Subjective Symptoms and Objective Confusion: A Review of Concussion Diagnostic Tools Studied Since 2022

Abstract

Emerging research has increasingly highlighted the substantial long-term consequences associated with repeated concussions. Beyond the acute presentation of debilitating symptoms, structural, physiological, and psychological alterations may persist for more than a year post-injury and, in some cases, progress to chronic impairment. Despite the implementation of National Collegiate Athletic Association regulations and the widespread use of sideline assessment tools such as the Sports Concussion Assessment Tool 6, concussion diagnosis remains heavily reliant on subjective measures. This limitation places collegiate athletes, particularly in the evolving landscape of Name, Image, and Likeness agreements and associated external pressures, at elevated risk for repeated mild traumatic brain injury and its ensuing sequelae. Ensuring athlete safety across all levels of sport requires the development and adoption of more objective and precise diagnostic methodologies. This study presents a scoping review conducted in accordance with PRISMA-ScR guidelines and systematically maps the literature on sport-related concussion diagnostic tools published following the 6th International Conference on Concussion in Sport. A total of 55 full-text studies met the inclusion criteria and were categorized into seven diagnostic domains. Analysis of these categories provides a comprehensive overview of the current diagnostic landscape and highlights both the advancements and persistent limitations in sports-related concussion assessment. Collectively, these findings offer critical insight into the state of the field and help inform future directions as the scientific community approaches the 7th International Conference on Concussion in Sport.