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The Effects of Attention-Deficit/Hyperactivity Disorder Symptoms on the Association between Head Impacts and Post-Season Neurocognitive and Behavioral Outcomes

Published online by Cambridge University Press:  02 February 2022

James D. Lynch Open the ORCID record for James D. Lynch [Opens in a new window] ,
Megan E. Narad ,
Jed A. Diekfuss ,
Jason Avedesian ,
Taylor M. Zuleger ,
James Peugh ,
Gregory D. Myer  and
Jeffery N. Epstein Open the ORCID record for Jeffery N. Epstein [Opens in a new window]
James D. Lynch*
Affiliation:
Department of Psychology, University of Cincinnati, Cincinnati, OH, USA Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Megan E. Narad
Affiliation:
Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA University of Cincinnati, College of Medicine, Cincinnati, OH, USA
Jed A. Diekfuss
Affiliation:
Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA Emory Sports Medicine Center, Department of Orthopaedics, Emory University, Atlanta, GA, USA
Jason Avedesian
Affiliation:
Olympic Sports Strength and Conditioning, Clemson University, Clemson, SC, USA
Taylor M. Zuleger
Affiliation:
Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA Neuroscience Graduate Program, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
James Peugh
Affiliation:
Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA University of Cincinnati, College of Medicine, Cincinnati, OH, USA
Gregory D. Myer
Affiliation:
Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA Emory Sports Medicine Center, Department of Orthopaedics, Emory University, Atlanta, GA, USA
Jeffery N. Epstein
Affiliation:
Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA University of Cincinnati, College of Medicine, Cincinnati, OH, USA
*
*Correspondence and reprint requests to: James Lynch, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC10006, Cincinnati, OH 45229-3039, USA. E-mail: james.lynch@cchmc.org
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Abstract

Objective:

Having attention-deficit/hyperactivity disorder (ADHD) is a risk factor for concussion that impacts concussion diagnosis and recovery. The relationship between ADHD and repetitive subconcussive head impacts on neurocognitive and behavioral outcomes is less well known. This study evaluated the role of ADHD as a moderator of the association between repetitive head impacts on neurocognitive test performance and behavioral concussion symptoms over the course of an athletic season.

Method:

Study participants included 284 male athletes aged 13–18 years who participated in high school football. Parents completed the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) ratings about their teen athlete before the season began. Head impacts were measured using an accelerometer worn during all practices and games. Athletes and parents completed behavioral ratings of concussion symptoms and the Attention Network Task (ANT), Digital Trail Making Task (dTMT), and Cued Task Switching Task at pre- and post-season.

Results:

Mixed model analyses indicated that neither head impacts nor ADHD symptoms were associated with post-season athlete- or parent-reported concussion symptom ratings or neurocognitive task performance. Moreover, no relationships between head impact exposure and neurocognitive or behavioral outcomes emerged when severity of pre-season ADHD symptoms was included as a moderator.

Conclusion:

Athletes’ pre-season ADHD symptoms do not appear to influence behavioral or neurocognitive outcomes following a single season of competitive football competition. Results are interpreted in light of several study limitations (e.g., single season, assessment of constructs) that may have impacted this study’s pattern of largely null results.

Keywords

AttentionCognitionFootballAthletesAdolescentLongitudinal study
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 29 , Issue 1 , January 2023 , pp. 24 - 34
Copyright
Copyright © INS. Published by Cambridge University Press, 2022

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