Baseline Neurocognitive Performance and Symptoms in Those With Attention Deficit Hyperactivity Disorders and History of Concussion With Previous Loss of Consciousness.

Sarah Kaye,Eric E Hall,Ethan Williams,Caroline J Ketcham,Kirtida Patel,Mark H Sundman

doi:10.3389/fneur.2019.00396

Sarah Kaye, Eric E Hall + Show 4 more

Open Access

https://doi.org/10.3389/fneur.2019.00396

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Abstract

Previous consensus statements on sports concussion have highlighted the importance of Attention Deficit Hyperactivity Disorder (ADHD) and loss of consciousness (LOC) as risk factors related to concussion management. The present study investigated how self-reported history of either ADHD diagnosis or history of previous concussion resulting in LOC influence baseline neurocognitive performance and self-reported symptoms. This analysis was performed retrospectively on data collected primarily from student-athletes, both Division 1 and club sports athletes. The dataset (n = 1460) is comprised of college students (age = 19.1 ± 1.4 years). Significant differences were found for composite scores on the ImPACT for both history of concussion (p = 0.016) and ADHD (p = 0.014). For concussion history, those with a previous concussion, non-LOC, performed better on the visual motor speed (p = 0.004). Those with diagnosis of ADHD performed worse on verbal memory (p = 0.001) and visual motor speed (p = 0.033). For total symptoms, concussion history (p < 0.001) and ADHD (p = 0.001) had an influence on total symptoms. Those with ADHD reported more symptoms for concussion history; those with previous LOC concussion reported more symptoms than those with non-LOC concussion (p = 0.003) and no history (p < 0.001). These results highlight the importance of baseline measures of neurocognitive function and symptoms in concussion management in order to account for pre-existing conditions such as ADHD and LOC from previous concussion that could influence these measures.

Highlights

In recent years, concussion research has quickly made its way to the forefront of the medias’ attention and has been deemed a public health issue [1] and a silent, global epidemic [2]
The Multivariate Analyses of Variance (MANOVA) for the ImPACT composite scores found a statistically significant main effect for those diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) [F(4, 1451) = 3.16, Wilks’ λ = 0.99, p = 0.014] as well as for concussion history [F(8, 2902) = 2.34, Wilks’ λ = 0.99, p = 0.016], but not a significant interaction for concussion history and ADHD
For those with a previous diagnosis of ADHD, there was a significant difference for performance on verbal memory [F(1, 1454) = 10.41, p = 0.001] and visual motor speed [F(1, 1454) = 4.54, p = 0.033] as those who reported a previous diagnosis of ADHD performed worse on those measures

Summary

Introduction

Concussion research has quickly made its way to the forefront of the medias’ attention and has been deemed a public health issue [1] and a silent, global epidemic [2]. Among the factors that have been hypothesized to influence recovery from concussion and may warrant additional research include diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and having a previous concussion that resulted in loss of consciousness (LOC) [6, 7]. That study examined neurocognitive performance following a concussion and did not find any significant differences between groups (concussions with LOC and without LOC). This previous research suggests that those who are involved in concussion management should take into consideration factors such as ADHD and previous history of LOC when treating patients [7, 8, 20]

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