Zuckerman Scott L, Lee Young M, Odom Mitchell J, Solomon Gary S, Sills Allen K
Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Nashville, Tennessee 37212, USA.
J Neurosurg Pediatr. 2013 Aug;12(2):103-9. doi: 10.3171/2013.5.PEDS12524. Epub 2013 Jun 21.
Up to 16% of children in the US between the ages of 3 and 17 years have either attention deficit-spectrum disorder or a learning disability (LD). Sports-related concussions among youth athletes represent a significant public health concern, and neurocognitive testing is a method to evaluate the severity of cognitive impairment and recovery after a sports-related concussion. The goal of this study was to assess baseline neurocognitive differences between athletes with attention deficit hyperactivity disorder (ADHD) and/or LD versus those with neither disorder and to establish normative data for these special populations.
Between August 2007 and March 2012, 6636 young athletes underwent baseline neurocognitive testing performed using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery. Of these participants, 90 had self-reported LD only, 262 had self-reported ADHD only, and 55 reported both. Those with ADHD and/or LD were matched with 407 participants with no history of ADHD or LD by age, sex, and number of prior concussions. The mean scores and SDs were calculated for each group to obtain normative values. A pairwise comparison between each diagnostic group was done to assess whether LD and/or ADHD diagnostic status predicted participants' baseline neurocognitive scores.
Participants with ADHD had significantly lower verbal memory, visual memory, and visual motor processing speed scores, along with significantly higher reaction time, impulse control, and symptom scores compared with those without LD or ADHD. Participants with LD had similar results, with significantly lower verbal memory, visual memory, and visual motor processing speed scores, higher reaction time and symptom score, but did not differ in their impulse control score compared with those without LD or ADHD. Participants with both LD and ADHD had a significantly lower visual motor speed score and a significantly higher reaction time and symptom score than those without LD or ADHD, but did not differ with regard to the other composite scores.
Athletes with ADHD and/or LD have lower baseline ImPACT neurocognitive scores compared with athletes without ADHD and LD. Preliminary normative neurocognitive data for these special populations are provided.
在美国，年龄在3至17岁的儿童中，高达16%患有注意力缺陷谱系障碍或学习障碍（LD）。青少年运动员中与运动相关的脑震荡是一个重大的公共卫生问题，神经认知测试是评估与运动相关脑震荡后认知障碍严重程度和恢复情况的一种方法。本研究的目的是评估患有注意力缺陷多动障碍（ADHD）和/或LD的运动员与未患这些疾病的运动员之间的基线神经认知差异，并为这些特殊人群建立规范数据。
2007年8月至2012年3月期间，6636名年轻运动员接受了使用脑震荡后即刻评估和认知测试（ImPACT）套件进行的基线神经认知测试。在这些参与者中，90人仅自我报告有LD，262人仅自我报告有ADHD，55人同时报告有这两种疾病。将患有ADHD和/或LD的参与者与407名无ADHD或LD病史的参与者按年龄、性别和既往脑震荡次数进行匹配。计算每组的平均分数和标准差以获得规范值。对每个诊断组进行两两比较，以评估LD和/或ADHD诊断状态是否能预测参与者的基线神经认知分数。
与没有LD或ADHD的参与者相比，患有ADHD的参与者在言语记忆、视觉记忆和视觉运动处理速度分数方面显著更低，而反应时间、冲动控制和症状分数显著更高。患有LD的参与者有类似结果，在言语记忆、视觉记忆和视觉运动处理速度分数方面显著更低，反应时间和症状分数更高，但与没有LD或ADHD的参与者相比，其冲动控制分数没有差异。同时患有LD和ADHD的参与者与没有LD或ADHD的参与者相比，视觉运动速度分数显著更低，反应时间和症状分数显著更高，但在其他综合分数方面没有差异。
与没有ADHD和LD的运动员相比，患有ADHD和/或LD的运动员基线ImPACT神经认知分数更低。提供了这些特殊人群的初步规范神经认知数据。
