Samenvatting

Sport Related Concussion

Poelaerends, P. Wylleman, W. van Zoest & M. Hendriks

Of recent years, there are multiple examples of sport related head injuries. Sometimes they lead up to cognitive and behavioural disfunction. Since the interest in this subject has increased, the involvement of psychology has increased as well. With knowledge of both (neuro)psychological testing and the management of above mentioned cognitive, emotional and behavioural problems, the role of the (clinical neuro)psychologist has become more important. In this narrative review we describe a common definition of a sport related concussion, as well as describing international guidelines that can support in the ‘Return-to-play’ phase and we present a new tablet-based neurocognitive assessment battery for sport related concussions. This assessment battery is already being used by two sports organizations in the Netherlands.


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Vaak leidt sportgerelateerd hoofdletsel tot cognitieve en emotionele beperkingen. Met toenemende aandacht voor deze gevolgen is ook de betrokkenheid van de neuropsychologie toegenomen. In dit artikel wordt allereerst gekeken naar een gangbare definitie van sportgerelateerd (licht) traumatisch hersenletsel. Daarnaast wordt een multidisciplinaire richtlijn voor ‘Return to play’ gegeven. Ook wordt de ontwikkeling van een tabletondersteunende neuropsychologische testbatterij beschreven.

Sportgerelateerd (licht) traumatisch hersenletsel (SGH) komt de laatste jaren vaak in het nieuws. De eerste serieuze aanwijzingen voor het bestaan van deze aandoening kwamen naar voren nadat een van de grootste sporters ooit, bokser Muhammad Ali, opvallende (neuropsychologische) symptomen begon te vertonen op basis waarvan bij hem uiteindelijk de ziekte van Parkinson werd vastgesteld. Recent zijn er ook talloze voorbeelden1 te noemen waarbij forse cognitieve en emotionele beperkingen tot gevolg had. Bij een aantal professionele sporters is hierdoor de sportcarrière nadrukkelijk in het geding gekomen.

De sportkoepel NOC*SPN heeft de laatste jaren dan ook geïnvesteerd in het opstellen van beleid rondom diagnostiek en aanpak van SGH. Ook binnen afzonderlijke sportbonden wordt (inter)nationaal steeds meer aandacht besteed aan de gevolgen hiervan. Zo heeft de Koninklijke Nederlandse Voetbalbond (KNVB) binnen haar Sportmedisch Centrum een speciale polikliniek opgezet voor sporters die SGH&

Literatuurlijst

  1. Abrahams, S., Fie, S.M., Patricios, J., Posthumus, M. & September, A.V. (2014). Risk factors for sports concussion: an evidence-based systematic review.ÄBritish journal of sports medicine,Ä48(2), 91–97. https://doi.org/10.1136/bjsports-2013-092734
  2. Ahmed, O.H., Loosemore, M., Hornby, K., Kumar, B., Sylvester, R., Makalanda, H.L., Rogers, T., Edwards, D. & de Medici, A. (2017). Moving concussion care to the next level: The emergence and role of concussion clinics in the UK.ÄProgress in Brain Research, 234, 205-220. https://doi.org/10.1016/bs.pbr.2017.06.014
  3. Belanger, H.G., Curtiss, G., Demery, J.A., Lebowitz, B.K. & Vanderploeg, R. D. (2005). Factors moderating neuropsychological outcomes following mild traumatic brain injury: a meta-analysis. Journal of the International Neuropsychological Society, 11(3), 215–227. https://doi.org/10.1017/ S1355617705050277
  4. Belanger, H.G. & Vanderploeg, R.D. (2005). The neuropsychological impact of sports-related concussion: a meta-analysis. Journal of the International Neuropsychological Society, 11(4), 345–357. https://doi. org/10.1017/s1355617705050411
  5. Cheng, J., Ammerman, B., Santiago, K., Jivanelli, B., Lin, E., Casey, E. & Ling, D. (2019). Sex-Based Differences in the Incidence of Sports- Related Concussion: Systematic Review and Meta-analysis. Sports health, 11(6), 486–491. https://doi.org/10.1177/1941738119877186
  6. Crasta, J.E., Raja, A.E., Ca¶o, B.S., Hluchan, C.M. & Suskauer, S.J. (2021). The Effect of Age and Competition Level on Subtle Motor Performance in Adolescents Medically Cleared Postconcussion: Preliminary Findings. American journal of physical medicine & rehabilitation, 100(6), 563–569. https://doi.org/10.1097/PHM.0000000000001589
  7. Ekstrand, J., Krutsch, W., Spreco, A., van Zoest, W., Roberts, C., Meyer, T. & Bengtsson, H. (2020). Time before return to play for the most common injuries in professional football: a 16-year follow-up of the UEFA Elite Club Injury Study.ÄBritish journal of sports medicine,Ä54 (7), 421–426. https://doi.org/10.1136/bjsports-2019-100666
  8. Engelhardt, J., Brauge, D. & Loiseau, H. (2021). Second Impact Syndrome. Myth or reality?. Neuro-Chirurgie, 67(3), 265–275. https://doi. org/10.1016/j.neuchi.2019.12.007
  9. Echemendia, R.J. & Cantu, R.C. (2003). Return to play following sports-related mild traumatic brain injury: the role for neuropsychology. ÄApplied neuropsychology,Ä10(1), 48–55. https://doi.org/10.1207/ S15324826AN1001_7
  10. Echemendia, R.J. & Gioia, G.A. (2018). The role of neuropsychologists in concussion evaluation and management. Handbook of clinical neurology, 158, 179–191. https://doi.org/10.1016/B978-0-444-63954-7.00018-5
  11. Echemendia, R.J., Meeuwisse, W., McCrory, P., Davis, G.A. … Herring, S. (2017). The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale. British journal of sports medicine, 51(11), 848–850. https://doi.org/10.1136/bjsports-2017-097506
  12. Frencham, K.A., Fox, A.M. & Maybery, M.T. (2005). Neuropsychological studies of mild traumatic brain injury: a meta-analytic review of research since 1995. Journal of clinical and experimental neuropsychology, 27(3), 334–351. https://doi.org/10.1080/13803390490520328
  13. Gronwall, D. & Wrightson, P. (1974). Delayed recovery of intellectual function after minor head injury. Lancet, 2 (7881), 605–609. https://doi. org/10.1016/s0140-6736(74)91939-4
  14. Iverson, G.L., Lovell, M.R. & Collins, M.W. (2005). Validity of ImPACT for measuring processing speed following sports-related concussion. Journal of clinical and experimental neuropsychology, 27(6), 683–689. https://doi.org/10.1081/13803390490918435
  15. Jennett, B. & Bond, M. (1975). Assessment of outcome after severe brain damage. Lancet, 1 (7905), 480–484. https://doi.org/10.1016/s0140- 6736(75)92830-5
  16. Jennings, S., Collins, M.W. & Taylor, A.M. (2021). Neuropsychological Assessment of Sport-Related Concussion. Clinics in sports medicine, 40(1), 81–91. https://doi.org/10.1016/j.csm.2020.08.002
  17. Karr, J.E., Areshenkoff, C.N. & Garcia-Barrera, M.A. (2014). The neuropsychological outcomes of concussion: A systematic review of metaanalyses on the cognitive sequelae of mild traumatic brain injury. Neuropsychology, 28(3), 321–336. https://doi.org/10.1037/neu0000037
  18. Koerte, I.K., Schultz, V., Sydnor, V.J., Howell, D.R., Guenette, J.P., Dennis, E., Kochsiek, J., Kaufmann, D., Sollmann, N., Mondello, S., Shenton, M.E. & Lin, A. P. (2020). Sex-Related Differences in the Effects of Sports-Related Concussion: A Review. Journal of neuroimaging : official journal of the American Society of Neuroimaging, 30(4), 387–409. https:// doi.org/10.1111/jon.12726
  19. Lezak, M., Howieson, D.B. & Bigler, E.B. (2012). Neuropsychological assessment: fifth edition, Oxford University Press. Lovell, M.R., Iverson, G.L., Collins, M.W., McKeag, D. & Maroon, J.C. (1999). Does loss of consciousness predict neuropsychological decrements after concussion?. Clinical journal of sport medicine : offcial journal of the Canadian Academy of Sport Medicine, 9(4), 193–198. https://doi. org/10.1097/00042752-199910000-00002
  20. Maddocks, D.L., Dicker, G.D. & Saling, M.M. (1995). The assessment of orientation following concussion in athletes.ÄClinical Journal of Sport Medicine,Ä5(1), 32–35. https://doi.org/10.1097/00042752-199501000- 00006
  21. McClincy, M.P., Lovell, M.R., Pardini, J., Collins, M.W. & Spore, M.K. (2006). Recovery from sports concussion in high school and collegiate athletes. Brain injury, 20(1), 33–39. https://doi. org/10.1080/02699050500309817
  22. McCrea, M. (2001). Standardized Mental Status Testing on the Sideline After Sport-Related Concussion. Journal of athletic training, 36(3), 274–279.
  23. McCrea, M., Kelly, J.P., Kluge, J., Ackley, B. & Randolph, C. (1997). Standardized assessment of concussion in football players.Ä Neurology,Ä48(3), 586–588. https://doi.org/10.1212/wnl.48.3.586
  24. McCrory, P., Meeuwisse, W., Dvořák, J., Aubry, M. … Vos, P.E. (2017). Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016. British journal of sports medicine, 51(11), 838–847. https://doi.org/10.1136/ bjsports-2017-097699
  25. Rohling, M.L., Binder, L.M., Demakis, G.J., Larrabee, G.J., Ploetz, D.M. & Langhinrichsen-Rohling, J. (2011). A meta-analysis of neuropsychological outcome after mild traumatic brain injury: re-analyses and reconsiderations of Binder et al. (1997), Frencham et al. (2005), and Pertab et al. (2009).ÄThe Clinical neuropsychologist,Ä25(4), 608–623. https://doi.org/10.1080/13854046.2011.565076
  26. Stulemeijer, M., Van der Werf, S., Andriessen, T. & Vos, P.E. (2008) Onverklaarbare klachten na licht traumatisch schedelhersenletsel: De discripantie tussen cogintieve klachten en neuropsychologische testprestatie nader belicht. Tijdschrift voor neuropsychologie, 3(3), 2-11.
  27. Van Donkelaar, P., Langan, J., Rodriguez, E., Drew, A., Halterman, C., Osternig, L.R. & Chou, L.S. (2005). Attentional deficits in concussion. Brain injury, 19(12), 1031–1039. https://doi.org/10.1080/ 02699050500110363
  28. Wiese-Bjornstal, D. M. (2010). Psychology and socioculture affect injuryrisk, response, and recovery in high-intensity athletes: A consensus statement. Scandinavian Journal of Medicine & Science in Sports, 20, 103- 111. https://doi.org/10.1111/j.1600-0838.2010.01195.x.