Neuropsychological change after a single season of head impact exposure in youth football

Arthur Maerlender, Eric Smith, P. Gunnar Brolinson, Joseph Crisco, Jillian Urban, Amaris Ajamil, Steven Rowson, Eamon T. Campolettano, Ryan A. Gellner, Srinidhi Bellamkonda, Emily Kieffer, Mireille E. Kelley, Derek Jones, Alex Powers, Jonathan Beckwith, Joel Stitzel, Richard M. Greenwald, Stefan Duma

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes. Method: Over 200 participants (ages 9-13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre-and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes. Results: For the full sample, a small effect was found with season average rotational values predicting changes in list-learning such that HIE was related to negative score change: standardized beta (β) =-.147, t(205) =-2.12, and p =.035. When analyzed by age clusters (9-10, 11-13) and adding participant weight to models, the R 2 values increased. Splitting groups by weight (median split), found heavier members of the 9-10 cohort with significantly greater change than lighter members. Additionaly, significantly more participants had clinically meaningful negative changes: X 2 = 10.343, p =.001. Conclusion: These findings suggest that in the 9-10 age cluster, the average seasonal level of HIE had inverse, negative relationships with cognitive change over one season that was not found in the older group. The mediation effects of age and weight have not been explored previously and appear to contribute to the effects of HIE on cognition in youth football players.

Original languageEnglish (US)
Pages (from-to)113-123
Number of pages11
JournalJournal of the International Neuropsychological Society
Issue number2
StatePublished - Feb 2021


  • Cognition
  • Head impact exposure
  • NIH Toolbox
  • Neuropsychological test
  • Reliable change
  • Youth football

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health


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