Connecting the Dots: The Role of Pediatric Concussion on Pubertal Hormones and Psychological Health.

PURPOSE: Psychological health issues resulting from emotional dysregulation such as anxiety and depression following pediatric concussion are a public health concern, but the underlying mechanisms remain unclear. Puberty opens a window of vulnerability for emotion dysregulation and a link between pediatric concussion and hormonal deficits has been reported. We investigated the association between pubertal hormones and psychological health in children with and without concussion history.

METHODS

Participants included children (9-10 years) from the Adolescent Brain Cognitive Development study comprising with and without a reported history of concussion within the previous 2 years. Salivary Dehydroepiandrosterone (DHEA), testosterone and estradiol were used to determine levels of pubertal hormones, and the Child Behavior Checklist scores were used to characterize psychological health issues in late childhood (N = 264; 50% concussion history; 9.99 [0.64]yy; 36% female) and early adolescence (N = 112; 48% concussion history; 12.06 [0.66]yy; 33% female). Analyses of covariance were performed to relate concussion history to hormone levels from late childhood to early adolescence. Additional analyses determined whether hormone levels at late childhood or changes between late childhood and early adolescence mediated the effect of concussion history on psychological health.

RESULTS

Children with a concussion history had lower testosterone at late childhood (F = 6.5, p = .012, Q = 0.035) and larger DHEA increases over time (F = 6.0, p = .016, Q = 0.048). Larger DHEA increases partially mediated the association between concussion history and Child Behavior Checklist scores.

DISCUSSION: Pediatric concussion may increase vulnerability to psychological health issues in adolescence via pubertal hormones. Longitudinal studies evaluating the impact of pediatric concussion on psychological health and hormones are warranted to clarify this potential vulnerability.