Multicenter cohort study on association of genotypes with prospective sports concussion: Methods, lessons learned, and recommendations

Thomas R. Terrell, Roberd Bostick, Jeffrey Barth, Richard Sloane, Robert C. Cantu, Ellen Bennett, Leslie Galloway, Daniel Laskowitz, Dave Erlanger, Douglas McKeag, Verle Valentine, Gregory Nichols

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain "buy-in" from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.

Original languageEnglish (US)
Pages (from-to)77-89
Number of pages13
JournalJournal of Sports Medicine and Physical Fitness
Volume57
Issue number1-2
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Fingerprint

Multicenter Studies
Sports
Cohort Studies
Genotype
Prospective Studies
Genetic Polymorphisms
Athletes
Post-Concussion Syndrome
Genetic Testing
Apolipoproteins E
Research
Population
Genes
Motivation
Exons
History
Surveys and Questionnaires

Keywords

  • Apolipoprotein E
  • Brain concussion
  • Brain injuries
  • Football
  • Neuropsychological tests
  • Polymorphism, genetic

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Multicenter cohort study on association of genotypes with prospective sports concussion : Methods, lessons learned, and recommendations. / Terrell, Thomas R.; Bostick, Roberd; Barth, Jeffrey; Sloane, Richard; Cantu, Robert C.; Bennett, Ellen; Galloway, Leslie; Laskowitz, Daniel; Erlanger, Dave; McKeag, Douglas; Valentine, Verle; Nichols, Gregory.

In: Journal of Sports Medicine and Physical Fitness, Vol. 57, No. 1-2, 01.01.2017, p. 77-89.

Research output: Contribution to journalArticle

Terrell, TR, Bostick, R, Barth, J, Sloane, R, Cantu, RC, Bennett, E, Galloway, L, Laskowitz, D, Erlanger, D, McKeag, D, Valentine, V & Nichols, G 2017, 'Multicenter cohort study on association of genotypes with prospective sports concussion: Methods, lessons learned, and recommendations', Journal of Sports Medicine and Physical Fitness, vol. 57, no. 1-2, pp. 77-89. https://doi.org/10.23736/S0022-4707.16.05092-1
Terrell, Thomas R. ; Bostick, Roberd ; Barth, Jeffrey ; Sloane, Richard ; Cantu, Robert C. ; Bennett, Ellen ; Galloway, Leslie ; Laskowitz, Daniel ; Erlanger, Dave ; McKeag, Douglas ; Valentine, Verle ; Nichols, Gregory. / Multicenter cohort study on association of genotypes with prospective sports concussion : Methods, lessons learned, and recommendations. In: Journal of Sports Medicine and Physical Fitness. 2017 ; Vol. 57, No. 1-2. pp. 77-89.
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abstract = "BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain {"}buy-in{"} from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.",
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AU - Cantu, Robert C.

AU - Bennett, Ellen

AU - Galloway, Leslie

AU - Laskowitz, Daniel

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N2 - BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain "buy-in" from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.

AB - BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain "buy-in" from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.

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KW - Neuropsychological tests

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