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Int J Sports Med 2022; 43(06): 553-560
DOI: 10.1055/a-1538-0075
Clinical Sciences

Preseason Symptom Reporting and Cognition in Middle School Athletes with Past Concussions

Grant L. Iverson
1   Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, United States
2   Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Spaulding Research Institute, Charlestown, United States
3   MassGeneral Hospital for Children Sports Concussion Program, Boston, United States
,
Paul D. Berkner
4   College of Osteopathic Medicine, University of New England College of Osteopathic Medicine, Biddeford, United States
,
Ross Zafonte
1   Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, United States
2   Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Spaulding Research Institute, Charlestown, United States
5   Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, United States
6   Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Boston, United States
,
Bruce Maxwell
7   Department of Computer Science, Colby College,Waterville, United States
,
Douglas P. Terry
1   Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, United States
3   MassGeneral Hospital for Children Sports Concussion Program, Boston, United States
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Abstract

This study examined the association between past concussions and current preseason symptom reporting and cognitive performance in 9,257 youth ages 11–13. Participants completed neurocognitive testing prior to participating in a school sports between 2009 and 2019. We stratified the sample by gender and number of prior concussions and assessed group differences on the Post-Concussion Symptom Scale total score and the ImPACT cognitive composite scores. Those with≥2 prior concussions reported more symptoms than those with 0 concussions (d=0.43–0.46). Multiple regressions examining the contribution of concussion history and developmental/health history to symptom reporting showed the most significant predictors of symptoms scores were (in descending order): treatment for a psychiatric condition, treatment for headaches, history of learning disability (in boys only), history of attention-deficit/hyperactivity disorder, and age. Concussion history was the weakest statistically significant predictor in boys and not significant in girls. Cognitively, boys with 1 prior concussion had worse speed those with 0 concussions (d=0.11), and girls with≥2 prior concussions had worse verbal/visual memory than girls with 0 concussions (ds=0.38–0.39). In summary, youth with≥2 prior concussions reported more symptoms than those with no concussions. Boys with multiple concussions performed similarly on cognitive testing, while girls had worse memory scores.

Key words

concussion - cognition - sports - symptom reporting


Publication History

Received: 16 December 2020

Accepted: 11 June 2021

Article published online:
14 January 2022

© 2022. Thieme. All rights reserved.

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