Association of impulsivity, physical development, and mental health to perceptual-motor control after concussion in adolescents

Abstract

ABSTRACT Sport-related concussion (SRC) can affect multiple domains including impairment in perceptual-motor control (PMC) in adolescents, potentially increasing subsequent injury risk. Research suggests that impulsivity, physical development, and mental health may be associated with PMC after SRC, but researchers have yet to examine this association. Adolescents (12–18y; n = 48) within 21 days of SRC were compared to 20 healthy adolescents with no concussion history using the Perception-Action Coupling Task (PACT), Barratt Impulsivity Scale (BIS), Pubertal Development Scale (PDS), Generalized Anxiety Disorder-7 (GAD-7) and Personal Health Questionnaire-9 (PHQ-9). All outcomes were entered as predictors in linear regression (LR) models to predict PACT outcomes (accuracy; initiation, movement, and reaction times). Concussed adolescents had lower PACT accuracy (p = 0.016), higher PHQ-9 (p = 0.029), total BIS (p = 0.004), attention impulsivity (p = 0.005), and cognitive instability impulsivity (p = 0.004). All four LRs were statistically significant (R2 = 0.18–0.38; p < 0.05), and included 1 + impulsivity domains as significant predictors (p < 0.05). Cognitive instability impulsivity appeared in 3/4 models of PACT outcomes. ADD/ADHD history, anxiety, and physical development ratings were also significant predictors of PACT outcomes. This study revealed associations between PMC and medical history, impulsivity, physical development and mental health in adolescents following SRC. Future studies should investigate the temporal relationship among these variables in this at-risk population. Highlights After SRC, adolescents had deficits in action boundary perception accuracy, while reporting higher depression symptoms and impulsivity, including attention and cognitive instability components. Certain domains of impulsivity were predictive of action boundary perception accuracy and each perception actualization measure in the concussed group. ADD/ADHD history, anxiety scores, and physical development ratings were also significant predictors of perceptual-motor accuracy and actualization time.