Effect of Subconcussive Head Impact Exposure and Jugular Vein Compression on Behavioral and Cognitive Outcomes after a Single Season of High-School Football: A Prospective Longitudinal Trial

This prospective longitudinal trial aimed to (1) determine the role of head impact exposure on behavioral/cognitive outcomes, and (2) assess the protective effect(s) of a jugular vein compression (JVC) collar on behavioral/cognitive outcomes after one season of high-school football. Participants included 284 male high-school football players aged 13-18 years enrolled from seven Midwestern high-schools. Schools were allocated to the JVC collar intervention (four teams, 140 players) or no collar/no intervention control (three teams, 144 players) condition. Head impact exposure was measured throughout the season using CSx accelerometers. Outcome measures included post-season parent and adolescent report on Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale (SWAN) and Post-Concussion Symptom Inventory (PCSI), as well as adolescent performance on Attention Network Task (ANT), digital Trail Making Task (dTMT), and Cued Switching task. No significant effect of head impact exposure or JVC collar use on post-season SWAN or PCSI scores or performance on dTMT and Cued Switching task were noted. There was no effect of head impact exposure on ANT performance; however, the JVC collar group had greater post-season Alerting network scores than the no collar group (p = 0.026, d = 0.22). Findings provide preliminary evidence that the JVC collar may provide some protection to the alerting attention system. These findings should be interpreted cautiously as a greater understanding of the long-Term sequelae of head impact exposure and the role of cumulative head impact exposure behavioral/cognitive outcomes is required.