Center for Injury Research and Prevention

Quantitative Assessments for Sports-Related Concussion

sports concussion assessment
Head impact sensors are used to quantify biomechanical load exposure during competitive game play

In the US, there are more than four sports-related traumatic brain injuries every minute. There is emerging evidence that sports-related concussion (SRC) can affect academics, behaviors, and neurocognitive processes, such as working memory, concentration, processing speed, and eye and motor function.

Minds Matter research team has been hard at work to provide a scientific foundation to determine the incidence of SRCs in boys and girls by sport and demographic; to identify unbiased, sensitive prognostic and diagnostic metrics and markers; to design longitudinal studies to determine outcomes; and efforts to delineate age- and sex-related biomechanical determinants of injury risk.

Objective Translational Multi-domain Early Concussion Assessment Study

Study Objectives

This research project focuses specifically on developing a suite of quantitative assessment tools to enhance accuracy of sports-related concussion diagnoses, with a focus on eye-tracking, pupillometry and measures of cerebral blood flow. The study is determining sports settings with highest impact exposures through the use of head impact sensors and integrating across animal (porcine) and human studies to relate rapid head rotation magnitude and direction to short-term outcomes. These data will provide prognoses of the time-to-recovery and safe return-to-play for youth athletes. This study also looks at sex-specific data to see how prevention and diagnoses strategies need to be tailored uniquely for males and females.

Investigational Plan

Over the course of the study, researchers have been pursuing the following aims:

Aim 1- Develop and validate an unbiased assessment suite for SRC. Objective metrics include assessments of balance, oculomotor function, visual and auditory processing, and sleep. Researchers are determining if these metrics or certain combinations of these metrics identify the presence of SRC with high sensitivity and specificity and are predictive of days-to-clearance for sports. The research team are then validating the findings in a separate cohort.

Aim 2Translate nonverbal and effort-independent metrics from Aim 1 to an animal model where human-like measures of physical, cognitive, and sleep deficits are associated with SRC. This work is being led by Susan Margulies, PhD at Georgia Institute of Technology/Emory University. In Aim 2, we use a juvenile porcine TBI model to determine SRC mechanisms by relating the influence of sex and load frequency, magnitude and direction on neuro-function, biomarkers and neuropathology. Both single rapid head rotations will be studied as well as a multiple sub-concussive rotations. In this line of study, by developing new technologies to translate human outcome metrics to animals, we provide a human-like platform to develop and test injury treatments in the future.

  • In a 2020 study, Using Serum Amino Acids to Predict Traumatic Brain Injury: A Systematic Approach to Utilize Multiple Biomarkers, serum concentrations of 17 amino acids were studied for their potential utility as biomarkers of TBI using the porcine TBI model. The combination of serum glycine, taurine, and ornithine was optimal for TBI diagnosis, with high sensitivity and prediction rate in both a test and validation dataset. This combination of biomarkers outperformed any single biomarker. Future work will combine these results with other TBI assessments to develop and evaluate optimal multi-factorial diagnostic/prognostic TBI metrics. International Journal of Molecular Sciences. March 2020.

Aim 3 – Translate insights from Aim 2 from animals to teens. In Aim 2, we will translate insights from animals to teens, where head impact sensors are used to quantify biomechanical load exposure by sport and sex, and relationships between load exposure and neuro-functional metrics using the numerical assessment suite developed in Aim 1. This will provide new knowledge regarding high-risk biomechanical settings for the young brain.

Principal Investigators: Kristy Arbogast, PhD, Christina L. Master, MD, Susan Margulies, PhDFunding: National Institutes of Health (National Institute of Neurological Diseases and Stroke)

Related Content

Read the Philadelphia Inquirer article "Concussions in Teen Athletes: Making Sure the Brain is Okay Before Getting Cleared to Play."

Read a Research in Action blog article about research participant recruitment.

Read a September 2017 Bench to Bedside article about this research.

Read a press release about this research.