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青少年运动员注意力缺陷多动障碍与脑震荡后恢复的关系

Relationship of Attention Deficit Hyperactivity Disorder and Postconcussion Recovery in Youth Athletes.

作者信息

Mautner Kenneth, Sussman Walter I, Axtman Matthew, Al-Farsi Yahya, Al-Adawi Samir

机构信息

*Departments of Orthopaedics and Rehabilitation, Emory Sports Medicine Center, Emory University, Atlanta, Georgia; †Department of Rehabilitation, Emory University, Atlanta, Georgia; ‡Spectrum Health Medical Group, Orthopaedics and Sports Medicine, Grand Rapids, Michigan; §Department of Family Medicine & Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman; and ¶Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.

出版信息

Clin J Sport Med. 2015 Jul;25(4):355-60. doi: 10.1097/JSM.0000000000000151.

Abstract

OBJECTIVE

To investigate whether attention deficit hyperactivity disorder (ADHD) influences postconcussion recovery, as measured by computerized neurocognitive testing.

DESIGN

This is a retrospective case control study.

SETTING

Computer laboratories across 10 high schools in the greater Atlanta, Georgia area.

PARTICIPANTS

Immediate postconcussion assessment and cognitive testing (ImPACT) scores of 70 athletes with a self-reported diagnosis of ADHD and who sustained a sport-related concussion were compared with a randomly selected age-matched control group. Immediate postconcussion assessment and cognitive testing scores over a 5-year interval were reviewed for inclusion.

MAIN OUTCOME MEASURES

Postconcussion recovery was defined as a return to equivalent baseline neurocognitive score on the ImPACT battery, and a concussion symptom score of ≤7.

RESULTS

Athletes with ADHD had on average a longer time to recovery when compared with the control group (16.5 days compared with 13.5 days), although not statistically significant. The number of previous concussions did not have any effect on the rate of recovery in the ADHD or the control group. In addition, baseline neurocognitive testing did not statistically differ between the 2 groups, except in verbal memory.

CONCLUSIONS

Although not statistically significant, youth athletes with ADHD took on average 3 days longer to return to baseline neurocognitive testing compared with a control group without ADHD.

CLINICAL RELEVANCE

Youth athletes with ADHD may have a marginally prolonged recovery as indexed by neurocognitive testing and should be considered when prognosticating time to recovery in this subset of student athletes.

摘要

目的

通过计算机神经认知测试,调查注意缺陷多动障碍(ADHD)是否会影响脑震荡后的恢复情况。

设计

这是一项回顾性病例对照研究。

地点

佐治亚州大亚特兰大地区10所高中的计算机实验室。

参与者

对70名自我报告诊断为ADHD且遭受与运动相关脑震荡的运动员的脑震荡后即刻评估和认知测试(ImPACT)分数,与随机选择的年龄匹配对照组进行比较。回顾了5年期间脑震荡后即刻评估和认知测试分数以纳入研究。

主要观察指标

脑震荡后恢复定义为在ImPACT测试中恢复到相当于基线神经认知分数,且脑震荡症状评分为≤7。

结果

与对照组相比,患有ADHD的运动员平均恢复时间更长(分别为16.5天和13.5天),尽管无统计学意义。既往脑震荡次数对ADHD组或对照组的恢复率没有任何影响。此外,除言语记忆外,两组之间的基线神经认知测试在统计学上没有差异。

结论

虽然无统计学意义,但与无ADHD的对照组相比,患有ADHD的青少年运动员平均需要多3天才能恢复到基线神经认知测试水平。

临床意义

患有ADHD的青少年运动员可能在神经认知测试指标上恢复时间略有延长,在对这部分学生运动员的恢复时间进行预后评估时应予以考虑。

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