Yengo-Kahn Aaron M, Johnson Daniel J, Zuckerman Scott L, Solomon Gary S
Vanderbilt Sports Concussion Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
Vanderbilt Sports Concussion Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Am J Sports Med. 2016 Mar;44(3):801-11. doi: 10.1177/0363546515580313. Epub 2015 Apr 21.
Significant attention has been directed toward the immediate and long-term effects of sport-related concussions on athletes participating in contact sports, particularly football. The highest level of football, the National Football League (NFL), has received significant attention and criticism regarding player management and safety after mild traumatic brain injury (mTBI). Several review articles have reported data related to concussion in the NFL, but a succinct review and synthesis of data regarding NFL concussions is currently lacking.
To (1) review systematically the published data regarding concussion in the NFL and assess limitations of the studies, (2) elucidate areas where further research is needed, and (3) identify methods to improve future investigations of concussion in the NFL.
Systematic review of literature.
English-language titles and abstracts published between 1900 and September 2014 were searched systematically across electronic databases, and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Peer-reviewed journal articles were included if they contained NFL concussion data with or without additional associated long-term effects. Reviews, editorials, letters to the editor, and comments were not included.
Of the 344 records screened for review, 88 articles were assessed for eligibility. There were 31 studies that met the inclusion criteria and formed the basis of the evidence synthesis. Included in the current review were 8 case-control studies (Oxford Centre for Evidence-Based Medicine evidence level 3b), 6 descriptive epidemiological studies (level 4), 6 cross-sectional studies (level 4), 6 cohort studies (level 2b), and 5 case series (level 4).
The study of concussions in the NFL has been limited by lack of recent empirical data, reliance on self-reported concussion history, and ascertainment bias of brains donated for autopsy studies. The scientific community as well as the public should be cautious in interpreting the current literature surrounding concussion.
与运动相关的脑震荡对参与接触性运动的运动员，尤其是橄榄球运动员的即时和长期影响已受到广泛关注。橄榄球的最高级别赛事，即美国国家橄榄球联盟（NFL），在轻度创伤性脑损伤（mTBI）后的球员管理和安全方面受到了极大关注和批评。几篇综述文章报道了与NFL脑震荡相关的数据，但目前缺乏对NFL脑震荡数据的简洁综述和综合分析。
（1）系统回顾已发表的关于NFL脑震荡的数据，并评估研究的局限性；（2）阐明需要进一步研究的领域；（3）确定改进未来NFL脑震荡调查的方法。
文献系统综述。
系统检索1900年至2014年9月期间发表的英文标题和摘要的电子数据库，并根据系统评价和Meta分析的首选报告项目（PRISMA）声明进行综述。如果同行评审的期刊文章包含NFL脑震荡数据，无论是否有其他相关的长期影响，均纳入研究。综述、社论、给编辑的信和评论不纳入。
在筛选以供综述的344条记录中，88篇文章被评估是否符合纳入标准。有31项研究符合纳入标准，并构成了证据综合的基础。本综述包括8项病例对照研究（牛津循证医学中心证据水平3b）、6项描述性流行病学研究（水平4）、6项横断面研究（水平4）、6项队列研究（水平2b）和5个病例系列（水平4）。
NFL脑震荡的研究受到缺乏近期实证数据、依赖自我报告的脑震荡病史以及尸检研究中捐赠大脑的确定偏倚的限制。科学界和公众在解释当前有关脑震荡的文献时应谨慎。
