Influence of Family History of Neurodegenerative Diseases on Outcome Following Pediatric Concussion

Abstract

ObjectiveTo longitudinally evaluate the relation between family history of neurodegenerative disease and clinical symptoms, as well as vestibular-ocular and cognitive outcomes following concussion in children.BackgroundResearch indicates that pediatric concussion may lead to chronic alterations in neuropsychological health that can adversely affect neurodevelopment. Therefore, it is critical to identify risk factors that may moderate recovery to improve concussion outcomes in children. Evidence suggests that one such moderator may be a family history of neurodegenerative disease (FHND).Design/MethodsData were collected from a local pediatric concussion clinic. Patients were examined at 2- and 5-weeks post-injury. Clinical symptoms were measured using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). Vestibular-ocular function was assessed using the Vestibular/Ocular Motor Screening (VOMS) tool. Cognition was measured using a modified CogState Brain Injury Test Battery. Log-transformations were applied to normalize data. Group differences between those with (n = 13) and without (n = 26) a family history of neurodegenerative disease (Alzheimer’s, Non-Alzheimer’s Dementias, Parkinson’s, and/or Multiple Sclerosis) were analyzed. Children without FHND were double-matched based on sex, age, and concussion history.ResultsAcross timepoints, children with FHND reported more severe clinical symptoms on the RPQ (p’s < 0.05). Additionally, those with FHND showed higher VOMS saccades scores across timepoints compared to those without FHND (p’s < 0.05). Further, children with FHND reported greater dizziness following VOMS saccades and convergence tests at 5-weeks post-injury (p’s < 0.01). No group differences at any timepoint were observed for any measure of cognition.ConclusionsOur findings indicate that a family history of neurodegenerative disease is associated with more severe clinical symptoms and greater vestibular-ocular dysfunction following pediatric concussion.