Int J Sports Med
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
› Author Affiliations

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.



Publication History

Received: 16 December 2020

Accepted: 11 June 2021

Publication Date:
14 January 2022 (online)

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