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Background  Although concussion continues to be a major source of acute and chronic injury in automotive, athletic and military arenas, concussion injury mechanisms and risk functions are ill-defined. To overcome this knowledge gap, we have developed, tested and deployed a head impact monitoring mouthguard (IMM) system. The IMM system was first calibrated in 731 laboratory tests against Hybrid III and NOCSAE headforms with Reference kinematic sensors. Next, during on-field play involving n = 54 amateur American athletes in football and boxing, there were tens of thousands of kinematic signatures collected by the IMM. A total of 890 true positive head impacts were confirmed using a combination of signal processing and NINDS/NIH Common Data Elements methods [1].    Methods  Laboratory tests were conducted using an American football helmet (n = 451), padded headform (n = 99) or bare head (n = 181). The IMM included kinematics sensors, along with associated microprocessor, battery and data transmission. Peak linear acceleration (PLA) at headform center of gravity (cg) was compared in each test between Reference and IMM.54 athletes in football and boxing aged 11 to 22 were consented. Impact with cg PLA as low as 7 g were collected during practices/games.    Results/discussion  Laboratory data fit a linear model close to ideal y = x + 0, R2 = 1. There were &gt;100,000 triggering events, with 890 true positives. “False positives” contained high frequency data not indicative of head motion. The median/99th percentile of (PLA) and (PAA) were 20/50 g, and 1700 rad/s2/4600 rad/s2. There were no diagnosed concussions. One athlete was removed by athletic training staff after a significant head impact.    Conclusions  In the future, head impact dynamics data must be correlated with sensitive and specific assessments of cognitive, executive, vision and balance parameters in order to determine the concussion assessment threshold.   Disclosures:  Dr. Bartsch has nothing to disclose. Dr. Dama has nothing to disclose. Dr. Samorezov has nothing to disclose. Dr. Alberts has received personal compensation for activities with Boston Scientific Corporation. Dr. Benzel has nothing to disclose. Dr. Miele has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Humm has nothing to disclose. Dr. McCrea has nothing to disclose. Dr. Stemper has nothing to disclose.

Laboratory and on-field results of athlete head impact monitoring