As a sports neurologist, I see firsthand the passion and dedication young athletes bring to their chosen sports, and it's truly inspiring. As with anything, however, that dedication comes with risks, especially as young people get older. Head injuries, particularly concussions, are often what most concern parents, coaches, and athletic programs. Yet the field of Sports Neurology has becoming increasingly focused in recent years on the concept of gradually transitioning from the concept of “baseline testing” (which frames assessments solely in the context of brain injuries such as concussion) to “Brain Health Assessments,” which frames evaluation of the brain and nervous system in an overall health context and is important as a concept for ALL people (particularly athletes, who may be at risk for concussive injury). It is a subtle, but significant shift. Let me explain why.
Historically, baseline testing has involved a series of cognitive assessments completed by skilled neurologists and other health professionals on an athlete before their athletics season begins. These "baseline tests" measure various aspects of brain function, including memory, attention, visual acuity, mental processing speed, and reaction time. Baseline testing’s importance comes best into play when an athlete is injured. Think of a concussion as a disruption in the brain's regular electrical activity. When a young athlete sustains a head injury, it's often difficult to determine the full extent of the damage because we usually don't have a pre-injury "baseline" to compare it to. Without this baseline, we may not be able to accurately assess the severity of the injury, leading to potential complications or premature return to play.
On the other hand, brain health assessment shifts the focus from injury only, to overall brain wellness – in and outside of a sport, and whether any injury is sustained. To underscore this crucial shift in how neurologists approach brain health, even the American Academy of Neurology recently changed its mission statement to include “brain health.” As we shift away from an injury-only focus, there is significance to athletes from a standpoint of surveillance of overall brain health over time, training for optimal performance, and the ability to use brain health assessments for comparison to gauge recovery if injury does occur.
As a field of medicine, Sports Neurology is aiming more and more toward framing the brain health conversation away from concussion to brain health surveillance, and optimization of performance – which is particularly important for and of interest to athletes. But just like other aspects of sports medicine, our goal is to use the expanding fund of knowledge and lessons learned from working with athletes to benefit non-athletes as well, including students, young workers, mid-career professionals, and those transitioning into late or second careers and/or retirement.
Of course, none of this shift from baseline testing to brain health assessment means that concussion prevention and monitoring are of any less importance. Creating an environment of open communication is a crucial part of our collective responsibility in keeping young athletes safe. Coaches and parents, your role in this cannot be overstated. By fostering an atmosphere where athletes feel safe, comfortable, and supported in reporting any head or other injuries they may experience, you are empowering them to take charge of their brain and overall health and well-being. As parents, coaches, and brain health professionals, we can work together to ensure that young athletes can continue to enjoy their sports safely and confidently for as long as they choose to play. As a sports neurologist, I aim to empower young athletes to reach their full potential while prioritizing their brain health and overall wellness.
Sources:
https://www.vernonwilliamsmd.com/media/videos/dr-williams-explains-new-concussion-baseline-tec/
https://www.yahoo.com/news/play-not-play-concussion-100000678.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116697/
https://www.childrens.com/health-wellness/benefits-of-baseline-testing-for-your-young-athlete
https://playworksphysio.com/2018/09/concussion-baseline-testing-what-is-it/
https://www.uclahealth.org/news/article/baseline-concussion-testing-has-important-role-sports-safety