Department of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
J Neurotrauma. 2022 Mar;39(5-6):379-389. doi: 10.1089/neu.2020.7446. Epub 2022 Jan 31.
Evidence suggests neurodevelopmental disorders (NDs) may be associated with an increased incidence of concussion, but no studies have cross-sectionally and longitudinally assessed the associations of NDs and sex with concussion in collegiate athletes. We sought to assess the odds and relative risk (RR) of concussion in athletes self-reporting a diagnosis of attention deficit/hyperactivity disorder (ADHD), learning disability (LD), and ADHD+LD. Data from the Concussion Assessment, Research and Education (CARE) Consortium (2014-2017) were used to evaluate the likelihood of concussion for male and female athletes with ADHD, LD, and ADHD+LD, relative to controls. Odds ratios (ORs) of concussion history prior to enrollment and relative risk ratios for incurring a concussion following enrollment, with and without concussion history were calculated for all groups. Athletes with self-reported diagnosis of ADHD, LD, and ADHD+LD were more likely to report a single concussion (OR range = 1.528 to 1.828) and multiple concussions (OR range = 1.849 to 2.365) prior to enrollment in the CARE Consortium, irrespective of sex compared with control athletes. While enrolled in CARE, male athletes with ADHD, LD, and ADHD+LD had greater risk of incurring a concussion (RR range = 1.369 to 2.243) than controls, irrespective of concussion history. Male athletes with ADHD+LD with concussion history (RR = 2.221) and without concussion history (RR = 1.835) had greater risk of incurring a concussion than controls. These results suggest NDs may be associated with increased odds of single and multiple concussions, irrespective of sex. However, when we accounted for concussion history, it appears only male athletes with ADHD+LD had greater risk than respective controls. There were no significant differences between females and males with ADHD, LD, or ADHD+LD for either odds of concussion history or risk for incurring concussion.
有证据表明，神经发育障碍（NDs）可能与脑震荡发生率增加有关，但尚无研究从横断和纵向两个方面评估 NDs 和性别与大学生运动员脑震荡之间的关系。我们旨在评估报告患有注意力缺陷/多动障碍（ADHD）、学习障碍（LD）和 ADHD+LD 诊断的运动员发生脑震荡的几率和相对风险（RR）。使用来自脑震荡评估、研究和教育（CARE）联盟（2014-2017 年）的数据，来评估患有 ADHD、LD 和 ADHD+LD 的男性和女性运动员相对于对照组发生脑震荡的可能性。计算了所有组在入组前有脑震荡史和在入组后无脑震荡史和有脑震荡史时发生脑震荡的比值比（OR）和相对风险比（RR）。与对照组相比，报告 ADHD、LD 和 ADHD+LD 自我诊断的运动员在入组 CARE 联盟之前更有可能报告单次脑震荡（OR 范围为 1.528 至 1.828）和多次脑震荡（OR 范围为 1.849 至 2.365），无论性别如何。在 CARE 联盟中，患有 ADHD、LD 和 ADHD+LD 的男性运动员比对照组运动员无论是否有脑震荡史，发生脑震荡的风险都更高（RR 范围为 1.369 至 2.243）。有脑震荡史（RR=2.221）和无脑震荡史（RR=1.835）的 ADHD+LD 男性运动员发生脑震荡的风险高于对照组。这些结果表明，NDs 可能与单次和多次脑震荡的几率增加有关，而与性别无关。然而，当我们考虑到脑震荡史时，似乎只有患有 ADHD+LD 的男性运动员比相应的对照组风险更高。对于脑震荡史的几率或发生脑震荡的风险，ADHD、LD 或 ADHD+LD 的女性和男性之间没有显著差异。
