ADHD is prevalent in NCAA Division-I athletes and associated with history of past concussions. If replicated, these findings could have important implications in the prevention and management of concussions in athletes with ADHD.

There is growing concern about the late effects of traumatic brain injury (TBI). This scoping review summarizes clinical research from the past 10 years that evaluates the relationship between TBI and Alzheimer's disease. This review identified five studies that found increased risk for dementia after TBI, two studies that found no increased risk and four studies that found a relationship only under certain conditions or in specified subsamples. Methodological differences across studies preclude direct comparison of results, and discrepant findings elucidate the complex course of post-TBI neurodegeneration. We discuss the factors that influence the strength and direction of the relationship between TBI and Alzheimer's disease, and the implications of this body of research for patient care and future research.

Concussions are common in athletes and often go unreported. A likely contributor to underreporting of concussions in athletes is lack of knowledge of concussion-related symptoms. The current study assessed concussion symptom knowledge in 382 Division I athletes and 230 nonathletes. Participants were asked to identify potential symptoms following a concussion from a list of both real symptoms and distractors. Student-athletes expected significantly more total symptoms following a concussion than did nonathletes, and they correctly identified symptoms such as nausea and/or vomiting and being easily upset by loud noises more frequently than controls. However, many student-athletes failed to identify possible emotional symptoms resulting from a concussion, and approximately 70% of student-athletes endorsed the distracter item "forgetting names or faces of people you know well" as being a symptom of concussion. These current findings suggest that student-athletes may have an incomplete understanding of concussion-related symptoms, and future studies are needed to determine whether formal education sessions can improve knowledge for this high-risk population.

Intervention(s): An informational intervention regarding the importance of concussion testing to promote safety was administered before testing for the most recent season.Main Outcome Measure(s): We examined preseason ImPACT testing data across a 3-year period (total assessments ¼ 269). Based on invalid and sandbagging indices denoted by the ImPACT manual, protocols were examined to indicate how many invalid indices each athlete had.Results: A total of 27.9% (n ¼ 75) of assessments were suggestive of invalid scores, with 4.1% (n ¼ 11) suggesting invalid responding only, 17.5% (n ¼ 47) indicating ''sandbagging'' only, and 6.3% (n ¼ 17) showing both invalid and sandbagging responding. The informational intervention did not reduce the prevalence of invalid responding.Conclusions: These findings highlight the need for further information about the ImPACT validity indices and whether they truly reflect poor effort. Future work is needed to identify practices to reliably target and reduce invalid responding.Key Words: concussions, neuropsychological tests, malingering Key PointsMore than 25% (n ¼ 75) of the participants' baseline cognitive testing suggested suboptimal effort. Providing information about concussion risks and the importance of cognitive testing did not reduce the prevalence of poor effort; however, instructing athletes to repeat testing did reduce it. More research is needed to determine effective and efficient strategies to reduce the prevalence of invalid performance on Immediate Post-Concussion Assessment and Cognitive Testing.

Objective: Poor cardiovascular fitness has been implicated as a possible mechanism for obesity-related cognitive decline, though no study has examined whether BMI is associated with poorer cognitive function in persons with excellent fitness levels. The current study examined the relationship between BMI and cognitive function by the Immediate Post Concussion and Cognitive Test (ImPACT) in Division I collegiate athletes. Methods: Participants had an average age of 20.14 ± 1.78 years, were 31.3% female, and 53.9% football players. BMI ranged from 19.04 to 41.14 and averaged 26.72 ± 4.62. Results: Regression analyses revealed that BMI incrementally predicted performance on visual memory (R² change = 0.015, p = 0.026) beyond control variables. Follow-up partial correlation analyses revealed small but significant negative correlations between BMI and verbal memory (r = -0.17), visual memory (r = -0.16), and visual motor speed (r = -0.12). Conclusions: These results suggest that higher BMI is associated with reduced cognitive function, even in a sample expected to have excellent levels of cardiovascular fitness. Further work is needed to better understand mechanisms for these associations.