The Effects of Head Trauma on Collegiate Athletes
Condition: Cerebral Concussion; Brain Injuries
MeSH terms: Brain Injuries; Craniocerebral Trauma; Brain Concussion
Study type: Observational

Summary: 
      Recently, researchers and clinicians have examined many different forms of concussion testing
      aimed to assess if a brain injury has occurred and to what degree it affects the individual
      being tested. Due to the multifaceted and complex presentation of concussive injuries and the
      unknown effects of repeated head trauma, it is unlikely that a single test of physiological
      or behavioral function will reflect the full range of injury-related damages from a
      concussive event or from a series of cumulative head traumas, as well as the injury response
      within brain tissue. However, by combining a variety of objective assessments which may
      detect structural and functional alterations following head trauma into a single study, a
      clearer understanding of the multi-faceted presentation resulting from head trauma may be
      identified. The identification of biomarkers and the utilization of objective and clinically
      feasible tools will provide a method to assess three domains across multiple systems affected
      by head trauma: 1) the prognostic value of initial concussion assessments to identify injury
      severity and factors responsible for prolonged recovery, 2) the temporal window of recovery
      and potential vulnerability of brain tissue post-injury, and 3) the long-term alterations
      associated with repeated head trauma exposure.
    

Detailed description: 
      Student athletes from contact and collision sports, as well as non-contact sports, will
      complete a comprehensive assessment of neurological and behavioral function before and after
      a season of participation. Additionally, those who sustain a concussion will undergo a
      post-injury testing timeline where they are assessed within 5 days of injury and again at the
      following time points: 3-4 weeks, 3 months, 6 months, and 1 year post-injury. Each individual
      who completes testing as a concussion subject will be matched with a healthy control subject
      by height, weight, age, sport, and position, and each control subject will complete the same
      protocol in similar time increments as subjects with concussion.

      Through this study design, we hypothesize that we will be able to detect objective deficits
      resulting from concussion within one week of injury and determine the feasibility and added
      value of a comprehensive neurological and behavioral testing battery through a comparison of
      metrics between injured and healthy collegiate student athletes. Additionally, we hypothesize
      that for athletes who do not sustain a concussion, decrements between the pre-season and
      post-season time points will be greater in those who participate in collision/contact sports
      in comparison to those who participate in non-contact sports. Thus, outcomes from this study
      will enhance the understanding of the pathophysiology of concussion through a rigorous
      laboratory testing component, but with simultaneous direct translation to clinical
      implementation through the use of a highly-feasible clinical testing paradigm that possesses
      potential for ubiquitous and widespread use throughout sports medicine practices.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Subjects will be comprised of active members of various varsity teams at Harvard
        University.
      
Biospecimen description: 
      Urine and blood samples will be acquired and stored in a biorepository.
    
Keywords: TBI; Mild Traumatic Brain Injury; Post-Concussion Syndrome; Recovery of Function; Motor Activity; Diffusion Tensor Imaging; Neural Injury; Biomarkers