Long-term effects of traumatic brain injury in athletes: The most common clinical manifestations

Introduction . Traumatic brain injury (TBI) is a pressing issue in high-performance sports. Although most sports-related TBIs are classified as mild, their frequent occurrence and resulting cumulative effect can negatively impact an athlete’s health. Furthermore, this impact may not become apparent until several years after the injury, and sometimes only after the athlete has retired from the sport. Objective . To identify the most frequent clinical manifestations associated with the long-term effects of traumatic brain injury in active and retired athletes from various sports. Materials and methods . In order to assess the prevalence of symptoms associated with various TBI consequences, a total of 902 active and former athletes from Russian national teams were surveyed anonymously using a secure online platform, LimeSurvey, with a proprietary domain. The participants included 662 (73.4%) adult and 240 (26.6%) minor athletes. The study methodology was based on a questionnaire and did not include objective instrumental examinations. The questionnaire presented to the athletes contained questions clarifying anamnestic data and the presence of symptoms that could serve as clinical manifestations of the long-term effects of intracranial injuries. The entire sample of athletes was divided into groups according to age at the time of the survey (adults and minors). The group of adult athletes was also subdivided based on the number of TBIs in their history, the presence of contact/impacts during training (contact and non-contact sports), and age (18–30 years; 31–40 years; 41–50 years; ≥ 51 years). Statistical data analysis was performed using IBM SPSS Statistics 23.0 software. Results . The prevalence of concussion among the adult athletes was statistically significantly higher than among the minors (15.3% vs. 2.5%, p < 0.001). The most common issues reported by the adult athletes with a history of concussion were sleep (36.6%) and visual disturbances (23.8%), as well as cognitive (25.7%), behavioral (22.8%), and affective (27.7%) disturbances. The aforementioned abnormalities were statistically significantly more frequent in the athletes participating in contact sports ( p < 0.05). The athletes aged 18–30 years most commonly noted affective disturbances and changes in sleep, while visual disturbances were more prevalent in older age groups. Conclusions . The most common clinical manifestations of TBI consequences in athletes consist of a complex of affective, cognitive, and behavioral disturbances, as well as impaired sleep and vision. Most consequences of intracranial injuries present with non-specific symptoms. Therefore, a crucial approach to optimizing the biomedical support system for athletes with a history of TBI consists in continuous monitoring of their health status post-injury. This involves developing screening protocols, followed by the formation of risk groups and early identification of impairments, which will help prevent or slow their progression.