Mary A Iaccarino1, Maura Fitzgerald1, Alexa Pulli1, K Yvonne Woodworth1, Thomas J Spencer1, Ross Zafonte1, Joseph Biederman1. 1. Department of Physical Medicine and Rehabilitation (MAI, RZ), Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital; Department of Physical Medicine and Rehabilitation (RZ), Brigham and Women's Hospital; Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD (MF, AP, KYW, TJS, JB), Massachusetts General Hospital; and Department of Psychiatry (TJS, JB), Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is associated with impulsive behavior and inattention, making it a potential risk factor for sport-related concussion (SRC). The objectives of this study were to determine whether ADHD is an antecedent risk factor for SRC and whether ADHD complicates recovery from SRC in youth athletes. METHODS: Student athletes with a history of SRC were evaluated for the presence of ADHD using diagnostic interview and to determine whether ADHD symptoms began before or after SRC. Concussion-specific measures of concussive symptoms and cognitive function were compared in SRC + ADHD and SRC + No ADHD groups to assess SRC recovery between groups. RESULTS: ADHD was overrepresented in youth with SRC compared with population rates. ADHD was found to be an antecedent risk factor for SRC, with age at ADHD onset earlier than the date of SRC. Student athletes with SRC and ADHD reported more concussive symptoms compared with athletes without ADHD and were more likely to have a history of greater than one concussion. CONCLUSIONS: The results of this study support our hypothesis that ADHD is an antecedent risk factor for SRC and may contribute to a more complicated course of recovery from SRC. Future research should focus on determining whether screening, diagnosis, and treating ADHD in youth athletes may prevent SRC. Providers that care for youth athletes with ADHD should be aware of the vulnerabilities of this population toward SRC and its complications.
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is associated with impulsive behavior and inattention, making it a potential risk factor for sport-related concussion (SRC). The objectives of this study were to determine whether ADHD is an antecedent risk factor for SRC and whether ADHD complicates recovery from SRC in youth athletes. METHODS: Student athletes with a history of SRC were evaluated for the presence of ADHD using diagnostic interview and to determine whether ADHD symptoms began before or after SRC. Concussion-specific measures of concussive symptoms and cognitive function were compared in SRC + ADHD and SRC + No ADHD groups to assess SRC recovery between groups. RESULTS: ADHD was overrepresented in youth with SRC compared with population rates. ADHD was found to be an antecedent risk factor for SRC, with age at ADHD onset earlier than the date of SRC. Student athletes with SRC and ADHD reported more concussive symptoms compared with athletes without ADHD and were more likely to have a history of greater than one concussion. CONCLUSIONS: The results of this study support our hypothesis that ADHD is an antecedent risk factor for SRC and may contribute to a more complicated course of recovery from SRC. Future research should focus on determining whether screening, diagnosis, and treating ADHD in youth athletes may prevent SRC. Providers that care for youth athletes with ADHD should be aware of the vulnerabilities of this population toward SRC and its complications.
Authors: William E Pelham; Keith McBurnett; Gary W Harper; Richard Milich; Debra A Murphy; Joseph Clinton; Cathy Thiele Journal: J Consult Clin Psychol Date: 1990-02
Authors: J Biederman; S V Faraone; E Mick; S Williamson; T E Wilens; T J Spencer; W Weber; J Jetton; I Kraus; J Pert; B Zallen Journal: J Am Acad Child Adolesc Psychiatry Date: 1999-08 Impact factor: 8.829
Authors: Larry J Seidman; Joseph Biederman; Michael C Monuteaux; Eve Valera; Alysa E Doyle; Stephen V Faraone Journal: Dev Neuropsychol Date: 2005 Impact factor: 2.253
Authors: Michelle A Shanahan; Bruce F Pennington; Benjamin E Yerys; Ashley Scott; Richard Boada; Erik G Willcutt; Richard K Olson; John C DeFries Journal: J Abnorm Child Psychol Date: 2006-10
Authors: Ronald C Kessler; Lenard Adler; Russell Barkley; Joseph Biederman; C Keith Conners; Olga Demler; Stephen V Faraone; Laurence L Greenhill; Mary J Howes; Kristina Secnik; Thomas Spencer; T Bedirhan Ustun; Ellen E Walters; Alan M Zaslavsky Journal: Am J Psychiatry Date: 2006-04 Impact factor: 18.112
Authors: Jeffrey E Max; Amy E Lansing; Sharon L Koele; Carlos S Castillo; Hirokazu Bokura; Russell Schachar; Nicole Collings; Kathryn E Williams Journal: Dev Neuropsychol Date: 2004 Impact factor: 2.253
Authors: Brett S Gunn; Thomas W McAllister; Michael A McCrea; Steven P Broglio; R Davis Moore Journal: J Neurotrauma Date: 2022-01-31 Impact factor: 5.269
Authors: Kathryn L Van Pelt; Jaclyn B Caccese; James T Eckner; Margot Putukian; M Alison Brooks; Kenneth L Cameron; Megan N Houston; Matthew A Posner; Jonathan C Jackson; Gerald T McGinty; Cameron J Hillis; Thomas W McAllister; Michael A McCrea; Steven P Broglio; Thomas A Buckley Journal: J Sport Health Sci Date: 2021-01-14 Impact factor: 7.179