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Concussion Patient’s Guide — References

This page lists the academic and web-based sources that informed the Concussion Patient’s Guide. It is provided for those who wish to review the references used within the guide.

Web Resources:

Academic Resources:

  • Massé, O., Mercurio, C.M., Dupuis, S. et al., 2026. Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis. BMJ, 393, e088050. Available at: https://www.bmj.com/content/393/bmj-2025-088050.long [Accessed 21 Sep. 2026].
  • Cong, B. and Zhang, H., 2025. The effects of combined calcium and vitamin D supplementation on bone mineral density and fracture risk in postmenopausal women with osteoporosis: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders, 26, 928. Available at: https://doi.org/10.1186/s12891-025-09089-7 [Accessed 21 Sep. 2026].
  • Groenendijk, I., den Boeft, L., van Loon, L.J.C. and de Groot, L.C.P.G.M., 2019. High versus low dietary protein intake and bone health in older adults: a systematic review and meta-analysis. Computational and Structural Biotechnology Journal, 17, pp.1101–1112. Available at: https://pubmed.ncbi.nlm.nih.gov/31462966/ [Accessed 21 Sep. 2026].
  • Farsinejad-Marj, M., Saneei, P. and Esmaillzadeh, A., 2016. Dietary magnesium intake, bone mineral density and risk of fracture: a systematic review and meta-analysis. Osteoporosis International, 27(4), pp.1389–1399. Available at: https://pubmed.ncbi.nlm.nih.gov/26556742/ [Accessed 21 Sep. 2026].
  • Xie, C., Gong, J., Zheng, C. et al., 2024. Effects of vitamin K supplementation on bone mineral density at different sites and bone metabolism in the middle-aged and elderly population: a meta-analysis and systematic review of randomized controlled trials. Bone & Joint Research, 13(12), pp.750–763. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11631259/ [Accessed 21 Sep. 2026].
  • Sun, C., Yang, A., Teng, F. and Xia, Y., 2025. Efficacy of collagen peptide supplementation on bone and muscle health: a meta-analysis. Frontiers in Nutrition, 12, 1646090. Available at: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1646090/full [Accessed 21 Sep. 2026].
  • Tsourdi, E., Zillikens, M.C., Meier, C. et al., 2021. Fracture risk and management of discontinuation of denosumab therapy: a systematic review and position statement by ECTS. The Journal of Clinical Endocrinology & Metabolism, 106(1), pp.264–281. Available at: https://academic.oup.com/jcem/article/106/1/264/5939974 [Accessed 21 Sep. 2026].
  • Brooke-Wavell, K., Skelton, D.A., Barker, K.L. et al., 2022. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine, 56(15), pp.837–846. Available at: https://pubmed.ncbi.nlm.nih.gov/35577538/ [Accessed 21 Sep. 2026].
  • Giza, C.C. and Hovda, D.A., 2014. The new neurometabolic cascade of concussion. Neurosurgery, 75(Suppl 4), pp.S24–S33. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4479139/ [Accessed 18 Sep. 2026].
  • Finnegan, E., Daly, E., Pearce, A.J. and Ryan, L., 2022. Nutritional interventions to support acute mTBI recovery. Frontiers in Nutrition, 9, 977728. Available at: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.977728/full [Accessed 18 Sep. 2026].
  • Ryan, T., Nagle, S., Daly, E., Pearce, A.J. and Ryan, L., 2023. A potential role exists for nutritional interventions in the chronic phase of mild traumatic brain injury, concussion and sports-related concussion: a systematic review. Nutrients, 15(17), p.3726. Available at: https://www.mdpi.com/2072-6643/15/17/3726 [Accessed 18 Sep. 2026].
  • Katz, D.I., Bernick, C., Dodick, D.W., Mez, J., Mariani, M.L., Adler, C.H., Alosco, M.L., Balcer, L.J., Banks, S.J., Barr, W.B., Brody, D.L., Cantu, R.C., Dams-O'Connor, K., Geda, Y.E., Jordan, B.D., McAllister, T.W., Peskind, E.R., Petersen, R.C., Wethe, J.V., Zafonte, R.D., Foley, É.M., Babcock, D.J., Koroshetz, W.J., Tripodis, Y., McKee, A.C., Shenton, M.E., Cummings, J.L., Reiman, E.M. and Stern, R.A., 2021. National Institute of Neurological Disorders and Stroke consensus diagnostic criteria for traumatic encephalopathy syndrome. Neurology, 96(18), pp.848–863. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8166432/ [Accessed 18 Sep. 2026].
  • McKee, A.C., Stein, T.D., Huber, B.R., Crary, J.F., Bieniek, K., Dickson, D., Alvarez, V.E., Cherry, J.D., Farrell, K., Butler, M., Uretsky, M., Abdolmohammadi, B., Alosco, M.L., Tripodis, Y., Mez, J. and Daneshvar, D.H., 2023. Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts. Acta Neuropathologica, 145(4), pp.371–394. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10020327/ [Accessed 18 Sep. 2026].
  • Patricios, J.S., Schneider, K.J., Dvorak, J., Ahmed, O.H., Blauwet, C., Cantu, R.C., Davis, G.A. et al., 2023. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), pp.695–711. doi: 10.1136/bjsports-2023-106898. Available at: https://bjsm.bmj.com/content/57/11/695 [Accessed 18 Sep. 2026].
  • Eliason, P.H., Galarneau, J.M., Kolstad, A.T., Pankow, M.P., West, S.W., Bailey, S., Miutz, L. et al., 2023. Prevention strategies and modifiable risk factors for sport-related concussions and head impacts: a systematic review and meta-analysis. British Journal of Sports Medicine, 57(12), pp.749–761. doi: 10.1136/bjsports-2022-106656. Available at: https://pubmed.ncbi.nlm.nih.gov/37316182/ [Accessed 18 Sep. 2026].
  • Hislop, M.D., Stokes, K.A., Williams, S., McKay, C.D., England, M.E., Kemp, S.P.T. and Trewartha, G., 2017. Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial. British Journal of Sports Medicine, 51(15), pp.1140–1146. doi: 10.1136/bjsports-2016-097434. Available at: https://pubmed.ncbi.nlm.nih.gov/28515056/ [Accessed 18 Sep. 2026].
  • Shill, I.J., van den Berg, C., West, S.W., Galarneau, J.M., Fraser, K., Schneider, K.J., Pasanen, K. et al., 2026. Is a neuromuscular training warm-up enough for injury and concussion prevention in high school girl rugby players? Journal of Orthopaedic & Sports Physical Therapy, 56(4), pp.261–271. doi: 10.2519/jospt.2026.13373. Available at: https://pubmed.ncbi.nlm.nih.gov/41919929/ [Accessed 18 Sep. 2026].
  • LeMarshall, S.J., Stevens, L.M., Ragg, N.P., Barnes, L., Foster, J. and Canetti, E.F.D., 2023. Virtual reality-based interventions for the rehabilitation of vestibular and balance impairments post-concussion: a scoping review. Journal of NeuroEngineering and Rehabilitation, 20, p.31. Available at: https://link.springer.com/article/10.1186/s12984-023-01145-4 [Accessed 18 Sep. 2026].
  • Hutchison, M.G., Schweizer, T.A., Tam, F., Graham, S.J., and Comper, P., 2014. fMRI and brain activation after sport concussion: A tale of two cases. Frontiers in Neurology, 5. Available at: https://www.frontiersin.org/articles/10.3389/fneur.2014.00046/full [Accessed 1 Feb. 2025].
  • Johnson, C.D., Green, B.N., Nelson, R.C., Moreau, B., and Nabhan, D., 2013. Chiropractic and concussion in sport: a narrative review of the literature. The Journal of Chiropractic Medicine, 12(4), pp.216–229. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838721/ [Accessed 1 Feb. 2025].
  • Germann, D., Marshall, C., and Kazemi, M., 2020. Multi-modal management of sport and non-sport related concussion by chiropractic sports specialists: a case series. Journal of the Canadian Chiropractic Association, 64(3), pp.214–226. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815178/ [Accessed 1 Feb. 2025].
  • Barrett, E.C., McBurney, M.I., and Ciappio, E.D., 2014. ω-3 Fatty Acid Supplementation as a Potential Therapeutic Aid for the Recovery from Mild Traumatic Brain Injury/Concussion. Advances in Nutrition, 5(3), pp.268–277. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013179/ [Accessed 1 Feb. 2025].
  • Heileson, J.L., Anzalone, A.J., Carbuhn, A.F., Askow, A.T., Stone, J.D., Turner, S.M., Hillyer, L.M., Ma, D.W.L., Luedke, J.A., Jagim, A.R., and Oliver, J.M., 2021. The effect of omega-3 fatty acids on a biomarker of head trauma in NCAA football athletes: a multi-site, non-randomized study. Journal of the International Society of Sports Nutrition, 18(1), p.65. Available at: https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00461-1 [Accessed 1 Feb. 2025].
  • Arabi, S.M., Sedaghat, A., Ehsaei, M.R., Safarian, M., Ranjbar, G., Rezaee, H., Rezvani, R., Tabesh, H., and Norouzy, A., 2020. Efficacy of high-dose versus low-dose vitamin D supplementation on serum levels of inflammatory factors and mortality rate in severe traumatic brain injury patients: study protocol for a randomized placebo-controlled trial. Trials, 21(1), p.685. Available at: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04622-6 [Accessed 1 Feb. 2025].
  • Denniss, R.J. and Barker, L.A., 2023. Brain Trauma and the Secondary Cascade in Humans: Review of the Potential Role of Vitamins in Reparative Processes and Functional Outcome. Behavioral Sciences, 13(5), p.388. Available at: https://www.mdpi.com/2076-328X/13/5/388 [Accessed 1 Feb. 2025].
  • Khalili, H., Abdollahifard, S., Niakan, A., and Aryaie, M., 2022. The effect of vitamins C and E on clinical outcomes of patients with severe traumatic brain injury: A propensity score matching study. Surgical Neurology International, 13, p.548. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805612/ [Accessed 1 Feb. 2025].
  • Institute of Medicine (US) Committee on Nutrition, Trauma, and the Brain, 2011. Antioxidants. In: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel. Washington (DC): National Academies Press (US). Available at: https://www.ncbi.nlm.nih.gov/books/NBK209332/ [Accessed 1 Feb. 2025].
  • Standiford, L., O'Daniel, M., Hysell, M., and Trigger, C., 2021. A randomized cohort study of the efficacy of PO magnesium in the treatment of acute concussions in adolescents. The American Journal of Emergency Medicine, 44, pp.419–422. Available at: https://pubmed.ncbi.nlm.nih.gov/33243533/ [Accessed 1 Feb. 2025].
  • Institute of Medicine (US) Committee on Nutrition, Trauma, and the Brain, 2011. Magnesium. In: Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel. Washington (DC): National Academies Press (US). Available at: https://www.ncbi.nlm.nih.gov/books/NBK209305/ [Accessed 1 Feb. 2025].
  • Wu, F., Xu, K., Liu, L., Zhang, K., Xia, L., Zhang, M., Teng, C., Tong, H., He, Y., Xue, Y., Zhang, H., Chen, D., and Hu, A., 2019. Vitamin B12 enhances nerve repair and improves functional recovery after traumatic brain injury by inhibiting ER stress-induced neuron injury. Frontiers in Pharmacology, 10, p.406. Available at: https://pubmed.ncbi.nlm.nih.gov/31105562/ [Accessed 1 Feb. 2025].
  • Hoane, M.R., Akstulewicz, S.L., and Toppen, J., 2003. Treatment with vitamin B3 improves functional recovery and reduces GFAP expression following traumatic brain injury in rats. Journal of Neurotrauma, 20(11), pp.1189–1199. Available at: https://pubmed.ncbi.nlm.nih.gov/14651806/ [Accessed 1 Feb. 2025].
  • Wu, A., Ying, Z., and Gomez-Pinilla, F., 2006. Dietary curcumin counteracts the outcome of traumatic brain injury on oxidative stress, synaptic plasticity, and cognition. Experimental Neurology, 197(2), pp.309–317. Available at: https://pubmed.ncbi.nlm.nih.gov/16364299/ [Accessed 1 Feb. 2025].
  • Zhu, H., Bian, C., Yuan, J., Chu, W., Xiang, X., Chen, F., Wang, C., Feng, H., and Lin, J., 2014. Curcumin attenuates acute inflammatory injury by inhibiting the TLR4/MyD88/NF-κB signaling pathway in experimental traumatic brain injury. Journal of Neuroinflammation, 11, p.59. Available at: https://jneuroinflammation.biomedcentral.com/articles/10.1186/1742-2094-11-59 [Accessed 1 Feb. 2025].
  • Cope, E.C., Morris, D.R., Scrimgeour, A.G., VanLandingham, J.W., and Levenson, C.W., 2012. Zinc supplementation provides behavioral resiliency in a rat model of traumatic brain injury. Physiology & Behavior, 106(2), pp.248–255. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3801180/ [Accessed 1 Feb. 2025].
  • Levenson, C.W., 2020. Zinc and Traumatic Brain Injury: From Chelation to Supplementation. Medical Sciences, 8(3), p.36. Available at: https://pubmed.ncbi.nlm.nih.gov/32824524/ [Accessed 1 Feb. 2025].
  • Hoffer, M.E., Balaban, C., Slade, M.D., Tsao, J.W., and Hoffer, B., 2013. Amelioration of acute sequelae of blast induced mild traumatic brain injury by N-acetyl cysteine: a double-blind, placebo controlled study. PLoS One, 8(1), p.e54163. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0054163 [Accessed 1 Feb. 2025].
  • McPherson, R.A., Mangram, A.J., Barletta, J.F., and Dzandu, J.K., 2022. N-acetylcysteine is associated with reduction of postconcussive symptoms in elderly patients: a pilot study. Journal of Trauma and Acute Care Surgery, 93(5), pp.644–649. Available at: https://pubmed.ncbi.nlm.nih.gov/35393384/ [Accessed 1 Feb. 2025].
  • Dean, P.J.A., Arikan, G., Opitz, B., and Sterr, A., 2017. Potential for use of creatine supplementation following mild traumatic brain injury. Concussion, 2(2), CNC34. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6094347/ [Accessed 18 Sep. 2026].
  • Sakellaris, G., Kotsiou, M., Tamiolaki, M., Kalostos, G., Tsapaki, E., Alevizou, A., and Karkavelas, G., 2006. Prevention of complications related to traumatic brain injury in children and adolescents with creatine administration: an open label randomized pilot study. Journal of Trauma, 61(2), pp.322–329. Available at: https://pubmed.ncbi.nlm.nih.gov/16917445/ [Accessed 1 Feb. 2025].
  • Candow, D.G., Forbes, S.C., Ostojic, S.M., Prokopidis, K., Stock, M.S., Harmon, K.K., and Faulkner, P., 2023. “Heads Up” for creatine supplementation and its potential applications for brain health and function. Sports Medicine, 53(Suppl 1), pp.49–65. Available at: https://link.springer.com/article/10.1007/s40279-023-01870-9 [Accessed 18 Sep. 2026].
  • Matthews, R.T., Yang, L., Browne, S., Baik, M., and Beal, M.F., 1998. Coenzyme Q10 administration increases brain mitochondrial concentrations and exerts neuroprotective effects. Proceedings of the National Academy of Sciences, 95(15), pp.8892–8897. Available at: https://pubmed.ncbi.nlm.nih.gov/9671775/ [Accessed 1 Feb. 2025].
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  • Fernández-Portero, C., Amián, J.G., de la Bella, R., López-Lluch, G., and Alarcón, D., 2023. Coenzyme Q10 levels associated with cognitive functioning and executive function in older adults. The Journals of Gerontology: Series A, 78(1), pp.1–8. Available at: https://pubmed.ncbi.nlm.nih.gov/35908233/ [Accessed 1 Feb. 2025].
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  • Clark, J.E. and Sirois, E., 2020. The possible role of hydration in concussions and long-term symptoms of concussion for athletes: A review of the evidence. Journal of Concussion, 4, p.2059700220939404. Available at: https://journals.sagepub.com/doi/10.1177/2059700220939404 [Accessed 1 Feb. 2025].
  • McAllister, T. and McCrea, M., 2017. Long-term cognitive and neuropsychiatric consequences of repetitive concussion and head-impact exposure. Journal of Athletic Training, 52(3), pp.309–317. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5384827/ [Accessed 18 Sep. 2026].
  • Knapik, J.J., Hoedebecke, B.L., Rogers, G.G., Sharp, M.A., and Marshall, S.W., 2019. Effectiveness of mouthguards for the prevention of orofacial injuries and concussions in sports: systematic review and meta-analysis. Sports Medicine, 49(8), pp.1217–1232. Available at: https://pubmed.ncbi.nlm.nih.gov/31148073/ [Accessed 1 Feb. 2025].
  • Mihalik, J.P., McCaffrey, M.A., Rivera, E.M., Pardini, J.E., Guskiewicz, K.M., Collins, M.W., and Lovell, M.R., 2007. Effectiveness of mouthguards in reducing neurocognitive deficits following sports-related cerebral concussion. Dental Traumatology, 23(1), pp.14–20. Available at: https://pubmed.ncbi.nlm.nih.gov/17227375/ [Accessed 18 Sep. 2026].
  • Scorza, K.A. and Cole, W., 2019. Current concepts in concussion: Initial evaluation and management. American Family Physician, 99(7), pp.426–434. Available at: https://www.aafp.org/pubs/afp/issues/2019/0401/p426.html [Accessed 1 Feb. 2025].
  • McKee, A.C., Stein, T.D., Kiernan, P.T., and Alvarez, V.E., 2015. The neuropathology of chronic traumatic encephalopathy. Brain Pathology, 25(3), pp.350–364. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526170/ [Accessed 1 Feb. 2025].
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  • Thomas, K.D., Lombard, Z.K., and Shadiack, A.L., 2023. Osteopathic manipulative treatment for concussions and postconcussive syndrome in athletes: a literature review. Journal of Osteopathic Medicine, 123(8), pp.395–403. Available at: https://pubmed.ncbi.nlm.nih.gov/37283218/ [Accessed 1 Feb. 2025].
  • Yao, S.C., Zwibel, H., Angelo, N., Leder, A., and Mancini, J., 2020. Effectiveness of osteopathic manipulative medicine vs concussion education in treating student athletes with acute concussion symptoms. Journal of the American Osteopathic Association. Available at: https://pubmed.ncbi.nlm.nih.gov/32766808/ [Accessed 1 Feb. 2025].
  • Lee, H., Song, M., Shin, S., Kim, Y., Oh, H., and Kim, J., 2019. The impact of vitamin D deficiency on the acute and long-term outcomes of patients with traumatic brain injury. Brain Injury, 33(5), pp.562–568. Available at: https://pubmed.ncbi.nlm.nih.gov/30904798/ [Accessed 1 Feb. 2025].
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