Department of Kinesiology, Penn State University, 25 Recreation Hall, University Park, PA, 16802, USA.
Department of Psychology, Penn State University, University Park, PA, 16802, USA.
Brain Imaging Behav. 2022 Feb;16(1):503-517. doi: 10.1007/s11682-021-00489-6. Epub 2021 Jul 26.
Examine the effect of subconcussive impact accumulation on cognitive/functional, imaging, and biomarker outcomes over the course of a single season, specifically in contact sport athletes at collegiate level or younger. Systematic review following PRISMA guidelines and using Oxford Center for Evidence-Based Medicine 2011 Levels of Evidence and Newcastle Ottawa Assessment Scale. PubMed MEDLINE, PsycInfo, SPORT-Discus, Web of Science. Original research in English that addressed the influence of subconcussive impacts on outcomes of interest with minimum preseason and postseason measurement in current youth, high school, or college-aged contact sport athletes. 796 articles were initially identified, and 48 articles were included in this review. The studies mostly involved male football athletes in high school or college and demonstrated an underrepresentation of female and youth studies. Additionally, operationalization of previous concussion history and concussion among studies was very inconsistent. Major methodological differences existed across studies, with ImPACT and diffusion tensor imaging being the most commonly used modalities. Biomarker studies generally showed negative effects, cognitive/functional studies mostly revealed no effects, and advanced imaging studies showed generally negative findings over the season; however, there was variability in the findings across all types of studies. This systematic review revealed growing literature on this topic, but inconsistent methodology and operationalization across studies makes it challenging to draw concrete conclusions. Overall, cognitive measures alone do not seem to detect changes across this timeframe while imaging and biomarker measures may be more sensitive to changes following subconcussive impacts.
检查亚撞击性冲击积累对认知/功能、成像和生物标志物结果的影响，特别是在大学或更年轻的接触性运动运动员中。按照 PRISMA 指南进行系统评价，并使用牛津循证医学中心 2011 年证据水平和纽卡斯尔-渥太华评估量表。PubMed MEDLINE、PsycInfo、SPORT-Discus、Web of Science。原始研究以英文发表，探讨了亚撞击性冲击对当前青年、高中或大学年龄段接触性运动运动员感兴趣的结果的影响，且研究具有最少的 preseason 和 postseason 测量。最初确定了 796 篇文章，其中 48 篇文章包含在本次综述中。这些研究主要涉及高中或大学的男性足球运动员，并且女性和青年研究的代表性不足。此外，研究中对既往脑震荡史和脑震荡的操作化非常不一致。研究之间存在主要的方法学差异，其中 ImPACT 和弥散张量成像（diffusion tensor imaging）是最常用的方式。生物标志物研究通常显示出负面影响，认知/功能研究大多显示出无影响，高级成像研究在整个赛季中显示出普遍的负面发现；然而，所有类型的研究都存在发现的变异性。这项系统评价揭示了关于这一主题的越来越多的文献，但研究之间不一致的方法和操作化使得难以得出具体结论。总体而言，单独的认知测量似乎无法在这段时间内检测到变化，而成像和生物标志物测量可能对亚撞击性冲击后的变化更敏感。
