Influence of Preexisting Conditions and Concussion History on Postconcussion Symptom Severity and Recovery Time in Collegiate Athletes.

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY
Niki A Konstantinides, Sean M Murphy, Bridget M Whelan, Kimberly G Harmon, Sourav K Poddar, Theresa D Hernández, Rachel K Rowe
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引用次数: 0

Abstract

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.

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。
大学生运动员报告的精神健康状况和脑震荡病史可能会导致脑震荡后恢复期延长和症状严重程度加重。这项研究以美国大学生体育协会(NCAA)一级联盟的运动员为研究对象,探讨了脑震荡病史、原有病症和性别与运动相关脑震荡(SRC)后初始症状严重程度和恢复持续时间之间的潜在关联。这项前瞻性队列研究利用 Pac-12 CARE 附属计划和健康分析计划收集的数据,分析了运动相关脑震荡(SRC)后报告的症状严重程度、恢复时间和重返赛场时间。研究人员在基线时填写了健康史问卷,其中包括自我报告的既往病史。当经同意的运动员被诊断为脑震荡时,将对其脑震荡后的每日症状评分进行评估,直到临床确定运动员无症状为止。采用广义线性模型和考克斯比例危险模型来确定原有状况与恢复和重返赛场时间之间的关系。92 例脑震荡符合纳入标准。患有情绪障碍([Cohen's d] = 0.51)和多动症(ADHD)的女性和男性在初始症状严重程度上存在显著差异(d = 0.93)。之前的脑震荡次数是运动员报告之前存在情绪障碍、抑郁症、焦虑症和多动症的有力预测因素(p = 0.008-0.04)。与男性相比,之前脑震荡次数≥2 次的女性需要更多的天数才能重返赛场(d = 0.31-0.72)。有或没有学习障碍(HRRecovery = 0.32,HRRTP = 0.22,d = 1.96-2.30)和多动症(ADHD)(HRRecovery = 3.38,HRRTP = 2.74,d = 1.71-4.14)的运动员每周恢复和重返赛场的概率有很大差异。虽然脑震荡史与急性症状严重程度之间不存在关联,但有脑震荡史的大学生运动员报告抑郁、情绪障碍、焦虑和多动症的概率较高。多动症或学习障碍可能会严重影响大学生运动员的康复时间和重返赛场的时间。
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来源期刊
Journal of neurotrauma
Journal of neurotrauma 医学-临床神经学
CiteScore
9.20
自引率
7.10%
发文量
233
审稿时长
3 months
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.
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