Emerging Concepts in Sport-Related Concussion: Overview and Data From the Concussion Assessment, Research, and Education (CARE) Consortium

CHAIR

Thomas McAllister

PRESENTERS

• Steven P. Broglio
• Michael McCrea

DESCRIPTION

“Despite recent advances, much remains unknown about the natural history of concussion and much of our available data on concussion has historically been limited to male American football players. Funded by the U.S. National Collegiate Athletic Association and the U.S. Department of Defense in 2014, the Concussion Assessment, Research and Education (CARE) Consortium is the largest, multi-site study of the natural history of concussion in both sexes and multiple sports, designed to address current gaps in our knowledge, and shed light on the neurobiological mechanisms of concussion and trajectory of recovery. The aims of the CARE project include (1) create a national multi-site consortium as a sustainable framework to answer critical scientific questions about concussion; (2) conduct a prospective, longitudinal, multi-center, multi-sport investigation that delineates the natural history of concussion in both men and women by incorporating a multi-dimensional assessment of standardized clinical measures of postconcussive symptoms, performance-based testing (cognitive function, postural stability), and psychological health; and (3) conduct advanced scientific studies which integrate biomechanical, clinical, neuroimaging, neurobiological and genetic markers of injury to characterize the neurobiology of concussion. In the first 18 months of the project over 20,000 well-characterized athletes and cadets have been enrolled and over 1,000 sport-related concussions captured with the goal of better informing public debate about concussion care and policy.

This symposium will present an overview of findings from the initial period of CARE data collection. The session will consist of four presentations:

I. Overview of Sport-related Concussion: What We Know and What We Need to Know. In this talk, Dr. Thomas McAllister will review what is known about the natural history and neurobiology of concussion and highlight current knowledge gaps and controversies.

II. CARE Data: What is the Natural History of Concussion? In this talk, Dr. Steven Broglio will present demographic and clinical data on the initial cohort of over 20,000 collegiate athletes enrolled in the study. Data on the injury characteristics, symptom resolution, return to play, and 6-month follow-up will be presented from the initial cohort of over 1000 concussed athletes.

III. CARE Data: What do Biomechanics, Neuroimaging & Biomarkers tell us about the Neurobiology of Concussion? In this talk, Dr. Michael McCrea will summarize biomechanical and neuroimaging data on the initial cohort of concussed athletes. Methodological and logistical challenges will be discussed.

IV. What is next for CARE? This summary presentation will outline lessons learned from the CARE project to date, outline plans for continued follow-up of the cohort, and discuss the implications of the emerging data for informing policy on sport-related concussion as well as implications for concussion prevention and management.”

LEARNING OBJECTIVES

• Relate what is known about the natural history and neurobiology of concussion and highlight current knowledge gaps and controversies.
• Discuss findings from the CARE project related to the natural history and neurobiology of concussion.
• Examine lessons learned from the CARE project to date, plans for continued follow-up of the cohort and implications of the emerging data for informing policy regarding and prevention and management of sport-related concussion.