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Cited by 118Traumatic Brain Injury ResearchSports injuries and preventionAttention Deficit Hyperactivity Disorder

Multiple self-reported concussions are more prevalent in athletes with ADHD and learning disability

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Nelson, Lindsay D., Guskiewicz, Kevin M., Marshall, Stephen W., Hammeke, Thomas, Barr, William, Randolph, Christopher, McCrea, Michael A.·2016·Clinical Journal of Sport Medicine
DOI 10.1097/jsm.0000000000000207PMC PMC6938223
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Abstract

OBJECTIVE: We evaluated how attention deficit-hyperactivity disorder (ADHD) and learning disability (LD) are associated with concussion history and performance on standard concussion assessment measures. Based on previous reports that developmental disorders are associated with increased injury proneness and poorer cognitive performance, we anticipated that ADHD and LD would be associated with increased history of concussion and poorer baseline performance on assessment measures. DESIGN: Cross-sectional study. SETTING: Clinical research center. PARTICIPANTS: The study sample aggregated data from two separate projects: the National Collegiate Athletic Association Concussion Study and Project Sideline. INTERVENTIONS: We analyzed preseason baseline data from 8056 high school and collegiate athletes (predominantly male football players) enrolled in prior studies of sport-related concussion. MAIN OUTCOME MEASURES: Measures included demographic/health history, symptoms, and cognitive performance. RESULTS: Attention deficit-hyperactivity disorder and LD were associated with 2.93 and 2.08 times the prevalence, respectively, of 3+ historical concussions (for comorbid ADHD/LD the prevalence ratio was 3.38). In players without histories of concussion, individuals with ADHD reported more baseline symptoms, and ADHD and LD were associated with poorer performance on baseline cognitive tests. Interactive effects were present between ADHD/LD status and concussion history for self-reported symptoms. CONCLUSIONS: Neurodevelopmental disorders and concussion history should be jointly considered in evaluating concussed players. CLINICAL RELEVANCE: Clinical judgments of self-reported symptoms and cognitive performance should be adjusted based on athletes' individual preinjury baselines or comparison with appropriate normative samples.

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  • A US study of over 8,000 high school and collegiate athletes, mostly male football players, found that those with ADHD were three times as likely to have had three or more reported concussions.

    “A U.S. study of over 8,000 high school and collegiate athletes (predominantly male football players) found that those with ADHD were three times as likely to have had three or more reported concussions”

    From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Nelson et al., 2016

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2 of the 36 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. [27]Reitan RM, Wolfson D. The Halstead-reitan Neuropsychological Test Battery: Therapy and Clinical Interpretation. Tuscon, AZ: Neuropsychological Press; 1985.
  2. [30]Strauss E, Sherman EMS, Spreen O. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. 3rd ed. New York, NY: Oxford University Press; 2006.
  3. [36]McCrea M, Nelson LD. Effects of multiple concussions. In: Iverson REG, ed. Oxford Handbook of Sport-Related Concussion. New York, NY: Oxford; in press.

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Authors
Nelson, L. D., Guskiewicz, K. M., Marshall, S. W., Hammeke, T., Barr, W., Randolph, C., & McCrea, M. A.
Affiliations
University of North Carolina at Chapel Hill (US)
ORCID
Venue
Clinical Journal of Sport Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-03
Volume
26
Issue
2
Pages
120-127
ISSN
1050-642X (ISSN-L)
DOI
10.1097/jsm.0000000000000207
PMC
PMC6938223
OpenAlex
W2102757444
Semantic Scholar
6cb7bf4fdcb79b73bc03a056c6b1aabc7868937f
Cited by
118
References
36
Citations by year
2026: 5 · 2025: 5 · 2024: 5 · 2023: 12 · 2022: 11 · 2021: 17 · 2020: 13 · 2019: 14 · 2018: 17 · 2017: 13 · 2016: 4 · 2014: 1
FWCI
8.89
Type
journal article
Language
en
Open access
Locations
  • Clinical Journal of Sport Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • NFL Charities
  • National Operating Committee on Standards for Athletic Equipment
  • National Institutes of Health (RR00058)
  • Injury Prevention Research Center
  • National Center for Research Resources (M01RR000058)
  • National Center for Injury Prevention and Control
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Keywords
sports-related concussion, attention deficit hyperactivity disorder, learning disabilities, neurodevelopmental disorders, concussion history, self-reported symptoms, baseline cognitive performance, football players, concussion assessment
MeSH terms
Adolescent, Attention Deficit Disorder with Hyperactivity, Brain Concussion, Female, Humans, Learning Disabilities, Male, Neuropsychological Tests, Prospective Studies, United States, Young Adult, Athletes, Self Report

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