Context: Increasing attention is being paid to the deleterious effects of sport-related concussion on cognitive and brain health.Objective: To evaluate the influence of concussion incurred during early life on the cognitive control and neuroelectric function of young adults.Design: Cross-sectional study. Setting: Research laboratory.Patients or Other Participants: Forty young adults were separated into groups according to concussive history (0 or 1þ). Participants incurred all injuries during sport and recreation before the age of 18 years and were an average of 7.1 6 4.0 years from injury at the time of the study.Intervention(s): All participants completed a 3-stimulus oddball task, a numeric switch task, and a modified flanker task during which event-related potentials and behavioral measures were collected.Main Outcome Measure(s): Reaction time, response accuracy, and electroencephalographic activity.Results: Compared with control participants, the concussion group exhibited decreased P3 amplitude during target detection within the oddball task and during the heterogeneous condition of the switch task. The concussion group also displayed increased N2 amplitude during the heterogeneous version of the switch task. Concussion history was associated with response accuracy during the flanker task.Conclusions: People with a history of concussion may demonstrate persistent decrements in neurocognitive function, as evidenced by decreased response accuracy, deficits in the allocation of attentional resources, and increased stimulusresponse conflict during tasks requiring variable amounts of cognitive control. Neuroelectric measures of cognitive control may be uniquely sensitive to the persistent and selective decrements of concussion.Key Words: concussions, inhibition, mental flexibility, attention, P3, N2
Key PointsSeven years after concussion, participants displayed disrupted higher-order neurocognition in the form of chronically impaired attention, working memory, inhibition, and interference control. The observed deficits in attention and conflict monitoring were only evident when cognitive demands were increased. Subtle deficits may remain unrecognized with other types of testing.