Abstract Details

Title Exploring the Impact of ADHD on Concussion Recovery in Adolescent Athletes

Topic Neuro Trauma and Critical Care

Presentation(s) S26 - Neuro Trauma and Sports Neurology (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background Adolescent athletes with ADHD experience a higher prevalence of concussions compared to their peers. ADHD and learning disorders (LD) have the potential to impact performance on neurocognitive testing. Concussed adolescent athletes with ADHD are at risk of experiencing undetected post-injury symptoms, as the effect of ADHD on post-concussive testing is not well understood.

Objective This study evaluated differences in post-concussion symptoms amongst adolescent athletes with comorbid attention-deficit/hyperactivity-disorder (ADHD).

Design/Methods Athletes aged 10-18 years in the North Texas Concussion Registry (ConTex) between 2015-2024 diagnosed with a concussion within 30 days of their injury were included. Patients were divided into two groups based on self-reporting – only-ADHD (ADHD) and patients without any learning disorder or ADHD (no-LD). Post-concussion testing included neurocognitive function (ImPACT®) and ocular movements (King-Devick) at initial visit, and neuropsychiatric symptoms (GAD-7, PHQ-8, PQSI) at initial visit and 3-month follow-up. Mann-Whitney U tests determined differences between ADHD and no-LD groups (p<0.05).

Results 1,518 concussed athletes were included (53.4% male; 46.6% female) (p<0.001). More athletes with ADHD (n=155) reported one (24.4%) or multiple (10.9%) prior concussions compared to no-LD group (n=1363) experiencing one (17.5%) or multiple concussions (8.7%) (p<0.05). ADHD-only athletes had worse ImPACT® impulse control scores (μ=10.43) than the no-LD group (μ=8.49) (p<0.05). No differences were found between ADHD and no-LD groups for other ImPACT® cognitive scores, ImPACT® total symptom scores, and KD testing. GAD-7 and PHQ-8 scores were higher in the group with ADHD (μ=4.24; μ=5.46) compared to no-LD adolescents (μ=3.37; μ=4.36) (p<0.05). PSQI scores showed no differences between groups. No differences were found for any neuropsychiatric measures at 3-month follow-up.

Conclusions Athletes with ADHD demonstrated differences in neurocognitive and psychological post-concussion testing results compared to peers without LD or ADHD. Understanding the impact of ADHD on specific measures of concussion may assist clinicians in interpreting clinical testing and ensuring appropriate care.

Authors/Disclosures
Joshua A. Beitchman, MD, MBS (UT Southwestern Medical Center) PRESENTER	Dr. Beitchman has nothing to disclose.
Ashna Shah, Medical Student	Ms. Shah has nothing to disclose.
Jane S. Chung, MD	Dr. Chung has nothing to disclose.
Cheryl H. Silver, PhD	Dr. Silver has nothing to disclose.
Munro Cullum, PhD (Univ of Texas Southwestern Medical Center)	The institution of Dr. Cullum has received research support from NIH. Dr. Cullum has received intellectual property interests from a discovery or technology relating to health care. Dr. Cullum has received personal compensation in the range of $10,000-$49,999 for serving as a Scientific Director with Texas Alzheimers Research and Care Consortium.
Shane Miller	Shane Miller has nothing to disclose.
Mathew Stokes, MD (University of Texas SW Medical School, Child Neurology)	The institution of Dr. Stokes has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Global Medical Response.

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