title: Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes.
abstract: BACKGROUND
  Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.
  
  
  OBJECTIVE
  The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.
  
  
  METHODS
  A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.
  
  
  RESULTS
  Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.
  
  
  CONCLUSIONS
  Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby.
authors.affiliation: Psychiatry Department, Stellenbosch University , Stellenbosch, South Africa .
authors.forename: D G
authors.initials: DG
authors.lastname: Alexander
authors.forename: A B
authors.initials: AB
authors.lastname: Shuttleworth-Edwards
authors.forename: M
authors.initials: M
authors.lastname: Kidd
authors.forename: C M
authors.initials: CM
authors.lastname: Malcolm
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D001924:Brain Concussion / Q000534:rehabilitation; D001930:Brain Injuries / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D003071:Cognition; D004522:Educational Status; D005538:Football / Q000293:injuries*; D006801:Humans; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D013019:South Africa; D016896:Treatment Outcome
keywords: Academic performance; MTBI; adolescence; concussion; mild traumatic brain injury; neurocognitive; rugby