Influence of the College Football Athletes' Cumulative Head Impact Exposure (HIE) on the mTBI incidence and post-mTBI health outcomes

项目摘要 运动相关脑震荡(SRC)是一个重大的公共卫生问题，每年导致超过20万人次前往 美国的急诊部(ED)每年发生多达380万个SRC。从… 从生物力学的角度来看，脑震荡的机制包括头部撞击导致高幅度头部 旋转加速。测量与脑震荡头部撞击相关的加速度的人体研究 绘制了损伤风险曲线，从临床和安全角度来看，这些曲线非常有用。然而， 最近的文献表明，与脑震荡撞击相关的加速度大小 这是可变的，并不一定与常规持续的头部撞击大小不同。越来越多的证据 来自人体的研究表明，重复头部撞击暴露(HIE)可能有助于减少 接触性运动运动员对SRC的耐受性。 专注于量化HIE和突发脑震荡之间的关系的研究一直是 动力不足，因为在观察期内发生的脑震荡次数有限。我们会 利用NCAA-DoD震荡评估、研究和教育联盟(CARE)的数据 头部撞击测量核心，迄今为止对SRC和重复HIE进行的最大规模和最全面的研究， 和来自项目2(PHTH2)的数据，这是一项关于SRC和HIE的大规模研究，在大学和高等 学校运动员：(1)确定HIE与SRC发生和SRC后恢复的关联 在足球活动中头部受到撞击的频率、次数、近期和严重程度；及(2)建立 基于HIT系统HIE时间序列数据的SRC风险动态预测算法 以及其他因素，包括人口统计数据、脑震荡病史、影响特征和网络措施。

Project Abstract Sport-related concussion (SRC) is a significant public health problem resulting in over 200,000 annual trips to the Emergency Department (ED) in the United States with as many as 3.8 million SRCs occurring annually. From a biomechanical standpoint, the concussion mechanism includes head impact resulting in high magnitude head rotational accelerations. Human studies measuring the accelerations associated with concussive head impacts developed injury risk curves that can be extremely useful from the clinical and safety perspectives. However, recent literature has shown that acceleration magnitudes associated with concussive impacts are extremely variable and not necessarily distinct from the routinely sustained head impact magnitudes. Mounting evidence from human studies has demonstrated that repetitive head impact exposure (HIE) may contribute to decreased SRC tolerance in contact sport athletes. Studies focused on quantifying the relationship between the HIE and incident concussion have been underpowered, as there were limited number of concussions occurring during the observation period. We will utilize the data from the NCAA-DoD Concussion Assessment, Research and Education Consortium (CARE) Head Impact Measurement Core, the largest and most comprehensive study of SRC and repetitive HIE to date, and data from Project Head-to-Head 2 (PHTH2), a large-scale study of SRC and HIE in both collegiate and high school athletes to: (1) determine the association of HIE to SRC occurrence and post-SRC recovery based on the frequency, number, recency, and severity of head impacts sustained in football activities; and (2) build a dynamic predictive algorithm of the SRC risk based on the HIE time series data obtained from the HIT System and other factors, including demographics, concussion history, impact characteristics, and network measures.