It Gets Worse

June 5, 2018

New research by the Vanderbilt Sports Concussion Center indicates the severity of concussions among high school football players is worse later in the season.

Scott Zuckerman, MD, MPH, co-director of the Vanderbilt Sports Concussion Center, said sport-related concussions that occur during this time frame may require more conservative management by physicians and athletic trainers.

The study, which was published recently in Sports Medicine, revealed that total symptom scores from athletes injured in games that occurred during late-season or playoff time were twice that of athletes injured early in the season. Mid-season scores were also significantly higher than early season scores.

Zuckerman, along with Benjamin Brett, a neuropsychologist from the University of Memphis, five other researchers from the Vanderbilt Sports Concussion Center and the Vanderbilt Department of Neurological Surgery conducted a retrospective analysis of 2,594 high school football players who underwent Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), including preseason baseline testing. ImPACT is a computerized concussion management tool used at more than 7,400 high schools. The research team worked with the lead programmer at ImPACT to obtain anonymous deidentified data for the study.

“We hypothesized that with the stakes being higher later in the season with playoffs and championship games, there would be a higher concussion symptom burden,” Zuckerman said.

However, the study was not designed to determine the reasons for the increased symptom burden, which could be due to a myriad of factors, the researchers acknowledged. Further study is needed to determine those reasons and also provide further validation of the seasonality effect, they concluded.

Zuckerman said less severe concussions may go unreported late in the season because this is a time when players could be compelled to mask or minimize symptoms because of commitments to having a winning season or wanting to take part in playoff games.

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