ABSTRACT
Research on traumatic brain injury (TBI) sustained in contact sport is important for many reasons. Many people who regularly participate in contact sports are at a significant risk of sustaining concussion. Sport and recreation activities frequently rate as one of the top five causes of mild TBI (Bazarian et al., 1999; Sosin, Sniezek, & Thurman, 1996). Although it is believed that the majority of cases of single uncomplicated mild TBI and sports concussion lead to short-term neurobehavioural dysfunction, followed by full recovery, a sufficiently clear understanding of the sequelae is not currently available. Moreover, the high incidence of repeat concussion in contact sport has lead to concerns over protracted sequelae, traumatic encephalopathy, and even death due to second impact syndrome (Cantu, 1998). Perhaps the most problematic aspect of the diagnosis and management of concussion is the difficulty in reliably identifying a pathological change in the brain following trauma (McCrory, Johnston, Mohtadi, & Meeuwisse, 2001; Hovda et al., 1999). Contemporary imaging techniques regularly fail to reveal abnormality in cases of concussion, with diagnostic criteria relying almost solely on neurological indicators (Johnston, McCrory, Mohtadi, & Meeuwisse, 2001). The difficulty in identifying the underlying pathology of concussion is reflected in popular definitions of the injury, which rely almost exclusively on behavioural observation and assessment (see Johnston et al., 2001). Consequently, early attempts to standardise 170the diagnosis and management of concussion in sport have been based on clinical judgement with little empirical substance. The standardization of appropriate assessment techniques would provide an empirical basis for management of concussion in contact sport. A growing body of evidence suggests that of the various techniques available, neuropsychological assessment of brain function may be the most sensitive to dysfunction in concussion. The validation of such assessment in the context of contact sport has risen rapidly since 1995. Trauma sustained within the context of contact sport is likely to be of the mildest form seen in human activity (Alexander, 1995) and provides a model for examining the sequelae of TBI. The study of TBI in contact sport allows a unique opportunity to assess function before trauma occurs, permitting a more sensitive analysis of the effects of concussion on subsequent recovery. Thus, we see at least two reasons for neuropsychology to focus more attention on TBI in the sporting arena: (1) to gain a better understanding of minimal brain trauma, (2) to investigate the potential role of neuropsychological assessment in the management of sports-related TBI.
