Shuttleworth-Edwards Ann B, Radloff Sarah E, Whitefield-Alexander Victoria J
Department of Psychology, Rhodes University, Grahamstown, South Africa.
Prog Neurol Surg. 2014;28:213-25. doi: 10.1159/000358785. Epub 2014 Jun 6.
The aim of this report is to illustrate the utility of neurocognitive testing as an investigative method to establish the presence of persistent effects of concussive brain injury amongst players of a contact sport with high risk of such injury. The report reviews the outcomes of three previously published neuropsychological studies on South African Rugby Union (hereafter 'rugby') from school through to the national adult level. The diagnostic utility of differential effects per se, as well as differential practice effects on visuomotor function, as a means of distinguishing poorer neurocognitive outcome for rugby versus demographically equivalent noncontact sports players, is described. From various methodological angles, at each level of play, the reviewed studies attest to the presence of long-term vulnerability in visuomotor speed in association with participation in rugby, in turn implicating diffuse frontotemporal dysfunction due to repetitive concussive and subconcussive injury amongst rugby players. As visuomotor speed is a prime function called upon for optimal scholastic and occupational performance, the robustly demonstrated decrement is of immediate clinical importance. Of critical heuristic relevance, however, is evidence of residual brain dysfunction in association with rugby as early as school level, which may ultimately be the precursor of chronic traumatic encephalopathy.
本报告的目的是说明神经认知测试作为一种调查方法的实用性，以确定在具有脑震荡高风险的接触性运动项目运动员中，脑震荡性脑损伤持续影响的存在情况。该报告回顾了三项先前发表的关于南非橄榄球联盟（以下简称“橄榄球”）的神经心理学研究结果，研究对象涵盖了从学校到国家成年水平的球员。描述了差异效应本身以及对视觉运动功能的差异练习效应的诊断效用，以此作为区分橄榄球运动员与人口统计学上相当的非接触性运动项目运动员较差神经认知结果的一种手段。从各个方法学角度来看，在每个比赛水平上，所审查的研究都证明，参与橄榄球运动与视觉运动速度的长期易损性有关，这反过来又暗示了橄榄球运动员因重复性脑震荡和亚脑震荡损伤而导致的弥漫性额颞叶功能障碍。由于视觉运动速度是学业和职业表现达到最佳状态所需的主要功能，因此有力证明的视觉运动速度下降具有直接的临床重要性。然而，具有关键启发意义的是，早在学校水平就有证据表明与橄榄球运动相关的残留脑功能障碍，这可能最终是慢性创伤性脑病的先兆。
