High School Athletes With ADHD and Learning Difficulties Have a Greater Lifetime Concussion History

2016 ◽  
Vol 24 (8) ◽  
pp. 1095-1101 ◽  
Author(s):  
Grant L. Iverson ◽  
Magdalena Wojtowicz ◽  
Brian L. Brooks ◽  
Bruce A. Maxwell ◽  
Joseph E. Atkins ◽  
...  
Keyword(s):  
Sex Differences ◽  
Learning Difficulties ◽  
Prevalence Rates ◽  
High School Athletes ◽  
Adolescent Athletes ◽  
Developmental Problems ◽  
Lifetime History ◽  
History Of ◽  
Concussion History ◽  
Developmental Conditions

Objective: Examine lifetime history of concussions in adolescents who have developmental problems in comparison with those with no developmental problems. Method: Thirty-two thousand four hundred eighty-seven adolescent athletes completed baseline/pre-season evaluations. Based on self-reported histories, athletes were divided into four groups: ADHD only, ADHD and learning difficulties (LD), LD only, and controls. Results: Athletes with ADHD, LD, or ADHD plus LD reported a greater prevalence of prior concussions than athletes without these developmental conditions ( ps < .05). When adjusting for sex differences in concussion prevalence rates (boys are greater than girls), there was an increase in prevalence of prior injuries in those with ADHD, and ADHD plus learning difficulties compared with those with LD only. This pattern was found for both girls and boys. There was no additive effect of having both conditions. Conclusion: Developmental conditions in adolescent athletes, such as ADHD and learning difficulties, are associated with a greater prevalence rate of prior concussion.

scholarly journals Neuropsychiatric morbidity in focal epilepsy

2008 ◽  
Vol 192 (6) ◽  
pp. 464-469 ◽  
Author(s):  
Sophia J. Adams ◽  
Terence J. O'Brien ◽  
John Lloyd ◽  
Christine J. Kilpatrick ◽  
Michael R. Salzberg ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Focal Epilepsy ◽  
Prevalence Rates ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Lifetime History ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
History Of Depression

BackgroundPrevious work has identified elevated prevalence rates for psychiatric disorders in individuals with medically refractory focal epilepsy, particularly temporal lobe epilepsy. Many studies were undertaken before the advent of video electroencephalogram monitoring (VEM) and magnetic resonance imaging (MRI).AimsTo investigate which characteristics of the focal epilepsy syndromes are associated with the presence of depression or psychosis.MethodThree hundred and nineteen individuals with focal epilepsy admitted for VEM were seen over an 11-year period. The lifetime history of depression and psychosis, epileptic site, laterality and type of lesion were determined by clinical assessment, VEM and MRI scan.ResultsThere was a significant association between the prevalence of depressive symptoms and non-lesional focal epilepsy. There were no significant differences in prevalence of neuropsychiatric disorders between the groups with temporal lobe epilepsy and those with extratemporal lobe epilepsy.ConclusionsThese findings contrast with previous findings in smaller cohorts. The association between non-lesional focal epilepsy and depression may be due to the effects of a more diffuse epileptogenic area.

Specialist Referral and Outcomes in Adolescent Athletes With Prior Concussion History

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S19.2-S20
Author(s):  
Hannah Worrall ◽  
Jane Chung ◽  
Munro Cullum ◽  
Shane Miller
Keyword(s):  
Symptom Severity ◽  
Small Difference ◽  
Limited Evidence ◽  
Adolescent Athletes ◽  
Rates Of Return ◽  
Specialist Referral ◽  
History Of ◽  
Concussion History ◽  
Return To Activity ◽  
Made In

ObjectiveTo examine specialist referral patterns and clinical outcomes in adolescents with differing levels of prior concussion history.BackgroundLimited evidence exists on healthcare utilization and outcomes in concussed adolescent athletes with and without a history of prior concussion.Design/MethodsData were prospectively collected from participants aged 12–18 diagnosed with a sport-related concussion and documented prior concussion history between August 2015-March 2020. Participants were separated into 3 groups: 0, 1, and 2 + prior concussions. Demographics, medical history, specialist referrals, and clinical outcome variables obtained at 3-months post-concussion were analyzed.ResultsOne thousand one hundred ninety-seven participants were included: 114 (10.4%) had 2+, 213 (19.4%) had 1, and 770 (70.2%) had 0 prior concussions. There was no difference in sex or time to presentation. A small difference was found across age (15.3 ± 1.6 vs 14.9 ± 1.6 vs 14.5 ± 1.6 years, p < 0.001). Significant differences were also observed between groups in self-reported history of psychological disorders (14.9 vs 15 vs 8.4%, p = 0.01) and headaches/migraines (25.4 vs 20.2 vs 15.5%, p = 0.02). Significant differences between the groups were found in specialist referrals, with more referrals made in the 2 + group to physical therapy (39.6 vs 28.2 vs 23.4%, p = 0.001), neuropsychology (17.1 vs 5.3 vs 7.5%, p = 0.001), and neurology (8.9 vs 2.9 vs 2.2%, p = 0.001). Fewer participants in the 2 + group recovered in = 30 days (53.6 vs 65.6 vs 68.5%, p = 0.04) and reported lower rates of return to activity at 3-months post-concussion (67.9 vs 85.9 vs 87.6%, p < 0.001). No differences were seen in symptom severity, PHQ-8, or GAD-7 scores. All reported as 2 + vs 1 vs 0.ConclusionsConcussed adolescent athletes with a history of 2 or more prior concussions had a higher rate of specialist referrals, were less likely to have returned to prior level of play/activity 3 months following injury, and were less likely to have resolution of symptoms in 30 days or less.

scholarly journals B-50 Frequency of Sports-Related Concussion in Athletes with Neurodevelopmental Conditions

2019 ◽  
Vol 34 (6) ◽  
pp. 996-996
Author(s):  
S Flood ◽  
H Kuwabara ◽  
J Hussey ◽  
B Fraga ◽  
T Kinsora ◽  
...  
Keyword(s):  
Neurodevelopmental Disorders ◽  
Past Research ◽  
Control Group ◽  
Clinical Group ◽  
High School Athletes ◽  
Chi Square ◽  
Increased Risk ◽  
History Of ◽  
Concussion History ◽  
Chi Square Analysis

Abstract Objective Research demonstrates that athletes with neurodevelopmental diagnoses may have a higher frequency of lifetime concussions (Iverson et al., 2016; Alosco, Fedor & Gunstad, 2014) possibly due to underlying attention, processing speed, or reaction time difficulties. The present study investigates concussion history and sports-related concussions between athletes with and without a history of neurodevelopmental disorders in a longitudinal, state-wide sample. Method Participants included 39,586 high school athletes (Mage = 15.18; 56.2% males) who were assessed pre and post-concussion with ImPACT between 2008 and 2016. There were 36,880 athletes (55.1% males) who did not report neurodevelopmental disorders and served as the control group and 2,706 athletes (71.4% males) in the clinical group who self-reported diagnosis of ADHD (55.6%), Learning Disability (LD;13.6%), Autism (3.2%), ADHD+LD (4.5%), and athletes in special education but no reported diagnosis (SpEd; 22%). Concussion frequency in each group was analyzed using chi-square analysis. Results Athletes were more likely to report prior concussions if they had a self-reported neurodevelopmental diagnosis (17%) compared to the control group (9%, χ2(1) = 112.11, p < .001). Odds ratios indicated that athletes with neurodevelopmental conditions were 1.43 times more likely to have a sports-related concussion. Conclusions Consistent with past research, results indicate that neurodevelopmental conditions are associated with greater lifetime risk of concussion, including sport-related concussions. Future studies may expand this research by examining underlaying causes of this increased risk in order to develop specific interventions to help reduce rates of concussion for this population.

scholarly journals A-110 Are Invalid Baselines More Frequent in those with Concussion History?

2020 ◽  
Vol 35 (6) ◽  
pp. 903-903
Author(s):  
Maietta J ◽  
Hopkins N ◽  
Maietta L ◽  
Flood S ◽  
Johnson L ◽  
...  
Keyword(s):  
High School ◽  
Test Performance ◽  
Impact Testing ◽  
Cognitive Testing ◽  
Return To Play ◽  
Future Research ◽  
High School Athletes ◽  
History Of ◽  
Concussion History ◽  
The Impact

Abstract Objective The Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) is a commonly utilized measure for sports concussion. Across the literature we have reviewed there is an abundance of information that focuses on invalid baselines and the effects of concussions. Yet, no previous studies have investigated the effect of a history of concussion on frequency of invalid baselines. The current study examined these effects within high school athletes. Methods Participants included 47,874 high school athletes (mean age = 15.0, SD = 1.2; mean education = 9.0; SD = 1.5; 42.6% female). These athletes were selected from a larger database of athletes who completed baseline ImPACT testing from 2008–2016. Self-reported history of concussion (none vs. 1+) was obtained from the demographic section of the ImPACT. Invalid performance was based on standard ImPACT criteria (“Baseline++”). Results Chi-square tests of homogeneity were performed to assess differences in invalid baselines between those with and without a history of concussion. Results revealed significantly more invalid baselines for those with a history of concussion (p &lt; .01). Conclusions Results indicate that high school athletes with a self-reported history of concussion may be more likely to have invalid baseline test performance. Based on these preliminary results, clinicians who are managing return-to-play decisions may want to take into account concussion history when interpreting baseline data. Future research should, of course, investigate whether this result is consistent in other samples and, if so, whether alternative validity criteria may be needed. Future investigations of athletes with confirmed clinical diagnosis of concussion is an important next step in investigating differences in rates of invalid baselines.

Association Between Concussion History and Factors Relating to Cognitive, Behavioral, and Emotional Health Among American High School Athletes: A Cross-sectional Analysis

2020 ◽  
Vol 48 (10) ◽  
pp. 2534-2543
Author(s):  
Gregory Knell ◽  
Scott O. Burkhart ◽  
Todd J. Caze ◽  
John D. Polousky ◽  
Harold W. Kohl ◽  
...  
Keyword(s):  
High School ◽  
Emotional Health ◽  
Cognitive Behavioral ◽  
High School Athletes ◽  
Cross Sectional ◽  
The Past ◽  
History Of ◽  
Concussion History ◽  
Composite Scores ◽  
Relevant Factors

Background: The cognitive, behavioral, and emotional deficits that may be associated with sports-related concussions among adolescents are unclear. Purpose: To examine the association between reported concussion history and factors relating to cognitive, behavioral, and emotional health among a population-based sample of US high school–aged adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Participants included a representative sample of US high school student-athletes who reported a concussion history (in the past 12 months) and relevant behaviors/outcomes within 3 domains: cognitive (academics, difficulty concentrating), behavioral (drinking and driving, carrying a weapon, physically fighting, tobacco use, marijuana use, binge drinking), and emotional (symptoms of depression, suicidal thoughts/actions). The adjusted relative odds of experiencing 0 and at least 1, 2, 3, or ≥4 concussions were modeled while mutually adjusting for the behaviors of interest in addition to age, race/ethnicity, and sleep problems. Data were reported in sex stratum. Results: A total of 13,268 participants were included in the unweighted data set. Overall, 14.5% (95% CI, 12.9%-16.2%) of female and 18.1% (95% CI, 16.4%-19.8%) of male student-athletes had at least 1 concussion in the past 12 months. As compared with those who reported not engaging in any of the behaviors deleterious to health or having had any of the negative health outcomes (composite score of 0), female athletes with composite scores of 1 to 4, 5 to 7, and 8 to 11 were 1.94 (95% CI, 1.55-2.43), 3.13 (95% CI, 2.30-4.33), and 6.05 (95% CI, 3.75-9.75) times more likely to have a recent history of concussions after accounting for relevant factors. As compared with those having a composite score of 0, male athletes with composite scores of 1 to 4, 5 to 7, and 8 to 11 were 2.03 (95% CI, 1.58-2.59), 3.80 (95% CI, 2.71-5.34), and 8.23 (95% CI, 4.91-13.77) times more likely to have a recent history of concussions after accounting for relevant factors. Conclusion: Self-reported concussions among US high school athletes is related to several deleterious health behaviors and outcomes. These associations should be confirmed in longitudinal analyses.

Ankle Dorsiflexion in Adolescent Athletes

2003 ◽  
Vol 93 (4) ◽  
pp. 312-314 ◽  
Author(s):  
Amol Saxena ◽  
Will Kim
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Ankle Dorsiflexion ◽  
T Test ◽  
Ankle Injury ◽  
High School Athletes ◽  
Adolescent Athletes ◽  
Left Ankle ◽  
History Of ◽  
The Right

Ankle equinus has been proposed to be associated with lower-extremity pathology. Physiologically normal measurements have been quantified in various populations. Forty high-school athletes (16 girls and 24 boys) without a history of ankle injury had ankle dorsiflexion measured with the knee extended and flexed by an experienced evaluator using a goniometer with the subjects supine. The group mean ± SD dorsiflexion for the right ankle was 0.35° ± 2.2° with the knee extended and 4.88° ± 3.23° with the knee flexed. The values for the left ankle were –0.6° ± 2.09° and 4.68° ± 3.33°, respectively. There were no statistically significant differences between limbs using the Student t-test. In girls, values for right and left ankle dorsiflexion were 0.19° ± 2.1° and –0.7° ± 2.3°, respectively, with the knee extended and 4.88° ± 3.59° and 4.88° ± 3.07°, respectively, with the knee flexed. In boys, these values were 0.46° ± 2.3° and –0.5° ± 1.98° with the knee extended and 4.88° ± 3.04° and 4.54° ± 3.55° with the knee flexed. There were no statistically significant differences between boys and girls. Ankle dorsiflexion in asymptomatic adolescent athletes is approximately 0° with the knee extended and just less than 5° with the knee flexed. (J Am Podiatr Med Assoc 93(4): 312-314, 2003)

Cumulative Effects of Concussion in High School Athletes

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1175-1181 ◽  
Author(s):  
Michael W. Collins ◽  
Mark R. Lovell ◽  
Grant L. Iverson ◽  
Robert C. Cantu ◽  
Joseph C. Maroon ◽  
...  
Keyword(s):  
High School ◽  
Sports Medicine ◽  
Cumulative Effect ◽  
Anterograde Amnesia ◽  
Loss Of Consciousness ◽  
High School Athletes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
History Of ◽  
Concussion History

Abstract OBJECTIVE A common assumption in sports medicine is that a history of concussion is predictive of a lower threshold for, as well as a worse outcome after, subsequent concussive injury. The current study was conducted to investigate the relationship between concussion history in high school athletes and the on-field presentation of symptoms after subsequent concussion. METHODS One hundred seventy-three athletes who experienced sports-related concussion composed the initial study group. Binary groups were subsequently created on the basis of concussion history. Sixty athletes with no concussion history were compared with 28 athletes with a history of three or more concussions. The groups were compared in terms of the on-field presentation of symptoms after an in-study concussion. Dependent variables included the postinjury presence of loss of consciousness, anterograde amnesia, retrograde amnesia, and confusion. RESULTS Athletes with three or more prior concussions were more likely to experience on-field positive loss of consciousness (χ2 = 8.0, P = 0.005), anterograde amnesia (χ2 = 5.5, P = 0.019), and confusion (χ2 = 5.1, P = 0.024) after a subsequent cerebral concussion. An odds ratio revealed that athletes with a history of three concussions were 9.3 times more likely than athletes with no history of concussion to demonstrate three to four abnormal on-field markers of concussion severity. CONCLUSION This study is the first to suggest a cumulative effect of concussion in high school athletes. A more severe on-field presentation of concussion markers is evidenced in high school athletes with a pronounced history of concussion. This study's findings highlight the need for more long-term outcome studies in high school athletes who sustain sports-related concussions.

Variability in diurnal testosterone, exposure to violence, and antisocial behavior in young adolescents

2015 ◽  
Vol 27 (4pt1) ◽  
pp. 1341-1352 ◽  
Author(s):  
Melissa K. Peckins ◽  
Elizabeth J. Susman
Keyword(s):  
Sex Differences ◽  
Antisocial Behavior ◽  
Violence Exposure ◽  
Exposure To Violence ◽  
Individual Variability ◽  
Young Adolescents ◽  
Lifetime History ◽  
History Of ◽  
History Of Violence ◽  
Lifetime Exposure

AbstractThe purpose of this report is to provide evidence of an association between within-person variability in diurnal testosterone over 1 year, lifetime exposure to violence, and the manifestation of antisocial behavior in 135 pubertal-aged adolescents across 1 year. Adolescents' sex and lifetime history of violence exposure moderated the association between within-person variability in diurnal testosterone and antisocial behavior. Furthermore, sex-stratified analyses revealed that lifetime history of exposure to violence moderated the association between within-person variability in diurnal testosterone and antisocial behavior in females only. This report is unique in that it illuminates sex differences inwithin-personassociations among exposure to violence, individual variability in diurnal testosterone, and antisocial behavior.

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