Study Finds No Correlation Between Brain Function and Head Impacts After Two Seasons of Youth Tackle Football

In a prospective study of children playing tackle football, researchers find minimal changes in neurocognitive outcomes – and any changes were not correlated to number or severity of head impacts

July 11, 2019

COLUMBUS, Ohio – Many parents, potential players and medical providers are increasingly wary of youth contact sports participation. The concern over the potential short- and long-term effects of head impacts experienced by youth football players has likely driven decreasing participation, according to a group of researchers.

To date, most studies that have attempted to understand connections between neurocognitive function and sub-concussive head impacts have been retrospective – and inconclusive. Tracking athletes in real time can account for confounding factors such as pre-participation cognitive ability.  

This was the idea behind a study led by Sean Rose, MD, pediatric sports neurologist and co-director of the Complex Concussion Clinic at Nationwide Children’s Hospital. He collaborated with MORE Foundation, The Sports Neurology Clinic, and other researchers to follow more than 150 youth tackle football players ages 9 to 18.

Recently, they published the results of the first two years of the study in Journal of Neurotrauma, and the researchers plan to continue the study an additional two years. The data from the first season was published in 2018 in Journal of Head Trauma Rehabilitation.

“When trying to determine the effects of repeated, sub-concussive head impacts, prospective outcomes studies are an important addition to the existing retrospective studies,” says Dr. Rose. “We designed this study to include a wide variety of neurocognitive outcomes tests, to give us new insights into how repeated hits might influence outcomes.”

The pre and postseason assessments used to measure outcomes included:

  • Neuropsychological (cognitive) testing
  • Symptoms assessment
  • Vestibular and ocular-motor screening
  • Balance testing
  • Parent-reported ADHD symptoms
  • Self-reported behavioral adjustment

Sensors placed in the helmets recorded sub-concussive head impacts during practices and games. In the full 166 player group, a computerized test of processing speed declined over time. The other 22 outcome measures improved or did not change over time. Neither the total number of impacts nor the intensity of impacts correlated with change in outcomes from before season 1 to after season 2 in the 55 players who participated in both seasons of the study.

“So far, the study is showing us that sub-concussive impacts don’t seem to be associated with changes in neurocognitive function over two seasons of youth football. And we’re finding that other factors, such as ADHD and younger age are more predictive of worsening scores on our pre and post-season tests,” says Dr. Rose. “However, we remain concerned about repetitive head impacts in children, and longer follow up times are necessary to look for delayed effects on neurocognition.”

Citation: 
Rose SC, Yeates KO, Nguyen JT, McCarthy MT, Ercole PM, Pizzimenti NM. Neurocognitive function and head impact burden over two seasons of youth tackle footballJournal of Neurotrama. July 2019. [Epub ahead of print]

Featured Expert

Sean Rose
Sean C. Rose, MD
Pediatrics

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2019-20 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.5 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at NationwideChildrens.org.