Multiple prior concussions are associated with symptoms in high school athletes
Article first published online: 3 JUN 2014
© 2014 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Annals of Clinical and Translational Neurology
Volume 1, Issue 6, pages 433–438, June 2014
How to Cite
Mannix, R., Iverson, G. L., Maxwell, B., Atkins, J. E., Zafonte, R. and Berkner, P. D. (2014), Multiple prior concussions are associated with symptoms in high school athletes. Annals of Clinical and Translational Neurology, 1: 433–438. doi: 10.1002/acn3.70
- Issue published online: 19 JUN 2014
- Article first published online: 3 JUN 2014
- Manuscript Accepted: 14 MAY 2014
- Manuscript Revised: 10 MAY 2014
- Manuscript Received: 23 APR 2014
- Goldfarb Center for Public Policy and Civic Engagement/Colby College
- Bill and Joan Alfond Foundation
- Department of Defense Psychological Health/Traumatic Brain Injury Research Program. Grant Number: X81XWH-07-CC-CSDoD
- NIH/EKS-NICHD. Grant Number: 1 R24 HD065688
The purpose of this study was to evaluate the association of prior concussion on baseline computerized neurocognitive testing in a large cohort of high school athletes.
This is a retrospective cohort study of student athletes from 49 Maine High Schools in 2010 who underwent baseline computerized neurocognitive evaluation with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®). As part of the ImPACT®, subjects reported a prior history of concussion as well as demographic information and a symptom questionnaire. We used linear regression to evaluate the association of prior concussion with baseline: (1) ImPACT® composite scores; and (2) symptom scores.
Six thousand seventy-five subjects were included in the study, of whom 57% were boys. The majority of student athletes (85.3%) reported no prior history of concussion while 4.6% reported having sustained two or more prior concussions. On simple linear regression, increasing number of concussions was related to worse performance in verbal memory (P = 0.039) and greater symptoms scores (P < 0.001). On multivariate modeling, only the association with baseline symptoms remained (P < 0.001). Other factors associated with baseline symptom reporting in the multivariate model included mental health history, headache/migraine history, gender, developmental and/or learning problems, and number of prior concussions.
In this large-scale, retrospective survey study, history of multiple prior concussions was associated with higher symptom burden but not baseline computerized neurocognitive testing. The association between baseline symptom reporting and clinical and demographic factors was greater than the association with a history of multiple concussions.