Maryse Lassonde, Louis de Beaumont, Luke Henry, Martin Thériault,
Dave Ellemberg, Suzanne Leclerc, Hugo Théoret
Université de Montréal
Français
There are an estimated 300 000 sports related concussions each year in the USA, and this is likely an underestimation as many athletes and coaches often fail to recognize them, especially when there is no loss of consciousness. Concussions often lead to neuropsychological dysfunctions that affect memory, attention, and executive functions, which last anywhere from one month to two years and that can significantly interfere with everyday activities. In fact, when athletes return to play before complete recovery, their risks of suffering a subsequent trauma increases significantly. Moreover, if a second concussion occurs before the brain has sufficiently recovered, it can cause severe cognitive symptoms or even death. This is known as the second impact syndrome and it has triggered the development of more sensitive diagnostic tools to quantify recovery in order to guide return to play decisions. Members of our team have already developed a series of such tools that have been successfully used with College athletes.
Moreover, there is a growing body of evidence suggesting that there are cumulative effects of concussions that manifest as increased susceptibility to subsequent concussions as well as an increase in their severity. Recent findings suggest that the effects of a concussion far outlast the acute phase. For example, it has been shown that former athletes who suffered multiple concussions have a fivefold prevalence of mild cognitive impairment (MCI) (a condition that converts at a rate of about 10-20% annually into dementia) compared with retirees without a history of concussion. Moreover, TBI has been described as the most robust environmental AD risk factor in the general population.
We have recently compared a group of healthy former athletes in late adulthood (60 years old) who sustained their last sport-related concussion in early adulthood with healthy former athletes with no history of concussion. These older concussed athletes showed memory and impulse control deficits that correlated with electrophysiological anomalies, as well as abnormal motor responses. Considering the accumulating evidence obtained through epidemiological and case studies indicating that concussions may lead to pathological aging, it is of vital importance to reproduce these results in a larger sample and broader age range.
As importantly, little to nothing is known, about the consequences of sports-related concussions in children, and that despite statistics indicating that one child out of 100, between the ages of 7 and 13, has suffered a concussion. Further, although studies suggest that the developing brain is more ‘plastic’ than that of the adult, the brain’s potential for recovery following a concussion during childhood is unknown. The objectives of one of our grant applications are to 1) determine the nature of the neuropsychological deficits caused by a concussion during development, 2) identify the associated neurophysiological deficits, 3) determine if there is a relationship between the age at which the concussion occurred and the severity of the deficits, 4) chart the recovery period for the different age groups and the different brain functions, and 5) develop a diagnostic tool for children that takes into account age at the time of injury and that can be used to assess recovery.
Results pertaining to the effects of sports concussions on cerebral functions will be summarized for children, young and older athletes. These results stress the need for longitudinal studies to better define safe return-to-play guidelines.
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