Nowinski Christopher J, Bureau Samantha C, Rhim Hye Chang, Zafonte Ross D, Cantu Robert C, Daneshvar Daniel H
Concussion Legacy Foundation, Boston, MA 02115, USA.
Boston University Alzheimer's Disease Research and CTE Centers, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA.
Diagnostics (Basel). 2024 Oct 17;14(20):2314. doi: 10.3390/diagnostics14202314.
: Diagnosing concussions is problematic, in part due to the invisible nature of concussion symptoms, in addition to personal and interpersonal factors that influence symptom reporting. As a result, observable signs of concussion can ensure concussions are identified and appropriately treated. Here, we define a potential novel sign, the spontaneous headshake after a kinematic event (SHAAKE) and evaluate its utility in the diagnosis of concussion. : A cross-sectional survey study of 347 athletes (age 27, IQR: 25-29; 47.6% female; highest level of play: college-46.1%, high school-41.2%) identified whether SHAAKE occurred, the reasons underlying SHAAKEs, and its utility for self-reported concussion. Sensitivity and positive predictive value were calculated across all sports and these parameters, as well as estimates for specificity and negative predictive value leveraging published helmet sensor data, were calculated for football players. : The median number of times participants reported SHAAKE was 5 (IQR: 3-10), with 4 (IQR: 2-7) associated with a self-reported concussion. Overall, 84.9% of participants reported concussion symptoms as the most common reason for their SHAAKEs. Across all sports, SHAAKE had a sensitivity of 49.6% and positive predictive value 72.4% for diagnosing concussion. In football players, SHAAKE had a sensitivity of 52.3%, estimated specificity of 99.9%, positive predictive value of 91.9%, and estimated negative predictive value of 99.5% for diagnosing self-reported concussion. : These results demonstrate that nearly three-quarters of athletes reported a SHAAKE associated with a self-reported concussion, which supports the potential for SHAAKE to be used as a concussion screening tool.
诊断脑震荡存在问题，部分原因是脑震荡症状具有隐匿性，此外还有影响症状报告的个人和人际因素。因此，脑震荡的可观察迹象能够确保脑震荡得到识别和适当治疗。在此，我们定义了一种潜在的新迹象，即运动事件后的自发头部摇晃（SHAAKE），并评估其在脑震荡诊断中的效用。
对347名运动员（年龄27岁，四分位距：25 - 29岁；47.6%为女性；最高比赛水平：大学 - 46.1%，高中 - 41.2%）进行的横断面调查研究，确定了SHAAKE是否发生、SHAAKE发生的原因及其对自我报告脑震荡的效用。计算了所有运动项目的敏感性和阳性预测值，并利用已发表的头盔传感器数据为足球运动员计算了这些参数以及特异性和阴性预测值的估计值。
参与者报告SHAAKE的次数中位数为5次（四分位距：3 - 10次），其中4次（四分位距：2 - 7次）与自我报告的脑震荡相关。总体而言，84.9%的参与者报告脑震荡症状是其SHAAKE最常见的原因。在所有运动项目中，SHAAKE诊断脑震荡的敏感性为49.6%，阳性预测值为72.4%。在足球运动员中，SHAAKE诊断自我报告脑震荡的敏感性为52.3%，估计特异性为99.9%，阳性预测值为91.9%，估计阴性预测值为99.5%。
这些结果表明，近四分之三的运动员报告了与自我报告脑震荡相关的SHAAKE，这支持了SHAAKE作为脑震荡筛查工具的潜力。
