Deakin Naomi D, Suckling John, Hutchinson Peter J
Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK.
BMJ Open Sport Exerc Med. 2021 Jan 13;7(1):e000879. doi: 10.1136/bmjsem-2020-000879. eCollection 2021.
Concussion is a clinical diagnosis, based on self-reported patient symptoms supported by clinical assessments across many domains including postural control, ocular/vestibular dysfunction, and neurocognition. Concussion incidence may be rising in motorsport which, combined with unresolved challenges to accurate diagnosis and lack of guidance on the optimal return-to-race timeframe, creates a difficult environment for healthcare practitioners.
Research Evaluating Sports ConcUssion Events-Rapid Assessment of Concussion and Evidence for Return (RESCUE-RACER) evaluates motorsports competitors at baseline (Competitor Assessment at Baseline; Ocular, Neuroscientific (CArBON) study) and post-injury (Concussion Assessment and Return to motorSport (CARS) study), including longitudinal data. CArBON collects pre-injury neuroscientific data; CARS repeats the CArBON battery sequentially during recovery for competitors involved in a potentially concussive event. As its primary outcome, RESCUE-RACER will develop the evidence base for an accurate trackside diagnostic tool. Baseline objective clinical scoring (Sport Concussion Assessment Tool-5th edition (SCAT5)) and neurocognitive data (Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)) will be assessed for specificity to motorsport and relationship to existing examinations. Changes to SCAT5 and ocular, vestibular, and reaction time function (Dx 100) will be estimated by the reliability change index as a practical tool for trackside diagnosis. Neuropsychological (Cambridge Neuropsychological Test Automated Battery (CANTAB)) assessments, brain MRI (7 Tesla) and salivary biomarkers will be compared with the new tool to establish utility in diagnosing and monitoring concussive injuries.
Ethical approval was received from East of England-Cambridge Central Research Ethics Committee (18/EE/0141). Participants will be notified of study outcomes via publications (to administrators) and summary reports (funder communications). Ideally, all publications will be open access.
February 2019 nationally (Central Portfolio Management System 38259) and internationally (ClinicalTrials.gov NCT03844282).
脑震荡是一种临床诊断，基于患者自我报告的症状，并通过包括姿势控制、眼/前庭功能障碍和神经认知等多个领域的临床评估来支持。在赛车运动中，脑震荡的发生率可能正在上升，这与准确诊断方面尚未解决的挑战以及缺乏关于最佳重返比赛时间框架的指导相结合，给医疗从业者带来了困难的环境。
评估运动性脑震荡事件-脑震荡快速评估与重返比赛证据（RESCUE-RACER）研究在基线时（基线时的参赛者评估；眼科学、神经科学（CArBON）研究）和受伤后（脑震荡评估与重返赛车运动（CARS）研究）对赛车运动参赛者进行评估，包括纵向数据。CArBON收集受伤前的神经科学数据；CARS在恢复过程中对参与可能发生脑震荡事件的参赛者依次重复CArBON测试组。作为其主要结果，RESCUE-RACER将为准确的赛场边诊断工具建立证据基础。将评估基线客观临床评分（运动性脑震荡评估工具第5版（SCAT5））和神经认知数据（脑震荡后即刻评估和认知测试（ImPACT））在赛车运动中的特异性以及与现有检查的关系。将通过可靠性变化指数估计SCAT5以及眼、前庭和反应时间功能（Dx 100）的变化，作为赛场边诊断的实用工具。将神经心理学评估（剑桥神经心理学测试自动成套系统（CANTAB））、脑部MRI（7特斯拉）和唾液生物标志物与新工具进行比较，以确定其在诊断和监测脑震荡损伤方面的效用。
获得了英格兰东部剑桥中央研究伦理委员会的伦理批准（18/EE/0141）。将通过出版物（给管理人员）和总结报告（与资助者沟通）向参与者通报研究结果。理想情况下，所有出版物都将开放获取。
2019年2月在国内（中央项目管理系统38259）和国际上（ClinicalTrials.gov NCT03844282）注册。
