Niki A Konstantinides, Sean M Murphy, Bridget M Whelan, Kimberly G Harmon, Sourav K Poddar, Theresa D Hernández, Rachel K Rowe
{"title":"大学运动员脑震荡前状况和脑震荡史对脑震荡后症状严重程度和恢复时间的影响。","authors":"Niki A Konstantinides, Sean M Murphy, Bridget M Whelan, Kimberly G Harmon, Sourav K Poddar, Theresa D Hernández, Rachel K Rowe","doi":"10.1089/neu.2024.0201","DOIUrl":null,"url":null,"abstract":"<p><p>Mental health conditions and concussion history reported by a collegiate athlete may contribute to prolonged recovery and symptom severity after concussion. This work examined the potential associations among concussion history, preexisting conditions, and sex relative to initial symptom severity and recovery duration following sport-related concussion (SRC) in a cohort of Division 1 National Collegiate Athletic Association athletes. This prospective cohort study analyzed symptom severity, recovery, and return-to-play (RTP) times reported post-SRC using data collected as part of the Pac-12 Concussion Assessment, Research and Education Affiliated Program and Health Analytics Program. Health history questionnaires that included self-reported history of preexisting conditions were completed at baseline. When consented athletes were diagnosed with a concussion, daily postconcussion symptom scores were evaluated until an athlete was clinically determined to be asymptomatic. Generalized linear and Cox proportional hazards models were used to determine associations between preexisting conditions and recovery and RTP times. Ninety-two concussions met inclusion criteria. Notable differences in initial symptom severity existed between females and males who had mood disorders (effect size [<i>d</i>] = 0.51) and attention-deficit hyperactivity disorder (ADHD; <i>d</i> = 0.93). The number of previous concussions was a strong predictor of athletes reporting preexisting mood disorders, depression, anxiety, and ADHD (<i>p</i> = 0.008-0.04). Females with ≥2 previous concussions required more days to RTP than males (<i>d</i> = 0.31-0.72). Weekly recovery and RTP probabilities substantially differed between athletes who did or did not have learning disorders (LDs; hazard ratio [HR]<sub>Recovery</sub> = 0.32, HR<sub>RTP</sub> = 0.22, <i>d</i> = 1.96-2.30) and ADHD (HR<sub>Recovery</sub> = 3.38, HR<sub>RTP</sub> = 2.74, <i>d</i> = 1.71-4.14). Although no association existed between concussion history and acute symptom severity, collegiate athletes with a history of concussion had higher probabilities of reporting depression, mood disorders, anxiety, and ADHD. Having ADHD or LDs likely strongly affects time to recovery and RTP for collegiate athletes.</p>","PeriodicalId":16512,"journal":{"name":"Journal of neurotrauma","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of Preexisting Conditions and Concussion History on Postconcussion Symptom Severity and Recovery Time in Collegiate Athletes.\",\"authors\":\"Niki A Konstantinides, Sean M Murphy, Bridget M Whelan, Kimberly G Harmon, Sourav K Poddar, Theresa D Hernández, Rachel K Rowe\",\"doi\":\"10.1089/neu.2024.0201\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Mental health conditions and concussion history reported by a collegiate athlete may contribute to prolonged recovery and symptom severity after concussion. This work examined the potential associations among concussion history, preexisting conditions, and sex relative to initial symptom severity and recovery duration following sport-related concussion (SRC) in a cohort of Division 1 National Collegiate Athletic Association athletes. This prospective cohort study analyzed symptom severity, recovery, and return-to-play (RTP) times reported post-SRC using data collected as part of the Pac-12 Concussion Assessment, Research and Education Affiliated Program and Health Analytics Program. Health history questionnaires that included self-reported history of preexisting conditions were completed at baseline. When consented athletes were diagnosed with a concussion, daily postconcussion symptom scores were evaluated until an athlete was clinically determined to be asymptomatic. Generalized linear and Cox proportional hazards models were used to determine associations between preexisting conditions and recovery and RTP times. Ninety-two concussions met inclusion criteria. Notable differences in initial symptom severity existed between females and males who had mood disorders (effect size [<i>d</i>] = 0.51) and attention-deficit hyperactivity disorder (ADHD; <i>d</i> = 0.93). The number of previous concussions was a strong predictor of athletes reporting preexisting mood disorders, depression, anxiety, and ADHD (<i>p</i> = 0.008-0.04). Females with ≥2 previous concussions required more days to RTP than males (<i>d</i> = 0.31-0.72). Weekly recovery and RTP probabilities substantially differed between athletes who did or did not have learning disorders (LDs; hazard ratio [HR]<sub>Recovery</sub> = 0.32, HR<sub>RTP</sub> = 0.22, <i>d</i> = 1.96-2.30) and ADHD (HR<sub>Recovery</sub> = 3.38, HR<sub>RTP</sub> = 2.74, <i>d</i> = 1.71-4.14). Although no association existed between concussion history and acute symptom severity, collegiate athletes with a history of concussion had higher probabilities of reporting depression, mood disorders, anxiety, and ADHD. Having ADHD or LDs likely strongly affects time to recovery and RTP for collegiate athletes.</p>\",\"PeriodicalId\":16512,\"journal\":{\"name\":\"Journal of neurotrauma\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurotrauma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/neu.2024.0201\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurotrauma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/neu.2024.0201","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Influence of Preexisting Conditions and Concussion History on Postconcussion Symptom Severity and Recovery Time in Collegiate Athletes.
Mental health conditions and concussion history reported by a collegiate athlete may contribute to prolonged recovery and symptom severity after concussion. This work examined the potential associations among concussion history, preexisting conditions, and sex relative to initial symptom severity and recovery duration following sport-related concussion (SRC) in a cohort of Division 1 National Collegiate Athletic Association athletes. This prospective cohort study analyzed symptom severity, recovery, and return-to-play (RTP) times reported post-SRC using data collected as part of the Pac-12 Concussion Assessment, Research and Education Affiliated Program and Health Analytics Program. Health history questionnaires that included self-reported history of preexisting conditions were completed at baseline. When consented athletes were diagnosed with a concussion, daily postconcussion symptom scores were evaluated until an athlete was clinically determined to be asymptomatic. Generalized linear and Cox proportional hazards models were used to determine associations between preexisting conditions and recovery and RTP times. Ninety-two concussions met inclusion criteria. Notable differences in initial symptom severity existed between females and males who had mood disorders (effect size [d] = 0.51) and attention-deficit hyperactivity disorder (ADHD; d = 0.93). The number of previous concussions was a strong predictor of athletes reporting preexisting mood disorders, depression, anxiety, and ADHD (p = 0.008-0.04). Females with ≥2 previous concussions required more days to RTP than males (d = 0.31-0.72). Weekly recovery and RTP probabilities substantially differed between athletes who did or did not have learning disorders (LDs; hazard ratio [HR]Recovery = 0.32, HRRTP = 0.22, d = 1.96-2.30) and ADHD (HRRecovery = 3.38, HRRTP = 2.74, d = 1.71-4.14). Although no association existed between concussion history and acute symptom severity, collegiate athletes with a history of concussion had higher probabilities of reporting depression, mood disorders, anxiety, and ADHD. Having ADHD or LDs likely strongly affects time to recovery and RTP for collegiate athletes.
期刊介绍:
Journal of Neurotrauma is the flagship, peer-reviewed publication for reporting on the latest advances in both the clinical and laboratory investigation of traumatic brain and spinal cord injury. The Journal focuses on the basic pathobiology of injury to the central nervous system, while considering preclinical and clinical trials targeted at improving both the early management and long-term care and recovery of traumatically injured patients. This is the essential journal publishing cutting-edge basic and translational research in traumatically injured human and animal studies, with emphasis on neurodegenerative disease research linked to CNS trauma.