Objective: To determine the degree to which preinjury and acute postinjury psychosocial and injury-related variables predict symptom duration following sport-related concussion.
Methods: A total of 2,055 high school and collegiate athletes completed preseason evaluations. Concussed athletes (n = 127) repeated assessments serially (<24 hours and days 8, 15, and 45) postinjury. Cox proportional hazard modeling was used to predict concussive symptom duration (in days). Predictors considered included demographic and history variables; baseline psychological, neurocognitive, and balance functioning; acute injury characteristics; and postinjury clinical measures.
Results: Preinjury somatic symptom score (Brief Symptom Inventory-18 somatization scale) was the strongest premorbid predictor of symptom duration. Acute (24-hour) postconcussive symptom burden (Sport Concussion Assessment Tool-3 symptom severity) was the best injury-related predictor of recovery. These 2 predictors were moderately correlated (r = 0.51). Path analyses indicated that the relationship between preinjury somatization symptoms and symptom recovery was mediated by postinjury concussive symptoms.
Conclusions: Preinjury somatization symptoms contribute to reported postconcussive symptom recovery via their influence on acute postconcussive symptoms. The findings highlight the relevance of premorbid psychological factors in postconcussive recovery, even in a healthy athlete sample relatively free of psychopathology or medical comorbidities. Future research should elucidate the neurobiopsychosocial mechanisms that explain the role of this individual difference variable in outcome following concussive injury.
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http://dx.doi.org/10.1212/WNL.0000000000002679 | DOI Listing |
J Head Trauma Rehabil
January 2025
Author Affiliations: Department of Neurosurgery (Dr Meier, Mr Huber, and Dr McCrea), Department of Biomedical Engineering (Dr Meier), Department of Biophysics (Ms Goeckner), Department of Cell Biology, Neurobiology and Anatomy (Dr Meier), Department of Neurology (Dr McCrea), Medical College of Wisconsin, Milwaukee, Wisconsin; National Institute of Nursing Research (Dr Gill), National Institutes of Health, Bethesda, Maryland, USA; Johns Hopkins School of Nursing and Medicine (Dr Gill), Baltimore, MD; Department of Physical Medicine and Rehabilitation (Dr Pasquina), Uniformed Services University of the Health Sciences, Bethesda, Maryland; Michigan Concussion Center (Dr Broglio), University of Michigan, Ann Arbor, Michigan; Department of Psychiatry (Dr McAllister), Indiana University School of Medicine, Indianapolis, IN; and Department of Epidemiology and Biostatistics (Dr Harezlak), School of Public Health-Bloomington, Indiana University, Bloomington, Indiana.
J Head Trauma Rehabil
April 2022
Department of Neurological Surgery (Drs Yengo-Kahn, Bonfield, and Zuckerman), Vanderbilt Sport Concussion Center (Drs Yengo-Kahn, Bonfield, Gifford, Zuckerman, and Dennis and Ms Hibshman), Division of Epidemiology, Department of Medicine (Mr Torstenson), Vanderbilt Epidemiology Center, Institute for Medicine and Public Health (Mr Torstenson), Vanderbilt Genetics Institute (Mr Torstenson and Drs Davis and Dennis), Department of Neurology (Dr Gifford), and Division of Genetic Medicine, Department of Medicine (Drs Davis and Dennis), Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt University School of Medicine, Nashville, Tennessee (Ms Hibshman); British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada (Ms Belikau and Dr Dennis); and Department of Medical Genetics, The University of British Columbia, Vancouver, British Columbia, Canada (Dr Dennis).
Objective: To identify risk factors and generate hypotheses for pediatric persistent postconcussion symptoms (PPCS).
Setting: A regional healthcare system in the Southeastern United States.
Participants: An electronic health record-based algorithm was developed and validated to identify PPCS cases and controls from an institutional database of more than 2.
Am J Sports Med
March 2020
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Background: Symptoms, cognition, balance, and other domains are commonly assessed at baseline testing as part of comprehensive preseason evaluations among collegiate student-athletes. Although approximately 27% of college students have at least 1 sleep disorder, researchers have yet to examine the role of a preexisting sleep disorder on preinjury baseline performance.
Purpose: To compare athletes with and without a reported history of diagnosed sleep disorders on commonly used baseline concussion assessments.
Neurology
May 2016
From the Departments of Neurosurgery & Neurology (L.D.N., M.A.M.), Department of Neurosurgery (A.A.L.), Division of Biostatistics, Institute for Health and Society (S.T.), Department of Psychiatry & Behavioral Medicine (T.A.H.), Medical College of Wisconsin, Milwaukee; Department of Neurology (W.B.B.), New York University School of Medicine, New York; Department of Exercise and Sport Science (K.G.), University of North Carolina, Chapel Hill; and Department of Neurology (C.R.), Loyola University Medical Center, Maywood, IL.
J Pediatr
July 2016
Children's Hospital Colorado, Aurora, CO; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO.
Objective: To characterize the psychological factors associated with persistent symptoms after pediatric concussion.
Study Design: Longitudinal cohort study of 179 children with concussion 8-18 years old evaluated in a pediatric emergency department. Participants were followed for 1 month for delayed symptom resolution, defined as ≥3 symptoms that were new/worse than preinjury symptoms measured by the use of graded symptom inventory.
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