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Young L, Esagoff AI, Reisch A, Bernick CB, Peters ME, Narapareddy BR. Cocaine history and impulsiveness in professional boxers and mixed martial arts fighters. Am J Addict 2024; 33:92-95. [PMID: 37670433 DOI: 10.1111/ajad.13479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND/OBJECTIVES Impulsiveness is linked to cocaine history (CH) in the general population and greater fight exposure in professional fighters. Among fighters, no previous studies have quantified CH or investigated its relationship with impulsiveness. METHODS Adjusted multivariable regressions were utilized to examine the relationship between CH and impulsiveness in 335 fighters from the Professional Fighters Brain Health Study. RESULTS Twenty percent of fighters reported CH. CH was significantly associated with impulsiveness overall and on three subscales. DISCUSSION/CONCLUSION Cocaine's prevalence and significant association with impulsiveness in fighters merit further study. SCIENTIFIC SIGNIFICANCE We quantify CH and demonstrate its significant association with impulsiveness in professional fighters for the first time.
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Affiliation(s)
- Lisa Young
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron I Esagoff
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anne Reisch
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Charles B Bernick
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA
| | - Matthew E Peters
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bharat R Narapareddy
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
- Institute of Living, Hartford Hospital, Hartford, Connecticut, USA
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2
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Loftin MC, Zynda AJ, Pollard-McGrandy A, Eke R, Covassin T, Wallace J. Racial differences in concussion diagnosis and mechanism of injury among adults presenting to emergency departments across the United States. Brain Inj 2023; 37:1326-1333. [PMID: 37607067 DOI: 10.1080/02699052.2023.2248581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/20/2023] [Accepted: 08/13/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES The purpose of this study was to examine the association between race and concussion diagnosis as well as the association between race and mechanism of injury (MOI) for concussion diagnoses in adult patients (>19 years old) visiting the emergency department (ED). METHODS A retrospective analysis of patient visits to the ED for concussion between 2010 and 2018, using the National Hospital Ambulatory Medical Care Survey, was conducted. Outcome measures included concussion diagnosis and MOI. Multivariable and multinomial logistic regression analyses were conducted to assess associations between race and outcome variables. The results were weighted to reflect population estimates with a significance set at p < 0.05. RESULTS Overall, 714 patient visits for concussions were identified, representing an estimated 4.3 million visits nationwide. Black adults had lower odds of receiving a concussion diagnosis [p < 0.05, Odds Ratio (OR), 0.54; 95% Confidence Interval (CI), 0.38-0.76] compared to White adults in the ED. There were no significant differences in MOI for a concussion diagnosis by race. CONCLUSION Racial differences were found in the ED for concussion diagnosis. Disparities in concussion diagnosis for Black or other minoritized racial groups could have significant repercussions that may prolong recovery or lead to long-term morbidity.
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Affiliation(s)
- Megan C Loftin
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Aaron J Zynda
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | | | - Ransome Eke
- Department of Community Medicine, School of Medicine, Mercer University, Columbus, Georgia
| | - Tracey Covassin
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Jessica Wallace
- Department of Health Science, The University of Alabama, Tuscaloosa, Alabama, USA
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3
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Liebel SW, Van Pelt KL, Pasquina PF, McAllister TW, McCrea MA, Broglio SP. Sport-Specific Recovery Trajectories for NCAA Collegiate Athletes Following Concussion. Ann Biomed Eng 2023:10.1007/s10439-023-03406-8. [PMID: 37962676 DOI: 10.1007/s10439-023-03406-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023]
Abstract
The recovery trajectories of collegiate athletes with sport-related concussion (SRC) are well characterized in contact/collision sports but are less well understood in limited contact sports with lower risk, reducing the ability of clinicians to effectively manage the return-to-play (RTP) process. The current study investigated the time to asymptomatic and RTP across a broad range of male and female collegiate sports and sought to group sports by recovery intervals. Data from the Concussion Assessment, Research and Education (CARE) Consortium included 1049 collegiate athletes who sustained a SRC while participating in game or practice/training of their primary sport. Injury setting and subsequent clinical presentation data were obtained. Survival analysis using the Cox Proportional Hazard model estimated the median recovery times for each sport. Optimal univariate K-means clustering grouped sports into recovery categories. Across all sports, median time to asymptomatic following SRC ranged from 5.9 (female basketball) to 8.6 days (male wrestling). Median RTP protocol duration ranged from 4.9 days (female volleyball) to 6.3 days (male wrestling). Median total RTP days ranged from 11.2 days (female lacrosse) to 16.9 days (male wrestling). Sport clusters based on recovery differences in time to asymptomatic (3) and RTP protocol duration (2) were identified. The findings from this study of a large sample of more than 1000 NCAA collegiate athletes with SRC show there exists ranges in recovery trajectories. Clinicians can thus manage athletes with similar guidelines, with individualized treatment and recovery plans.
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Affiliation(s)
- Spencer W Liebel
- Department of Neurology, Traumatic Brain Injury & Concussion Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA.
| | | | - Paul F Pasquina
- Department of Physical Medicine & Rehabilitation, Uniformed Services University, Bethesda, MD, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
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Willmott C, Reyes J, K Nguyen JV, McIntosh A, Makovec-Knight J, Makdissi M, Clifton P, Harcourt P, Mitra B. A pilot case crossover study of the use of padded headgear in junior Australian football. Concussion 2022; 7:CNC99. [PMID: 36694693 PMCID: PMC9855304 DOI: 10.2217/cnc-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/18/2022] [Indexed: 01/26/2023] Open
Abstract
Aim To explore soft-shell padded headgear (HG) use, player behavior and injuries associated with HG in junior Australian football. Methods Prospective case-crossover with head impact measurement, injury surveillance and video review. Results 40 players (mean age: 12.43 years, standard deviation: 1.36) across 15 matches were observed. Frequency of head/neck (p = 0.916) or body (p = 0.883) contact events, and match incidents were similar between HG and no HG conditions. Without HG, females had higher frequency of body contacts compared with males (p = 0.015). Males sustained more body contacts with HG than without HG (p = 0.013). Conclusion Use of HG in junior football was not associated with injury or head contact rate. Associations between HG use and body contact may differ across sexes. (ID: ACTRN12619001165178).
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Affiliation(s)
- Catherine Willmott
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia,Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia,Author for correspondence: Tel.: +61 431 545 495;
| | - Jonathan Reyes
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia,Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia
| | - Jack V K Nguyen
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Andrew McIntosh
- McIntosh Consultancy and Research, Sydney, Australia,Monash University Accident Research Centre, Monash University, Melbourne, Australia,School of Engineering, Edith Cowan University, Joondalup, Australia
| | - Jennifer Makovec-Knight
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Michael Makdissi
- Florey Institute of Neuroscience & Mental Health, Austin Campus, Melbourne Brain Centre, Melbourne, Australia,Olympic Park Sports Medicine Centre, Melbourne, Australia
| | | | | | - Biswadev Mitra
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia,Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia,Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
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Broggi M, Ready RE. Academic skills, self-perceptions, and grades in university students with a history of multiple concussions: The mediating roles of processing speed and psychological symptoms. Clin Neuropsychol 2022; 36:2188-2204. [PMID: 34402398 DOI: 10.1080/13854046.2021.1958924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study determined if university students with a history of multiple concussions may be at risk for academic difficulties and poor academic performance. We investigated if executive functioning, processing speed, and/or psychological symptoms might partially account for differences in academic performance of students with and without a history of multiple concussions. University students with a history of three or more concussions (n = 58), one concussion (n = 57), or no concussion (n = 57) completed academic, cognitive, and psychological assessments. Students with a history of multiple concussions read fewer words per minute and reported more learning difficulties than the no concussion group. Processing speed mediated the association between concussion status and reading rate. Psychological symptoms mediated the association between concussion status and self-reported learning difficulties. University students with a history of multiple concussions may be at risk for poor academic outcomes due, at least in part, to slower processing speed and psychological symptoms.Treatment of psychological symptoms, cognitive rehabilitation to augment processing speed, and academic accommodations might improve academic outcomes for students with a history of three or more concussions.
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Affiliation(s)
- Michael Broggi
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Rebecca E Ready
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Weishaar MG, Stephens JA, Conner BT. Personality Predictors of Sports-Related Concussion Incidence: Analysis of Data From a Large, Heterogeneous Undergraduate Sample. Am J Phys Med Rehabil 2022; 101:738-745. [PMID: 34596098 PMCID: PMC8958175 DOI: 10.1097/phm.0000000000001901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Studies investigating the associations between personality and sports-related concussion are limited. The current study aimed to address this gap by examining whether specific personality dimensions predicted self-reported sports-related concussion outcomes. DESIGN This study included 1141 undergraduate students ( Mage = 19.47, SD = 2.14, female = 64.5%) who completed a battery of online personality measures and self-reported sports-related concussion items. The self-reported sports-related concussion outcomes included a single diagnosed sports-related concussion incident (i.e., "diagnosed sports-related concussion incidence") and incidents of multiple diagnosed sports-related concussions (i.e., "multiple diagnosed sports-related concussion incidents"). Analyses included splitting data randomly into training and validation data sets. Multivariate logistic regression models were then fit to each data set to determine predictors of sports-related concussion. RESULTS In both training and validation data sets, extraversion and experience seeking were found to be positively and most strongly associated with both sports-related concussion outcomes, whereas motor inhibition was found to be negatively associated with both outcomes. Additional personality dimensions showed differential relations with each sports-related concussion outcome. CONCLUSIONS The current study highlights the importance of considering personality dimensions in the context of self-reported sports-related concussion outcomes, as there are differential relations between personality dimensions and these outcomes. Thus, prevention efforts for sports-related concussion may benefit from evaluating additional athlete factors, like personality traits.
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Affiliation(s)
- Megan G Weishaar
- From the Department of Psychology-Counseling Psychology, Colorado State University, Fort Collins, Colorado (MGW, BTC); and Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado (JAS)
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DiFabio MS, Smith DR, Breedlove KM, Buckley TA, Johnson CL. Relationships between aggression, sensation seeking, brain stiffness, and head impact exposure: Implications for head impact prevention in ice hockey. Brain Behav 2022; 12:e2627. [PMID: 35620849 PMCID: PMC9304837 DOI: 10.1002/brb3.2627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The objectives of this study were to (1) examine the relationship between the number of head impacts sustained in a season of men's collegiate club ice hockey and behavioral traits of aggression and sensation seeking, and (2) explore the neural correlates of these behaviors using neuroimaging. DESIGN Retrospective cohort study. METHODS Participants (n = 18) completed baseline surveys to quantify self-reported aggression and sensation-seeking tendencies. Aggression related to playing style was quantified through penalty minutes accrued during a season. Participants wore head impact sensors throughout a season to quantify the number of head impacts sustained. Participants (n = 15) also completed baseline anatomical and magnetic elastography neuroimaging scans to measure brain volumetric and viscoelastic properties. Pearson correlation analyses were performed to examine relationships between (1) impacts, aggression, and sensation seeking, and (2) impacts, aggression, and sensation seeking and brain volume, stiffness, and damping ratio, as an exploratory analysis. RESULTS Number of head impacts sustained was significantly related to the number of penalty minutes accrued, normalized to number of games played (r = .62, p < .01). Our secondary, exploratory analysis revealed that number of impacts, sensation seeking, and aggression were related to stiffness or damping ratio of the thalamus, amygdala, hippocampus, and frontal cortex, but not volume. CONCLUSIONS A more aggressive playing style was related to an increased number of head impacts sustained, which may provide evidence for future studies of head impact prevention. Further, magnetic resonance elastography may aid to monitor behavior or head impact exposure. Researchers should continue to examine this relationship and consider targeting behavioral modification programs of aggression to decrease head impact exposure in ice hockey.
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Affiliation(s)
- Melissa S DiFabio
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA.,Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximillians-Universität München, Munich, Germany
| | - Daniel R Smith
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Curtis L Johnson
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
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Callahan CE, Kossman MK, Mihalik JP, Marshall SW, Gildner P, Kerr ZY, Cameron KL, Houston MN, Mrazik M, Register-Mihalik JK. Association between Sensation-Seeking Behaviors and Concussion-Related Knowledge, Attitudes, Perceived Norms, and Care-Seeking Behaviors among Collegiate Student-Athletes. J Sports Sci Med 2022; 21:33-42. [PMID: 35250331 PMCID: PMC8851124 DOI: 10.52082/jssm.2022.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/27/2021] [Indexed: 06/14/2023]
Abstract
There are limited data connecting personality and behavioral tendencies and traits related to concussion care-seeking/disclosure behaviors and minimal research exists surrounding the relationship between risky behaviors, sensation-seeking, and concussion-related outcomes. This study examined the association between sensation-seeking and a student-athlete's concussion-related knowledge, attitudes, perceived social norms, and concussion care-seeking/disclosure behaviors (intention to disclose concussion symptoms, perceived control over symptom disclosure, self-removal from play due to concussion symptoms, continued play with concussion symptoms, and disclosure of all concussions at the time of injury). The current study utilized a retrospective cohort of collegiate student-athletes at a single National Collegiate Athletic Association Division I institution. Separate multivariable linear regression models estimating mean differences (MD) and 95% Confidence Intervals (CI) estimated the association between sensation-seeking and concussion knowledge, concussion attitudes, and perceived social norms. Separate multivariable binomial regression models estimating adjusted prevalence ratios (PR) and 95%CI estimated the association between sensation-seeking and intention to disclose concussion symptoms, perceived control over symptom disclosure, self-removal from play due to concussion symptoms, continued play with concussion symptoms, and disclosure of all concussions at the time of injury. All models were adjusted for sex, sport participation, and concussion history. Higher sensation-seeking was significantly associated with less favorable concussion attitudes (adjusted MD = -1.93; 95%CI = -3.04,-0.83), less favorable perceived social norms surrounding concussion (adjusted MD = -1.39; 95%CI = -2.06,-0.72), and continuing to play while experiencing concussion symptoms (adjusted PR = 1.50; 95%CI = 1.10, 2.06). Student-athletes with increased sensation-seeking could be at risk for failing to disclose a concussion, decreasing athlete safety and resulting in less optimal care post-injury. Results will inform future theory-based concussion education programs which consider behavioral tendencies and traits as well as sport culture to promote concussion care-seeking/disclosure and individualized interventions based on risky behavior engagement.
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Affiliation(s)
- Christine E Callahan
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
| | - Melissa K Kossman
- School of Health Professions, University of Southern Mississippi, MS, USA
| | - Jason P Mihalik
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
| | - Stephen W Marshall
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
| | - Paula Gildner
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
| | - Zachary Y Kerr
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
| | - Kenneth L Cameron
- John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, NY, USA
- Departments of Physical Medicine and Rehabilitation and Surgery, Uniformed Services University of the Health Sciences, MD, USA
| | - Megan N Houston
- John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, NY, USA
| | - Martin Mrazik
- Department of Educational Psychology, University of Alberta, AB, Canada
| | - Johna K Register-Mihalik
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill NC, USA
- STAR Heel Performance Laboratory, The University of North Carolina at Chapel Hill, NC, USA
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Abstract
PURPOSE OF REVIEW Sport-related concussion (SRC) is a significant public health problem. Understanding the behavioral and personal factors that influence risk and incidence of SRC is critically important for appropriate care and management. Sensation-seeking and impulsivity have been posited to be two such factors that may be significantly associated with SRC. We performed a focused review of recent evidence of the relationships between sensation-seeking and impulsivity in athletes with SRC. RECENT FINDINGS While the research is relatively limited, extant findings demonstrate a significant relationship between sensation-seeking and contact sport participation and risk of prior and future SRC. Impulsivity appears to be common among athletes competing in high contact sports and may contribute to neural and functional brain changes following SRC; however, causal relationships between impulsivity, contact sport participation, and SRC have not been demonstrated. Both sensation-seeking and impulsivity are significantly associated with SRC in collegiate athletes. Interventions designed to ameliorate high levels of these constructs may prove to be beneficial avenues to reducing SRC risk and improving patient care and outcomes.
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Affiliation(s)
- Spencer W Liebel
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA.
| | - Katherine A M Edwards
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
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