In an investigation of head impact burden and change in neurocognitive function during a football season, researchers find that sub-concussive is not correlated with worsening performance in neurocognitive function.

Each year, more than 3 million children in primary and high school play tackle football in the United States. Growing concern about the possible negative effects of repetitive sub-concussive head led to an increased number of physicians and parents who counsel against youth participation in full-contact sports.

A research team, led by Sean Rose, MD, pediatric sports neurologist and co-director of the Complex Concussion Clinic at Nationwide Children's Hospital, followed by 112 youth football players age 9-18 during the 2016 season in a prospective study.

"When trying to determine the chronic effects of repetitive sub-concussive head, the prospective outcomes studies are an important complement to the existing retrospective studies," says Dr. Rose. "In this study of primary school and high school football players, a battery of neurocognitive outcomes tests did not detect any worsening of performance associated with cumulative head."

The pre- and post-season assessments used to measure outcomes included:

  1. Neuropsychological testing
  2. Symptoms assessment
  3. Vestibular and ocular-motor screening
  4. Balance testing
  5. Parent-reported ADHD symptoms
  6. Self-reported behavioral adjustment

Sensors placed in the helmets recorded sub-concussive head during practices and games. Researchers added the impact g-forces to yield to cumulative impact measure. According to the study, cumulative impact did not predict changes (from pre-season to post-season) in any of the outcomes measures. Additionally, Dr. Rose notes, having one or more concussions prior to entering the study was not associated with worse pre-season testing.

Attention deficit hyperactivity disorder

In their secondary analysis, they found that younger age and reported history of attention deficit hyperactivity disorder (ADHD) predicted score changes on several cognitive testing measures and parent-reported ADHD symptoms.

Additionally, a reported history of anxiety or depression predicted changes in scores of symptom reporting.history of attention deficit hyperactivity disorder (ADHD) predicted score changes on several cognitive testing measures and parent-reported ADHD symptoms. Additionally, a reported history of anxiety or depression predicted changes in scores of symptom reporting.

"We expected repetitive and uncoordinated function with neurocognitive function , but we found that the sub-concussive head of the course was not associated with neurocognitive functional outcomes not associated with worse outcome, "says Dr. Rose. "The lack of a significant association may reflect the need for a longer follow-up to continue children across multiple seasons."

This publication is the first analysis in a four-year prospective cohort study. Dr. Rose will be presenting data from the second year of the study at the upcoming Child Neurology Society meeting in mid-October. The team is currently collecting data for a third year.