measurement. Optical pumping with coherent, linearly-polarized, resonant light leads to a relatively long-lived polarized ground state of the cesium vapour contained in a measurement cell.

Progesterone and Estradiol Levels Associated with Concussion and Clinical Outcomes and Recovery in Female Athletes and Cadets.

Introduction: Female athletes are underrepresented in concussion research, and few studies have investigated associations of ovarian hormones with concussion outcomes. This study explored associations of concussion with levels and variability of progesterone, estradiol, and their ratio (P/E) and examined relationships of hormone levels with clinical measures and recovery after concussion in CARE Consortium female athletes and cadets.Methods: Female participants enrolled (n = 749) at pre-injury baseline.

Clinical profile of patients with acute traumatic brain injury undergoing cranial surgery in the United States: report from the 18-centre TRACK-TBI cohort study.

Background: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery.

Methods: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014-2018; ClinicalTrials.

The Role of Body Mass Index on Physical Activity, Symptoms, and Related Outcomes Following Pediatric Concussion.

Objective: To determine the step count and self-reported activity levels for obese and nonobese pediatric patients following concussion and predict self-reported symptoms, quality of life, and psychological health over time.

Study Design: Participants completed the Post-Concussion Symptom Scale (PCSS), Pediatric Quality of Life (PedsQL), and Behavioral Symptom Inventory-18 (BSI-18) at an initial visit (<72 hours), 3-5 days postinjury, 10-18 days postinjury, and 1 and 2 months postinjury. Physical activity data (eg, step count) were collected via a commercial actigraph.

Single Leg Hop Performance After Anterior Cruciate Ligament Reconstruction: Ready for Landing but Cleared for Take-Off?

Context: Understanding former professional football players engagement with health promoting behaviors (physical exercise, high quality diet, and good sleep hygiene) will be helpful for developing lifestyle interventions to improve their feelings of well-being, a relatively understudied facet of health among this population.

Objective: Examine associations among health-promoting behaviors and subjective outcomes related to well-being among former National Football League (NFL) players.

Design: Cross-sectional.

Distinct trajectories of neuropsychiatric symptoms in the 12 months following traumatic brain injury (TBI): a TRACK-TBI study.

Background: Neuropsychiatric symptoms are common after traumatic brain injury (TBI) and often resolve within 3 months post-injury. However, the degree to which individual patients follow this course is unknown. We characterized trajectories of neuropsychiatric symptoms over 12 months post-TBI.

SCAT Symptom Evolution in the Acute Concussion Phase: Findings from the NCAA-DoD CARE Consortium.

The Sport Concussion Assessment Tool (SCAT) is the most widely used tool following sport-related concussion (SRC). Initial SCAT symptom burden is a strong predictor of recovery in collegiate athletes; however, it is unknown if symptom presentation varies within the acute (<48 h) post-SRC phase. The purpose of this cohort study was to examine acute SRC symptom presentation among the National Collegiate Athletic Association (NCAA) athletes.

Optimizing Concussion Care Seeking: Using Machine Learning to Predict Delayed Concussion Reporting.

Background: Early medical attention after concussion may minimize symptom duration and burden; however, many concussions are undiagnosed or have a delay in diagnosis after injury. Many concussion symptoms (eg, headache, dizziness) are not visible, meaning that early identification is often contingent on individuals reporting their injury to medical staff. A fundamental understanding of the types and levels of factors that explain when concussions are reported can help identify promising directions for intervention.

Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study.

Objectives: An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.

Sex Differences Across Concussion Characteristics in US Service Academy Cadets: A CARE Consortium Study.

Objective: To describe sex differences in concussion characteristics in US Service Academy cadets.

Design: Descriptive epidemiology study.

Setting: Four US service academies.

Association of Sport Helmet Status on Concussion Presentation and Recovery in Male Collegiate Student-Athletes.

Sporting helmets contain force attenuating materials which reduce traumatic head injury risk and may influence sport-related concussion (SRC) sequelae. The purpose of this study was to examine the association of sport helmet status with SRC-clinical presentation and recovery trajectories in men's collegiate athletes. Sport helmet status was based on the nature of sports being either helmeted/non-helmeted.

Latent Profiles of Acute Symptoms, Cognitive Performance, and Balance in Sport-Related Concussions.

Background: A sport-related concussion (SRC) is a common injury that affects multiple clinical domains such as cognition, balance, and nonspecific neurobehavioral symptoms. Although multidimensional clinical assessments of concussion are widely accepted, there remain limited empirical data on the nature and clinical utility of distinct clinical profiles identified by multimodal assessments.

Purpose: Our objectives were to (1) identify distinct clinical profiles discernible from acute postinjury scores on the Sport Concussion Assessment Tool (SCAT), composed of a symptom checklist, a cognitive assessment (Standardized Assessment of Concussion), and a balance assessment (Balance Error Scoring System), and (2) evaluate the clinical utility of the identified profiles by examining their association with injury characteristics, neuropsychological outcomes, and clinical management-related outcomes.

Association of Premorbid Anxiety and Depression Symptoms in Concussion Recovery in Collegiate Student-Athletes.

Background: Mental health disorders are linked to prolonged concussion symptoms. However, the association of premorbid anxiety/depression symptoms with postconcussion return-to-play timelines and total symptom burden is unclear.

Objective: To examine the association of self-reported premorbid anxiety/depression symptoms in collegiate student-athletes with (1) recovery times until asymptomatic, (2) return-to-play, and (3) postconcussion symptom burden.

Longitudinal Characterization of Pain Interference and Influential Factors in Former National Football League (NFL) Players Over a 19-Year Period: An NFL-LONG Study.

Previous studies on pain experiences in retired contract sport athletes have been cross-sectional, leaving gaps in our understanding of the evolution of pain interference (PI) and factors that influence trajectories decades after sport discontinuation. This study investigated the longitudinal course of PI in former male National Football League (NFL) players over a 19-year period following sport discontinuation and examined factors influencing overall levels and trajectories of PI. Former NFL players completed health surveys in 2001, 2010, and 2019, with PI ratings measured using the 36-Item Short Form Health Survey (2001 and 2010) and the Patient-Reported Outcomes Measurement Information System (2019).

Symptom Exacerbation and Adverse Events During a Randomized Trial of Early-Stage Rehabilitation After Sport-Related Concussion: Safety Outcomes From the Active Rehab Study.

Context: Authors of few studies have used randomized controlled trials (RCTs) to quantify clinical intervention safety of rehabilitation after sport-related concussion across sport levels.

Objective: Describe symptom exacerbation and adverse events (AEs) associated with two concussion rehabilitation interventions.

Design: Cluster RCT (NCT02988596).

The Prevalence and Influence of New or Worsened Neck Pain After a Sport-Related Concussion in Collegiate Athletes: A Study From the CARE Consortium.

Background: Neck pain in a concussion population is an emerging area of study that has been shown to have a negative influence on recovery. This effect has not yet been studied in collegiate athletes.

Hypothesis: New or worsened neck pain is common after a concussion (>30%), negatively influences recovery, and is associated with patient sex and level of contact in sport.

The Interval Between Concussions Does Not Influence Time to Asymptomatic or Return to Play: A CARE Consortium Study.

Introduction: The purpose of this study was to determine if the time interval between two concussive events influences the number of days to asymptomatic status, days to return to play, or performance on common post-concussion assessments following the second concussion.

Methods: Data from 448 collegiate athletes and service academy cadets with two concussions (time between concussions: median 295.0 days [interquartile range: 125.

White Matter Hyperintensities and Microstructural Alterations in Contact Sport Athletes from Adolescence to Early Midlife.

Studies have demonstrated associations between cumulative concussion and repetitive head impact exposure (RHI) through contact sports with white matter (WM) alterations later in life. The course of WM changes associated with exposure earlier in the lifespan is unclear. This study investigated alterations in white matter (WM hyperintensity [WMH] volume and microstructural changes) associated with concussion and RHI exposure from adolescence to early midlife, as well as the interaction between exposure and age cohort (i.