Michael L Alosco1,2, Johnny Jarnagin1,2, Yorghos Tripodis3, Brett Martin1,4, Christine Chaisson1,3,4, Christine M Baugh1,2,5, Alcy Torres6,7, Christopher J Nowinski8, Robert C Cantu1,2,8,9, Robert A Stern1,2,9,10. 1. a Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine , Boston , MA , USA. 2. b Department of Neurology , Boston University School of Medicine , Boston , MA , USA. 3. c Department of Biostatistics , Boston University School of Public Health , Boston , MA , USA. 4. d Data Coordinating Center , Boston University School of Public Health , Boston , MA , USA. 5. e Interfaculty Initiative in Health Policy , Harvard University , Cambridge , MA , USA. 6. f Pediatric Neurology , Boston University School of Medicine , Boston , MA , USA. 7. g Pediatric Neurology , Boston Medical Center , Boston , MA , USA. 8. h Concussion Legacy Foundation , Waltham , MA , USA. 9. i Department of Neurosurgery , Boston University School of Medicine , Boston , MA , USA. 10. j Department of Anatomy & Neurobiology , Boston University School of Medicine , Boston , MA , USA.
Abstract
OBJECTIVE: Former National Football League (NFL) players' working knowledge of concussion has not yet been evaluated, despite this population being a major clinical research target due to the association between repetitive head impacts (RHI) and long-term clinical impairments. This study examined former NFL players' understanding of the current concussion definition, and the association between number of concussions with clinical function. METHODS: 95 former NFL players (mean age = 55.29; mean NFL year = 8.10) self-reported number of concussions before being provided with a concussion definition and after being read a modern definition of concussion. Subjects reported number of concussions with loss of consciousness (LOC). Principal Component Analysis of a battery of tests generated behaviour/mood, psychomotor speed/executive function, and verbal and visual memory factor scores. RESULTS: Post-definition number of concussions (median = 50) was five times the pre-definition (median = 10; p < 0.001). Greater pre- (p = 0.019) and post-definition concussions (p = 0.036) correlated with worse behaviour/mood scores, after controlling for years of football played, with specific effects for depressive symptoms and impulsivity. LOC did not account for variance beyond number of concussions. CONCLUSIONS: Practitioners and clinical researchers should provide a definition of concussion in the assessment of concussion history in former football players to facilitate accuracy and standardization.
OBJECTIVE: Former National Football League (NFL) players' working knowledge of concussion has not yet been evaluated, despite this population being a major clinical research target due to the association between repetitive head impacts (RHI) and long-term clinical impairments. This study examined former NFL players' understanding of the current concussion definition, and the association between number of concussions with clinical function. METHODS: 95 former NFL players (mean age = 55.29; mean NFL year = 8.10) self-reported number of concussions before being provided with a concussion definition and after being read a modern definition of concussion. Subjects reported number of concussions with loss of consciousness (LOC). Principal Component Analysis of a battery of tests generated behaviour/mood, psychomotor speed/executive function, and verbal and visual memory factor scores. RESULTS: Post-definition number of concussions (median = 50) was five times the pre-definition (median = 10; p < 0.001). Greater pre- (p = 0.019) and post-definition concussions (p = 0.036) correlated with worse behaviour/mood scores, after controlling for years of football played, with specific effects for depressive symptoms and impulsivity. LOC did not account for variance beyond number of concussions. CONCLUSIONS: Practitioners and clinical researchers should provide a definition of concussion in the assessment of concussion history in former football players to facilitate accuracy and standardization.
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