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  • Print publication year: 2019
  • Online publication date: February 2019

19 - Contribution of Objective Tests to the Diagnosis of Sport-Related Concussion

from Part III - Diagnosis and Management of Concussion

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1.Guskiewicz, KM, McCrea, M, Marshall, SW, et al. Cumulative effects associated with recurrent concussion in collegiate football players: The NCAA Concussion Study. JAMA 2003;290(19):25492555.
2.Delaney, JS, Lacroix, VJ, Leclerc, S, Johnston, KM. Concussions among university football and soccer players. Clin J Sport Med 2002;12(6):331338.
3.Patel, AV, Mihalik, JP, Notebaert, AJ, Guskiewicz, KM, Prentice, WE. Neuropsychological performance, postural stability, and symptoms after dehydration. J Athl Train 2007;42(1):66.
4.McCrory, P, Meeuwisse, WH, Aubry, M, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. J Am Coll Surg 2013;216(5):11.
5.McCrea, M, Guskiewicz, KM, Marshall, SW, et al. Acute effects and recovery time following concussion in collegiate football players: The NCAA Concussion Study. JAMA 2003;290(19):25562563.
6.McCrea, M, Barr, WB, Guskiewicz, K, et al. Standard regression-based methods for measuring recovery after sport-related concussion. J Int Neuropsychol Soc 2005;11(01):5869.
7.Piland, SG, Motl, RW, Ferrara, MS, Peterson, CL. Evidence for the factorial and construct validity of a self-report concussion symptoms scale. J Athl Train 2003;38(2):104.
8.Collins, MW, Iverson, GL, Lovell, MR, McKeag, DB, Norwig, J, Maroon, J. On-field predictors of neuropsychological and symptom deficit following sports-related concussion. Clin J Sport Med 2003;13(4):222229.
9.Lovell, MR, Collins, MW, Iverson, GL, et al. Recovery from mild concussion in high school athletes. J Neurosurg 2003;98(2):296301.
10.Giza, CC, Kutcher, JS, Ashwal, S, et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports. Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013; 80(24):22502257.
11.Mansell, JL, Tierney, RT, Higgins, M, McDevitt, J, Toone, N, Glutting, J. Concussive signs and symptoms following head impacts in collegiate athletes. Brain Inj 2010;24(9):10701074.
12.Van Kampen, DA, Lovell, MR, Pardini, JE, Collins, MW, Fu, FH. The “value added” of neurocognitive testing after sports-related concussion. Am J Sports Med 2006;34(10):16301635.
13.McCrea, M. Standardized mental status testing on the sideline after sport-related concussion. J Athl Train 2001;36(3):274279.
14.McCrea, M, Kelly, JP, Randolph, C, et al. Standardized assessment of concussion (SAC): On-site mental status evaluation of the athlete. J Head Trauma Rehabil 1998;13(2):2735.
15.Barr, WB, McCrea, M. Sensitivity and specificity of standardized neurocognitive testing immediately following sports concussion. J Int Neuropsychol Soc 2001;7(6):693702.
16.French, L, McCrea, M, Baggett, M. The Military Acute Concussion Evaluation (MACE). J Special Ops Med 2008;8(1):6877.
17.McCrea, M, Jaffee, M, Helmick, K, Guskiewicz, K, Doncevic, S. Validation of the Military Acute Concussion Evaluation (MACE) for in-theater evaluation of combat-related traumatic brain injury. DTIC document; 2009. Defense Technical Information Center document. Available at
18.Coldren, RL, Kelly, MP, Parish, RV, Dretsch, M, Russell, ML. Evaluation of the Military Acute Concussion Evaluation for use in combat operations more than 12 hours after injury. Milit Med 2010;175(7):477481.
19.Riemann, BL, Guskiewicz, KM, Shields, EW. Relationship between clinical and forceplate measures of postural stability. J Sport Rehabil 1999;8:7182.
20.Balance Error Scoring System (BESS) manual. Developed by researchers and clinicians at the University of North Carolina’s Sports Medicine Research Laboratory. Available at
21.Riemann, BL, Guskiewicz, KM. Effects of mild head injury on postural stability as measured through clinical balance testing. J Athl Train 2000;35(1):1925.
22.McCrea, M, Guskiewicz, K, Randolph, C, et al. Incidence, clinical course, and predictors of prolonged recovery time following sport-related concussion in high school and college athletes. J Int Neuropsychol Soc 2013;19(1):2233.
23.Guskiewicz, KM. Postural stability assessment following concussion: One piece of the puzzle. Clin J Sport Med 2001;11(3): 182189.
24.Valovich McLeod, TC, Perrin, DH, Guskiewicz, KM, Shultz, SJ, Diamond, R, Gansneder, BM. Serial administration of clinical concussion assessments and learning effects in healthy young athletes. Clin J Sport Med 2004;14(5):287295.
25.Susco, TM, McLeod, TCV, Gansneder, BM, Shultz, SJ. Balance recovers within 20 minutes after exertion as measured by the Balance Error Scoring System. J Athl Train 2004;39(3):241.
26.Fox, ZG, Mihalik, JP, Blackburn, JT, Battaglini, CL, Guskiewicz, KM. Return of postural control to baseline after anaerobic and aerobic exercise protocols. J Athl Train 2008;43(5):456–463.
27.Sport Concussion Assessment Tool, 3rd edition. Available at:
28.Guskiewicz, KM, Register-Mihalik, J, McCrory, P, et al. Evidence-based approach to revising the SCAT2: Introducing the SCAT3. Br J Sports Med 2013;47(5):289293.
29.Putukian, M, Echemendia, R, Dettwiler-Danspeckgruber, A, Duliba T, Bruce J, Furtado JL, et al. Prospective clinical assessment using Sideline Concussion Assessment Tool-2 testing in the evaluation of sport-related concussion in college athletes. Clin J Sport Med 2015;25:3642.
30.Iverson, GL, Lovell, MR, Collins, MW. Interpreting change on ImPACT following sport concussion. Clin Neuropsychol 2003;17(4):460467.
31.Schatz, P, Pardini, JE, Lovell, MR, Collins, MW, Podell, K. Sensitivity and specificity of the ImPACT test battery for concussion in athletes. Arch Clin Neuropsychol 2006;21:9199.
32.Gualtieri, CT, Johnson, LG, Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Arch Clin Neuropsychol 2006;21:623643.
33.Levinson, D, Reeves, D. Monitoring recovery from traumatic brain injury using Automated Neuropsychological Assessment Metrics (ANAM V1.0). Arch Clin Neuropsychol 1997;12(2):155166.
34.Erlanger, D, Saliba, E, Barth, J, Almquist, J. Monitoring resolution of postconcussion symptoms in athletes: Preliminary results of a web-based neuropsychological test protocol. J Athl Train 2001;36:280287.
35.Louey, AG, Cromer, JA, Schembri, A., Darby, DG, Maruff, P, Makdissi, M, McCrory, P. Detecting cognitive impairment after concussion: Sensitivity of change from baseline and normative data methods using the CogSport/Axon cognitive test battery. Arch Clin Neuropsychol 2014;29(5):432441.
36.Erlanger, D, Feldman, D, Kutner, K, et al. Development and validation of a web-based neuropsychological test protocol for sports-related return-to-play decision-making. Arch Clin Neuropsychol 2003;18(3):293316.
37.Erlanger, D, Kaushik, T, Cantu, R, et al. Symptom-based assessment of the severity of a concussion. J Neurosurg 2003;98(3):477484.
38.Collie, A, Makdissi, M, Maruff, P, Bennell, K, McCrory, P. Cognition in the days following concussion: Comparison of symptomatic versus asymptomatic athletes. J Neurol Neurosurg Psychiatry 2006;77(2):241245.
39.Broglio, SP, Macciocchi, SN, Ferrara, MS. Sensitivity of the concussion assessment battery. Neurosurgery 2007;60(6):10501057.
40.McClincy, MP, Lovell, MR, Pardini, J, Collins, MW, Spore, MK. Recovery from sports concussion in high school and collegiate athletes. Brain Inj 2006;20(1):3339.
41.Macciocchi, SN, Barth, JT, Alves, W, Rimel, RW, Jane, JA. Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurg 1996;39(3):510514.
42.Randolph, C, McCrea, M, Barr, WB. Is neuropsychological testing useful in the management of sport-related concussion? J Athl Train 2005;40(3):139152.
43.Collins, MW, Grindel, SH, Lovell, MR, et al. Relationship between concussion and neuropsychological performance in college football players. JAMA 1999;282(10):964970.
44.Broglio, SP, Ferrara, MS, Sopiarz, K, Kelly, MS. Reliable change of the sensory organization test. Clin J Sport Med 2008;18(2):148154.
45.Peterson, CL, Ferrara, MS, Mrazik, M, Piland, S, Elliott, R. Evaluation of neuropsychological domain scores and postural stability following cerebral concussion in sports. Clin J Sport Med 2003;13(4):230237.
46.Slobounov, S, Slobounov, E, Newell, K. Application of virtual reality graphics in assessment of concussion. Cyberpsychol Behav 2006;9(2):188191.
47.Slobounov, S, Tutwiler, R, Sebastianelli, W, Slobounov, E. Alteration of postural responses to visual field motion in mild traumatic brain injury. Neurosurg 2006;59(1):134139.
48.Teel, EF, Ray, WJ, Geronimo, AM, Slobounov, SM. Residual alterations of brain electrical activity in clinically asymptomatic concussed individuals: An EEG study. Clin Neurophysiol 2014;125(4):703707.
49.Slobounov, S, Wu, T, Hallett, M, Shibasaki, H, Slobounov, E, Newell, K. Neural underpinning of postural responses to visual field motion. Biol Psychol 2006;72(2):188197.
50.Slobounov, SM, Zhang, K, Pennell, D, Ray, W, Johnson, B, Sebastianelli, W. Functional abnormalities in normally appearing athletes following mild traumatic brain injury: A functional MRI study. Exp Brain Res 2010;202(2):341354.
51.Jaiswal, N, Ray, W, Slobounov, S. Encoding of visual-spatial information in working memory requires more cerebral efforts than retrieval: Evidence from an EEG and virtual reality study. Brain Res 2010;6:8089.
52.Rose, FD, Brooks, BM, Rizzo, AA. Virtual reality in brain damage rehabilitation: Review. CyberPsychol Behav 2005;8(3):241262.
53.Parker, TM, Osternig, LR, Lee, H-J, Donkelaar, Pv, Chou, L-S. The effect of divided attention on gait stability following concussion. Clin Biomech 2005;20(4):389395.
54.Catena, RD, van Donkelaar, P, Chou, L-S. Cognitive task effects on gait stability following concussion. Exp Brain Res 2007; 176(1):2331.
55.Parker, TM, Osternig, LR, van Donkelaar, P, Chou, L-S. Balance control during gait in athletes and non-athletes following concussion. Med Engineer Physics 2008;30(8):959967.
56.Parker, TM, Osternig, LR, P VAND, Chou, LS. Gait stability following concussion. Med Sci Sports Exerc 2006;38(6):10321040.
57.Guskiewicz, K, Bruce, S, Cantu, R, Ferrara MS, Kelly JP, McCrea M, et al. Research based recommendations on management of sport related concussion: Summary of the National Athletic Trainers’ Association position statement. Br J Sports Med 2006;40(1):610.
58.Gaetz, M, Bernstein, DM. The current status of electrophysiologic procedures for the assessment of mild traumatic brain injury. J Head Trauma Rehabil 2001;16(4):386405.
59.Leon-Carrion, J, Martin-Rodriguez, JF, Damas-Lopez, J, Martin, JMB, Dominguez-Morales, MDR. A QEEG index of level of functional dependence for people sustaining acquired brain injury: The Seville Independence Index (SINDI). Brain Inj 2008;22(1):6174.
60.Arciniegas, DB. Clinical electrophysiologic assessments and mild traumatic brain injury: State-of-the-science and implications for clinical practice. Int J Psychophysiol 2011;82(1):4152.
61.Thatcher, RW, Walker, R, Gerson, I, Geisler, F. EEG discriminant analyses of mild head trauma. Electroencephalogr Clin Neurophysiol 1989;73(2):94106.
62.Duncan, CC, Barry, RJ, Connolly, JF, et al. Event-related potentials in clinical research: Guidelines for eliciting, recording, and quantifying mismatch negativity, P300, and N400. Clin Neurophysiol 2009;120(11):18831908.
63.Broglio, SP, Pontifex, MB, O’Connor, P, Hillman, CH. The persistent effects of concussion on neuroelectric indices of attention. J Neurotrauma 2009;26(9):14631470.
64.Bazarian, JJ, Zhong, J, Blyth, B, Zhu, T, Kavcic, V, Peterson, D. Diffusion tensor imaging detects clinically important axonal damage after mild traumatic brain injury: A pilot study. J Neurotrauma 2007;24(9):14471459.
65.Miller, L. Neuropsychology and pathophysiology of mild head injury and the postconcussion syndrome: Clinical and forensic considerations. J Cogn Rehabil 1996;15:823.
66.Mittl, R, Grossman, R, Hiehle, J, et al. Prevalence of MR evidence of diffuse axonal injury in patients with mild head injury and normal head CT findings. Am J Neuroradiol 1994;15(8):15831589.
67.Povlishock, JT, Coburn, TH. Morphopathological change associated with mild head injury. Mild Head Inj 1989;3753.
68.Shenton, M, Hamoda, H, Schneiderman, J, et al. A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. Brain Imaging Behav 2012;6(2):137192.
69.Bazarian, JJ, Zhu, T, Blyth, B, Borrino, A, Zhong, J. Subject-specific changes in brain white matter on diffusion tensor imaging after sports-related concussion. Magnet Res Imag 2012;30(2):171180.
70.Hammeke, TA, McCrea, M, Coats, SM, et al. Acute and subacute changes in neural activation during the recovery from sport-related concussion. J Int Neuropsychol Soc 2013;19(8):863872.
71.Ogawa, S, Lee, T, Kay, A, Tank, D. Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci 1990;87(24):98689872.
72.Ogawa, S, Menon, R, Tank, D, et al. Functional brain mapping by blood oxygenation level-dependent contrast magnetic resonance imaging. A comparison of signal characteristics with a biophysical model. Biophys J 1993;64(3):803812.
73.Jueptner, M, Weiller, C. Review: Does measurement of regional cerebral blood flow reflect synaptic activity? Implications for PET and fMRI. NeuroImage 1995;2(2PA):148156.
74.Hillary, FG, Steffener, J, Biswal, BB, Lange, G, DeLuca, J, Ashburner, J. Functional magnetic resonance imaging technology and traumatic brain injury rehabilitation: Guidelines for methodological and conceptual pitfalls. J Head Trauma Rehabil 2002;17(5):411430.
75.Heeger, DJ, Ress, D. What does fMRI tell us about neuronal activity? Nature Rev Neurosci 2002;3(2):142151.
76.Slobounov, S, Gay, M, Johnson, B, Zhang, K. Concussion in athletics: Ongoing clinical and brain imaging research controversies. Brain Imaging Behav 2012;6(2):224243.
77.Maruta, J, Lee, SW, Jacobs, EF, Ghajar, J. A unified science of concussion. Ann NY Acad Sci 2010;1208(1):5866.
78.Chu, Z, Wilde, E, Hunter, J, et al. Voxel-based analysis of diffusion tensor imaging in mild traumatic brain injury in adolescents. Am J Neuroradiol 2010;31(2):340346.