Ransom DM, Vaughan CG, Pratson L, Sady MD, McGill
CA, Gioia GA. Academic
Effects of Concussion in Children and Adolescents. Pediatrics. 2015 May 11. pii:
peds.2014-3434. [Epub ahead of print]
Effects of Concussion in Children and Adolescents. Pediatrics. 2015 May 11. pii:
peds.2014-3434. [Epub ahead of print]
Abstract
OBJECTIVE:
The aim of this work is to study the
nature and extent of the adverse academic effects faced by students recovering
from concussion.
METHOD:
A sample of 349 students ages 5 to
18 who sustained a concussion and their parents reported academic concerns and
problems (eg, symptoms interfering, diminished academic skills) on a structured
school questionnaire within 4 weeks of injury. Postconcussion symptoms were
measured as a marker of injury severity. Results were examined based on
recovery status (recovered or actively symptomatic) and level of schooling
(elementary, middle, and high school).
RESULTS:
Actively symptomatic students and
their parents reported higher levels of concern for the impact of concussion on
school performance (P < .05) and more school-related problems (P < .001)
than recovered peers and their parents. High school students who had not yet
recovered reported significantly more adverse academic effects than their
younger counterparts (P < .05). Greater severity of postconcussion symptoms
was associated with more school-related problems and worse academic effects,
regardless of time since injury (P < .001).
CONCLUSIONS:
This study provides initial evidence
for a concussion's impact on academic learning and performance, with more
adverse effects reported by students who had not yet recovered from the injury.
School-based management with targeted recommendations informed by postinjury
symptoms may mitigate adverse academic effects, reduce parent and student
concerns for the impact of the injury on learning and scholastic performance,
and lower the risk of prolonged recovery for students with active
postconcussion symptoms.
They assessed the role of sex and previous concussion on long-term neurocognitive performance in 148 Division I college athletes in 11 sports during a single season at the University of Michigan in Ann Arbor. The athletes are participating in the National Sport Concussion Outcome Study (NSCOS).
ReplyDeleteSixty-seven (45%) were women, 51% played a contact sport, and 36 (24%) had a history of sports-related concussion (average, 0.32 concussions; range, 0 to 4). Most concussed athletes had a single concussive injury (78%), with the most recent concussion having occurred 42 months previously on average. Men and women were equally likely to have a history of concussion.
Women and men with a history of at least one concussion had similar scores on computerized cognitive baseline testing. "This finding that cognitive skills were not significantly affected by having a concussion for either gender should be reassuring to athletes who have experienced a concussion and wonder about its later effects," O'Connor said.
However, all women, regardless of concussion history, had more symptoms, greater symptom severity, and poorer cognitive performance than men at baseline, she reported.
Women on average had 1.5 more symptoms and scored 3 points higher on symptom severity than men. On a clinical reaction time task, women were 19 milliseconds slower to react than men. Women also scored on average 7% below men on cognitive tasks assessing processing speed, attention, and working memory speed, with the greatest difference on processing speed (8.5%).
"In addition to our analysis, other research groups…have found that females endorse more symptoms at baseline and postinjury," O'Connor told Medscape Medical News. "It is still unclear why females report more symptoms and perform differently at preseason assessment. It is too early to speculate why these baseline gender differences exist. This is another area that requires further investigation," she noted.
http://www.medscape.com/viewarticle/848742?nlid=85766_3404&src=wnl_edit_medn_neur&uac=60196BR&spon=26&impID=779283&faf=1