Concussion-related deficits in the general population predict impairments in varsity footballers

• Published in: Journal of neurology Vol. 267; no. 7; pp. 1970 - 1979
• Main Authors: Stafford, Clara Alexandra, Stojanoski, Bobby, Wild, Conor J., Brewer-Deluce, Danielle, Wilson, Timothy D., Owen, Adrian M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2020; Springer Nature B.V
• Subjects: Adult; Anxiety - physiopathology; Athletic Injuries - complications; Athletic Injuries - physiopathology; Attention - physiology; Brain Concussion - complications; Brain Concussion - physiopathology; Cognitive ability; Cognitive Dysfunction - etiology; Cognitive Dysfunction - physiopathology; Concussion; Depression - physiopathology; Executive function; Executive Function - physiology; Female; Football; Football - injuries; Humans; Inhibition, Psychological; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neuroradiology; Neurosciences; Original Communication; Population studies; Psychomotor Performance - physiology; Stroop Test; High-response rate survey; Varsity football; Inhibitory control; Neuropsychology; Concussion
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-020-09749-9

Objective We investigated the long-term cognitive effects of concussion in 19,261 members of the general population and a cohort of varsity American football players with a history of frequent head impacts, using tests that are known to be sensitive to small changes in performance. Methods We asked 19,261 participants to complete a demographic questionnaire and 12 cognitive tests measuring aspects of executive function, including inhibitory control. We compared the performance of those reporting a history of concussion (post-concussion) to those reporting no history of concussion (non-concussed) on the cognitive battery and four non-cognitive variables. We used the results of this population-level study to predict the profile of cognitive performance in varsity American football players, who completed the same cognitive tasks. Results Post-concussion and non-concussed participants did not differ on 11 of the 12 cognitive tasks employed. However, on a test of inhibitory control based on the classic Stroop paradigm, post-concussion participants showed accuracy-related impairments specific to the incongruent conditions of the task. Post-concussion participants reported higher levels of anxiety, depression, and trouble concentrating. An entirely independent sample of 74 varsity American football players demonstrated the same pattern of impairment: compared to healthy controls, they scored significantly lower on the test of inhibitory control but were indistinguishable from controls on the 11 other tasks. Interpretation Self-reported concussion is not associated with long-term general effects on cognitive function. Nevertheless, those who report at least one concussion and those who expose themselves to long-term frequent sport-related head impacts do have a modest, but statistically robust, deficit of inhibitory control.