Table 2

Research Evaluating Sports ConcUssion Events—Rapid Assessment of Concussion and Evidence for Return assessments and their outputs

AssessmentSummary of data collected
Demographic assessmentData collected within the clinical review:
  • Participant demographics and medical history

Name, address, date of birth, National Health Service number with MRN (local hospital identifier—where available), mobile number, up to two next of kin details (name, relationship, contact number), postal address, email address, general practitioner name and address, local hospital, medical and surgical history, current medications, allergies, family history, previous concussion assessments (type, number, date), time and date of last caffeine intake, the time from which the participant is advised to consume water only, if female—date of last menstrual period
  • Motorsport history

Current level of competition, highest level of motorsport, years at current level, total number of years in motorsport competition of any type, current competition car and class, use of: helmet, head and neck support or hybrid device; type of seat
  • Concussion history

Number of previous concussions and for each: date, setting, presence of loss of consciousness (LOC) and duration, confusion, retro/antero-grade amnesia (presence and duration), medical review, imaging, concussion assessment, time away from sport, referring hospital, length of admission, contact for medical information; estimated number of head injuries not formally diagnosed as concussion

From ImPACT:
  • Participant demographics and educational history

Native country, native language, second language, completed years of education, previous completion of: speech therapy or special education classes, repetition of one or more school years, diagnosis of a learning disability, problems with attention deficit disorder (ADD) or hyperactivity
  • Sporting history

Current sport, level of participation, primary competitive event, years at this level
  • Concussion history

Number of concussions and for each presence of LOC, confusion, retrograde or anterograde amnesia; total number of sporting events missed due to concussion
  • Potential confounding factors

Treatment for: headaches, migraines, epilepsy or seizures, substance/alcohol abuse, psychiatric conditions (such as depression, anxiety); previous brain surgery or meningitis, diagnoses of: ADD or attention-deficit hyperactivity disorder (ADHD), dyslexia, autism; strenuous exercise in the last 3 hours, hours of sleep the night prior to testing, current medications.
From CANTAB: age at assessment, handedness
From MRI: current weight (kg) and height (cm), previous operations, presence of metal implants, previous brain injury or LOC
Sport Concussion Assessment Tool 5
  • Symptoms—number (range 0–22) and severity (rated as 0–6), summed to form a symptom severity score (range 0–132), with higher scores indicating worse symptoms

  • Orientation score (out of 5)

  • Immediate memory score (out of 30)

  • Concentration score (out of 5)

  • Neurological examination (normal/abnormal)

  • Number of balance errors (out of 30)

  • Delayed recall score (out of 10)

Immediate Post-concussion Assessment and Cognitive Testing (ImPACT)Demographics—see ‘Demographic assessment’
Composite and raw scores assessing:
  • Attention (including processing)

  • Memory (verbal and visual recognition (%); visual working)

  • Visual motor speed

  • Impulse control (response inhibition)

  • Delayed memory (delayed repetition of verbal and visual memory tasks, %)

Neurolign Dx100
  • Ocular tests—saccades (vertical, horizontal, predictive, self-paced, memory-guided and anti-), smooth pursuit, optokinetic reflex, vergence, light reflex

  • Vestibular tests—subjective visual vertical

  • Reaction time assessments—auditory, visual

Cambridge Neuropsychological Test Automated Battery (CANTAB)The CANTAB study protocol includes a variety of assessments across attention (processing and psychomotor speed), memory (visual episodic), executive function and decision-making (working memory and strategy; planning).
Example tasks and their key outcome measures include:
  • Spatial working memory (error, strategy)

  • Reaction time (error scores, reaction, and movement times)

  • Paired associates learning (error, number of trials to correctly locate patterns, stages completed)

  • Multi-tasking test (performance during intermixed vs consistent rules and in/congruent information)

Saliva sample for biomarker analysisTo include, where possible, levels of:
  • Neuronal injury such as neurofilament light chain (NFL)

  • Glial injury such as S100B (a calcium-binding peptide)

  • Epigenetic effects as measured by micro RNA levels (miRNA)

  • Neurofibrillary degeneration as measured by tau

MRI of the brain
  • High-resolution T1-weighted structural imaging

  • Susceptibility-weighted imaging

  • Diffusion-weighted imaging

  • Resting-state functional MRI