The Effects of Concussive and Sub-concussive Head Impacts on Brain Activity.

Context: 7 million athletes participate in high school sports annually. Approximately 1 million of these athletes participate in football, which is associated with repetitive head impacts. Concussion literature suggests sub-concussive impacts may lead to declines in brain function across a season of football. Furthermore, recent research suggests following clinical concussion recovery, metabolic and neurophysiological recovery may not be complete. Objective: The purpose of this study was to monitor head impacts and cognitive function during (72hour, asymptomatic) and after concussion and longer term over a full football season (pre-season, mid-season, post-season). Participants: 106 male adolescent (46 football-athletes, 42 controls for football-athletes, 9 concussed-athletes, 9 controls for concussed-athletes). Outcome measures: The Head Impact Telemetry System encoder was used to track the location and magnitude of head impacts during football participation. Psychophysiology was measured using Electroencephalography and was quantified using a 256 channel system to record brain activity during an auditory oddball task. All Participants completed Axon neurocognitive testing, clinical reaction time task (CRT), symptom inventory and two Health Related Quality of Life Surveys (Health Behavior Inventory, Satisfaction with Life) throughout the above testing time-points. Results: Football-athletes sustained a mean of 482 head impacts during all practices and games. Mixed measures ANOVA indicated a significant decrement on one BNA output score, Target amplitude, with lower post-season scores (p0.05). Furthermore, P3a amplitudes were significantly larger and N2 latency was longer during post-season testing. Mixed measured ANOVAs indicated no significant deficits in BNA output scores, Axon performance, CRT, and HRQOL, for concussed and matched controls across post-injury time points. Additionally, there was a significantly longer P3a latency post-season latencies across groups and smaller P3a amplitudes at post-season for concussed compared to controls (p<0.05). Conclusion: Overall, these findings suggest electrophysiology changes between pre and post-season testing among football athletes and control participants without concussion, with the majority demonstrating improved cognitive function. Therefore, no negative effects may be associated with repeated head impacts in one season of football. Furthermore, no cognitive deficits were present during asymptomatic testing following concussion.PhDKinesiologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/133275/1/richellm_1.pd

Adolescent Athletes’ Perspectives on the Social Implications of Sport-Related Concussion

Purpose: Sport-related concussion can affect many domains of a patient’s health status. Social functioning is an important consideration, especially for adolescent athletes. Our purpose was to explore adolescent athletes’ social perspectives regarding sport and concussion. Methods: Using a qualitative study design we interviewed 12 interscholastic athletes who had sustained a sport-related concussion. The interviews focused on injury details, and explored the physical, psychosocial, emotional, and spiritual components of sport and health. Themes and categories were identified using the consensual qualitative research process by a three-person research team. A comprehensive codebook that captured the main themes and categories resulted. Results: Following concussion, participants discussed two primary themes: perceptions regarding the social aspects of sport and social perspectives regarding their concussion. Specific categories related to the social aspects of sport included: friendships and family and decision to participate based on peers. Specific categories regarding the social perspectives of the concussion included uncertainty of the diagnosis, perceptions of others regarding their injury, being ashamed of the concussion, parent and peer roles, and communication and expectation about their concussion. Conclusions: Participation in sport and removal from sport following a concussion have significant social implications for adolescent athletes. Specifically, the perceptions of peers, parents/guardians, and others regarding the injury can influence reporting of symptoms and recovery following concussion. Limited communication regarding recovery and expectations post-concussion may cause undue social pressures to return to activity prematurely. Providing a supportive environment in which patients can recover from concussion while engaging with peers and teammates is important. Anticipatory guidance, with education regarding the possible signs and symptoms, risk factors pre- and post-injury, and recovery expectations following a concussion are important to include in post-injury management and should be known to all stakeholders

A randomized placebo-controlled trial to investigate the effect of lactolycopene on semen quality in healthy males

Purpose Poor sperm quality is a major contributor to infertility in heterosexual couples, but at present there are few empirical therapies. Several studies have examined the role of dietary factors and data from randomized controlled trials suggest that oral antioxidant therapy can improve some sperm parameters. Health benefits of lycopene supplementation have been proposed for a variety of health conditions and here we examine whether it can help improve sperm quality. This study aimed to investigate the effect of 14 mg daily lactolycopene for 12 weeks on semen quality in healthy men. Methods Sixty healthy male participants were recruited and randomized to this double-blind, placebo-controlled parallel study and received either 14 mg/d lactolycopene or a placebo for 12 weeks. The primary endpoint was a change in motile sperm concentration. Secondary endpoints were all other aspects of sperm quality, including the level of sperm DNA damage. Results Fifty-six men completed the intervention and the level of plasma lycopene was significantly increased in the men randomized to receive lycopene supplementation. There was no significant change in the primary endpoint (motile sperm concentration) post-intervention (p = 0.058). However, the proportion of fast progressive sperm (p = 0.006) and sperm with normal morphology (p < 0.001) did improve significantly in response to lactolycopene intervention. Conclusions Supplementation with 14 mg/d lactolycopene improves sperm motility and morphology in young healthy men

Secondary School Coaches’ Perceptions of Sport-Related Concussions: A Qualitative Approach

Purpose: This study was conducted to understand current perceptions of secondary school coaches on concussion culture, safety, and management. Method: In this consensual qualitative research study, 17 secondary school coaches participated (12 males, 5 females). Participants were recruited through the state secondary school athletic associations. Participants were interviewed over Zoom using a semi-structured interview guide to allow for flexibility (16 questions). All interviews (30 - 60 minutes in length) were recorded and transcribed. A codebook, including themes and subthemes, was created and data were analyzed using thematic analysis. The researchers each reviewed the transcripts separately. The initial codebook was determined using a sample of transcripts; following consensus, another subsection of transcripts was analyzed to determine codebook effectiveness. The research team went through 5 phases of analysis to ensure agreement on the themes and subthemes of each transcript. Trustworthiness was established through peer review and member checks. Results: We discovered four themes 1.) reporting, 2.) concussion education, 3.) awareness, and 4.) culture. Participants described their players’ preferences, attitudes, and willingness for reporting and to whom players report. Coaches indicated that players primarily report concussions to their coaches and may apprehensively report to the athletic trainer. The concussion education that coaches receive was described, including the platforms, type, frequency, and suggestive changes. Many participants described their annual concussion education as repetitive and needing updates. Emphasis was placed on the lack of player education. Coaches identified a need for content to improve players’ concussion reporting and education. Lastly, participants emphasized the culture surrounding concussions in their sport and the preferences on concussions from both player and coach perspectives, the attitudes of the players in their sport surrounding concussions, past attitudes and culture in their sport, player safety, and long-term concerns. Conclusions: Secondary school coaches expressed the current mandated concussion education video was the same annually and could be updated with new information and be more engaging, while also expressing the need for educational content for students. Further efforts should be placed on concussion informational videos, fact sheets, and education for students to increase reporting behaviors, improve sports culture regarding concussions and enhance player safety

Concussion Recovery Time Among High School and Collegiate Athletes: A Systematic Review and Meta-Analysis

BackgroundConcussion diagnosis and management is made through the clinical exam using assessment tools that include self-report symptomatology, postural control, and cognitive evaluations. The specific timing of concussion resolution varies between individuals. However, despite a lack of research in concussion recovery, it is widely accepted that the majority of young adults will recover in 7-10&nbsp;days, with youth athletes taking longer.ObjectivesThe purpose of this review is to directly compare the recovery duration among high school and collegiate athletes on symptom reports and cognitive assessments following concussion.Data sourcesData were collected from a literature search comprising high school or college athletes only. This included studies (n&nbsp;=&nbsp;6) that reported symptom or cognitive performance recovery to the exact day.ResultsHigh school athletes self-reported symptom recovery at 15&nbsp;days compared with 6&nbsp;days in collegiate athletes. Both college and high school athletes showed cognitive recovery at similar rates of 5 and 7&nbsp;days.LimitationsThis review only included articles that were directly related to concussed high school or college athletes. Additionally, athletes in the high school and college setting typically receive a battery of neurocognitive tests that may not be as sensitive or as comprehensive as a full neuropsychological exam.ConclusionThe review finds that neurocognitive recovery rates are similar among high school and college athletes, while symptom reporting shows longer recovery time points in high school than in college.Implications of key findingsAn individualized and stepwise concussion management plan is important for proper concussion recovery regardless of age

Global Control of Histone Modification by the Anaphase-Promoting Complex

Acetylation and phosphorylation of the amino-terminal tails of the core histones fluctuate on a global scale in concert with other major events in chromosome metabolism. A ubiquitin ligase, the anaphase-promoting complex (APC), controls events in chromosome metabolism such as sister chromatid cohesion and may regulate H3 phosphorylation by targeting Aurora A, one of several S10-directed H3 kinases in vertebrate cells, for destruction by the proteasome. Our analysis of apc10Δ and apc11(ts) loss-of-function mutants reveals that the APC controls the global level of H3 S10 phosphorylation in cycling yeast cells. Surprisingly, it also regulates dephosphorylation of H3 and global deacetylation of H2B, H3, and H4 during exit from the cell cycle into G(0). Genetic, biochemical, and microarray analyses suggest that APC-dependent cell cycle control of H3 phosphorylation is exerted at the level of an Aurora H3 kinase, Ipl1p, while APC-dependent transcriptional induction of GLC7, an essential H3 phosphatase, contributes to sustained H3 dephosphorylation upon cell cycle withdrawal. Collectively, our results establish that core histone acetylation state and H3 phosphorylation are physiologically regulated by the APC and suggest a model in which global reconfiguration of H3 phosphorylation state involves APC-dependent control of both an H3 kinase and a conserved phosphatase

Reliability of the Sway Balance Mobile Application: A Retrospective Analysis

Postural control deficits are a key component to injury assessment and, more specifically, following concussion. However, these assessments are often administered in a serial manner to track deficits and recovery, thus the stability or test-retest reliability of these measures is important. With the advent of mobile applications to assess postural control, it is important to evaluate the reliability of these tools; therefore our purpose was to estimate reliability for the Sway Balance„¢ mobile application, a portable device for postural control assessment. Postural control assessment of males between ages 7€“22 showed good-to-excellent reliability in the overall composite score of the Sway Balance„¢. Sway Balance„¢ is a reliable tool for measuring postural control

Epidemiology of Secondary School Boys\u27 and Girls\u27 Basketball injuries: National Athletic Treatment, Injury and Outcomes Network

© by the National Athletic Trainers\u27 Association, Inc Context: Little is known about non-time-loss (NTL) injury patterns in basketball athletes. Knowledge of these patterns may aid in the development of prevention and management strategies for patients with these injuries. Objective: To describe the epidemiology of time-loss (TL) and NTL injuries sustained by secondary school boys\u27 and girls\u27 basketball athletes. Design: Descriptive epidemiology study. Setting: Eighty-six unique schools provided data, with 84 and 83 contributing to boys\u27 and girls\u27 basketball, respectively. Patients or Other Participants: Athletes participating in secondary school-sponsored boys\u27 and girls\u27 basketball. Main Outcome Measure(s): Boys\u27 and girls\u27 basketball data from the National Athletic Treatment, Injury and Outcomes Network (NATION) injury-surveillance program (2011-2012 through 2013-2014 years) were analyzed. Injury counts, rates, and rate ratios (IRRs) were reported with 95% confidence intervals (CIs). Results: The NATION captured 2653 injuries over 364 355 athlete-exposures (AEs) for boys\u27 basketball and 2394 injuries over 288 286 AE for girls\u27 basketball, producing rates of 7.28/ 1000 AEs (95% CI = 7.00, 7.56) for boys and 8.30/1000 AEs (95% CI = 7.97, 8.64) for girls. The overall injury rates were slightly lower for boys (IRR = 0.88; 95% CI = 0.83, 0.93). For boys, 559 (21.1%) injuries were TL and 2094 (78.9%) were NTL, producing a TL injury rate of 1.53/1000 AEs (95% CI = 1.40, 1.66) and an NTL injury rate of 5.75/1000 AEs (95% CI = 5.50, 5.99). For girls, 499 (20.8%) injuries were TL and 1895 (79.2%) were NTL, producing a TL injury rate of 1.73/1000 AEs (95% CI = 1.58, 1.88) and an NTL injury rate of 6.57/1000 AEs (95% CI = 6.28, 6.87). Rates of TL injuries were similar between boys\u27 and girls\u27 basketball (IRR = 0.89; 95% CI = 0.79, 1.00); NTL injury rates were lower for boys (IRR = 0.87; 95% CI = 0.82, 0.93). Conclusions: When NTL injuries were included, the rates of injury in boys\u27 and girls\u27 secondary school basketball were higher than previously reported