4.3 Article

Multiple Self-Reported Concussions Are More Prevalent in Athletes With ADHD and Learning Disability

Journal

CLINICAL JOURNAL OF SPORT MEDICINE
Volume 26, Issue 2, Pages 120-127

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JSM.0000000000000207

Keywords

learning disability; concussion; standardized assessment of concussion; attention deficit

Funding

  1. National Collegiate Athletic Association (NCAA)
  2. National Operating Committee on Standards for Athletic Equipment (NOCSAE)
  3. Center for Disease Control's National Center for Injury Prevention and Control
  4. University of North Carolina Injury Prevention Research Center
  5. Waukesha Memorial Hospital Foundation
  6. National Academy of Neuropsychology
  7. National Federation of State High School Associations
  8. NFL Charities
  9. Green Bay Packer Foundation
  10. Milwaukee Bucks
  11. Herbert H. Kohl Charities
  12. Waukesha Service Club
  13. Medical College of Wisconsin General Clinical Research Center from the National Institutes of Health [M01 RR00058]

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Objective: We evaluated how attention deficit-hyperactivity disorder (ADHD) and learning disability (LD) are associated with concussion history and performance on standard concussion assessment measures. Based on previous reports that developmental disorders are associated with increased injury proneness and poorer cognitive performance, we anticipated that ADHD and LD would be associated with increased history of concussion and poorer baseline performance on assessment measures. Design: Cross-sectional study. Setting: Clinical research center. Participants: The study sample aggregated data from two separate projects: the National Collegiate Athletic Association Concussion Study and Project Sideline. Interventions: We analyzed preseason baseline data from 8056 high school and collegiate athletes (predominantly male football players) enrolled in prior studies of sport-related concussion. Main Outcome Measures: Measures included demographic/health history, symptoms, and cognitive performance. Results: Attention deficit-hyperactivity disorder and LD were associated with 2.93 and 2.08 times the prevalence, respectively, of 3+ historical concussions (for comorbid ADHD/LD the prevalence ratio was 3.38). In players without histories of concussion, individuals with ADHD reported more baseline symptoms, and ADHD and LD were associated with poorer performance on baseline cognitive tests. Interactive effects were present between ADHD/LD status and concussion history for self-reported symptoms. Conclusions: Neurodevelopmental disorders and concussion history should be jointly considered in evaluating concussed players. Clinical Relevance: Clinical judgments of self-reported symptoms and cognitive performance should be adjusted based on athletes' individual preinjury baselines or comparison with appropriate normative samples.

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