Citation

Davis GA, Patricios J, Schneider KJ, Iverson GL, Silverberg ND. Br. J. Sports Med. 2023; 57(11): 617-618.

Copyright

(Copyright © 2023, BMJ Publishing Group)

DOI

10.1136/bjsports-2022-106650

PMID

37316209

Abstract

The field of sport-related concussion (SRC) has long-endured the absence of a universally accepted definition, complicated by different terminology such as 'concussion' and 'mild traumatic brain injury' (mTBI). Critical to this issue is agreement and implementation of conceptual and operational definitions. A conceptual (theoretical) definition explains what a disease entity is (eg, pathophysiology and typical clinical presentation), but does not identify which clinical features are necessary or sufficient to classify a 'case' with the disease.1 An operational definition specifies how to determine whether an individual has the disease, such as by applying diagnostic criteria. Conceptual and operational definitions are complementary.

The Concussion in Sport Group (CISG) proposed a conceptual definition of SRC in 2001.2 This definition has undergone updates and modifications at subsequent CISG meetings, with the most recent being in Berlin in 2016.3 In preparation for the 6th International Conference on Concussion in Sport, the scientific committee considered that the Berlin definition may require further modification to align with more recent scientific evidence relating to advances in our understanding of the pathophysiology of SRC.

Concurrently, between 2018 and 2022, the Mild Traumatic Brain Injury Task Force of the American Congress of Rehabilitation Medicine (ACRM) Brain Injury Special Interest Group undertook an update of the 1993 ACRM definition for mTBI.4 Expert panel member ratings of the diagnostic importance of various signs, symptoms and examination findings,5 and a series of rapid evidence reviews informed an initial draft of the updated diagnostic criteria. The criteria then underwent a Delphi consensus process, with revisions after each round of voting, until expert consensus was reached.5 Key elements of the ACRM diagnostic criteria for mTBI are reprinted in the table 1. There are also criteria …

Language: en

Keywords

Brain Concussion