Characterizing the Effects of Concussion and Head Impact Exposure: Design, Methods, and Participant Traits of the CARE 2.0 Study.

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-10-10 DOI:10.1176/appi.neuropsych.20240022

Thomas W McAllister, Steven P Broglio, Susan M Perkins, Barry P Katz, Paul F Pasquina, Michael A McCrea

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Abstract

Objective: This article describes the design, methods, and participant characteristics of the second phase of the Concussion Assessment, Research, and Education (CARE) Consortium study ("CARE 2.0") of the effects of concussion and repetitive head impact exposure on neuropsychiatric health.

Methods: The authors conducted a prospective multisite observational study of male and female collegiate athletes and military service academy cadets and midshipmen participating in the CARE study. Participants were assessed at three time points: undergraduate baseline (UB), before departure from university or service academy (exit), and up to 6 years following graduation (postgrad) via an online battery of brain health assessments. Participant characteristics were compared across the three time points and four levels of head impact exposure.

Results: A total of 4,643 participants completed the exit assessment, and 3,981 completed the postgrad assessment. Relative to the UB assessment cohort, the exit and postgrad assessment cohorts differed with respect to the percentage of women, baseline Wechsler Test of Adult Reading scores, National Collegiate Athletic Association division category, sport contact level, and number of previous concussions. The median standardized difference across balancing variables, assessment time points, and degree of head impact exposure was 0.12 (with 90% of effect sizes ≤0.29).

Conclusions: Although there were some statistically significant differences between participants across assessments, the effect sizes were modest, and overall the data suggest that the exit and postgrad cohorts reflect the characteristics of the baseline cohort. The CARE study design and its large, richly characterized sample provide an opportunity to answer important questions about cumulative and persistent effects of concussion and repetitive head impact exposure on neuropsychiatric health.

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描述脑震荡和头部撞击的影响：CARE 2.0 研究的设计、方法和参与者特征。

研究目的本文介绍了脑震荡评估、研究和教育联盟（CARE）研究（"CARE 2.0"）第二阶段的设计、方法和参与者特征，该研究旨在探讨脑震荡和重复性头部撞击对神经精神健康的影响：作者对参加 CARE 研究的男女大学生运动员、军事院校学员和实习生进行了一项前瞻性多地点观察研究。研究人员在三个时间点对参与者进行了评估：大学本科基线（UB）、离开大学或军校前（退出）以及毕业后长达 6 年的时间（毕业后）。在三个时间点和四个头部撞击暴露水平上对参与者的特征进行了比较：共有 4643 人完成了毕业评估，3981 人完成了毕业后评估。与大学预科评估组相比，毕业后评估组和毕业后评估组在女性比例、韦氏成人阅读测试基线分数、全国大学体育协会分部类别、运动接触水平和既往脑震荡次数方面存在差异。在平衡变量、评估时间点和头部受撞击程度之间的标准化差异中位数为 0.12（90% 的效应大小≤0.29）：尽管参与者在不同评估中存在一些统计学意义上的显著差异，但效应大小并不明显，总体数据表明，毕业和研究生组群反映了基线组群的特征。CARE 研究的设计及其庞大、丰富的样本为回答脑震荡和重复头部撞击对神经精神健康的累积性和持续性影响等重要问题提供了机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuropsychiatry and Clinical Neurosciences 医学-精神病学

CiteScore

5.30

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.