Contact Information

Youth Sports Concussion Program

101 Merrimac Street, 10th Floor
Boston, MA  02114

Phone: 617-724-9722

Explore This Lab

    Overview

    A sport-related concussion is a brain injury. The Centers for Disease Control and Prevention described sport-related concussion as an epidemic1. In an epidemiological study of high school athletes, concussion rates have increased steadily in the past decade2, possibly due to greater awareness among physicians, with recent estimates suggesting as many as 300,000 concussive injuries each year3. Student athletes who experience a concussion are at statistically increased risk for experiencing a future concussion.

    There is tremendous interest and concern about sport-related concussion in youth athletes reflected by thousands of media stories and every state in the United States passing legislation relating to educational efforts, identification, and/or medical management of this injury. Massachusetts law mandates that school athletic personnel and medical professionals be responsible for education about concussion risk, management of injured athletes, and clearance of these athletes in order for them to return to play.

    There is considerable concern regarding the long-term effects of this injury, especially in children and adolescents who suffer repetitive injuries. Whether or not there is a long-term effect of multiple concussions in high school athletes is not well understood. There are conflicting results in the medical and scientific literature.

    There are some good resources available to health care professionals relating to the assessment, acute medical management, return to school, return to sports, and treatment and rehabilitation services for those who are slow to recover. However, a large amount of research is needed to better inform the medical community on how to manage this injury, and how to provide the most effective treatment and rehabilitation services for student athletes who are slow to recover.

    Accelerate Knowledge/Improve Care

    As one of the top hospitals in the country, Mass General epitomizes what makes an academic medical center special - translating research discoveries into better care for patients. We have a productive, diverse, and internationally recognized research program in sport-related concussion. We collaborate with clinicians and researchers locally, regionally, nationally, and internationally. Our research is designed to enhance knowledge and improve health care for student athletes who have sustained a concussion. We approach our research from a broad biopsychosocial perspective, and we use diverse technologies, biomarkers, and outcome measures such as microstructural neuroimaging (i.e., diffusion tensor imaging), cognitive testing, psychological assessment, and balance testing. We provide research training and experience to graduate students, medical residents, and post-doctoral fellows seeking careers in health service delivery or clinical research. Some of our priority areas of research are listed below.

    1. Understanding the Effects of Multiple Concussions: Athletes, parents, coaches, athletic trainers, physicians, scientists, and society as a whole are concerned about the possible effects of multiple concussions on adolescents and young adults. We are conducting a series of studies designed to address the questions below.

      1. Are high school athletes who have had prior concussions at increased risk for future concussions?

      2. Do athletes with multiple past concussions have worse effects of a future concussion than athletes who have no prior injuries?

      3. Are athletes with developmental problems, such as attention-deficit hyperactivity disorder (ADHD) or a learning disability, at increased risk for (a) sustaining a concussion, or (b) having worse outcome or slower recovery from this injury?

      4. Are multiple past concussions associated with current cognitive difficulties or symptoms (e.g., headaches) in adolescent student athletes?

    2. Improving the Methodology for Assessing Cognitive Impairment Following Concussion. Concussions can have an immediate and large adverse effect on cognitive functioning. This can interfere with an adolescent’s ability to function in daily life and school. We are conducting a series of studies that examine the reliability, accuracy, and clinical usefulness of computerized cognitive testing as a component of a sport concussion management program.

    3. Examining the Usefulness of Baseline, Preseason Testing. Few would doubt that a reliable, valid, and accurate assessment of a person’s pre-injury cognitive functioning would be useful for determining the nature and extent of post-injury cognitive deficits and the rate of recovery. There are multiple challenges and problems, however, associated with baseline testing. First, baseline computerized testing is often conducted in group settings, and one study illustrated that athletes tested in group settings perform more poorly than athletes tested individually10. As such, some authors have recommended individual baseline testing or testing in small, carefully monitored groups (e.g., 3-5 students)11. Second, baseline testing can be fairly expensive and labor intensive, depending on how it is done. Third, some tests used in concussion management programs have modest test-retest reliability12-14. Therefore, it can be difficult to accurately and precisely assess baseline and post-injury change scores. Finally, the value of baseline testing is largely assumed, and baseline testing is often encouraged in consensus15 or agreement16-17 statements—at least with some athletes. Few studies have examined this issue empirically, however.

      We believe that having an accurate measure of baseline cognitive functioning would be helpful for quantifying cognitive deficits following injury and for assessing recovery. This is especially true for athletes who have above average or below average cognitive functioning at baseline. Moreover, it can be helpful for athletes with developmental conditions, such as attention-deficit hyperactivity disorder or a learning disability. Students with self-reported ADHD, learning disabilities, or both perform more poorly on ImPACT® than students who do not have a developmental condition18. At present, however, there is insufficient evidence to conclude that having baseline test results is time- and cost-effective, or clearly superior to not having baseline test results. With our collaborators, we are pursuing studies relating to the advantages, disadvantages, and appropriate use of baseline testing.

    4. Improving Exertional Testing and Return to Play Protocols: Injured athletes are expected to undergo a progressive series of exercises and exertional tests, spanning several days, prior to be cleared to return to contact sports. It is important to understand and document the effects of exertional testing on athletes who are not injured so we have normative reference values to compare to athletes who are injured. We are examining the effects of exertional testing on cardiac physiology, balance, cognition, and subjective symptoms in both uninjured and injured athletes.

    5. Active Rehabilitation for Children and Adolescents Who are Slow to Recover from Concussion. There are no scientifically-established, evidence-based guidelines for providing treatment and rehabilitation services to student athletes who are slow to recover from concussion. An active rehabilitation treatment program for children and adolescents who are slow to recover following concussion has been offered at the Montreal Children’s Hospital Trauma Center since 2007. This group of clinicians and researchers is part of our research network. In addition, we are collaborating with clinicians from GF Strong Rehabilitation Hospital in Vancouver, Canada to do a small clinical trial on active rehabilitation with adolescents who are slow to recover. Through a series of studies conducted locally and with our Canadian collaborators, we will advance knowledge and refine treatment strategies for children and adolescents who have persistent symptoms and problems following their injuries.

    References

    1. Injury Prevention and Control: Traumatic Brain Injury. http://www.cdc.gov/concussion/sports/facts.html. Accessed February 26, 2014.
    2. Lincoln AE, Caswell SV, Almquist JL, Dunn RE, Norris JB, Hinton RY. Trends in concussion incidence in high school sports: a prospective 11-year study. The American journal of sports medicine. 2011;39(5):958-963.
    3. Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of concussions among United States high school athletes in 20 sports. The American journal of sports medicine. 2012;40(4):747-755.
    4. Mannix R, Meehan WP, Mandeville J, Grant PE, Gray T, Berglass J, et al. Clinical correlates in an experimental model of repetitive mild brain injury. Annals of neurology. 2013;74(1):65-75.
    5. Meehan WP, 3rd, Zhang J, Mannix R, Whalen MJ. Increasing recovery time between injuries improves cognitive outcome after repetitive mild concussive brain injuries in mice. Neurosurgery. 2012;71(4):885-891.
    6. Guskiewicz KM, Marshall SW, Bailes J, McCrea M, Harding HP, Jr., Matthews A, et al. Recurrent concussion and risk of depression in retired professional football players. Medicine and science in sports and exercise. 2007;39(6):903-909.
    7. Kerr ZY, Marshall SW, Harding HP, Jr., Guskiewicz KM. Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players. The American journal of sports medicine. 2012;40(10):2206-2212.
    8. Schwenk TL, Gorenflo DW, Dopp RR, Hipple E. Depression and pain in retired professional football players. Medicine and science in sports and exercise. 2007;39(4):599-605.
    9. Guskiewicz KM, McCrea M, Marshall SW, Cantu RC, Randolph C, Barr W, et al. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA: the journal of the American Medical Association. 2003;290(19):2549-2555.
    10. Moser RS, Schatz P, Neidzwski K, Ott SD. Group versus individual administration affects baseline neurocognitive test performance. Am J Sports Med 2011;39:2325-2330.
    11. Echemendia RJ, Iverson GL, McCrea M, Macciocchi SN, Gioia GA, Putukian M, Comper P. Advances in neuropsychological assessment of sport-related concussion. Br J Sports Med 2013;47:294-298.
    12. Mayers LB, Redick TS. Clinical utility of ImPACT assessment for postconcussion return-to-play counseling: psychometric issues. J Clin Exp Neuropsychol 2012;34:235-242.
    13. Broglio SP, Ferrara MS, Macciocchi SN, Baumgartner TA, Elliott R. Test-retest reliability of computerized concussion assessment programs. J Athl Train 2007;42:509-514.
    14. Resch J, Driscoll A, McCaffrey N, Brown C, Ferrara MS, Macciocchi S, Baumgartner T, Walpert K. ImPact test-retest reliability: reliably unreliable? J Athl Train 2013;48:506-511.
    15. McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R. Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. J Athl Train 2009;44:434-448.
    16. Guskiewicz KM, Bruce SL, Cantu RC, Ferrara MS, Kelly JP, McCrea M, Putukian M, McLeod TC. Research based recommendations on management of sport related concussion: summary of the National Athletic Trainers' Association position statement. Br J Sports Med 2006;40:6-10.
    17. Moser RS, Iverson GL, Echemendia RJ, Lovell MR, Schatz P, Webbe FM, Ruff RM, Barth JT. Neuropsychological evaluation in the diagnosis and management of sports-related concussion. Arch Clin Neuropsychol 2007;22:909-916.
    18. Elbin RJ, Kontos AP, Kegel N, Johnson E, Burkhart S, Schatz P. Individual and combined effects of LD and ADHD on computerized neurocognitive concussion test performance: evidence for separate norms. Arch Clin Neuropsychol 2013;28:476-484.

    Publications

    Day-of-Injury Assessment and Diagnostics

    Chung, J.P.Y., Lee, J.H., Howell, D.R., Iverson, G.L., & Gardner, A.J. (2018). Effects of Exercise on Sport Concussion Assessment Tool-Performance in Women. Clinical Journal of Sport Medicine. [Epub ahead of print].See in PubMed

    Lamm, A.G., Babu, A., Zafonte, R., Iaccarino, M.A. (2018). Utilizing a Workshop Format for Physiatry Trainees in the Management of Acute Sports-Related Concussion. American Journal of Physical Medicine & Rehabilitation. [Epub ahead ofprint].See in PubMed

    Hänninen, T., Parkkari, J., Tuominen, M., Iverson, G.L., Öhman, J., Vartiainen, M., Luoto, T.M. (2017). Interpreting change on the SCAT3 in professional ice hockey players. Journal of Science and Medicine in Sport, 20(5): 424-431.See in PubMed

    Hänninen, T., Tuominen, M., Parkkari, J., Vartiainen, M., Öhman, J., Iverson, G.L., and Luoto, T.M. (2015). Sport concussion assessment tool - 3rd edition - normative reference values for professional ice hockey players. Journal of Science and Medicine in Sport, 19(8): 636-41.See in PubMed

    Vartiainen, M.V., Holm, A., Peltonen, K., Luoto, T. M., Iverson, G.L., Hokkanen, L. (2015). King-Devick test normative reference values for professional male ice hockey players. Scandinavian Journal of Medicine and Science in Sports. 25(3): e327-30.See in PubMed

    McCrea, M., Iverson, G.L., Echemendia, R., Makdissi, M., & Raftery, M. (2013). Day of injury assessment of sport-related concussion. British Journal of Sports Medicine, 47(5): 272-284. See in PubMed

    McCrory, P., Echemendia, R.J., Meeuwisse, W.H., Iverson, G.L., Dvořák, J., & Kutcher, J.S. (2013). What is the lowest threshold to make a diagnosis of concussion? British Journal of Sports Medicine, 47(5): 268-271. See in PubMed

    Video Analysis of Injuries

    Gardner, A.J., Kohler, R.M.N., Levi, C.R., & Iverson, G.L. (2017). Usefulness of Video Review of Possible Concussions in National Youth Rugby League. International Journal of Sport, 38(1): 71-75.See in PubMed

    Gardner, A.J., Howell, D.R., & Iverson, G.L. (2018). A video review of multiple concussion signs in National Rugby League match play. Sports Medicine - Open, 4(1): 5.Read Study

    Gardner, A.J., Levi, C.R., & Iverson, G.L. (2017). Observational review and analysis of concussion: A method for conducting a standardized video analysis of concussion in rugby league. Sports Medicine - Open, 3(1): 26.Read Study

    Gardner, A.J., Wojtowicz, M., Terry, D., Levi, C.R., Zafonte, R., & Iverson, G.L. (2017). Video and clinical screening of Australian National Rugby League players suspected of sustaining concussion, Brain Injury., 31(13-14): 1918-1924.See in PubMed

    Gardner, A.J., Howell, D.R., Levi, C.R., & Iverson, G.L. (2017). Evidence of Concussion Signs in National Rugby League Match Play: A Video Review and Validation Study. Sports Medicine - Open, 3(1): 29.Read Study

    Gardner, A.J., Iverson, G.L., Stanwell, P., Moore, T., Ellis, J., Levi, C.R. (2016). A Video Analysis of Use of the New 'Concussion Interchange Rule' in the National Rugby League. International Journal of Sports Medicine, 37(4): 267-73.See in PubMed

    Gardner A.J., Iverson G.L., Quinn T.N., Makdissi M., Levi C.R., Shultz S.R., Wright D.K., Stanwell P. (2015). A preliminary video analysis of concussion in the National Rugby League. Brain Injury., 29(10): 1182-1185.See in PubMed

    Role of Rest and Active Rehabilitation

    Gauvin-Lepage, J., Friedman, D., Grilli, L., Sufrategui, M., De, C. M., Iverson, G. L., & Gagnon, I. (2018). Effectiveness of an Exercise-Based Active Rehabilitation Intervention for Youth Who Are Slow to Recover After Concussion. Clinical Journal of Sport Medicine. [Epub ahead of print].See in PubMed

    Sullivan, K. A., Hills, A. P., & Iverson, G. L. (2018). Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome. Current Neurology and Neuroscience Reports, 18(11): 75.See in PubMed

    Lee, J.H., Howell, D.R., Meehan, W., Iverson, G.L., & Gardner, A.J. (2017). Effects of Exercise on Sports Concussion Assessment Tool-Third Edition Performance in Professional Athletes. The Orthopaedic Journal of Sports Medicine, 5(9).Read Study

    Chan, C., Iverson, G. L., Purtzki, J., Wong, K., Kwan, V., Gagnon, I., & Silverberg, N. D. (2018). Safety of active rehabilitation for persistent symptoms after pediatric sport-related concussion: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation., 99(2): 242-249.See in PubMed

    Silverberg, N.D., & Iverson, G.L. Rest and Recovery from Concussion: How should rest be used in concussion management. In I Gagnon and A. Ptito (Eds.). Sport Concussion: A Complete Guide to Recovery and Management. Boca Raton, FL: CRC Press; 2017, 131-148.

    Silverberg, N.D., Iverson, G.L., McCrea, M., Apps, J.N., Hammeke, T., & Thomas, D.G. (2016). Activity-Related Symptom Exacerbations after Pediatric Concussion. JAMA Pediatrics., 170(10): 946-953.See in PubMed

    Flaherty, M.R., Raybould, T., Jamal-Allial, A., Kaafarani, H.M., Lee, J., Gervasini, A., Ginsburg, R., Mandell, M., Donelan, K., & Masiakos, P.T. (2016). Impact of a State Law on Physician Practice in Sports-Related Concussions. Journal of Pediatrics, 178: 268-274.See in PubMed

    DiFazio, M., Silverberg, N.D., Kirkwood, M.W., Bernier, R., & Iverson, G.L. (2015). Prolonged Activity Restriction After Concussion: Are We Worsening Outcomes? Clinical Pediatrics, 55(5): 443-51.See in PubMed

    Gagnon, I., Grilli, L., Friedman, D., & Iverson, G. L. (2015).A pilot study of active rehabilitation for adolescents who are slow to recover from sport-related concussion.Scandinavian Journal of Medicine and Science in Sports, 26(3): 299-306.See in PubMed

    Iverson, G.L. (2015). Rest Following Sport-Related Concussion. In R. Echemendia and GL Iverson (Editors), Oxford Handbook of Sport-Related Concussion.

    Moser, R.S., Schatz P., Glenn, M., Kollias, K.E., & Iverson, G.L. (2015). Examining Prescribed Rest as Treatment for Adolescents who are Slow to Recover from Concussion. Brain Injury., 29(1): 58-63.See in PubMed

    Reed, N., Greenspoon, D., Iverson, G.L., DeMatteo, C., Fait, P., Gauvin-Lepage, J., Hunt, A., and Gagnon, I.J. (2015). Management of persistent postconcussion symptoms in youth: a randomised control trial protocol. BMJ Open, 5(7): e008468.See in PubMed

    Schneider, K.J., Iverson, G.L., Emery, C.A., McCrory, P., Herring, S.A., & Meeuwisse, W.H. (2013). The effects of rest and treatment following sport-related concussion: A systematic review of the literature. British Journal of Sports Medicine, 47(5): 304-307. See in PubMed

    Multiple Concussions

    Brooks, B.L., Silverberg, N., Maxwell, B., Mannix, R., Zafonte, R., Berkner, P.D., & Iverson, G.L., (2018). Investigating effects of sex differences and prior concussions on symptom reporting and cognition among adolescent soccer players. American Journal of Sports Medicine, 46(4): 961-968.See in PubMed

    Brooks, B.L., Mannix, R., Maxwell, B., Zafonte, R., Berkner, P.D., & Iverson, G.L. (2016). Multiple Past Concussions in High School Football Players. American Journal of Sports Medicine, 44(12): 3243-3251.See in PubMed

    Wojtowicz, M., Iverson, G.L., Silverberg, N.D., Mannix, R., Zafonte, R.D., Maxwell, B., Berkner, P.D. (2017). Consistency of Self-reported Concussion History in Adolescent Athletes. Journal of Neurotrauma, 34(2): 322-327.See in PubMed

    Iverson, G.L., Wojtowicz, M., Brooks, B.L., Maxwell, B.A., Atkins, J.E., Zafonte, R., & Berkner, P.D. (2016). High School Athletes with Attention-Deficit Hyperactivity Disorder and Learning Difficulties Have a Greater Lifetime Concussion History. Journal of Attention Disorders. [Epub ahead of print].See in PubMed

    Iverson, G. L., Atkins, J. E., Zafonte, R. & Berkner, P. D. (2016). Concussion History in Adolescent Athletes with Attention-Deficit Hyperactivity Disorder. Journal of Neurotrauma. 33(23): 2077-2080.See in PubMed

    Mannix, R., Iverson, G.L., Maxwell, B., Atkins, J.E., Zafonte, R., & Berkner, P.D. (2014). Multiple Prior Concussions are Associated with Symptoms in High School Athletes. Annals of Clinical and Translational Neurology, 1(6): 433-438. See in PubMed

    Improving Assessment Methods: Cognition, Symptoms, and Balance

    Iverson, G.L., Schatz, P. (2018). Brief iPad-Based Assessment of Cognitive Functioning with ImPACT® Pediatric. Developmental Neuropsychology, [Epub ahead of print]. See in PubMed

    Schmidt, J.D., Terry, D.P., Ko, J., Newell, K.M., & Miller, L.S. (2018). Balance regularity among former high school football players with or without a history of concussion. Journal of Athletic Training, 53(2): 109-114.See in PubMed

    Brett, B.L., Zuckerman, S.L., Terry, D.P., Solomon, G.S., Iverson, G.L. (2018). Normative Data for the Sway Balance System. Clinical Journal of Sports Medicine, [Epub ahead of print]. See in PubMed

    Howell, D.R., Kirkwood, M., Provance, A., Iverson, G.L., & Meehan III, W.P. (2018). Using concurrent gait and cognitive assessments to identify impairments after concussion: a narrative review. Concussion, 3(1): CNC54.Read Study

    Terry, D.P., Huebschmann, N.A., Maxwell, B.A., Cook, N.E., Mannix, R., Zafonte, R. Seifert, T., Berkner, P.D., & Iverson, G.L. (2018). Pre-injury migraine history as a risk factor for prolonged return to school and sports following concussion. Journal of Neurotrauma, [Epub ahead of print].See in PubMed

    Terry, D.P., Wojtowicz, M., Cook, N.E., Maxwell, B., Zafonte, R., Seifert, T., Silverberg, N., Berkner, P., & Iverson, G.L. (2018). Factors associated with concussion history in middle school children. Clinical Journal of Sport Medicine, [Epub ahead of print].See in PubMed

    Cook, N.E., Huang, D.S., Silverberg, N.D., Brooks, B.L., Maxwell, B., Zafonte, R., Berkner, P.D., Iverson, G.L. (2017). Baseline cognitive test performance and concussion-like symptoms among adolescent athletes with ADHD: examining differences based on medication use. The Clinical Neuropsychologist, 31(8): 1341-1352.See in PubMed

    Collings, L.J., Cook, N.E., Porter, S., Kusch, C., Sun, J., Virji-Babul, N., Iverson, G.L., & Panenka, W.J. (2017). Attention-Deficit/Hyperactivity Disorder is Associated with Baseline Child Sport Concussion Assessment Tool Third Edition Scores in Child Hockey Players. Brain Injury., 31(11): 1479-1485.See in PubMed

    Gerrard, P.B., Iverson, G.L., Atkins, J.E., Maxwell, B.A., Zafonte, R., Schatz, P., & Berkner, P.D. (2017). Factor Structure of ImPACT® in Adolescent Student Athletes. Archives of Clinical Neuropsychology, 32(1): 117-122.See in PubMed

    Cook, N. E., Huang, D., Silverberg, N., Maxwell, B., Zafonte, R., Berkner, P., & Iverson, G. L. (2016). Concussion-like symptom reporting in high school student athletes with ADHD. PM R, (9S): S156.See in PubMed

    Silverberg, N.D., Berkner, P.D., Atkins, J.E., Zafonte, R., & Iverson, G.L. (2015). Relationship between low sleep quality and preseason concussion testing. Clinical Journal of Sports Medicine, 26(3), 226-31.See in PubMed

    Iverson, G.L., Silverberg, N.D., Mannix, R., Maxwell, B.A., Atkins, J.E., Zafonte, R., & Berkner, P.D. (2015). Factors Associated with Concussion-Like Symptom Reporting in High School Athletes. JAMA Pediatrics, 169(12): 1132-1140.See in PubMed

    Brooks, B.L., Iverson, G.L., Atkins, J.E., Zafonte, R., Berkner, P.D. (2015). Sex Differences andSelf-Reported Attention Problems During Baseline Concussion Testing.Applied Neuropsychology- Child, 5(2): 119-26.See in PubMed

    Iverson, G.L., & Schatz, P. (2015). Advanced Topics in Neuropsychological Assessment Following Sport-Related Concussion. Brain Injury., 29(2): 263-275.See in PubMed

    Ritchie, L.J., Mrazik, M., Alfano, D.P., Chase, D., Comper, P., Czarnota, M., Garcia-Barrera, M.A., Iverson, G.L., Maclean, M., Mendella, P., & Williams, T. (2015). The role of neuropsychology in the management of youth concussion in Canada. Current Research: Concussion, 2(1): 8-10.

    Echemendia, R.J., Iverson, G.L., McCrea, M., Macciocchi, S.A., Gioia, G.A., Putukian, M., & Comper, P. (2013). Advances in neuropsychological assessment of sport-related concussion. British Journal of Sports Medicine, 47(5): 294-298. See in PubMed

    Brain Imaging and Biomarkers

    Conley, A.C., Cooper, P.S., Karayanidis, F., Gardner, A.J., Levi, C.R., Stanwell, P., Gaetz, M.B., Iverson, G.L (2018). Resting State Electroencephalography and Sports-Related Concussion: A Systematic Review. Journal of Neurotrauma. [Epub ahead of print]. See in PubMed

    Terry, D.P., & Miller, L.S. (2018). Repeated mild traumatic brain injuries is not associated with volumetric differences in former high school football players. Brain Imaging and Behavior, 12(3): 631-639.See in PubMed

    Wojtowicz, M., Gardner, A. J., Stanwell, P., Zafonte, R., Dickerson, B.C., & Iverson, G.L. (2018). Cortical thickness and subcortical brain volumes in professional rugby league players. Neuroimage Clinical, 18: 377-381.See in PubMed

    Gardner, AJ, Iverson G.L., Wojtowicz, M., Levi, C.R., Kay-Lambkin, F., Schofield, P.W., Shultz, S.R., Zafonte, R.D., Lin, A.P., & Stanwell, P. (2017). MR Spectroscopy Findings in Retired Professional Rugby League Players. International Journal of Sports Medicine, 38(3): 241-252.See in PubMed

    Gardner, A, Iverson, G.L., van Donkelaar, P., & Ainslie, P.N. (2014). Magnetic Resonance Spectroscopy, Diffusion Tensor Imaging, and Transcranial Doppler Ultrasound Following Sport-Related Concussion. In R. Echemendia and GL Iverson (Editors), Oxford Handbook of Sport-Related Concussion.

    Gardner, A.J., Tan, C.O., Ainslie, P.N., van Donkelaar, P., Stanwell, P., Levi, C.R., Iverson, G.L. (2015). Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: a systematic review. British Journal of Sports Medicine,49(16): 1050-1055.See in PubMed

    Marsden, K.R., Strachan, N.C., Monteleone, B.J., Ainslie, P.N., Iverson, G.L., & van Donkelaar, P. (2015). The relationship between exercise-induced increases in cerebral perfusion and headache exacerbation following sport-related concussion: A preliminary study. Current Research: Concussion, 2(1): 17-21.

    Gardner, A., Iverson, G.L., van Donkelaar, P., & Ainslie, P.N. (2015). Magnetic Resonance Spectroscopy, Diffusion Tensor Imaging, and Transcranial Doppler Ultrasound Following Sport-Related Concussion. In R. Echemendia and GL Iverson (Editors), Oxford Handbook of Sport-Related Concussion.

    Gardner, A., Iverson, G.L., & Stanwell, P. (2014). A Systematic Review of Proton Magnetic Resonance Spectroscopy Findings in Sport-Related Concussion. Journal of Neurotrauma, 31(1): 1-18.See in PubMed

    Tan, C.O., Meehan, W., Iverson, G.L., & Taylor, J.A. (2014). Cerebrovascular Regulation, Exercise, and Mild Traumatic Brain Injury. Neurology, 83(18): 1665-72.See in PubMed

    Koerte, I.K., Ertl-Wagner, B., Reiser, M., Zafonte, R., & Shenton, M.E. (2012). White matter integrity in the brains of professional soccer players without a symptomatic concussion. Journal of the American Medical Association (JAMA), 308(18): 1859-61. See in PubMed

    Reviews and Consensus Statements

    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., Johnston, K.M., Kissick, J., Kutcher, J., Leddy, J.J., Maddocks, D., Makdissi, M., Manley, G.T., McCrea, M., Meehan, W.P., Nagahiro, S., Patricios, J., Putukian, M., Schneider, K.J., Sills, A., Tator, C.H., Turner, M., Vos, P.E. (2017). Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11): 838-847.Read Study

    Iverson, G.L., Gardner, A.J., Terry, D.P., Ponsford, J.L., Sills, A.K., Broshek, D.K., and Solomon, G.S. (2017). Predictors of Clinical Recovery from Concussion: A Systematic Review. British Journal of Sports Medicine, 51(12): 941-948.Read Study

    Davis, G.A., Purcell, L., Schneider, K., Yeates, K.O., Gioia, G., Anderson, V., Ellenbogen, R., Echemendia, R., Makdissi, M., Sills, A. Iverson, G.L., Dvorak, J., McCrory, P., and Meeuwisse, W. (2017). The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). British Journal of Sports Medicine, 51(11): 859-861.See in PubMed

    Schneider, K.J., Leddy, J.J., Guskiewicz, K.M., Seifert, T., McCrea, M., Silverberg, N.D., Feddermann-Demont, N., Iverson, G.L., Hayden, K.A., and Makdissi, M. (2017). Rest and Treatment/Rehabilitation Following Sport-Related Concussion: A Systematic Review. British Journal of Sports Medicine, 51(12): 930-934.See in PubMed

    Iverson, G.L. & Gioia, G.A. (2016). Returning to School Following Sport-Related Concussion. Physical Medicine and Rehabilitation Clinics of North America, 27(2): 429-436.See in PubMed

    Gardner, A., Iverson, G.L., Levi, C.R., Schofield, P.W., Kay-Lambkin, F., Kohler, R.M.N., & Stanwell, P. (2015). A systematic review of concussion in Rugby League. British Journal of Sports Medicine, 49(8): 495-498.See in PubMed

    Gardner, A., Iverson, G.L., Williams, W.H., Baker, S., & Stanwell, P. (2014). A systematic review and meta-analysis of concussion in Rugby Union. Sports Medicine, 44(12): 1717-31.See in PubMed

    Giza, C.C., Kutcher, J.S., Ashwal, S., Barth, J., Getchius, T.S., Gioia, G.A., Gronseth, G.S., Guskiewicz, K., Mandel, S., Manley, G., McKeag, D.B., Thurman, D.J., Zafonte, R. (2013). Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 80(24): 2250-7. Read Study.

    McCrory, P., Meeuwisse, W.H., Aubry, M., Cantu, B., Dvorak, J., Echemendia, R.J., Engebretsen, L., Johnston, K., Kutcher, J.S., Raftery, M., Sills, A., Benson, B.W., Davis, G.A., Ellenbogen, R.G., Guskiewicz, K., Herring, S.A., Iverson, G.L., Jordan, B.D., Kissick, J., McCrea, M., McIntosh, A.S., Maddocks, D., Makdissi, M., Purcell, L., Putukian, M., Schneider, K., Tator, C.H., & Turner, M. (2013). Consensus statement on concussion in sport: The 4th international conference on concussion in sport held in Zurich, November 2012. British Journal of Sports Medicine, 47(5): 250-258.Read Study

    Head Impact Exposure & Sensors

    Wilcox, B.J., Beckwith, J.G., Greenwald, R.M., Chu, J.J., McAllister T.W., Flashman L.A., Maerlender A.C., Duhaime A.C., Crisco J.J. (2014). Head impact exposure in male and female collegiate ice hockey players. Journal of Biomechanics, 47(1): 109-14.Read Study

    Brainard, L.L., Beckwith, J.G., Chu, J.J., Crisco, J.J., McAllister, T.W., Duhaime, A.C., Maerlender, A.C., Greenwald, R.M. (2012). Gender differences in head impacts sustained by collegiate ice hockey players. Medicine and Science in Sports and Exercise, 44(2): 297-304.Read Study

    Crisco, J.J., Wilcox, B.J., Machan, J.T., McAllister, T.W., Duhaime, A.C., Duma, S.M., Rowson, S., Beckwith, J.G., Chu, J.J., Greenwald, R.M. (2012). Magnitude of head impact exposures in individual collegiate football players. Journal of Applied Biomechanics, 28(2): 174-183.Read Study

    Duhaime, A.C., Beckwith, J.G., Maerlender, A.C., McAllister, T.W., Crisco, J.J., Duma, S.M., Brolinson, P.G., Rowson, S., Flashman, L.A., Chu, J.J., Greenwald, R.M. (2012). Spectrum of acute clinical characteristics of diagnosed concussions in college athletes wearing instrumented helmets: clinical article. Journal of Neurosurgery, 117(6): 1092-1099.Read Study

    McAllister, T.W., Flashman, L.A., Maerlender, A., Greenwald, R.M., Beckwith, J.G., Tosteson, T.D., Crisco, J.J., Brolinson, P.G., Duma, S.M., Duhaime, A.C., Grove, M.R., Turco, J.H. (2012). Cognitive effects of one season of head impacts in a cohort of collegiate contact sport athletes. Neurology, 78(22): 1777-1784.Read Study

    Rowson, S., Duma, S.M., Beckwith, J.G., Chu, J.J., Greenwald, R.M., Crisco, J.J., Brolinson, P.G., Duhaime, A.C., McAllister, T.W., Maerlender, A.C. (2012). Rotational head kinematics in football impacts: an injury risk function for concussion. Annals of Biomedical Engineering, 40(1): 1-13.Read Study

    Long-Term Effects and Chronic Traumatic Encephalopathy

    Iverson, G.L., Keene, C.D., Perry, G., & Castellani, R.J. (2018). The need to separate chronic traumatic encephalopathy neuropathology from clinical features. Journal of Alzheimer’s Disease, 61(1): 17-28.Read Study

    Manley, G.T., 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., 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.Read Study

    Webner, D. & Iverson, G.L. (2016). Suicide in Professional American Football Players in the Past 95 Years. Brain Injury. 30(13-14): 1718-1721.See in PubMed

    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.See in PubMed

    Iverson, G.L. (2016). Suicide and Chronic Traumatic Encephalopathy. Journal of Neuropsychiatry and Clinical Neurosciences., 28(1): 9-16.See in PubMed

    Castellani, R.J., Perry G., Iverson G.L. (2015). Chronic effects of mild neurotrauma: putting the cart before the horse? Journal of Neuropathology and Experimental Neurology., 74(6): 493-499.Read Study

    Gardner, A., Iverson, G.L., & McCrory, P. (2014). Chronic traumatic encephalopathy in sport: A systematic review. British Journal of Sports Medicine, 48(2): 84-90. See in PubMed

    Iverson, G.L. (2014). Chronic traumatic encephalopathy and risk of suicide in former athletes. British Journal of Sports Medicine, 48(2): 162-165.See in PubMed

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