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Background: Whilst the scientific understanding of mild traumatic brain injury sequelae has advanced, the consequences of neurological insults sustained during football play in the form of multiple concussions and heading remains unclear. Method: To the authors’ knowledge, this is the first longitudinal prospective study to follow-up a group of footballers and controls over time. Thirty-two elite young professional footballers were recruited and 24 were identified at follow-up. Thirty-three controls were recruited and 17 identified at follow-up. Medical examination, MRI (brain) imaging and detailed neuropsychological data were collected on the footballers at baseline and 5-year follow-up. Medical examination and detailed neuropsychological data were collected on the controls at baseline and 5-year follow-up. Results: All participants had normal neurological examination at both time points. At baseline, 37% of the footballers had sustained minor neurological insults. Between baseline and 5 years, 66% of the footballers had sustained minor neurological insults. No MRI (brain) abnormalities were identified among the footballers at either time point. Regarding the neuropsychology, there was a 6-point IQ difference between footballers and controls, with the footballers being low. Test–re-test analysis on a range of carefully selected neurocognitive tests revealed a picture of good stability in cognitive functioning over this 5-year period. Conclusions: These longitudinal prospective data indicate no significant neurological, structural brain imaging or neuropsychological change among a sample of young elite professional footballers over the first 5 years of their professional career. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the course and impact of family optimism in the post-acute stage of acquired brain injury. Methods: At Time 1, 30 family relatives of in-patients in rehabilitation units and 30 relatives of patients recently discharged from such units completed questionnaires relating to their emotional health, engagement in the rehabilitation process and expectations about the future consequences and controllability of the injury. At Time 2 (12-18 months later), 23 of the original sample completed questionnaires about their emotional health and actual consequences and controllability of the injury. Results: At Time 1, optimism about future consequences and controllability was associated with greater engagement in the rehabilitation process and better emotional health. The two groups did not differ on any of the measures, which did not support the expectation that the patient's discharge home would trigger a loss of optimism and emotional upset for the family. At Time 2, the actual consequences were worse than had been expected at Time 1 and greater disappointment was associated with a greater decline in emotional wellbeing. Conclusion: Family expectations about recovery are linked with important variables such as emotional wellbeing and engagement in the rehabilitation process and need careful management by clinicians. [ABSTRACT FROM AUTHOR]

Objective: A small minority of individuals experience long-term or permanent post-concussion symptoms (PCS) after a mild head injury (MHI). There has been no systematic, quantitative research examining a wide range of variables in a representative sample of such patients (i.e. with PCS for more than 18 months). This study explores a broad spectrum of demographic, cognitive, emotional and psychosocial factors (known to be important in the development of early PCS) in a representative sample of patients with permanent PCS. Method: One hundred consecutively referred patients to a Community Head Injury Service in Buckinghamshire, UK for the treatment of persistent PCS, at least 18 months post-MHI, were identified and invited to participate. An exploratory design evaluated a range of demographic, cognitive, emotional and psychosocial variables and their relationship to PCS severity and quality-of-life (QoL). Results: Twenty-four participants, with a mean time post-injury of 6.9 years, responded. They were characterized by: (i) older age compared to those typically presenting with MHI, (ii) very high levels of PCS, (iii) high post-injury unemployment, (iv) pre- or post-morbid factors which might exacerbate post-concussional difficulties, (v) elevated levels of anxiety and depression and (vi) mildly reduced scores on tests of short-term memory and speed of information processing. Post-hoc analysis of the total sample ( n == 100) confirmed older age and a high proportion having pre- or post-morbid factors. QoL negatively correlated with PCS severity, and anxiety scores accounted for 45.9%% of the variance in PCS severity. Conclusions: Very high levels of PCS, high post-injury unemployment and measurable cognitive deficits can be permanent features of MHI. Quality-of-life is directly related to symptom severity. Age, pre-/post-morbid concomitant factors, neuropsychological deficits and emotional status are key variables in understanding the phenomenon of permanent PCS. Important vulnerability factors in the development of such may therefore be older age and any additional compromise to an individual's emotional or cognitive capacities. [ABSTRACT FROM AUTHOR]