In this episode, we discuss the long-term cognitive and mental health effects of sport related concussion, which includes an in depth conversation about chronic traumatic encephalopathy (CTE), with Dr. Nyaz Didehbani. Specific topics covered include methodological limitations of the literature on long-term effects of concussion, risk of neurodegenerative diseases from TBI (mild to severe), and CTE history, neuropathology, clinical symptoms, and sociocultural/sociopolitical influences.
If you’d like to receive APA-approved CE credit for listening to this episode, click here.
About Nyaz
Nyaz Didehbani, Ph.D., is a Licensed Psychologist with the Texas State Board of Examiners of Psychologists. She is an Associate Professor in the Departments of Psychiatry and Physical Medicine & Rehabilitation at UT Southwestern Medical Center. She specializes in neuropsychological assessment, with a primary interest in examining individuals with sports-related concussion and neurocognitive disorders. Dr. Didehbani’s current research focuses on the longitudinal effects of head impact in youth athletes and the aging effects of TBI. She has delivered scores of presentations and published numerous academic articles. In 2019, she earned the Early Career Award from the Sports Neuropsychology Society.
References
Alosco, M. L., Cherry, J. D., Huber, B. R., Tripodis, Y., Baucom, Z., Kowall, N. W., Saltiel, N., Goldstein, L. E., Katz, D. I., Dwyer, B., Daneshvar, D. H., Palmisano, J. N., Martin, B., Cantu, R. C., Stern, R. A., Alvarez, V. E., Mez, J., Stein, T. D., & McKee, A. C. (2020). Characterizing tau deposition in Chronic traumatic encephalopathy (CTE): Utility of the mckee CTE staging scheme. Acta Neuropathologica, 140(4), 495–512. https://doi.org/10.1007/s00401-020-02197-9
Alosco, M. L., Mariani, M. L., Adler, C. H., Balcer, L. J., Bernick, C., Au, R., Banks, S. J., Barr, W. B., Bouix, S., Cantu, R. C., Coleman, M. J., Dodick, D. W., Farrer, L. A., Geda, Y. E., Katz, D. I., Koerte, I. K., Kowall, N. W., Lin, A. P., Marcus, D. S., … Wethe, J. V. (2021). Developing methods to detect and diagnose chronic traumatic encephalopathy during life: Rationale, design, and methodology for the diagnose CTE research project. Alzheimer’s Research & Therapy, 13(1). https://doi.org/10.1186/s13195-021-00872-x
Asken, B. M., Sullan, M. J., DeKosky, S. T., Jaffee, M. S., & Bauer, R. M. (2017). Research gaps and controversies in chronic traumatic encephalopathy. JAMA Neurology, 74(10), 1255. https://doi.org/10.1001/jamaneurol.2017.2396
Asken, B. M., Tanner, J. A., VandeVrede, L., Casaletto, K. B., Staffaroni, A. M., Mundada, N., Fonseca, C., Iaccarino, L., La Joie, R., Tsuei, T., Mladinov, M., Grant, H., Shankar, R., Wang, K. K., Xu, H., Cobigo, Y., Rosen, H., Gardner, R. C., Perry, D. C., … Rabinovici, G. D. (2022). Multi-modal biomarkers of repetitive head impacts and traumatic encephalopathy syndrome: A clinicopathological case series. Journal of Neurotrauma, 39(17–18), 1195–1213. https://doi.org/10.1089/neu.2022.0060
Baldwin, G. T., Breiding, M. J., & Dawn Comstock, R. (2018). Epidemiology of Sports Concussion in the United States. Sports Neurology, 63–74. https://doi.org/10.1016/b978-0-444-63954-7.00007-0
Barr, W. B. (2020). Believers versus deniers: The radicalization of sports concussion and chronic traumatic encephalopathy (CTE) science. Canadian Psychology / Psychologie Canadienne, 61(2), 151–162. https://doi.org/10.1037/cap0000210
Belanger, H. G., Wortzel, H. S., Vanderploeg, R. D., & Cooper, D. B. (2019). A model for intervening with veterans and service members who are concerned about developing chronic traumatic encephalopathy (CTE). The Clinical Neuropsychologist, 34(6), 1105–1123. https://doi.org/10.1080/13854046.2019.1699166
Bell, K. R., Rinaldi, R., & DIDEHBANI, N. (2018). Assessment and Management of Sports Concussion. In Rehabilitation After Traumatic Brain Injury (pp. 59–71). essay, Elsevier.
Bergauer, A., van Osch, R., van Elferen, S., Gyllvik, S., Venkatesh, H., & Schreiber, R. (2022). The diagnostic potential of fluid and imaging biomarkers in chronic traumatic encephalopathy (CTE). Biomedicine & Pharmacotherapy, 146, 112602. https://doi.org/10.1016/j.biopha.2021.112602
Bieniek, K. F., Cairns, N. J., Crary, J. F., Dickson, D. W., Folkerth, R. D., Keene, C. D., Litvan, I., Perl, D. P., Stein, T. D., Vonsattel, J.-P., Stewart, W., Dams-O’Connor, K., Gordon, W. A., Tripodis, Y., Alvarez, V. E., Mez, J., Alosco, M. L., & McKee, A. C. (2021). The second NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Journal of Neuropathology & Experimental Neurology, Publish Ahead of Print. https://doi.org/10.1093/jnen/nlab001
Bunt, S. C., Didehbani, N., LoBue, C., Stokes, M., Heinzelmann, M., Rossetti, H., Miller, S. M., Nakonezny, P. A., Bell, K., Batjer, H., & Cullum, C. M. (2020). Sex differences in reporting of concussion symptoms in adults. The Clinical Neuropsychologist, 36(6), 1290–1303. https://doi.org/10.1080/13854046.2020.1842500
Bunt, S. C., Didehbani, N., Tarkenton, T., Rossetti, H., Hicks, C., Vargas, B., Silver, C., Nakonezny, P., Bell, K., Batjer, H., & Cullum, C. M. (2020). Sex differences and reporting of SCAT-5 concussion symptoms in adolescent athletes. Clinical Journal of Sport Medicine, 31(5). https://doi.org/10.1097/jsm.0000000000000788
Casson, I. R., & Viano, D. C. (2022). Using the NINDS consensus diagnostic criteria for traumatic encephalopathy syndrome on 4 cohorts of retired contact sport athletes. Sports Health: A Multidisciplinary Approach, 194173812211392. https://doi.org/10.1177/19417381221139259
Chung, J. S., Zynda, A. J., Didehbani, N., Hicks, C., Hynan, L. S., Miller, S. M., Bell, K. R., & Cullum, C. M. (2019). Association between sleep quality and recovery following sport-related concussion in Pediatrics. Journal of Child Neurology, 34(11), 639–645. https://doi.org/10.1177/0883073819849741
Covassin, T., Savage, J. L., Bretzin, A. C., & Fox, M. E. (2018). Sex differences in sport-related concussion long-term outcomes. International Journal of Psychophysiology, 132, 9–13. https://doi.org/10.1016/j.ijpsycho.2017.09.010
Cullum, C. M., Bunt, S., Hicks, C., Didehbani, N., Miller, S., Vargas, B., Sabo, T., Bell, K., & Batjer, H. H. (2020). The North Texas Concussion Registry (contex). BMJ Open, 10(1). https://doi.org/10.1136/bmjopen-2019-032345
Cunningham, J., Broglio, S. P., O’Grady, M., & Wilson, F. (2020). History of sport-related concussion and long-term clinical cognitive health outcomes in retired athletes: A systematic review. Journal of Athletic Training, 55(2), 132–158. https://doi.org/10.4085/1062-6050-297-18
Daneshvar, D. H., & Rovito, C. A. (2023). <I>letter to the editor:</i> telling the whole story: Articles linking chronic traumatic encephalopathy and repetitive head impacts have higher journal impact factors. Journal of Neurotrauma, 40(3–4), 410–412. https://doi.org/10.1089/neu.2022.0374
Decq, P., Gault, N., Blandeau, M., Kerdraon, T., Berkal, M., ElHelou, A., Dusfour, B., & Peyrin, J.-C. (2015). Long-term consequences of recurrent sports concussion. Acta Neurochirurgica, 158(2), 289–300. https://doi.org/10.1007/s00701-015-2681-4
Didehbani, N., Cullum, C. M., Mansinghani, S., Conover, H., & Hart, J. (2013). Depressive symptoms and concussions in aging retired NFL players. Archives of Clinical Neuropsychology, 28(5), 418–424. https://doi.org/10.1093/arclin/act028
Didehbani, Nyaz, Fields, L. M., Wilmoth, K., LoBue, C., Hart, J., & Cullum, C. M. (2020). Mild cognitive impairment in retired professional football players with a history of mild traumatic brain injury: A pilot investigation. Cognitive and Behavioral Neurology, 33(3), 208–217. https://doi.org/10.1097/wnn.0000000000000240
Didehbani, Nyaz, Wilmoth, K., Fields, L., LoBue, C., Strain, J., Spence, J., Dieppa, M., Cullum, M., & Hart, J. (2017). Reliability of Self-Reported Concussion History in Retired NFL Players. Annals of Sports Medicine and Research, 1–5.
Eagle, S. R., & Okonkwo, D. O. (2023). Telling the whole story: Bibliometric network analysis to evaluate impact of media attention on chronic traumatic encephalopathy research. Journal of Neurotrauma, 40(1–2), 148–154. https://doi.org/10.1089/neu.2022.0266
Gallo, V., Motley, K., Kemp, S. P., Mian, S., Patel, T., James, L., Pearce, N., & McElvenny, D. (2020). Concussion and long-term cognitive impairment among professional or Elite Sport-persons: A systematic review. Journal of Neurology, Neurosurgery & Psychiatry, 91(5), 455–468. https://doi.org/10.1136/jnnp-2019-321170
Harmon, K. G., Clugston, J. R., Dec, K., Hainline, B., Herring, S., Kane, S. F., Kontos, A. P., Leddy, J. J., McCrea, M., Poddar, S. K., Putukian, M., Wilson, J. C., & Roberts, W. O. (2019). American Medical Society for Sports Medicine Position Statement on Concussion in sport. British Journal of Sports Medicine, 53(4), 213–225. https://doi.org/10.1136/bjsports-2018-100338
Hearn, R., Selfe, J., Cordero, M. I., & Dobbin, N. (2022). The effects of active rehabilitation on symptoms associated with Tau Pathology: An umbrella review. implications for chronic traumatic encephalopathy symptom management. PLOS ONE, 17(7). https://doi.org/10.1371/journal.pone.0271213
Iverson, G. L., & Gardner, A. J. (2020). Risk for misdiagnosing chronic traumatic encephalopathy in men with anger control problems. Frontiers in Neurology, 11. https://doi.org/10.3389/fneur.2020.00739
Iverson, G. L., & Gardner, A. J. (2021). Symptoms of traumatic encephalopathy syndrome are common in the US general population. Brain Communications, 3(1). https://doi.org/10.1093/braincomms/fcab001
Iverson, G. L. (2016). Suicide and chronic traumatic encephalopathy. The Journal of Neuropsychiatry and Clinical Neurosciences, 28(1), 9–16. https://doi.org/10.1176/appi.neuropsych.15070172
Iverson, G. L., Gardner, A. J., McCrory, P., Zafonte, R., & Castellani, R. J. (2015). A critical review of chronic traumatic encephalopathy. Neuroscience & Biobehavioral Reviews, 56, 276–293. https://doi.org/10.1016/j.neubiorev.2015.05.008
Iverson, G. L., Gardner, A. J., Shultz, S. R., Solomon, G. S., McCrory, P., Zafonte, R., Perry, G., Hazrati, L.-N., Keene, C. D., & Castellani, R. J. (2019). Chronic traumatic encephalopathy neuropathology might not be inexorably progressive or unique to repetitive neurotrauma. Brain, 142(12), 3672–3693. https://doi.org/10.1093/brain/awz286
Iverson, G. L., Keene, C. D., Perry, G., & Castellani, R. J. (2017). The need to separate chronic traumatic encephalopathy neuropathology from clinical features. Journal of Alzheimer’s Disease, 61(1), 17–28. https://doi.org/10.3233/jad-170654
Iverson, G. L., Luoto, T. M., & Castellani, R. J. (2020). Authors’ reply: Age-related tau aggregates resemble chronic traumatic encephalopathy Neuropathologic change. Journal of Neuropathology & Experimental Neurology, 79(8), 924–928. https://doi.org/10.1093/jnen/nlaa047.001
Iverson, G. L., Luoto, T. M., Karhunen, P. J., & Castellani, R. J. (2019). Mild chronic traumatic encephalopathy neuropathology in people with no known participation in contact sports or history of repetitive neurotrauma. Journal of Neuropathology & Experimental Neurology, 78(7), 615–625. https://doi.org/10.1093/jnen/nlz045
Kanser, R. J., Kretzmer, T., Soble, J. R., & Hanks, R. A. (2023). Neuropsychologists’ perspectives of chronic traumatic encephalopathy (CTE). The Clinical Neuropsychologist, 1-20.
Katsumoto, A., Takeuchi, H., & Tanaka, F. (2019). Tau pathology in chronic traumatic encephalopathy and alzheimer’s disease: Similarities and differences. Frontiers in Neurology, 10. https://doi.org/10.3389/fneur.2019.00980
Katz, D. I., Bernick, C., Dodick, D. W., Mez, J., Mariani, M. L., Adler, C. H., Alosco, M. L., Balcer, L. J., Banks, S. J., Barr, W. B., Brody, D. L., Cantu, R. C., Dams-O’Connor, K., Geda, Y. E., Jordan, B. D., McAllister, T. W., Peskind, E. R., Petersen, R. C., Wethe, J. V., … Stern, R. A. (2021a). National Institute of Neurological Disorders and stroke consensus diagnostic criteria for traumatic encephalopathy syndrome. Neurology, 96(18), 848–863. https://doi.org/10.1212/wnl.0000000000011850
Kelly, J. P., Priemer, D. S., Perl, D. P., & Filley, C. M. (2023). Sports concussion and chronic traumatic encephalopathy: Finding a path forward. Annals of Neurology, 93(2), 222–225. https://doi.org/10.1002/ana.26566
LoBue, C., Cullum, C. M., Didehbani, N., Yeatman, K., Jones, B., Kraut, M. A., & Hart, J. (2018a). Neurodegenerative Dementias after traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 30(1), 7–13. https://doi.org/10.1176/appi.neuropsych.17070145
LoBue, C., Munro, C., Schaffert, J., Didehbani, N., Hart, J., Batjer, H., & Cullum, C. M. (2019). Traumatic brain injury and risk of long-term brain changes, accumulation of pathological markers, and developing dementia: A Review. Journal of Alzheimer’s Disease, 70(3), 629–654. https://doi.org/10.3233/jad-190028
LoBue, C., Wadsworth, H., Wilmoth, K., Clem, M., Hart, J., Womack, K. B., Didehbani, N., Lacritz, L. H., Rossetti, H. C., & Cullum, C. M. (2016). Traumatic brain injury history is associated with earlier age of onset of alzheimer disease. The Clinical Neuropsychologist, 31(1), 85–98. https://doi.org/10.1080/13854046.2016.1257069
Manley, G., Gardner, A. J., Schneider, K. J., Guskiewicz, K. M., Bailes, J., Cantu, R. C., Castellani, R. J., Turner, M., Jordan, B. D., Randolph, C., Dvořák, J., Hayden, K. A., Tator, C. H., McCrory, P., & Iverson, G. L. (2017). A systematic review of potential long-term effects of sport-related concussion. British Journal of Sports Medicine, 51(12), 969–977. https://doi.org/10.1136/bjsports-2017-097791
Martini, D. N., & Broglio, S. P. (2018). Long-term effects of sport concussion on cognitive and Motor Performance: A Review. International Journal of Psychophysiology, 132, 25–30. https://doi.org/10.1016/j.ijpsycho.2017.09.019
Mavroudis, I., Kazis, D., Chowdhury, R., Petridis, F., Costa, V., Balmus, I.-M., Ciobica, A., Luca, A.-C., Radu, I., Dobrin, R. P., & Baloyannis, S. (2022). Post-concussion syndrome and chronic traumatic encephalopathy: Narrative review on the neuropathology, neuroimaging and fluid biomarkers. Diagnostics, 12(3), 740. https://doi.org/10.3390/diagnostics12030740
McCann, H., Bahar, A. Y., Burkhardt, K., Gardner, A. J., Halliday, G. M., Iverson, G. L., & Shepherd, C. E. (2022). Prevalence of chronic traumatic encephalopathy in the Sydney Brain Bank. Brain Communications, 4(4). https://doi.org/10.1093/braincomms/fcac189
McCrory, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., Cantu, R. C., Cassidy, D., Echemendia, R. J., Castellani, R. J., Davis, G. A., Ellenbogen, R., Emery, C., Engebretsen, L., Feddermann-Demont, N., Giza, C. C., Guskiewicz, K. M., Herring, S., Iverson, G. L., … Vos, P. E. (2017). Consensus statement on concussion in sport—the 5thinternational conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2017-097699
McKee, A. C. (2020). The neuropathology of chronic traumatic encephalopathy: The status of the literature. Seminars in Neurology, 40(04), 359–369. https://doi.org/10.1055/s-0040-1713632
McKee, A. C., Stein, T. D., Huber, B. R., Crary, J. F., Bieniek, K., Dickson, D., Alvarez, V. E., Cherry, J. D., Farrell, K., Butler, M., Uretsky, M., Abdolmohammadi, B., Alosco, M. L., Tripodis, Y., Mez, J., & Daneshvar, D. H. (2023). Chronic traumatic encephalopathy (CTE): Criteria for neuropathological diagnosis and relationship to repetitive head impacts. Acta Neuropathologica, 145(4), 371–394. https://doi.org/10.1007/s00401-023-02540-w
Mez, J., Alosco, M. L., Daneshvar, D. H., Saltiel, N., Baucom, Z., Abdolmohammadi, B., Uretsky, M., Nicks, R., Martin, B. M., Palmisano, J. N., Nowinski, C. J., Montenigro, P., Solomon, T. M., Mahar, I., Cherry, J. D., Alvarez, V. E., Dwyer, B., Goldstein, L. E., Katz, D. I., … McKee, A. C. (2021). Validity of the 2014 traumatic encephalopathy syndrome criteria for CTE pathology. Alzheimer’s & Dementia, 17(10), 1709–1724. https://doi.org/10.1002/alz.12338
Mez, J., Daneshvar, D. H., Kiernan, P. T., Abdolmohammadi, B., Alvarez, V. E., Huber, B. R., Alosco, M. L., Solomon, T. M., Nowinski, C. J., McHale, L., Cormier, K. A., Kubilus, C. A., Martin, B. M., Murphy, L., Baugh, C. M., Montenigro, P. H., Chaisson, C. E., Tripodis, Y., Kowall, N. W., … McKee, A. C. (2017). Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA, 318(4), 360. https://doi.org/10.1001/jama.2017.8334
Murray, H. C., Osterman, C., Bell, P., Vinnell, L., & Curtis, M. A. (2022). Neuropathology in chronic traumatic encephalopathy: A systematic review of comparative post-mortem histology literature. Acta Neuropathologica Communications, 10(1). https://doi.org/10.1186/s40478-022-01413-9
Nguyen, V. T., Zafonte, R. D., Chen, J. T., Kponee-Shovein, K. Z., Paganoni, S., Pascual-Leone, A., Speizer, F. E., Baggish, A. L., Taylor, H. A., Nadler, L. M., Courtney, T. K., Connor, A., & Weisskopf, M. G. (2019). Mortality among professional American-style football players and professional American baseball players. JAMA Network Open, 2(5). https://doi.org/10.1001/jamanetworkopen.2019.4223
Nowinski, C. J., Bureau, S. C., Buckland, M. E., Curtis, M. A., Daneshvar, D. H., Faull, R. L., Grinberg, L. T., Hill-Yardin, E. L., Murray, H. C., Pearce, A. J., Suter, C. M., White, A. J., Finkel, A. M., & Cantu, R. C. (2022). Applying the Bradford Hill criteria for causation to repetitive head impacts and chronic traumatic encephalopathy. Frontiers in Neurology, 13. https://doi.org/10.3389/fneur.2022.938163
Pierre, K., Dyson, K., Dagra, A., Williams, E., Porche, K., & Lucke-Wold, B. (2021). Chronic traumatic encephalopathy: Update on current clinical diagnosis and management. Biomedicines, 9(4), 415. https://doi.org/10.3390/biomedicines9040415
Plessow, F., Pascual-Leone, A., McCracken, C. M., Baker, J., Krishnan, S., Baggish, A., Connor, A., Courtney, T. K., Nadler, L. M., Speizer, F. E., Taylor, H. A., Weisskopf, M. G., Zafonte, R. D., & Meehan, W. P. (2020). Self-reported cognitive function and mental health diagnoses among former professional American-style football players. Journal of Neurotrauma, 37(8), 1021–1028. https://doi.org/10.1089/neu.2019.6661
Priemer, D. S., Iacono, D., Rhodes, C. H., Olsen, C. H., & Perl, D. P. (2022). Chronic traumatic encephalopathy in the brains of military personnel. New England Journal of Medicine, 386(23), 2169–2177. https://doi.org/10.1056/nejmoa2203199
Redlinger, F., Sicard, V., Caron, G., & Ellemberg, D. (2022). Long-term cognitive impairments of sports concussions in college-aged athletes: A meta-analysis. Translational Journal of the American College of Sports Medicine, 7(2). https://doi.org/10.1249/tjx.0000000000000193
Schaffert, J., Chiang, H.-S., Fatima, H., LoBue, C., Hart, J., & Cullum, C. M. (2023). History of traumatic brain injury does not alter course of neurocognitive decline in older adults with and without cognitive impairment. Neuropsychology. https://doi.org/10.1037/neu0000892
Schaffert, J., Didehbani, N., LoBue, C., Hart, J., Rossetti, H., Lacritz, L., & Cullum, C. M. (2021). Frequency and predictors of traumatic encephalopathy syndrome in a prospective cohort of retired professional athletes. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.617526
Schaffert, J., LoBue, C., White, C. L., Chiang, H.-S., Didehbani, N., Lacritz, L., Rossetti, H., Dieppa, M., Hart, J., & Cullum, C. M. (2018). Traumatic brain injury history is associated with an earlier age of dementia onset in autopsy-confirmed alzheimer’s disease. Neuropsychology, 32(4), 410–416. https://doi.org/10.1037/neu0000423
Silverberg, N. D., Iverson, G. L., Group, A. B. I. S. I., Cogan, A., Dams-O-Connor, K., Delmonico, R., . . . Kamins, J. (2023). The American Congress of rehabilitation medicine diagnostic criteria for mild traumatic brain injury. Archives of physical medicine and rehabilitation, 104(8), 1343-1355.
Smith, D. H., Johnson, V. E., Trojanowski, J. Q., & Stewart, W. (2019). Chronic traumatic encephalopathy — confusion and controversies. Nature Reviews Neurology, 15(3), 179–183. https://doi.org/10.1038/s41582-018-0114-8
Strain, J. F., Didehbani, N., Spence, J., Conover, H., Bartz, E. K., Mansinghani, S., Jeroudi, M. K., Rao, N. K., Fields, L. M., Kraut, M. A., Cullum, C. M., Hart, J., & Womack, K. B. (2017). White matter changes and confrontation naming in retired Aging National Football League athletes. Journal of Neurotrauma, 34(2), 372–379. https://doi.org/10.1089/neu.2016.4446
Strain, J., Didehbani, N., Cullum, C. M., Mansinghani, S., Conover, H., Kraut, M. A., Hart, J., & Womack, K. B. (2013). Depressive symptoms and white matter dysfunction in retired NFL players with concussion history. Neurology, 81(1), 25–32. https://doi.org/10.1212/wnl.0b013e318299ccf8
Strain, J. F., Womack, K. B., Didehbani, N., Spence, J. S., Conover, H., Hart, J., Kraut, M. A., & Cullum, C. M. (2015). Imaging correlates of memory and concussion history in retired National Football League athletes. JAMA Neurology, 72(7), 773. https://doi.org/10.1001/jamaneurol.2015.0206
Wilmoth, K., LoBue, C., Clem, M. A., Reddy, R., Hynan, L. S., Didehbani, N., Bell, K., Womack, K. B., Hart, J., Batjer, H., & Cullum, C. M. (2017). Consistency of traumatic brain injury reporting in older adults with and without cognitive impairment. The Clinical Neuropsychologist, 32(3), 524–529. https://doi.org/10.1080/13854046.2017.1378371
Wilmoth, K., Tan, A., Hague, C., Tarkenton, T., Silver, C. H., Didehbani, N., Rossetti, H. C., Batjer, H., Bell, K. R., & Cullum, C. M. (2019). Current state of the literature on psychological and social sequelae of sports-related concussion in school-aged children and adolescents. Journal of Experimental Neuroscience, 13, 117906951983042. https://doi.org/10.1177/1179069519830421
Zhang, Y., Ma, Y., Chen, S., Liu, X., Kang, H. J., Nelson, S., & Bell, S. (2019). Long-term cognitive performance of retired athletes with sport-related concussion: A systematic review and meta-analysis. Brain Sciences, 9(8), 199. https://doi.org/10.3390/brainsci9080199
