New registry seeks answers to sports concussion mysteriesNov. 1, 2018, 9:43 AM
by Kelsey Herbers
News of sport-related concussions may rule airtime on ESPN, but it wasn’t until the early 2000s that the situational factors surrounding concussions and the severity of symptoms were studied from a medical perspective.
Fast-forward to 2018 and, due to a range of factors, including limited funding for research, a lot of questions about concussion treatment remain unanswered — questions that Aaron Yengo-Kahn, MD, third-year neurosurgery resident, and Scott Zuckerman, MD, MPH, co-director of the Vanderbilt Sports Concussion Center, hope to help answer.
Beginning Oct. 1, Yengo-Kahn and Zuckerman began pilot testing a new sports concussion registry that asks several questions on a variety of concussion-related factors.
“This registry allows us to prospectively capture risk factors for prolonged recovery after sport-related concussion and better evaluate important outcome metrics such as return to school and scholastic performance,” said Zuckerman. “We can also investigate novel variables such as player aggressiveness and sportsmanship and how they may have a potential link to increased sport-related concussion incidence.”
Patients’ attitudes are evaluated through a serious of surveys that are scored using a Likert scale, asking whether they agree or disagree with statements such as ‘I become irritable if I’m disadvantaged during a match,’ or ‘I congratulate the opponent when they win’ and ‘I obey the referee.’ The questions are asked during the initial visit and again at varying intervals, beginning three months later.
According to Yengo-Kahn, this isn’t the first time the Vanderbilt Sports Concussion Center has established a registry to track patients over time. A registry begun in 2015 and lasting through late 2016 enrolled about 300 patients, which was a 50 percent capture rate of patients visiting the clinic.
“For the most part it was all retrospective — it wasn’t a prospective registry — so a lot of people were being enrolled after their injury,” said Yengo-Kahn. “We were really excited about what the registry was showing us, but there were always points when we were looking at it and thinking, ‘It’d be great if we had this other data point.’”
Gathering the data retrospectively meant it was subject to recall by the patients, who may remember the event differently over time.
“What we’re trying to do now is create a prospective registry with a goal to capture the same number of patients as before, but enroll them at the time of their initial visit for a more accurate sample,” said Yengo-Kahn.
Aside from attitude, aggression and recovery process, other areas of interest for Zuckerman and Yengo-Kahn include whether patients undergoing treatment are getting better, the effects of a concussion on patients with ADHD and if patients who have had concussions are more prone to orthopaedic injuries within the following six months.
“We hope to establish a robust, prospective database with short- and long-term outcomes of student-athletes with sport-related concussion, from youth and middle school to collegiate student-athletes,” Zuckerman said. “By developing a large registry, we can improve our study and learn more about the important public health issue of sports concussion and mild traumatic brain injury.”