Effects of Sports Concussions on Brain Development: Neurocognitive Implications for Policy Change

摘要

While the last decade has seen an increased awareness of sports related brain injuries amongst professional athletes, less attention has been given to adolescents. Of all reported concussions, almost three quarters of those receiving emergency medical attention are athletes under the age of 18. Concussions produce a neurometabolic cascade which, contrary to popular belief, does not always manifest as amnesia and/or loss of consciousness (LOC). Immediate indicators of injury include headache, dizziness, nausea, and confusion. Repetitive impacts have been shown to trigger the disruption of critical processes central to development, including myelination, synaptogenesis, and cellular pruning. Research has shown marked disruptions in frontal lobe functions, including judgment and decision making, attention and concentration, and the experience of emotion. These effects can mitigate the development and attainment of long term goals, development of relationships, and create enduring psychiatric and behavioral difficulties. Unlike professional leagues, adolescent sports, to include high school, are governed by local and state legislative authorities. A review of statewide legislation however, found discrepancies between current legislation and recommendations made by the Centers for Disease Control and Prevention. Mainly, an absence of prevention strategies, ongoing education, and implementation of a return to school management program was found. In addition, several states do not require the removal of an athlete from play after a suspected injury. The goal of this dissertation was to draft a manuscript to be submitted for publication. It incorporated findings from the literature review and interviews of field consultants. The purpose of the manuscript was to elucidate the need for amendments to nationwide state concussion legislation. Restructuring guidelines regarding RTP decisions, developing RTS guidelines, increasing injury prevention strategies, and mandating necessary education requirements are recommended.