Effects of Two Concussions on the Neuropsychological Functioning and Symptom Reporting of High School Athletes

Tsushima, William T.; Geling, Olga; Arnold, Monica; Oshiro, Ross

doi:10.1080/21622965.2014.902762

Cited by 9 publications

(4 citation statements)

References 19 publications

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“…These results are consistent with prior studies involving computerized cognitive testing of adolescents in mixed sports, 42,71,72 computerized testing with adolescent elite hockey players, 7,8 and a study involving traditional paper-and-pencil neuropsychological testing of youth who are not injured specifically in sports. 15 Collectively, these studies contain fairly large sample sizes and suggest that multiple prior concussions do not result in obvious lingering cognitive effects in adolescent athletes.…”

Section: Discussionsupporting

confidence: 89%

Multiple Past Concussions in High School Football Players

et al. 2016

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Background There is increasing concern about the possible long-term effects of multiple concussions, particularly on the developing adolescent brain. Whether the effect of multiple concussions is detectable in high school football players has not been well studied, although the public health implications are great in this population. Purpose To determine if there are measureable differences in cognitive functioning or symptom reporting in high school football players with a history of multiple concussions. Study Design Cross-sectional study; Level of evidence, 3. Methods Participants included 5232 male adolescent football players (mean [±SD] age, 15.5 ± 1.2 years) who completed baseline testing between 2009 and 2014. On the basis of injury history, athletes were grouped into 0 (n = 4183), 1 (n = 733), 2 (n = 216), 3 (n = 67), or ≥4 (n = 33) prior concussions. Cognitive functioning was measured by the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery, and symptom ratings were obtained from the Post-Concussion Symptom Scale. Results There were no statistically significant differences between groups (based on the number of reported concussions) regarding cognitive functioning. Athletes with ≥3 prior concussions reported more symptoms than did athletes with 0 or 1 prior injury. In multivariate analyses, concussion history was independently related to symptom reporting but less so than developmental problems (eg, attention or learning problems) or other health problems (eg, past treatment for psychiatric problems, headaches, or migraines). Conclusion In the largest study to date, high school football players with multiple past concussions performed the same on cognitive testing as those with no prior concussions. Concussion history was one of several factors that were independently related to symptom reporting.

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Section: Discussionsupporting

confidence: 89%

Multiple Past Concussions in High School Football Players

et al. 2016

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“…A number of studies have noted significant postconcussive cognitive and symptom differences between no concussion testing and repeated concussions in high school and collegiate athletes, 2 –4,13 whereas others find no significant differences. 1,14 –21 Similar conflicting results have been noted in studies evaluating specific sports. Repeated headers in soccer have been associated with poorer neurocognitive function in some studies, 22 –25 whereas others found no effect of repeated headers in soccer players 26 –29 when compared to nonathletes.…”

mentioning

confidence: 73%

Postconcussive Symptoms After Single and Repeated Concussions in 10- to 20-Year-Olds: A Cross-Sectional Study

2018

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The objective was to characterize cognitive deficits and postconcussive symptoms in a pediatric population with no concussion, a single concussion, and ≥2 concussions, using a cross-sectional design. Cognitive function and postconcussive symptoms were assessed in participants (age 10-20) with no concussion (n = 1118), single concussion (n = 368), and repeated (≥2) concussions (n = 252). Analyses were adjusted for age and gender. Individuals with ≥2 concussions exhibited more total postconcussive symptoms; more loss of consciousness, amnesia and confusion; more headaches; and poorer cognitive function compared to no concussion and single concussion. Postconcussive symptoms may play a modulatory role in cognitive dysfunction after repeated concussions as those with loss of consciousness, amnesia, confusion, or headaches exhibited worse verbal memory, visual memory, visual-motor processing, and poorer impulse control compared to those without these symptoms. This analysis demonstrates that repeated concussions is associated with poorer cognitive function and postconcussive symptoms compared to a single concussion.

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“…26,49 Several studies reported poorer cognitive function in concussed adolescents compared with control groups, 30,57,107 whereas other studies did not. 64,124,125 Similarly, when compared with baseline, impaired cognitive function was found in adolescents after SRC in some studies 79,80,110 but not others. 125 These conflicting results may have been due to differences in study design and other factors such as the tools used for evaluating participants' cognitive function, sex, age, and concussion history.…”

mentioning

confidence: 95%

“…64,124,125 Similarly, when compared with baseline, impaired cognitive function was found in adolescents after SRC in some studies 79,80,110 but not others. 125 These conflicting results may have been due to differences in study design and other factors such as the tools used for evaluating participants' cognitive function, sex, age, and concussion history. Given the importance of cognitive function in adolescent daily life and academic achievement and consistent with the suggestion of the CISG, 91 monitoring of cognitive function in a population particularly vulnerable to the effects of concussion is warranted.…”

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confidence: 95%

Sports-Related Concussion Affects Cognitive Function in Adolescents: A Systematic Review and Meta-analysis

Hou

Fei

et al. 2023

Am J Sports Med

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Background: Rates of sports-related concussion (SRC) are high in adolescents. Ambiguity exists regarding the effect of SRC on cognitive function in adolescents. Purpose: To rigorously examine adolescents’ cognitive function after SRC. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: Web of Science, Scopus, and PubMed were searched from database inception until September 2021. Studies were included if participants were adolescents aged 13 to 18 years, if the definition of SRC was fully consistent with the Berlin Consensus Statement on Concussion in Sport, if the study included a control group or in-group baseline test, and if the study reported cognitive outcomes (eg, visual memory, processing speed) that could be separately extracted. Results: A total of 47 studies were included in the systematic review, of which 31 were included in the meta-analysis, representing 8877 adolescents with SRC. Compared with individuals in the non-SRC group, individuals with SRC had worse performance in cognitive function and reported more symptoms not only in the acute phase but also in the prolonged phase (1-6 months after injury) (visual memory: d = −0.21, 95% CI, −0.37 to −0.05, P = .012; executive function: d = −0.56, 95% CI, −1.07 to −0.06, P = .028; and symptoms: d = 1.17, 95% CI, 0.13 to 2.22, P = .028). Lower scores in most of the outcomes of cognitive function were observed at <3 days and at 3 to 7 days, but higher scores for verbal memory ( d = 0.10; 95% CI, 0.03 to 0.17; P = .008) and processing speed ( d = 0.17; 95% CI, 0.10 to 0.24; P < .001) were observed at 7 to 14 days after SRC relative to baseline. The effects of SRC on cognitive function decreased over time (100% of the variance in reaction time, P < .001; 99.94% of the variance in verbal memory, P < .001; 99.88% of the variance in visual memory, P < .001; 39.84% of the variance in symptoms, P = .042) in control group studies. Study design, participant sex, measurement tools, and concussion history were found to be modulators of the relationship between cognitive function and SRC. Conclusion: This study revealed that adolescent cognitive function is impaired by SRC even 1 to 6 months after injury. Results of this study point to the need for tools to measure cognitive function with multiple parallel versions that have demographically diversiform norms in adolescents. Effective prevention of SRC, appropriate treatment, and adequate evaluation of cognitive function before return to play are needed in adolescent SRC management. Moreover, caution is warranted when using the baseline-to-postconcussion paradigm in return-to-play decisions.

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Effects of Two Concussions on the Neuropsychological Functioning and Symptom Reporting of High School Athletes

Cited by 9 publications

References 19 publications

Multiple Past Concussions in High School Football Players

Multiple Past Concussions in High School Football Players

Postconcussive Symptoms After Single and Repeated Concussions in 10- to 20-Year-Olds: A Cross-Sectional Study

Sports-Related Concussion Affects Cognitive Function in Adolescents: A Systematic Review and Meta-analysis

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