Research Reports - Potential long-term effects of sport-related concussion

Br J Sports Med. 2017 Jun;51(12):969-977. doi: 10.1136/bjsports-2017-097791. Epub
2017 Apr 28.

Manley G(1), Gardner AJ(2), Schneider KJ(3), Guskiewicz KM(4), Bailes J(5), Cantu
RC(6), Castellani RJ(7), Turner M(8), Jordan BD(9), Randolph C(10), Dvořák J(11),
Hayden KA(12), Tator CH(13), McCrory P(14), Iverson GL(15).

OBJECTIVE: Systematic review of possible long-term effects of sports-related
concussion in retired athletes.
DATA SOURCES: Ten electronic databases.
STUDY SELECTION: Original research; incidence, risk factors or causation related
to long-term mental health or neurological problems; individuals who have
suffered a concussion; retired athletes as the subjects and possible long-term
sequelae defined as >10 years after the injury.
DATA EXTRACTION: Study population, exposure/outcome measures, clinical data,
neurological examination findings, cognitive assessment, neuroimaging findings
and neuropathology results. Risk of bias and level of evidence were evaluated by
two authors.
RESULTS: Following review of 3819 studies, 47 met inclusion criteria. Some former
athletes have depression and cognitive deficits later in life, and there is an
association between these deficits and multiple prior concussions. Former
athletes are not at increased risk for death by suicide (two studies). Former
high school American football players do not appear to be at increased risk for
later life neurodegenerative diseases (two studies). Some retired professional
American football players may be at increased risk for diminishment in cognitive
functioning or mild cognitive impairment (several studies), and neurodegenerative
diseases (one study). Neuroimaging studies show modest evidence of
macrostructural, microstructural, functional and neurochemical changes in some
athletes.
CONCLUSION: Multiple concussions appear to be a risk factor for cognitive
impairment and mental health problems in some individuals. More research is
needed to better understand the prevalence of chronic traumatic encephalopathy
and other neurological conditions and diseases, and the extent to which they are
related to concussions and/or repetitive neurotrauma sustained in sports. 

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