The purpose of this study is to prospectively collect a comprehensive, multi-modality set of diagnostics on patients who have had a concussion, repeating some of these tests serially over time, so that the investigators may then in the future perform retrospective data mining to determine if there were a biomarker or risk calculator that could be used to guide return-to-play and other medical decisions.
Concussions comprise a type of mild traumatic brain injury in which mechanical forces disrupt brain metabolism causing transient neurological symptoms. At the current time, there is no universally agreed-upon objective biomarker or risk calculator of concussion upon which physicians can prognosticate future risk, identify optimal treatments, and for sports medicine physicians, decide if and when a particular player were safe to be returned to play. While the majority of patients experience a full recovery within a few weeks of a concussion, several going on to have chronic, debilitating symptoms, and all patients experience a permanently increased risk of experiencing more debilitating and long-lasting symptoms with each subsequent concussion. For certain people with certain genetic (e.g., ApoE status) and psychosocial (e.g., alcohol abuse, depression) risk factors, even a single concussion can put them at greater risk for earlier and more severe forms of dementia decades hence. The purpose of this study is to prospectively collect a comprehensive, multi-modality set of diagnostics on patients who have had a concussion, repeating some of these tests serially over time, so that the investigators may then in the future perform retrospective data mining to determine if there were a biomarker or risk calculator that could be used to guide return-to-play and other medical decisions. This study plans to collect biological specimens (blood, saliva, urine, hair follicles), electrophysiological (EEG, EKG), imaging (HCT, MRI, PET, SPECT), ambulatory (actigraphy), sensory thresholds (Von Frey), ophthalmologic (fundoscopic photographs, OCT, SSVEPs), vestibular (ENG, BESS, BioSway) along with demographic, medical history, medication, psychosocial data and the results on validated instruments of cognition, mood, sleep, head discomfort and quality of life. Because it is important to determine the variability not only within the concussion group but also between groups, the investigators will also recruit a control cohort, specifically athletes who are already undergoing baseline cognitive testing pre-season. The clinical focus of this study will be on concussed athletes, both children and adults, and the investigators will also include non-sports patients who have mild traumatic brain injury due to other situations including slip and fall, occupational, motor vehicle accidents, assault, and blast exposure.
Study Type
OBSERVATIONAL
Enrollment
1,000
Study groups are differentiated based on presence of concussion. No intervention is being made in either population (observational study)
Jefferson Comprehensive Concussion Center
Philadelphia, Pennsylvania, United States
RECRUITINGMedical history indicative of concussion
Basic medical history demographics gathered during patient's regular clincal visit.
Time frame: Upon enrollment
Neurocognitive Testing and Assessment Batteries
Sports Concussion Assessment Tool (SCAT-3)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Balance Error Scoring System (BESS)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
King Devick Test
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Acute Concussion Evaluation (ACE)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Beck Depression Inventory (BDI)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Beck Anxiety Inventory (BAI)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
World Health Organization-Five Well-being Index (WHO-5)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Multidimensional Anxiety Scale for Children (MASC)
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Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Spence Children's Anxiety Scale
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
"SCARED" Montgomery-Åsberg Depression Rating Scale
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
ImPACT
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Trails A and B Forward
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Reverse Digit Span
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Jefferson After Concussion Test (JACT)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Rivermead Post Concussion Symptom Questionnaire (RPQ)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Traumatic Brain Injury-Quality of Life (TBI-QOL)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Mayo-Portland Adaptability Inventory (MPAI-4)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Migraine Disability Assessment (MIDAS)
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Fatigue Severity Scale
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Epworth Sleepiness Scale
Time frame: 1 year
Neurocognitive Testing and Assessment Batteries
Pittsburgh Sleep Quality Index
Time frame: 1 year
Diagnostic Procedures
Galvanic skin response
Time frame: 1 year
Diagnostic Procedures
Electrocardiography (EKG)
Time frame: 1 year
Diagnostic Procedures
Electroencephalography (EEG)
Time frame: 1 year
Diagnostic Procedures
Fundoscopy Optical Coherence Tomography (OCT)
Time frame: 1 year
Diagnostic Procedures
Von Frey Sensory Filament Thresholds
Time frame: 1 year
Diagnostic Procedures
BioSway
Time frame: 1 year
Biospecimens
Blood
Time frame: 1 year
Biospecimens
Siliva
Time frame: 1 year
Biospecimens
Urine
Time frame: 1 year
Clinically Acquired Imaging
CT, MRI
Time frame: 1 year
Opthalmologic
Fundoscopic photographs
Time frame: 1 year
Opthalmologic
Optical coherence tomography
Time frame: 1 year
Tactile Sensation
Von Frey sensory thresholds
Time frame: 1 year