Brain injury · 2026
Long-term neurobehavioral and mental health outcomes in young athletes following sport-related concussion: the role of initial symptom severity.
СтатьяНазвание и аннотация: Перевод в очереди
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De Oliveira Nick, Horsey Jai, Fitch Samuel, Osama Tag, Williams Kristen L, Zuckerman Scott L, Terry Douglas P
Аннотация
OBJECTIVE: To examine whether initial concussion symptom severity predicts long-term neurobehavioral, anxiety, and depressive symptoms in adolescents with sport-related concussion (SRC).
METHODS: This cross-sectional study surveyed athletes treated for SRC between 2010 and 2017 who completed follow-up at least 5 years post-injury. Initial concussion data were obtained via chart review. Primary outcomes included the Neurobehavioral Symptom Inventory (NSI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Multivariable regression analyzed whether initial Post-Concussion Symptom Scale (PCSS) scores predicted long-term outcomes.
RESULTS: The cohort included 76 participants (current age 24.1 ± 2.5 years; 8.5 ± 1.5 years follow-up). At follow-up, 26.3% and 30.3% had clinically significant depressive (PHQ-9 ≥ 10) and anxiety (GAD-7 ≥ 10) symptoms, respectively. Amnesia at injury was associated with higher NSI (U = 612.0, p = 0.040) and GAD-7 (U = 554.0, p = 0.003). In multivariable regressions, higher initial PCSS at the time of injury was significantly associated with greater neurobehavioral (B = 0.227, p = 0.015) and depression symptoms (B = 0.083, p = 0.017). Amnesia after an initial injury independently predicted worse anxiety symptoms (B = 4.087, p = 0.009). However, these associations should be interpreted in light of the small sample size, potential selection bias, and the absence of pre-injury baseline symptom data.
CONCLUSIONS: Initial concussion symptom burden and amnesia at injury were associated with elevated neurobehavioral, depressive, and anxiety symptoms approximately 8.5 years post-concussion. These preliminary findings suggest that early symptom severity may be relevant to long-term prognosis, though the causal mechanism remains unclear: the small sample, potential selection bias, and absence of baseline data limit the strength of these conclusions.
METHODS: This cross-sectional study surveyed athletes treated for SRC between 2010 and 2017 who completed follow-up at least 5 years post-injury. Initial concussion data were obtained via chart review. Primary outcomes included the Neurobehavioral Symptom Inventory (NSI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Multivariable regression analyzed whether initial Post-Concussion Symptom Scale (PCSS) scores predicted long-term outcomes.
RESULTS: The cohort included 76 participants (current age 24.1 ± 2.5 years; 8.5 ± 1.5 years follow-up). At follow-up, 26.3% and 30.3% had clinically significant depressive (PHQ-9 ≥ 10) and anxiety (GAD-7 ≥ 10) symptoms, respectively. Amnesia at injury was associated with higher NSI (U = 612.0, p = 0.040) and GAD-7 (U = 554.0, p = 0.003). In multivariable regressions, higher initial PCSS at the time of injury was significantly associated with greater neurobehavioral (B = 0.227, p = 0.015) and depression symptoms (B = 0.083, p = 0.017). Amnesia after an initial injury independently predicted worse anxiety symptoms (B = 4.087, p = 0.009). However, these associations should be interpreted in light of the small sample size, potential selection bias, and the absence of pre-injury baseline symptom data.
CONCLUSIONS: Initial concussion symptom burden and amnesia at injury were associated with elevated neurobehavioral, depressive, and anxiety symptoms approximately 8.5 years post-concussion. These preliminary findings suggest that early symptom severity may be relevant to long-term prognosis, though the causal mechanism remains unclear: the small sample, potential selection bias, and absence of baseline data limit the strength of these conclusions.