Breton Asken

University of Florida | UF · Clinical and Health Psychology

Importance Scientific and lay interest in negative outcomes associated with exposure to repetitive brain trauma (RBT) continues to strengthen. Concerns about the association between RBT and dementia began more than a century ago, but have resurfaced in the last decade with the more recently described chronic traumatic encephalopathy (CTE). Chronic...

Background: Measuring plasma glial fibrillary acidic protein (GFAP) alongside cortical amyloid-β (Aβ) may shed light on astrocytic changes in aging and Alzheimer's disease (AD). Objective: To examine associations between plasma GFAP and cortical Aβ deposition in older adults across the typical aging-to-AD dementia spectrum. Methods: We studied...

Background and Scope of Review Varying severities and frequencies of head trauma may result in dynamic acute and chronic pathophysiologic responses in the brain. Heightened attention to long-term effects of head trauma, particularly repetitive head trauma, has sparked recent efforts to identify neuroimaging biomarkers of underlying disease processe...

Traumatic encephalopathy syndrome (TES) criteria were developed to aid diagnosis of chronic traumatic encephalopathy (CTE) pathology during life. Interpreting clinical and biomarker findings in patients with TES during life requires autopsy-based determination of the neuropathological profile. We report a clinico-pathological series of 9 patients w...

Background: Traumatic encephalopathy syndrome (TES) has overlapping clinical symptoms with Alzheimer's disease (AD). AD pathology commonly co-occurs with chronic traumatic encephalopathy (CTE) pathology. There are currently no validated CTE biomarkers. AD-specific biomarkers like plasma P-tau181 and P-tau217 may help to identify TES patients who h...

Background and objectives: Cavum septum pellucidum (CSP) is a common but nonspecific MRI finding in individuals with prior head trauma. The type and extent of head trauma related to CSP, CSP features specific to head trauma, and the impact of brain atrophy on CSP are unknown. We evaluated CSP cross-sectionally and longitudinally in healthy and cli...

Objective To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in National Collegiate Athletic Association (NCAA) student-athletes with no recent concussion. Design Cross-sectional, observational study. Setting Participants were recruited from 26 civilian schools as part of the NCAA-U.S. Department of Defense Grand...

Objective To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in service academy cadets with no recent concussion Design Cross-sectional, observational study Setting Participants were recruited from 3 U.S. service academies as part of the National Collegiate Athletic Association and U.S. Department of Defense Gran...

Background Estimates from the Alzheimer’s Association indicate that approximately one in ten older adults in the US have Alzheimer’s disease (AD) dementia while 15 to 20% have mild cognitive impairment (MCI), projecting that about a third of those will develop dementia within five years. The Cognitive Reserve/ Resilience (CR/R) theory postulates th...

Background Patients with a history of repetitive head impacts (RHI) risk progressive memory loss and executive dysfunction consistent with traumatic encephalopathy syndrome (TES). TES is a clinical phenotype sensitive but non‐specific to underlying chronic traumatic encephalopathy (CTE). Cognitive symptoms overlap with Alzheimer’s disease (AD), and...

Background Dementia diagnoses are more common among Hispanic (HW) than non‐Hispanic white (NHW) older adults. Alzheimer’s disease (AD) is the most common neuropathological finding in patients with dementia. Plasma AD biomarkers have accelerated efforts towards increasing access to timely diagnosis, but existing data often come from cohorts lacking...

Background Repetitive head impacts (RHI) occur routinely in sports like American football (AmFootball) and are the most well‐established risk factor for chronic traumatic encephalopathy, a neurodegenerative tauopathy. However, RHI is not routinely evaluated in older adults with other suspected neurodegenerative diseases. The prevalence of RHI among...

Objective Former professional American football players have a high relative risk for neurodegenerative diseases like chronic traumatic encephalopathy (CTE). Interpreting low cognitive test scores in this population occasionally is complicated by performance on validity testing. Neuroimaging biomarkers may help inform whether a neurodegenerative di...

Objective Approximately 10-15% of patients with mild traumatic brain injury (mTBI) report persistent, chronic symptoms more than one month later. Coping behaviors after mTBI can range from fear avoidance (FA), or a reluctance to return to activity because of the fear of symptom exaggeration, to endurance (END), or an overly aggressive return to act...

Objective Traumatic brain injury (TBI) and concussion are associated with increased dementia risk. Accurate TBI/concussion exposure estimates are relatively unknown for less common neurodegenerative conditions like frontotemporal dementia (FTD). We evaluated lifetime TBI and concussion frequency in patients diagnosed with a range of FTD spectrum co...

INTRODUCTION Alzheimer's disease studies often lack ethnic diversity. METHODS We evaluated associations between plasma biomarkers commonly studied in Alzheimer's (p‐tau181, GFAP, and NfL), clinical diagnosis (clinically normal, amnestic MCI, amnestic dementia, or non‐amnestic MCI/dementia), and Aβ‐PET in Hispanic and non‐Hispanic older adults. His...

INTRODUCTION Accumulating evidence indicates disproportionate tau burden and tau‐related clinical progression in females. However, sex differences in plasma phosphorylated tau (p‐tau)217 prediction of subclinical cognitive and brain changes are unknown. METHODS We measured baseline plasma p‐tau217, glial fibrillary acidic protein (GFAP), and neuro...

Background Traumatic encephalopathy syndrome (TES) is a clinical phenotype sensitive but non-specific to underlying chronic traumatic encephalopathy (CTE) neuropathology. However, cognitive symptoms of TES overlap with Alzheimer’s disease (AD), and features of AD pathology like beta-amyloid (Aβ) plaques often co-occur with CTE, making clinical-to-p...

Importance: Plasma phosphorylated tau217 (p-tau217), a biomarker of Alzheimer disease (AD), is of special interest in corticobasal syndrome (CBS) because autopsy studies have revealed AD is the driving neuropathology in up to 40% of cases. This differentiates CBS from other 4-repeat tauopathy (4RT)-associated syndromes, such as progressive supranu...

Background Measuring systemic inflammatory markers may improve clinical prognosis and help identify targetable pathways for treatment in patients with autosomal dominant forms of frontotemporal lobar degeneration (FTLD). Methods We measured plasma concentrations of IL-6, TNFα and YKL-40 in pathogenic variant carriers ( MAPT, C9orf72, GRN ) and non...

Astrocyte reactivity may contribute to pathogenic relationships between β‐amyloid (A), phosphorylated tau (T), neurodegeneration (N), and cognition (memory). We examined whether severity of astrocyte reactivity, characterized by plasma glial fibrillary acidic protein (GFAP), moderates relationships along the A/T/N and memory cascade in non‐demented...

The pathognomonic lesion of chronic traumatic encephalopathy (CTE) is the perivascular deposition of neuronal phosphorylated tau (p‐tau). Patchy p‐tau deposits initially accumulate in frontotemporal cortices. Medial temporal lobes (MTL) become involved in late stage. Validated in vivo biomarkers for CTE p‐tau do not exist. 18F‐MK‐6240 is a second‐g...

Background Continued participation after sport-related concussion (SRC) worsens outcomes, but it is unknown if duration of continued participation after SRC impacts recovery outcomes, and which athletes who continue to participate are at greatest risk for poor SRC outcomes. The purpose of this National Collegiate Athletic Association/Department of...

Introduction: Development of novel diagnostic tools is a top research priority in vascular dementia. A major obstacle is the lack of a simple, non-invasive method to visualize cerebral arteriolar walls in vivo. Retinal arterioles offer a window into the cerebral circulation. Methods: Intensity-based retinal arteriolar visualization in optical cohe...

Early-onset (age < 65) Alzheimer’s disease is associated with greater non-amnestic cognitive symptoms and neuropathological burden than late-onset disease. It is not fully understood whether these groups also differ in the associations between molecular pathology, neurodegeneration, and cognitive performance. We studied amyloid-positive patients wi...

Objective: To determine the synergistic effects of nutrition, specifically adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and physical activity on cognition and brain outcomes in a cross-sectional healthy aging cohort. Methods: A total of 132 adults (age range 52-91; Clinical Dementia Rating = 0) from the...

Cognitive post-acute sequelae of SARS-CoV-2 (PASC) can occur after mild COVID-19. Detailed clinical characterizations may inform pathogenesis. We evaluated 22 adults reporting cognitive PASC and 10 not reporting cognitive symptoms after mild SARS-CoV-2 infection through structured interviews, neuropsychological testing, and optional cerebrospinal f...

Background There is a paucity of data describing the association between blood pressure (BP) and cardiac remodeling in female collegiate athletes. Methods This retrospective cohort review describes the BP characteristics and echocardiographic features of female collegiate athletes during preparticipation evaluation. We evaluated data from 329 fema...

Background Microvascular injury is a significant contributor to cognitive impairment. Conventional neuroimaging is inadequate for assessing microvascular changes in the brain. Intensity‐based Retinal Arteriolar Visualization in OCT (I‐bRAVO) is a novel method that enables rapid, direct and non‐invasive visualization of retinal arterioles using stan...

We investigated whether clinically normal older adults with remote, mild traumatic brain injury (mTBI) show evidence of higher cortical Aβ burden. Our study included 134 clinically normal older adults (age 74.1 ± 6.8 years, 59.7% female, 85.8% white) who underwent Aβ positron emission tomography (Aβ-PET) and who completed the Ohio State University...

While an increased risk for late-life neurodegenerative disease and dementia has consistently been observed in professional athletes with very high exposure to repetitive head impacts, such as former professional boxers and US football players, much less is known about neurologic outcomes in sports with lower head trauma exposure. Soccer, known to...

Objective There are minimal data directly comparing plasma neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in aging and neurodegenerative disease research. We evaluated associations of plasma NfL and plasma GFAP with brain volume and cognition in two independent cohorts of older adults diagnosed as clinically normal (CN), mild...

Blood-based inflammatory markers hold considerable promise for diagnosis and prognostication of age-related neurodegenerative disease, though a paucity of research has empirically tested how reliably they can be measured across different experimental runs (“batches”). We quantified the inter-batch reliability of 13 cytokines and chemokines in a cro...

Background Symptom resolution is a key marker in determining fitness for return to activity following concussion, but in some cases, distinguishing persistent symptoms due to concussion versus symptoms related to other factors can be challenging.Objective To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in health...

Introduction: This study sought to determine whether adding cognition to a model with Alzheimer's disease biomarkers based on the amyloid, tau, and neurodegeneration/neuronal injury-AT(N)-biomarker framework predicts rates of cognitive and functional decline in older adults without dementia. Methods: The study included 465 participants who compl...

Though distinct pathological entities, corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP) share multiple biochemical and genetic features suggesting overlapping pathophysiology. We report the case of a patient with an 18-year clinical course consistent with behavioral variant frontotemporal dementia. The neuropathological asse...

As cases of coronavirus disease 2019 (COVID-19) mount worldwide, attention is needed on potential long-term neurologic impacts for the majority of patients who experience mild to moderate illness managed as outpatients. To date, there has not been discussion of persistent neurocognitive deficits in patients with milder COVID-19. We present two case...

American football participation is associated with a relatively high risk of sustaining mild traumatic brain injury or concussion. Concussion management practices have changed significantly over the past two decades due to rapidly progressing research. Several classic and newly emerging clinical tools are available to assist with acute diagnosis. T...

The link between traumatic brain injury (TBI) and risk for neurodegenerative disease has been studied for decades. Prior work focused mostly on how single or multiple isolated injuries involving loss of consciousness or posttraumatic amnesia influences risk for Alzheimer’s disease. Emerging data suggests that repetitive head impact exposure, both w...

Introduction: Cognitive composite scores offer a means of precisely measuring executive functioning (EF). Methods: We developed the Uniform Data Set v3.0 EF composite score (UDS3-EF) in 3507 controls from the National Alzheimer's Coordinating Center dataset using item-response theory and applied nonlinear and linear demographic adjustments. The...

Knowledge of cardiovascular adaptations in athletes has predominantly focused on males, with limited data available on females who compromise a substantial percentage of all collegiate athletes. A multicenter retrospective cohort review of preparticipation cardiovascular screening data of 329 National Collegiate Athletic Association Division I fema...

Objective We evaluated whether memory recall following an extended (1 week) delay predicts cognitive and brain structural trajectories in older adults. Method Clinically normal older adults (52–92 years old) were followed longitudinally for up to 8 years after completing a memory paradigm at baseline [Story Recall Test (SRT)] that assessed delayed...

Objective: We aimed to test the hypothesis that elevated neocortical β-amyloid (Aβ), a hallmark feature of Alzheimer's disease (AD), predicts sex-specific cognitive trajectories in clinically normal older adults, with women showing greater risk of decline than men. Method: Florbetapir Aβ positron emission tomography (PET) was acquired in 149 clini...

Objective: To assess the relationship between subjective cognitive symptoms and objective cognitive test scores in patients after concussion. We additionally examined factors associated with subjective and objective cognitive dysfunction, as well as their discrepancy. Participants: Eighty-six individuals (65.1% female; 74.4% adult) from an inter...

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Discrepancy-Based Evidence for Loss of Thinking Abilities (DELTA): Development and Validation of a Novel Approach to Identifying Cognitive Changes – Addendum

Background: Sports medicine clinicians routinely use computerized neurocognitive testing in sport-related concussion management programs. Debates continue regarding the appropriateness of normative reference comparisons versus obtaining individual baseline assessments, particularly for populations with greater likelihood of having below- or above-...

We prospectively evaluated serum concentrations of glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase L1 (UCH-L1), total tau (T-Tau), and neurofilament light (NF-L) from collegiate athletes at baseline and acutely after sport-related concussion (SRC) using the Quanterix Neurology 4Plex "B" (N4PB) multiplex assay. Uninjured contr...

Objective: To develop and validate the Discrepancy-based Evidence for Loss of Thinking Abilities (DELTA) score. The DELTA score characterizes the strength of evidence for cognitive decline on a continuous spectrum using well-established psychometric principles for improving detection of cognitive changes. Methods: DELTA score development used neu...

Objective: Neuropsychological evaluations include hold tests like word-reading ability as estimates of premorbid intellect thought to be resilient to the effects of neurologic insult. We tested the alternative hypothesis that exposure to concussion or repetitive subclinical head impacts throughout early life may stunt acquisition of word-reading sk...

Context Comprehensive assessments are recommended to evaluate sport-related concussion (SRC). The degree to which the King-Devick (KD) test adds novel information to an SRC evaluation is unknown. Objective To describe relationships at baseline among the KD and other SRC assessments and explore whether the KD provides unique information to a multim...

Objective: To evaluate the influences of sociodemographic factors, estimated head impact exposure, and academic aptitude on ImPACT scores in college athletes. Methods: Data were reported on 18,886 participants (58% male) from the NCAA/DoD CARE Consortium. Race, SES, concussion history, estimated repetitive head impact exposure (eRHIE), and academic...

Objectives To describe multivariate base rates (MBRs) of low scores and reliable change (decline) scores on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) in college athletes at baseline, as well as to assess MBR differences among demographic and medical history subpopulations. Methods Data were reported on 15,909 participants...

Background: Some remodelling of the aortic root may be expected to occur with exercise but can already vary due to different body sizes, compositions and genetic predispositions. Attributing the cause of borderline aortic root diameter (ARD) values to either physiological or pathological conditions in American college football athletes is difficul...

Prognostic modeling in moderate to severe traumatic brain injury (TBI) has historically focused primarily on the projection of crude outcomes such as the risk of mortality and disability. Initial work in this area has perpetuated the notion that prognosis after moderate to severe TBI can be measured as a single, static, and dichotomous outcome. How...

Concussions occur frequently among the general population, with athletes and certain military personnel being particularly vulnerable. Population differences (demographics, risk factors, injury frequency, injury severity, etc.) require that both clinicians and researchers carefully consider individual patient or participant characteristics. Recent...

Background Are borderline echocardiogram structural measurements due to physiological adaptation or pathology in college football players? The normal reference data are very limited in this population. We report left ventricular end-diastolic diameter (LVEDD) and interventricular septal diameter (IVSD) echocardiogram findings in college football at...

Biomarkers are now near ubiquitous across neurologic research and increasingly influence clinical care. Advanced neuroimaging and fluid-based biomarkers (eg, cerebrospinal fluid and blood) offer unique opportunities for characterizing biologic processes. Concussion biomarker research emerged with the hope that truly objective indicators may finally...

Objective: The Sport Concussion Assessment Tool (SCAT), fifth Edition, Symptom Evaluation (S5SE) differs from previous versions by having examinees report trait (i.e. "typical" feelings) as opposed to state (i.e., "how you feel right now") concussion-like symptoms at baseline. This study assessed differences among, and convergent validity of, scor...

Objective: Explore changes in micro-RNA (miRNA) expression in blood after sport-related concussion (SRC) in collegiate athletes. Methods: Twenty-seven collegiate athletes (~41% male, ~75% white, age 18.8 ± 0.8 years) provided both baseline and post-SRC blood samples. Serum was analyzed for expression of miR-153-3p (n = 27), miR-223-3p (n = 23), miR...

Objective: To investigate potential predictors of acute post-concussion symptom severity in a university population. Methods: Data were obtained from the University of Florida Student Health Care Center Concussion Databank. Symptom severity, measured by the Sport Concussion Assessment Tool – third edition Symptom Evaluation (S3SE), was analyzed at...

The study of contact and collision sport athletes at risk for concussion began approximately three decades ago. Since then, sport-related concussion (SRC) research across several medical specialties has helped to develop consensus guidelines for clinical management through interdisciplinary efforts. The modern landscape of SRC research includes lar...

Objective To evaluate changes in serum biomarker concentrations (β-amyloid peptide 42 [Aβ 42 ], total tau, ubiquitin carboxy-terminal hydrolyzing enzyme L1, S100 calcium binding protein B [S100B], glial fibrillary acidic protein [GFAP], microtubule associated protein 2 [MAP2], and 2′,3′-cyclic-nucleotide 3′-phosphodiesterase [CNPase]) after sport-r...

Objective: To describe variability in concussion biomarker concentrations collected from serum in a sample of healthy collegiate athletes, as well as report reliability metrics in a subsample of female athletes. Methods: In this observational cohort study, β-amyloid peptide 42 (Aβ42), total tau, S100 calcium binding protein B (S100B), ubiquitin...

Objective: To examine the effect of concussion history and cumulative exposure to collision sports on baseline serum biomarker concentrations, as well as associations between biomarker concentrations and clinical assessments. Methods: In this observational cohort study, β-amyloid peptide 42 (Aβ42), total tau, S100 calcium binding protein B (S100...

Objective: To explore differences in baseline King-Devick Test (KD) completion time between 2 testing modalities: (1) spiral-bound paper cards (cards) and (2) iPad application (iPad). Design: Cross-sectional cohort analysis. Setting: National Collegiate Athlete Association (NCAA) institutions. Participants: Student athletes from 13 women's a...

Chronic traumatic encephalopathy (CTE) occupies a unique and expanding position in both the scientific and lay communities concerned with sport participation at all levels. The benefits of rapid, widespread reporting and increased public awareness are counterbalanced by misinformation and an oversimplification of an increasingly complex topic. In t...

This study investigated drill-specific head impact biomechanics in a Division 1 collegiate football team using the Head Impact Telemetry System (HITS). A total of 32,083 impacts were recorded across 2 years of practices. Precise tracking of instrumented athletes, head impacts, and drill participation allowed quantification of hits sustained per per...

Objective: Prescription opioid misuse has become a significant public health issue. Previous research has examined predictors of prescription opioid use and misuse among former National Football League (NFL) players. The present study aimed to describe how reasons for prescription opioid use while in the NFL corresponds to use and misuse in retire...

This review seeks to summarize diffusion tensor imaging (DTI) studies that have evaluated structural changes attributed to the mechanisms of mild traumatic brain injury (mTBI) in adult civilian, military, and athlete populations. Articles from 2002 to 2016 were retrieved from PubMed/MEDLINE, EBSCOhost, and Google Scholar, using a Boolean search str...

Background: Timely removal from activity after concussion symptoms remains problematic despite heightened awareness. Previous studies indicated potential adverse effects of continuing to participate in physical activity immediately after sustaining a concussion. Hypothesis/Purpose: The purpose was to determine the effect of timing of removal from...

In Reply We thank Janigro for his letter regarding the specificity of chronic traumatic encephalopathy (CTE) pathology. In his letter, 2 studies of patients with refractory epilepsy are presented to support the argument that CTE pathology may result from conditions unrelated to repetitive brain trauma. We wish to clarify that statements regarding C...

Objectives: The purpose of this study was to assess the contribution of socioeconomic status (SES) and other multivariate predictors to baseline neurocognitive functioning in collegiate athletes. Methods: Data were obtained from the Concussion Assessment, Research and Education (CARE) Consortium. Immediate Post-Concussion Assessment and Cognitiv...

Traumatic brain injury (TBI) is an increasingly important issue among veterans, athletes and the general public. Difficulties with sleep onset and maintenance are among the most commonly reported symptoms following injury, and sleep debt is associated with increased accumulation of beta amyloid (Aβ) and phosphorylated tau (p-tau) in the interstitia...

Traumatic brain injury (TBI) is a widely recognized risk factor for neurodegenerative disease. The purpose of this review is to provide an update on the state of the science related to injury cascades in TBI-related neurodegeneration. Acute and chronic pathological outcomes of TBI are similar to those seen in several neurodegenerative conditions, s...

Neuropsychological assessment is a key component of the multidimensional approach recommended by international consensus guidelines for evaluation of athletes affected by sport-related concussion (SRC). Over the past 2 decades, a number of conventional and computerized neuropsychological test batteries have been developed for the assessment of SRC....

Objective Non-concussed individuals may report a variety of concussion-like symptoms even in the absence of a diagnosed brain injury. Previous studies described concussion-like symptom reporting in adolescent athletes. This study provides complementary data on concussion-like symptoms in collegiate athletes. Methods We analyzed baseline symptom sc...

Purpose: To characterize on-field features (location, player position, and time during game) and biomechanical features (anticipation status, closing distance, impact location and type) associated with concussions in NFL games over a 4-season period (2010-2011 to 2013-2014). Study Design: Descriptive epidemiology study Methods: We analyzed video...

Chronic traumatic encephalopathy (CTE) is a neuropathologically defined disease reportedly linked to a history of repetitive brain trauma. As such, retired collision sport athletes are likely at heightened risk for developing CTE. Researchers have described distinct pathological features of CTE as well a wide range of clinical symptom presentations...

Context: Computerized neurocognitive assessments are commonly used to manage sport-related concussion. Variations in baseline performance may influence neurocognitive performance after injury as well as the amount of time needed for an athlete to be cleared for return to sport participation. Objective: To investigate the relationship between mean...

Objective: The primary goals of this study were (1) to report rates of concussion-like symptoms in healthy adolescent student athletes assessed using the Sport Concussion Assessment Tool, 3rd edition (SCAT3) at baseline, (2) to examine rates of psychiatric diagnoses in this population, and (3) to evaluate effects of baseline symptoms on SCAT3 cogn...

Background: Concussions are common in football, and knowledge of their incidence rates across settings is needed to develop strategies to decrease occurrence. Purpose: To examine sports-related concussion rates in a National Collegiate Athletic Association (NCAA) Division I Football Bowl Subdivision sample based on the activity setting where inj...

Context: Preclinical research has demonstrated a window of vulnerability in the immediate aftermath of concussion wherein continued activity and stimulation can impair or prolong neurobehavioral recovery. However, this concept has not been quantified in a human population. Objective: To examine the effect of delayed reporting and removal from at...

Introduction: Increased variability in across-domain cognitive performance has been observed following sport-related concussion (SRC). Key factors affecting post-concussion performance variability have not been thoroughly explored. We examined whether one common symptom—changes in sleep following SRC—affects cognitive performance variability within...

Objective: The purpose of this study was to examine the dimensionality of the hypothetical constructs that compose the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), a popular, computerized assessment of neurocognitive function after concussion. Individual tests on the ImPACT are hypothesized to load onto four different factor...

OBJECTIVE: Sports concussion research supports the importance of baseline testing in collegiate athletes. Subjective symptom reporting scales reveal variable rates of concussion-related symptoms in this population even at baseline with some athletes appearing to meet concussion symptom criteria for ICD-10 Post-Concussion Syndrome (PCS) prior to inj...

Data published: Asken, B. M., McCrea, M. A., Clugston, J. R., Snyder, A. R., Houck, Z. M., & Bauer, R. M. (2016). “Playing Through It”: Delayed Reporting and Removal From Athletic Activity After Concussion Predicts Prolonged Recovery. Journal of athletic training, 51(4), 329-335.

Data showing the lack of association between baseline ImPACT performance and post-concussion deficits, as well as no association between post-concussion ImPACT deficits and return-to-play timeline. Associated manuscript currently in press.