Research

1. ProScope
2. Psychological Burden of Retirement
3. Medical Retirement Algorithm
4. Change in Heart Rate Variability after Concussion
5. Breakthrough Technology Improving Concussion

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Novel Concussion Biomarker Paves Way for New Diagnostic Tool

Researchers led by Thomas Bottiglieri and his team at Columbia University Irving Medical Center have identified a novel biomarker linked to head/neck/gaze instability (a subtle proprioceptive signal) that appears consistently in patients with more severe concussion symptoms, addressing limitations of current symptom-based assessments. By using an eye-tracking headset coupled with a machine-learning algorithm trained on data from over 200 patients (including controls), they developed a software tool (named “ProScope”) that quantifies head/neck/gaze motion to detect the signature biomarker with ~80-90 % sensitivity. This approach promises a more objective, measurable diagnostic metric for concussion—moving beyond self-reported symptoms and clinical observation—and could enable earlier, more precise decisions about injury management, athletic return, or retirement from sport.

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The Psychological Burden of Retirement from Sport

The authors review how retirement from athletics — particularly when it is involuntary (due to injury, illness, deselection, etc.) — poses significant psychological risks for collegiate and elite athletes. They highlight that while sports participation offers physical and mental benefits, the abrupt or unplanned end of a sporting career can lead to issues such as identity loss, depression, and anxiety. The review outlines a decision-making algorithm for clinicians faced with helping athletes transition out of sport, and advocates for early educational and support-program interventions to ease the career transition and reduce long-term psychological harm.

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Medical retirement from sport after concussions: A practical guide for a difficult discussion

The authors examine the challenging decision of medically retiring athletes from sport following concussion, noting the profound health, identity and psychosocial implications of ending a sports career prematurely. They review ten detailed case vignettes reflecting varied scenarios—such as persistent symptoms, radiographic evidence of brain injury, reduced injury threshold, or complex athlete motivations—and propose a structured decision-making algorithm to guide clinicians in discussions around return to sport versus retirement. Key considerations include athlete age, symptom duration and severity, prior injury history, neurologic findings, and non-medical factors such as athlete identity, financial implications and uncertainty about long-term risk. The paper emphasizes the need for nuanced, individualized discussions that balance athlete autonomy with long-term health risk, and underscores the lack of a one-size-fits-all rule in concussion retirement decisions.

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Change in Heart Rate Variability after Concussion in a Collegiate Soccer Player

This study investigated whether heart rate variability (HRV) could serve as a biomarker for concussion in athletes. Twenty NCAA Division II soccer players wore wrist heart rate sensors throughout a season and completed weekly symptom surveys. One athlete sustained a concussion, and researchers observed a significant drop in HRV in the week following the injury, with values returning to baseline alongside symptom resolution. Players without concussion showed stable HRV.

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Breakthrough Technology Improving Concussion Assessment and Player Safety

Dr. Thomas S. Bottiglieri was recently featured on the Advances in Care podcast, produced by NewYork-Presbyterian. In this episode, host Erin Welsh speaks with Dr. Bottiglieri about the evolving landscape of concussion care and the development of innovative tools designed to improve diagnosis and athlete safety.

Concussions affect millions of individuals each year in the United States, particularly athletes. While many injuries resolve with proper care, repeated head trauma and delayed diagnosis can increase the risk of long-term neurological complications. Improving the ability to objectively diagnose concussions has become a critical focus in sports medicine.

Through ongoing research and clinical investigation, Dr. Bottiglieri and his team identified a measurable biomarker associated with severe concussion injuries. This includes a subtle tremor of the head and neck that becomes more noticeable when a patient attempts to visually focus on a target. This discovery helped lead to the development of ProScope, an innovative eye-tracking technology that evaluates head and neck stability and assists clinicians in detecting concussion-related changes with high sensitivity.

This advancement represents an important step toward more accurate, accessible, and objective concussion diagnosis. The goal is to improve patient outcomes, support safer return-to-play decisions, and expand access to effective concussion care for athletes and active individuals.

Dr. Bottiglieri’s interest in concussion care is also personal. As a former college football linebacker, he understands firsthand the physical and emotional impact of sports injuries. His experience helps him connect with patients and guide them through recovery with a deeper perspective.

Listen to the full episode here: https://podcasts.apple.com/us/podcast/advances-in-care/id1671647417?i=1000750463693