Cross-modal cue effects in motion processing

The everyday environment brings to our sensory systems competing inputs from different modalities. The ability to filter these multisensory inputs in order to identify and efficiently utilize useful spatial cues is necessary to detect and process the relevant information. In the present study, we investigate how feature-based attention affects the detection of motion across sensory modalities. We were interested to determine how subjects use intramodal, cross-modal auditory, and combined audiovisual motion cues to attend to specific visual motion signals. The results showed that in most cases, both the visual and the auditory cues enhance feature-based orienting to a transparent visual motion pattern presented among distractor motion patterns. Whereas previous studies have shown cross-modal effects of spatial attention, our results demonstrate a spread of cross-modal feature-based attention cues, which have been matched for the detection threshold of the visual target. These effects were very robust in comparisons of the effects of valid vs. invalid cues, as well as in comparisons between cued and uncued valid trials. The effect of intramodal visual, cross-modal auditory, and bimodal cues also increased as a function of motion-cue salience. Our results suggest that orienting to visual motion patterns among distracters can be facilitated not only by intramodal priors, but also by feature-based cross-modal information from the auditory system.First author draf

The cost of a single concussion in American high school football: A retrospective cohort study

Aim: The potential financial burden of American football-related concussions (FRC) is unknown. Our objective was to describe the healthcare costs associated with an FRC and determine factors associated with increased costs. Methodology/results: A retrospective cohort study of concussed high school football players presenting between November 2017 and March 2020 was undertaken; 144 male high school football players were included. Total costs were about $115,000, for an average direct healthcare cost of$800.10/concussion. Visiting the emergency department (β = 502.29, 95% CI: 105.79-898.61; p = 0.01), the initial post-concussion symptom scale score (β = 0.39, 95% CI: 0.11-0.66; p = 0.01) and a post-concussion syndrome diagnosis (β = 670.37, 95% CI: 98.96-1241.79; p = 0.02) were each independently associated with total costs. Conclusion: A granular understanding of cost-driving factors associated with FRC is the first step in understanding the cost-effectiveness of prevention and treatment methods

“It was only a mild concussion”: Exploring the description of sports concussion in online news articles

Background/aims Concussion is widely discussed in online sports news articles, but the terms used to report this injury vary. This study aimed to use a systematic search strategy and explore the description of sports concussion in online sports news articles. Methods A systematic approach was employed to obtain online articles related to sports concussion from four sports associated with concussion (hockey, football, soccer, and rugby). Included articles were evaluated for the descriptors used in relation to concussion and possible consequences associated with concussion. Data was analysed to determine trends between each sport as well between the countries of origin of the articles. Results From 200 articles retrieved, 153 were included for analysis. The terms "Head injury" (30.1%) and "Brain injury" (20.9%) were most used to describe a concussive injury, and the most frequently mentioned consequence of concussion was "Chronic Traumatic Encephalopathy" (15%). Modifiers which potentially play down the importance of the injury were noted in 9.8% of the articles, with journalists the primary source of these terms. Conclusions The variability in reporting of concussion by online news articles may limit the transmission of correct concussion information to the public. To improve the consistency of this reporting, the "Media Concussion Checklist" was developed

Sport concussion assessment tool-Third edition normative reference values for professional Rugby Union players

Objectives: To establish normative reference data for the SCAT3 in professional Rugby Union players. Design: A cross sectional study in professional Rugby Union players competing in national and international professional competitions between 2015 and 2016. Methods: The SCAT3 was administered pre-season or prior to tournaments. Data was collected electronically using a custom tablet application. SCAT3 subcomponents distributions were described and normative ranges determined using percentile cut-offs for average, unusually low/high, and extremely low/high scores. The association between player characteristics and performance in SCAT3 subcomponents was also investigated in exploratory analyses. Results: A total of 3611 professional Rugby Union players were included. The most common baseline symptom was fatigue (14%). The symptom score median (md) was 0 (interquartile range (IQR) = 0-1). Symptom severity md was 0 (IQR = 0-1). The md of the SAC score was 28 (IQR = 26-29). The md of the MBESS was 2 (IQR = 0-4). The Tandem gait md was 11.1. s (IQR = 10.0-12.7. s). Upper limb coordination was normal in 98.4%. Younger age and lower educational level were associated with worse performance on delayed recall and reverse month sub-components of the SCAT3 (p. < . 0.0001). No statistically significant differences in SCAT3 subcomponents were evident across gender. Conclusions: Representative normative reference values for the SCAT3 among professional Rugby Union players are provided. Baseline performance on concentration and delayed recall tests may be lower in younger athletes or in those with lower educational level

Diagnosing Mild Traumatic Brain Injury Using Saliva RNA Compared to Cognitive and Balance Testing

BACKGROUND: Early, accurate diagnosis of mild traumatic brain injury (mTBI) can improve clinical outcomes for patients, but mTBI remains difficult to diagnose because of reliance on subjective symptom reports. An objective biomarker could increase diagnostic accuracy and improve clinical outcomes. The aim of this study was to assess the ability of salivary noncoding RNA (ncRNA) to serve as a diagnostic adjunct to current clinical tools. We hypothesized that saliva ncRNA levels would demonstrate comparable accuracy for identifying mTBI as measures of symptom burden, neurocognition, and balance. METHODS: This case‐control study involved 538 individuals. Participants included 251 individuals with mTBI, enrolled ≤14 days postinjury, from 11 clinical sites. Saliva samples (n = 679) were collected at five time points (≤3, 4‐7, 8‐14, 15‐30, and 31‐60 days post‐mTBI). Levels of ncRNAs (microRNAs, small nucleolar RNAs, and piwi‐interacting RNAs) were quantified within each sample using RNA sequencing. The first sample from each mTBI participant was compared to saliva samples from 287 controls. Samples were divided into testing (n = 430; mTBI = 201 and control = 239) and training sets (n = 108; mTBI = 50 and control = 58). The test set was used to identify ncRNA diagnostic candidates and create a diagnostic model. Model accuracy was assessed in the naïve test set. RESULTS: A model utilizing seven ncRNA ratios, along with participant age and chronic headache status, differentiated mTBI and control participants with a cross‐validated area under the curve (AUC) of .857 in the training set (95% CI, .816‐.903) and .823 in the naïve test set. In a subset of participants (n = 321; mTBI = 176 and control = 145) assessed for symptom burden (Post‐Concussion Symptom Scale), as well as neurocognition and balance (ClearEdge System), these clinical measures yielded cross‐validated AUC of .835 (95% CI, .782‐.880) and .853 (95% CI, .803‐.899), respectively. A model employing symptom burden and four neurocognitive measures identified mTBI participants with similar AUC (.888; CI, .845‐.925) as symptom burden and four ncRNAs (.932; 95% CI, .890‐.965). CONCLUSION: Salivary ncRNA levels represent a noninvasive, biologic measure that can aid objective, accurate diagnosis of mTBI

Do Neurocognitive SCAT3 Baseline Test Scores Differ Between Footballers (Soccer) Living With and Without Disability? A Cross-Sectional Study.

Objective: To determine if baseline Sport Concussion Assessment Tool, third Edition (SCAT3) scores differ between athletes with and without disability. Design: Cross-sectional comparison of preseason baseline SCAT3 scores for a range of England international footballers. Setting: Team doctors and physiotherapists supporting England football teams recorded players' SCAT 3 baseline tests from August 1, 2013 to July 31, 2014. Participants: A convenience sample of 249 England footballers, of whom 185 were players without disability (male: 119; female: 66) and 64 were players with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9). Assessment and Outcome Measures: Between-group comparisons of median SCAT3 total and section scores were made using nonparametric Mann-Whitney-Wilcoxon ranked-sum test. Main Results: All footballers with disability scored higher symptom severity scores compared with male players without disability. Male footballers with learning disability demonstrated no significant difference in the total number of symptoms, but recorded significantly lower scores on immediate memory and delayed recall compared with male players without disability. Male blind footballers' scored significantly higher for total concentration and delayed recall, and male footballers with cerebral palsy scored significantly higher on balance testing and immediate memory, when compared with male players without disability. Female footballers with deafness scored significantly higher for total concentration and balance testing than female footballers without disability. Conclusions: This study suggests that significant differences exist between SCAT3 baseline section scores for footballers with and without disability. Concussion consensus guidelines should recognize these differences and produce guidelines that are specific for the growing number of athletes living with disability

The performance of the World Rugby Head Injury Assessment Screening Tool: a diagnostic accuracy study

Abstract Background Off-field screening tools, such as the Sports Concussion Assessment Tool (SCAT), have been recommended to identify possible concussion following a head impact where the consequences are unclear. However, real-life performance, and diagnostic accuracy of constituent sub-tests, have not been well characterized. Methods A retrospective cohort study was performed in elite Rugby Union competitions between September 2015 and June 2018. The study population comprised consecutive players identified with a head impact event undergoing off-field assessments with the World Rugby Head Injury Assessment (HIA01) screening tool, an abridged version of the SCAT3. Off-field screening performance was investigated by evaluating real-life removal-from-play outcomes and determining the theoretical diagnostic accuracy of the HIA01 tool, and individual sub-tests, if player-specific baseline or normative sub-test thresholds were strictly applied. The reference standard was clinically diagnosed concussion determined by serial medical assessments. Results One thousand one hundred eighteen head impacts events requiring off-field assessments were identified, resulting in 448 concussions. Real-life removal-from-play decisions demonstrated a sensitivity of 76.8% (95% CI 72.6–80.6) and a specificity of 86.6% (95% CI 83.7–89.1) for concussion (AUROC 0.82, 95% CI 0.79–0.84). Theoretical HIA01 tool performance worsened if pre-season baseline values (sensitivity 89.6%, specificity 33.9%, AUROC 0.62, p < 0.01) or normative thresholds (sensitivity 80.4%, specificity 69.0%, AUROC 0.75, p < 0.01) were strictly applied. Symptoms and clinical signs were the HIA01 screening tool sub-tests most predictive for concussion; with immediate memory and tandem gait providing little additional diagnostic value. Conclusions These findings support expert recommendations that clinical judgement should be used in the assessment of athletes following head impact events. Substitution of the tandem gait and 5-word immediate memory sub-tests with alternative modes could potentially improve screening tool performance