A - 152 Won't Get Fooled Again: Factors in Persistent Complaints Following Youth Concussion.

Abstract

While symptoms following youth concussion typically resolve within one month of injury, some patients report persistent post-concussive symptoms (PPCS). The current project aims to characterize a sample of sports neuropsychology patients, examine clinical outcomes, and determine relevant factors. Sports neuropsychology evaluated 38 consecutively referred patients at a rural academic medical center. The sample was 50% female, mostly White (91.9%), and ranged from 7-22years of age (M = 16.45, SD = 2.92). Most had pre-existing conditions (medical/psychiatric; 78.9%), and 63% had at least one previous concussion. Months-from-injury varied (median = 4; range = 1-29). FSIQ was average (M = 107, SD = 15.45). We analyzed relationships between factors and outcomes using correlations (Spearman's rho or Pearson's r) and stepwise linear regression to determine prediction. Only nine patients' persistent complaints were due to concussion, while medical or psychiatric etiologies explained PPCS in the majority of the sample (76.3%). Outcomes were uncorrelated with gender, age, race, IQ, or months-since-injury. Pre-existing depression (rs(37) = -0.40, p = 0.01) and migraines (rs(37) = -0.35, p = 0.02) both showed significant moderate correlations with outcome. Stepwise regression indicated that only pre-existing depression (β= -0.360, p = 0.01) significantly predicted the non-concussion clinical outcome. In our sample, the etiology of PPCS was something other than concussion in over 76% of youth seen by sports neuropsychology. Pre-existing depression and migraines were significantly correlated with this outcome, and depression was a significant predictor. These results add to the literature on PPCS in children. Neuropsychologist involvement earlier in concussion care may help prevent PPCS by rapidly connecting patients to the proper interventions, thereby reducing families' economic burden and improving patients' quality of life.