Browsing by Author "Hoffman, Nicole L."

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    Age at First Concussion Influences Number of Subsequent Concussions
    (Elsevier, 2018) Schmidt, Julianne D.; Rizzone, Katherine; Hoffman, Nicole L.; Weber, Michelle L.; Jones, Courtney; Bazarian, Jeff; Broglio, Steven P.; McCrea, Michael; McAllister, Thomas W.; Psychiatry, School of Medicine
    Background: Individuals that sustain their first concussion during childhood may be at greater risk for sustaining multiple concussions throughout their lifetime, due to a longer window of vulnerability. Purpose: To estimate the association between age at first concussion with number of subsequent concussions. Methods: A total of 23,582 collegiate athletes from 26 universities and military cadets from three military academies completed a concussion history questionnaire (65% males, age: 19.9±1.4years). Participants self-reported concussions and age at time of each injury. Participants with a history of concussion (n=3,647, 15.5%) were categorized as having sustained their first concussion during childhood (<10 years old - yo) or adolescence (≥10yo & ≤18yo). Poisson regression was used to model age group (childhood, adolescence) predicting number of subsequent concussions (0, 1, 2+). A second Poisson regression was developed to determine whether age at first concussion predicted number of subsequent concussions. Results: Participants self-reporting their first concussion during childhood had an increased risk of sustaining subsequent concussions (RR=2.19, 95% CI: 1.82, 2.64) compared to participants self-reporting their first concussion during adolescence. For every one-year increase in age at first concussion, we observed a 16% reduction in the risk of subsequent concussion (RR=0.84, 95% CI:0.82,0.86). Conclusion(s): Individuals self-reporting a concussion at a young age sustained a higher number of concussions prior to the age of 18. Concussion prevention, recognition, and reporting strategies are of particular need at the youth level.
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    Relationship Between the King-Devick Test and Commonly Used Concussion Tests at Baseline
    (Allen Press, 2019-12) Clugston, James R.; Houck, Zachary M.; Asken, Breton M.; Boone, Jonathan K.; Kontos, Anthony P.; Buckley, Thomas A.; Schmidt, Julianne D.; Chrisman, Sara P.D.; Hoffman, Nicole L.; Harmon, Kimberly G.; Kaminski, Thomas W.; Collins, Michael W.; McAllister, Thomas W.; McCrea, Michael A.; Broglio, Steven P.; Ortega, Justus D.; Psychiatry, School of Medicine
    Context: Comprehensive assessments are recommended to evaluate sport-related concussion (SRC). The degree to which the King-Devick (KD) test adds novel information to an SRC evaluation is unknown. Objective: To describe relationships at baseline among the KD and other SRC assessments and explore whether the KD provides unique information to a multimodal baseline concussion assessment. Design: Cross-sectional study. Setting: Five National Collegiate Athletic Association institutions participating in the Concussion Assessment, Research and Education (CARE) Consortium. Patients or other participants: National Collegiate Athletic Association student-athletes (N = 2258, age = 20 ± 1.5 years, 53.0% male, 68.9% white) in 11 men's and 13 women's sports. Main outcome measure(s): Participants completed baseline assessments on the KD and (1) the Symptom Inventory of the Sport Concussion Assessment Tool-3rd edition, (2) the Brief Symptom Inventory-18, (3) the Balance Error Scoring System, (4) the Standardized Assessment of Concussion (SAC), (5) the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test battery, and (6) the Vestibular/Ocular Motor Screening tool during their first year in CARE. Correlation coefficients between the KD and the 6 other concussion assessments in isolation were determined. Assessments with ρ magnitude >0.1 were included in a multivariate linear regression analysis to evaluate their relative association with the KD. Results: Scores for SAC concentration, ImPACT visual motor speed, and ImPACT reaction time were correlated with the KD (ρ = -0.216, -0.276, and 0.164, respectively) and were thus included in the regression model, which explained 16.8% of the variance in baseline KD time (P < .001, Cohen f2 = 0.20). Better SAC concentration score (β = -.174, P < .001), ImPACT visual motor speed (β = -.205, P < .001), and ImPACT reaction time (β = .056, P = .020) were associated with faster baseline KD performance, but the effect sizes were small. Conclusions: Better performance on cognitive measures involving concentration, visual motor speed, and reaction time was weakly associated with better baseline KD performance. Symptoms, psychological distress, balance, and vestibular-oculomotor provocation were unrelated to KD performance at baseline. The findings indicate limited overlap at baseline among the CARE SRC assessments and the KD.