Short-Term Neurologic Manifestations of Repetitive Head Impacts Among Athletes: A Scoping Review.
Short-Term Neurologic Manifestations of Repetitive Head Impacts Among Athletes: A Scoping Review.
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运动员重复头部撞击的短期神经表现：范围界定审查。
DOI：
10.1097/htr.0000000000000767
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bazarian,JeffreyJ
中科院分区：
文献类型：
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作者：
Stephen,SteveJ;Hasman,Linda;Goldenberg,May;Merchant-Borna,Kian;Kawata,Keisuke;Mannix,Rebekah;Bazarian,JeffreyJ
目的：总结与接触性运动相关的重复性头部撞击（RHIs）和神经功能短期下降相关的证据。方法：根据系统性综述和荟萃分析扩展的范围综述（PRISMA-ScR）的首选报告项目指南进行范围综述，并检索3个数据库（PubMed、EMBASE和Web of Science）。同行评审的研究文章符合纳入条件，前提是它们是1999年至2019年期间发表的完整英文文章，研究暴露于RHIs的14至40岁的运动员，并在最后一次头部撞击暴露后4周内报告认知，前庭和/或眼科结果。结果：52篇文章符合审查标准：14例报告了眼科结局，23例报告了前庭结局，36例报告了认知功能。在42.9%的眼科研究、20.8%的前庭研究和33.3%的认知研究中报告了短期RHI相关的神经功能下降。52项研究中的大多数涉及大学（n= 23）或高中（n= 14）水平的美式足球，足球或冰球运动员。24项（46%）研究仅涉及男性运动员。24项研究（46%）使用可穿戴传感器测量RHI，而26项研究（50%）未测量RHI。此外，许多研究未能控制注意力缺陷/多动障碍/学习障碍和/或脑震荡史。结论：本次范围审查的结果表明，将RHI与神经功能短期下降联系起来的证据相对较少，并且缺乏方法学的严谨性。虽然大多数研究未能找到联系，那些做了更有可能使用RHI的客观措施，并控制混杂因素。可能需要更仔细的试验设计，以明确建立RHI和短期神经功能障碍之间的因果关系。
Objective:To summarize the evidence linking contact sports–related repetitive head impacts (RHIs) and short-term declines in neurologic function.Methods:A scoping review following the guidelines in the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and searching 3 databases (PubMed, EMBASE, and Web of Science) was performed. Peer-reviewed research articles were eligible for inclusion if they were full-length English language articles published between 1999 and 2019 examining athletes between the ages of 14 and 40 years exposed to RHIs, and reporting cognitive, vestibular, and/or oculomotor outcomes within 4 weeks of last head hit exposure.Results:Fifty-two articles met criteria for review: 14 reported oculomotor outcomes, 23 reported vestibular outcomes, and 36 reported cognitive function. Short-term RHI-related declines in neurologic function were reported in 42.9% of oculomotor studies, in 20.8% of vestibular studies, and in 33.3% of cognitive studies. Most of the 52 studies involved American football, soccer, or ice hockey athletes at the collegiate (n= 23) or high school (n= 14) level. Twenty-four (46%) studies involved only male athletes. Wearable sensors were used to measure RHIs in 24 studies (46%), while RHIs were not measured in 26 studies (50%). In addition, many studies failed to control for attention-deficit/hyperactivity disorder/learning disability and/or concussion history.Conclusion:The results of this scoping review suggest that the evidence linking RHIs to short-term declines in neurologic function is relatively sparse and lacking in methodological rigor. Although most studies failed to find a link, those that did were more likely to use objective measures of RHIs and to control for confounders. More careful trial design may be needed to definitively establish a causal link between RHIs and short-term neurologic dysfunction.