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Consensus Statement on Concussion in Sport—The 4th International Conference on Concussion in Sport Held in Zurich, November 2012

2013; Wiley; Volume: 5; Issue: 4 Linguagem: Inglês

10.1016/j.pmrj.2013.02.012

1934-1563

Paul McCrory, Willem Meeuwisse, Mark Aubry, Robert C. Cantu, Jiří Dvořák, Ruben J. Echemendía, Lars Engebretsen, Karen M. Johnston, Jeffrey S. Kutcher, Martin Raftery, Allen K. Sills, Brian W. Benson, Gavin A Davis, Richard Ellenbogen, Kevin M. Guskiewicz, Stanley A. Herring, Grant L. Iverson, Barry D. Jordan, James Kissick, Michael McCrea, Andrew S. McIntosh, David Maddocks, Michael Makdissi, Laura Purcell, Margot Putukian, Kathryn Schneider, Charles H. Tator, Michael S. Turner,

Injury Epidemiology and Prevention

PM&RVolume 5, Issue 4 p. 255-279 Special Feature Consensus Statement on Concussion in Sport—The 4th International Conference on Concussion in Sport Held in Zurich, November 2012 Paul McCrory MBBS, PhD, Paul McCrory MBBS, PhD Associate Professor, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia Disclosure: co-investigator, collaborator, consultant on grants relating to mild TBI funded by several governmental organizations; co-chair, Australian Centre for Research into Sports Injury and its Prevention, one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee; clinical and consulting practice in general and sports neurology; receives book royalties, McGraw-Hill; employed in an editorial capacity, British Medical Journal Publishing Group, 2001-2008; reimbursed by the government, professional scientific bodies, and sporting bodies for presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums; received consultancy fees, 2010, Axon Sports (US) for development of educational material (which was not renewed); received research funding since 2005, CogState Inc.; cofounder and shareholder in 2 biomedical companies (involved in eHealth and Compression garment technologies) but does not hold any individual shares in any company related to concussion or brain injury assessment or technology. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorWillem H. Meeuwisse MD, PhD, Willem H. Meeuwisse MD, PhD Professor and Co-chair, Sport Injury Prevention Research Centre, Faculty of Kinesiology and Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada Disclosure: received research grant support, University of Calgary from the Canadian Institutes of Health Research, Alberta Innovates Health Solutions, the International Football Association (FIFA), Alberta Children's Hospital Research Institute, and the Hotchkiss Brain Institute; co-chair, Sport Injury Prevention Research Centre, one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee; clinical and consulting practice in sport medicine, University of Calgary Sport Medicine Centre, focus on sport related concussion; received travel funding, FIFA and the Medical Commission of the IOC; editor-in-chief, 1998-2012, Clinical Journal of Sport Medicine and received editorial support funding, Lippincott-Wolters Kluwer; receives compensation as a medical consultant, National Hockey League; may receive royalty, BKIN Technologies; shareholder, Safebrain Canada and PrivIT Healthcare. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorMark Aubry MD, Mark Aubry MD Chief Medical Officer, International Ice Hockey Federation, Switzerland; Member of the IOC Medical Commission Games Group; Co-director, Ottawa Sport Medicine Centre, Ottawa, Ontario, Canada Disclosure: receives travel funding, IIHF and IOC Medical Commission Games Group for meetings, IIHF Championships, and Olympic Games. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorRobert C. Cantu MD, Robert C. Cantu MD Clinical Professor, Neurosurgery and Co-director, Center for the Study of Traumatic Encephalopathy, Boston University Medical Center, Boston, MA Disclosure: vice president, National Operating Committee on Standards for Athletic Equipment; co-founder and chairman medical director, Sports Legacy, Waltham, MA, USA; senior advisor, NFL's Head, Neck and Spine Committee; expert witness, trial testimony. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorJir̆í Dvor̆ák MD, Jir̆í Dvor̆ák MD Professor of Neurology, University of Zurich; Senior Consultant, Schulthess Clinic Zurich, Switzerland; Chairman F-MARC (FIFA Medical Assessment and Research Center) Zurich Switzerland Disclosure: received compensation, chief medical officer, FIFA. No other compensations or grants have been received. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorRuben J. Echemendia PhD, Ruben J. Echemendia PhD Psychological and Neurobehavioral Associates, Inc, State College, PA, USA; Adjunct Associate Professor of Psychology, University of Missouri, Kansas City, MO, USA Disclosure: receives financial compensation, consultant, National Hockey League, Major League Soccer, and the U.S. Soccer Federation; receives financial compensation, consultant, Princeton University; served as PI or co-PI on grants, NOCSAE, AMSSM, and the New Jersey Commission on Brain Injury Research; maintains a private practice focused on clinical neuropsychology, sports neuropsychology, and forensic applications of neuropsychology. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorLars Engebretsen MD, PhD, Lars Engebretsen MD, PhD Professor, Department of Orthopaedic Surgery, Oslo University Hospital and Faculty of Medicine, University of Oslo, Norway; Co-chair, Oslo Sports Trauma Research Center, Oslo, Norway; Head, Scientific Activities, International Olympic Committee (IOC), Lausanne Switzerland Disclosure: received research grant support, University of Oslo from the Norwegian Institutes of Health Research, The Health South East, the International Football Association; co-chair, Sport Injury Prevention Research Centre, one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committeel; professor and chair, Oslo University Orthopedic department; 2008-present, editor-in-chief, BJSM IPHP; January 2012-present, co-editor, The Journal of Bone and Joints. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorKaren M. Johnston MD, PhD, Karen M. Johnston MD, PhD Neurosurgeon, Division of Neurosurgery, University of Toronto; Concussion Management Program, Athletic Edge Sports Medicine, Toronto, Canada Disclosure: neurosurgeon subspecialized in brain trauma; clinical and research focus in sport concussion; received research funding through the CIHR, ONF, and Innovation Fund, American College of Surgeons, McGill University, Pashby Sport Safety Fund, and Think First Canada; independent consultant, many sport organizations. She has never had a formal reimbursed affiliation with any sport team or sport governing body. She did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorJeffrey S. Kutcher MD, Jeffrey S. Kutcher MD Associate Professor and Director, Michigan NeuroSport, Department of Neurology, University of Michigan, Ann Arbor, MI, USA Disclosure: director, Michigan NeuroSport, University of Michigan's academic sports neurology program; received research grant support, National Collegiate Athletic Association and ElMindA, Ltd.; director, National Basketball Association's Concussion Program; paid consultant, National Hockey League Players' Association; current member, National Football League Players' Association's Mackey-White TBI Committee; consulting neurologist, United States Ski and Snowboard Association; founding member and the first chairperson, Sports Neurology Section of the American Academy of Neurology. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorMartin Raftery MBBS, Martin Raftery MBBS Chief Medical Officer, International Rugby Board, Dublin, Ireland Disclosure: nothing to discloseSearch for more papers by this authorAllen Sills MD, Allen Sills MD Associate Professor, Neurosurgery, Orthopaedic Surgery and Rehabilitation; Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN, USA Disclosure: medical board, received travel funding, Federation Equestrian Internationale; unpaid neurosurgical consultant, US Equestrian Foundation, the Southeastern Conference Working Group on Concussion, and Nashville Predators (NHL) hockey team; clinical practice in neurosurgery, Vanderbilt University Medical Center, with a focus on neurological problems in athletes. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorBrian W. Benson MD, PhD, Brian W. Benson MD, PhD Adjunct Research Assistant Professor, Department of Clinical Neurosciences, Faculty of Medicine; Clinical Assistant Professor, Department of Family Medicine, Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada Disclosure: clinical and consulting practice, sport medicine, University of Calgary Sport Medicine Centre with a focus on sport-related concussion; director, Sport Concussion Clinic at the University of Calgary Sport Medicine Centre; may receive royalty from BKIN Technologies. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorGavin A. Davis MBBS, Gavin A. Davis MBBS Department of Neurosurgery, Austin and Cabrini Hospitals and The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia Disclosure: received travel funding, FIFA. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorRichard Ellenbogen MD, Richard Ellenbogen MD Professor and Chairman, Theodore S. Roberts Endowed Chair, Department of Neurological Surgery, University of Washington Seattle, WA. USA; Cochair, NFL Head, Neck and Spine Medical Committee Disclosure: nothing to discloseSearch for more papers by this authorKevin M. Guskiewicz PhD, Kevin M. Guskiewicz PhD Kenan Distinguished Professor and Chair, Department of Exercise and Sport Science; Co-director, Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Disclosure: serves on NCAA's Health and Safety Advisory Committee for Concussion, NFL's Head Neck and Spine Committee, and NFLPA's Mackey-White Committee; received funding for travel and honoraria for lectures on sports concussion for professional organizations, including the IOC and FIFA; expert testimony, traumatic brain injury/concussion cases; received research funding, National Institutes of Health, Centers for Disease Control and Prevention, National Operating Committee for Standards in Athletic Equipment, National Collegiate Athletic Association, NFL Charities, NFL Players' Association, USA Hockey, and National Athletic Trainers' Association. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorStanley A. Herring MD, Stanley A. Herring MD Clinical Professor, Departments of Rehabilitation Medicine, Orthopaedics, and Sports Medicine and Neurological Surgery, University of Washington; Co-Medical Director, Seattle Sports Concussion Program; Team Physician, Seattle Seahawks and Seattle Mariners, Seattle, WA, USA Disclosure: member, National Football League Head, Neck and Spine Committee; member, Football and Wellness Committee USA Football; member, Medical Advisory Board Pop Warner Football; chair, Medical Advisory Board X2IMPACT, a non-financial position; clinical and consulting practice, Harborview Medical Center focusing on the diagnosis and management of neurological and musculoskeletal injuries with particular interest in spinal disorders in active people and athletes and sports-related concussions. No form of financial support directly related to this manuscript was received.Search for more papers by this authorGrant L. Iverson PhD, Grant L. Iverson PhD Neuropsychology Outcome Assessment Laboratory; Professor, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada Disclosure: reimbursed by government, professional scientific bodies, and commercial organizations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums; clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs (including professional athletes); received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorBarry D. Jordan MD, Barry D. Jordan MD Associate Professor, Clinical Neurology at Weill Medical College of Cornell University. New York, NY, USA; Assistant Medical Director, Burke Rehabilitation Hospital, White Plains, NY, USA; Chief Medical Officer, New York State Athletic Commission, New York, NY, USA Disclosure: financial compensation, National Football League (NFL) Benefits Association for the establishment of Neurocognitive Disability Benefit for retired players; financial compensation, Innovative CEUs, developing a medical-based high school coaching education program; as the CMO of New York State Athletic Commission, is a governor's appointed public officer of the State of New York; maintains an inpatient and outpatient clinical practice, Burke Rehabilitation Hospital specializing in traumatic brain injury, dementia, and sports neurology; National Football League Players Association Mackey-White Traumatic Brain Injury Committee. Dr. Jordan did not receive any financial support related to this manuscript.Search for more papers by this authorJames Kissick MD, James Kissick MD Sport Medicine Physician, Ottawa Sport Medicine Centre, Ottawa, Canada; Clinical Lecturer, Department of Family Medicine, University of Ottawa, Ottawa, Canada; Team Physician, Canadian National Men's Sledge Hockey Team Disclosure: clinical and consulting practice in sport and exercise medicine, Ottawa Sport Medicine Centre. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorMichael McCrea PhD, Michael McCrea PhD Professor and Director, Brain Injury Research, Departments of Neurosurgery and Neurology, Medical College of Wisconsin, WI, USA Disclosure: funded, United States Department of Defense, U.S. Defense Veterans Brain Injury Center, NFL Charities, National Collegiate Athletic Association, National Operating Committee on Standards for Athletic Equipment, National Federation of High School Associations, and other funding organizations (past decade); member, NFL Head, Neck and Spine Committee; served on several U.S. national panels for scientific review and policy making relevant to sport-related concussion; funded by BrainScope, Inc. for prior studies, but receives no direct compensation from BrainScope or other industry entities/sports organizations; co-author, Standardized Assessment of Concussion (receives no financial compensation or support from publication or distribution of the SAC); PI on a study by the U.S. Department of Defense comparing several computerized neurocognitive assessment tools for the assessment of sport-related concussion. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorAndrew S. McIntosh PhD, Andrew S. McIntosh PhD Adjunct Associate Professor, Australian Centre for Research into Injury in Sports and its Prevention, Monash Injury Research Institute, Monash University; Adjunct Associate Professor, Transport and Road Safety Research, Faculty of Science, the University of New South Wales; Director, McIntosh Consultancy and Research Pty Ltd., Sydney, Australia Disclosure: self-employed consultant; has received grant support through UNSW from the Australian Research Council, NSW Racing, the IRB, the ARU, and the AFL; consultant, sport and sports injury, including the Australian Racing Board, McLaren F1, the IRB, and Albion; received travel funding, International Rugby Board, IIHF, FIFA, the Medical Commission of the IOC. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorDavid L. Maddocks LLB, PhD, David L. Maddocks LLB, PhD Barrister and Solicitor, Perry Maddocks Trollope Lawyers, Melbourne, Australia. Neuropsychologist in private practice Disclosure: received research grant support, Australian Football League (AFL); provides consultancy medico-legal advice, AFL; received travel funding, FIFA. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorMichael Makdissi MBBS, PhD, Michael Makdissi MBBS, PhD Research Fellow, The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Austin Campus, Melbourne, Australia; Research Fellow, Centre for Health Exercise and Sports Medicine, Melbourne Physiotherapy Department, University of Melbourne, Melbourne, Australia Disclosure: received research grant support, The Florey Institute of Neurosciences and Mental Health from the National Health and Medical Research Council, the Australian Football League, and AFL Medical Officers Association; received travel funding, FIFA; clinical and consulting practice in sports medicine. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorLaura Purcell MD, Laura Purcell MD Associate Clinical Professor, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Pediatric Sport Medicine Physician, David Braley Sport Medicine and Rehabilitation Centre, McMaster University, Hamilton, Ontario, Canada; President, Paediatric Sport and Exercise Medicine Section, CPS Disclosure: nothing to discloseSearch for more papers by this authorMargot Putukian MD, Margot Putukian MD Director of Athletic Medicine, Head Team Physician, Princeton University; Associate Clinical Professor, Robert Wood Johnson, University of Medicine and Dentistry of New Jersey (UMDNJ), NJ, USA Disclosure: received research grant support, New Jersey Commission on Brain Injury, the American Medical Society for Sports Medicine, and the National Operating Committee on Standards for Athletic Equipment; chair, US Lacrosse Sports Science & Safety Committee; serves on the National Football League Head Neck and Spine Committee, chairing the Return to Play subcommittee, NFL; team physician, Princeton University; team physician, US Men's National Lacrosse Team and US Soccer; consultant, concussion, Center for Disease Controls and National Collegiate Athletic Association; past president, AMSSM; president, AMSSM Foundation. Dr. Putukian does not receive any financial compensation for her work with the AMSSM, NFL, US Lacrosse, CDC or NCAA. She did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorKathryn Schneider PhD, Kathryn Schneider PhD Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada Disclosure: research grant support, University of Calgary from the Alberta Centre for Child, Family and Community Research; clinical and consulting practice in physiotherapy, Evidence Sport and Spinal and Centric Health with a focus on sport related concussion. She did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorCharles H. Tator MD, PhD, Charles H. Tator MD, PhD Professor of Neurosurgery, Toronto Western Hospital and University of Toronto, Canada; Senior Scientist, Krembil Neuroscience Centre, Toronto, Canada; Founder, ThinkFirst Canada; Board Member, Parachute Canada Disclosure: consultant, ImpaKt Protective; co-chair, Concussion Awareness and Recognition Committee of the Ontario Neurotrauma Foundation, chair, ThinkFirst's Concussion Education and Awareness Committee; project director, Canadian Sports Concussion Project, Krembil Neuroscience Centre; director, Ontario Concussion Centres Consortium; received research grants, public sources including Canadian Institute for Health Research, and Ontario Brain Institute. He did not receive any financial support related to this manuscript.Search for more papers by this authorMichael Turner MD, Michael Turner MD Chief Medical Adviser, British Horseracing Authority, London, United Kingdom Disclosure: chief medical advisor, British Horseracing Authority, Lawn Tennis Association; travel funding, FIFA, the IOC, the ACSM, and Gruppoforte (Physiomind), for attending conferences and lecturing; most conferences also provided free registration and support for accommodations. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this author Paul McCrory MBBS, PhD, Paul McCrory MBBS, PhD Associate Professor, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia Disclosure: co-investigator, collaborator, consultant on grants relating to mild TBI funded by several governmental organizations; co-chair, Australian Centre for Research into Sports Injury and its Prevention, one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee; clinical and consulting practice in general and sports neurology; receives book royalties, McGraw-Hill; employed in an editorial capacity, British Medical Journal Publishing Group, 2001-2008; reimbursed by the government, professional scientific bodies, and sporting bodies for presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums; received consultancy fees, 2010, Axon Sports (US) for development of educational material (which was not renewed); received research funding since 2005, CogState Inc.; cofounder and shareholder in 2 biomedical companies (involved in eHealth and Compression garment technologies) but does not hold any individual shares in any company related to concussion or brain injury assessment or technology. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorWillem H. Meeuwisse MD, PhD, Willem H. Meeuwisse MD, PhD Professor and Co-chair, Sport Injury Prevention Research Centre, Faculty of Kinesiology and Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada Disclosure: received research grant support, University of Calgary from the Canadian Institutes of Health Research, Alberta Innovates Health Solutions, the International Football Association (FIFA), Alberta Children's Hospital Research Institute, and the Hotchkiss Brain Institute; co-chair, Sport Injury Prevention Research Centre, one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee; clinical and consulting practice in sport medicine, University of Calgary Sport Medicine Centre, focus on sport related concussion; received travel funding, FIFA and the Medical Commission of the IOC; editor-in-chief, 1998-2012, Clinical Journal of Sport Medicine and received editorial support funding, Lippincott-Wolters Kluwer; receives compensation as a medical consultant, National Hockey League; may receive royalty, BKIN Technologies; shareholder, Safebrain Canada and PrivIT Healthcare. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorMark Aubry MD, Mark Aubry MD Chief Medical Officer, International Ice Hockey Federation, Switzerland; Member of the IOC Medical Commission Games Group; Co-director, Ottawa Sport Medicine Centre, Ottawa, Ontario, Canada Disclosure: receives travel funding, IIHF and IOC Medical Commission Games Group for meetings, IIHF Championships, and Olympic Games. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorRobert C. Cantu MD, Robert C. Cantu MD Clinical Professor, Neurosurgery and Co-director, Center for the Study of Traumatic Encephalopathy, Boston University Medical Center, Boston, MA Disclosure: vice president, National Operating Committee on Standards for Athletic Equipment; co-founder and chairman medical director, Sports Legacy, Waltham, MA, USA; senior advisor, NFL's Head, Neck and Spine Committee; expert witness, trial testimony. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorJir̆í Dvor̆ák MD, Jir̆í Dvor̆ák MD Professor of Neurology, University of Zurich; Senior Consultant, Schulthess Clinic Zurich, Switzerland; Chairman F-MARC (FIFA Medical Assessment and Research Center) Zurich Switzerland Disclosure: received compensation, chief medical officer, FIFA. No other compensations or grants have been received. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorRuben J. Echemendia PhD, Ruben J. Echemendia PhD Psychological and Neurobehavioral Associates, Inc, State College, PA, USA; Adjunct Associate Professor of Psychology, University of Missouri, Kansas City, MO, USA Disclosure: receives financial compensation, consultant, National Hockey League, Major League Soccer, and the U.S. Soccer Federation; receives financial compensation, consultant, Princeton University; served as PI or co-PI on grants, NOCSAE, AMSSM, and the New Jersey Commission on Brain Injury Research; maintains a private practice focused on clinical neuropsychology, sports neuropsychology, and forensic applications of neuropsychology. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorLars Engebretsen MD, PhD, Lars Engebretsen MD, PhD Professor, Department of Orthopaedic Surgery, Oslo University Hospital and Faculty of Medicine, University of Oslo, Norway; Co-chair, Oslo Sports Trauma Research Center, Oslo, Norway; Head, Scientific Activities, International Olympic Committee (IOC), Lausanne Switzerland Disclosure: received research grant support, University of Oslo from the Norwegian Institutes of Health Research, The Health South East, the International Football Association; co-chair, Sport Injury Prevention Research Centre, one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committeel; professor and chair, Oslo University Orthopedic department; 2008-present, editor-in-chief, BJSM IPHP; January 2012-present, co-editor, The Journal of Bone and Joints. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorKaren M. Johnston MD, PhD, Karen M. Johnston MD, PhD Neurosurgeon, Division of Neurosurgery, University of Toronto; Concussion Management Program, Athletic Edge Sports Medicine, Toronto, Canada Disclosure: neurosurgeon subspecialized in brain trauma; clinical and research focus in sport concussion; received research funding through the CIHR, ONF, and Innovation Fund, American College of Surgeons, McGill University, Pashby Sport Safety Fund, and Think First Canada; independent consultant, many sport organizations. She has never had a formal reimbursed affiliation with any sport team or sport governing body. She did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorJeffrey S. Kutcher MD, Jeffrey S. Kutcher MD Associate Professor and Director, Michigan NeuroSport, Department of Neurology, University of Michigan, Ann Arbor, MI, USA Disclosure: director, Michigan NeuroSport, University of Michigan's academic sports neurology program; received research grant support, National Collegiate Athletic Association and ElMindA, Ltd.; director, National Basketball Association's Concussion Program; paid consultant, National Hockey League Players' Association; current member, National Football League Players' Association's Mackey-White TBI Committee; consulting neurologist, United States Ski and Snowboard Association; founding member and the first chairperson, Sports Neurology Section of the American Academy of Neurology. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorMartin Raftery MBBS, Martin Raftery MBBS Chief Medical Officer, International Rugby Board, Dublin, Ireland Disclosure: nothing to discloseSearch for more papers by this authorAllen Sills MD, Allen Sills MD Associate Professor, Neurosurgery, Orthopaedic Surgery and Rehabilitation; Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN, USA Disclosure: medical board, received travel funding, Federation Equestrian Internationale; unpaid neurosurgical consultant, US Equestrian Foundation, the Southeastern Conference Working Group on Concussion, and Nashville Predators (NHL) hockey team; clinical practice in neurosurgery, Vanderbilt University Medical Center, with a focus on neurological problems in athletes. He did not receive any form of financial support directly related to this manuscript.Search for more papers by this authorBrian W. Benson MD, PhD, Brian W. Benson MD, PhD Adjunct Research Assistant Professor, Department of Clinical Neurosciences, Faculty of Medicine; Clinical Assistant Professor, Department of Family Medicine, Sport Medicine Centre, Faculty of Kinesiolog