Jaclyn B Caccese1, Grant L Iverson2, Katherine J Hunzinger3, Breton M Asken4, James R Clugston5, Kenneth L Cameron6, Megan N Houston6, Steven J Svoboda6, Jonathan C Jackson7, Gerald T McGinty7, Carlos A Estevez8, Adam J Susmarski9, Alexander Enrique3, Kelsey N Bryk3, Steven P Broglio10, Thomas W McAllister11, Michael McCrea12, Paul F Pasquina13, Thomas A Buckley3. 1. The Ohio State University, 228H Atwell Hall, 453 W 10th Ave, Columbus, OH, 43210, USA. jaclyn.caccese@osumc.edu. 2. Harvard Medical School, Spaulding Rehabilitation Hospital, Spaulding Research Institute, Mass General Hospital for Children Sports Concussion Program, Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA. 3. University of Delaware, Newark, DE, USA. 4. University of California, San Francisco, San Francisco, CA, USA. 5. University of Florida, Gainesville, FL, USA. 6. United States Military Academy, West Point, NY, USA. 7. United States Air Force Academy, Colorado Springs, CO, USA. 8. United States Coast Guard Academy, New London, CT, USA. 9. United States Naval Academy, Annapolis, MD, USA. 10. University of Michigan, Ann Arbor, MI, USA. 11. Indiana University School of Medicine, Indianapolis, IN, USA. 12. Medical College of Wisconsin, Milwaukee, WI, USA. 13. Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Abstract
BACKGROUND: Symptom resolution is a key marker in determining fitness for return to activity following concussion, but in some cases, distinguishing persistent symptoms due to concussion versus symptoms related to other factors can be challenging. OBJECTIVE: To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in healthy cadets and student athletes with no recent concussion. METHODS: 13,009 cadets and 21,006 student athletes completed baseline preseason testing. After inclusion/exclusion criteria were applied, the final sample included 12,039 cadets [9123 men (75.8%); 2916 women (24.2%)] and 18,548 student athletes [10,192 men (54.9%); 8356 women (45.1%)]. Participants completed the Sport Concussion Assessment Tool-3rd Edition (SCAT3) symptom evaluation as part of baseline preseason testing. The PCS diagnostic categorization was classified by the International Classification of Diseases, 10th Revision (ICD-10) symptom criteria for PCS. RESULTS: In the absence of recent concussion, subgroups of cadets (17.8% of men; 27.6% of women) and student athletes (11.4% of men; 20.0% of women) reported a cluster of symptoms that would meet the ICD-10 symptom criteria for PCS. Participants with insufficient sleep and/or preexisting conditions (e.g., mental health problems), freshmen cadets, and cadets at the U.S. Coast Guard Academy and at the U.S. Air Force Academy (freshmen were tested during basic cadet training) were more likely to report a cluster of symptoms that would meet the ICD-10 symptom criteria for PCS. CONCLUSION: The ICD-10 symptom criteria for PCS can be mimicked by preexisting conditions, insufficient sleep, and/or stress. Findings support person-specific assessment and management of symptoms following concussion.
BACKGROUND: Symptom resolution is a key marker in determining fitness for return to activity following concussion, but in some cases, distinguishing persistent symptoms due to concussion versus symptoms related to other factors can be challenging. OBJECTIVE: To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in healthy cadets and student athletes with no recent concussion. METHODS: 13,009 cadets and 21,006 student athletes completed baseline preseason testing. After inclusion/exclusion criteria were applied, the final sample included 12,039 cadets [9123 men (75.8%); 2916 women (24.2%)] and 18,548 student athletes [10,192 men (54.9%); 8356 women (45.1%)]. Participants completed the Sport Concussion Assessment Tool-3rd Edition (SCAT3) symptom evaluation as part of baseline preseason testing. The PCS diagnostic categorization was classified by the International Classification of Diseases, 10th Revision (ICD-10) symptom criteria for PCS. RESULTS: In the absence of recent concussion, subgroups of cadets (17.8% of men; 27.6% of women) and student athletes (11.4% of men; 20.0% of women) reported a cluster of symptoms that would meet the ICD-10 symptom criteria for PCS. Participants with insufficient sleep and/or preexisting conditions (e.g., mental health problems), freshmen cadets, and cadets at the U.S. Coast Guard Academy and at the U.S. Air Force Academy (freshmen were tested during basic cadet training) were more likely to report a cluster of symptoms that would meet the ICD-10 symptom criteria for PCS. CONCLUSION: The ICD-10 symptom criteria for PCS can be mimicked by preexisting conditions, insufficient sleep, and/or stress. Findings support person-specific assessment and management of symptoms following concussion.
Authors: Paul McCrory; Willem Meeuwisse; Jiří Dvořák; Mark Aubry; Julian Bailes; Steven Broglio; Robert C Cantu; David Cassidy; Ruben J Echemendia; Rudy J Castellani; Gavin A Davis; Richard Ellenbogen; Carolyn Emery; Lars Engebretsen; Nina Feddermann-Demont; Christopher C Giza; Kevin M Guskiewicz; Stanley Herring; Grant L Iverson; Karen M Johnston; James Kissick; Jeffrey Kutcher; John J Leddy; David Maddocks; Michael Makdissi; Geoff T Manley; Michael McCrea; William P Meehan; Shinji Nagahiro; Jon Patricios; Margot Putukian; Kathryn J Schneider; Allen Sills; Charles H Tator; Michael Turner; Pieter E Vos Journal: Br J Sports Med Date: 2017-04-26 Impact factor: 13.800
Authors: Jena N Moody; Jasmeet P Hayes; Thomas A Buckley; Julianne D Schmidt; Steven P Broglio; Thomas W McAllister; Michael McCrea; Paul F Pasquina; Jaclyn B Caccese Journal: Sports Med Date: 2022-07-06 Impact factor: 11.928