Maietta Julia E, Iverson Grant L, Cook Nathan E
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States.
Front Neurol. 2025 Jan 29;15:1487909. doi: 10.3389/fneur.2024.1487909. eCollection 2024.
Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are more likely to report a lifetime history of concussion compared to those without ADHD. Prior studies have predominantly relied on surveys of youth who self-reported their ADHD status (as opposed to parent report), examined samples with relatively narrow age ranges, and focused on youth athletes. It is unclear if ADHD severity or ADHD medication influences the association between ADHD and greater lifetime history of concussion. We investigated the association between parent-reported ADHD, ADHD severity, and medication status with parent-reported lifetime concussion history in children and adolescents ranging in age from 5 to 17, sampled from the United States general population.
Parent reported health data from 33,914 children and adolescents were selected from the 2021 National Survey of Children's Health. Lifetime history of concussion, current ADHD diagnosed by a healthcare provider, and, for those with current ADHD, ADHD severity (mild or moderate/severe), and current ADHD medication status (yes/no) were reported by parents. A Mantel-Haenszel analysis was used to assess the associations between ADHD and lifetime concussion history across five age groups (ages 5-7, 8-10, 11-13, 14-15, and 16-17). Additional Mantel-Haenszel analyses were used to assess the associations between lifetime history of concussion and ADHD severity as well as medication status across five age groups.
Overall, 6.2% of youth had a parent-reported history of concussion and 12.3% had parent-reported current ADHD. Twice as many youth with ADHD (10.6%) had a parent-reported history of concussion compared to youth without ADHD (5.6%). There were no differences in lifetime concussion history for those with mild (10.9%) versus moderate/severe ADHD (10.3%). Similarly, among those with ADHD, there were no differences in lifetime concussion history for those taking medication (9.9%) versus those not taking medication (11.6%).
Consistent with previous literature, youth with ADHD had greater lifetime concussion history than youth without ADHD (approximately twice the prevalence in those with ADHD). Contrary to our hypotheses among youth with ADHD, parent-reported ADHD severity and current medication status were not associated with lifetime concussion history.
与没有注意力缺陷多动障碍（ADHD）的儿童和青少年相比，患有该疾病的儿童和青少年更有可能报告有脑震荡的终生病史。先前的研究主要依赖于对自我报告ADHD状态（而非家长报告）的青少年进行调查，研究样本的年龄范围相对较窄，且主要关注青少年运动员。目前尚不清楚ADHD的严重程度或ADHD药物治疗是否会影响ADHD与更高的脑震荡终生病史之间的关联。我们调查了在美国普通人群中抽取的年龄在5至17岁的儿童和青少年中，家长报告的ADHD、ADHD严重程度以及用药状况与家长报告的脑震荡终生病史之间的关联。
从2021年全国儿童健康调查中选取了33914名儿童和青少年的家长报告的健康数据。家长报告了脑震荡的终生病史、由医疗保健提供者诊断的当前ADHD，以及对于患有当前ADHD的儿童和青少年，ADHD的严重程度（轻度或中度/重度）和当前的ADHD用药状况（是/否）。采用Mantel-Haenszel分析来评估五个年龄组（5至7岁、8至10岁、11至13岁、14至15岁和16至17岁）中ADHD与脑震荡终生病史之间的关联。另外的Mantel-Haenszel分析用于评估五个年龄组中脑震荡终生病史与ADHD严重程度以及用药状况之间的关联。
总体而言，6.2%的青少年有家长报告的脑震荡病史，12.3%的青少年有家长报告的当前ADHD。与没有ADHD的青少年（5.6%）相比，患有ADHD的青少年有家长报告的脑震荡病史的人数是其两倍（10.6%）。轻度ADHD患者（10.9%）与中度/重度ADHD患者（10.3%）的脑震荡终生病史没有差异。同样，在患有ADHD的青少年中，正在服药的青少年（9.9%）与未服药的青少年（11.6%）的脑震荡终生病史也没有差异。
与先前的文献一致，患有ADHD的青少年比没有ADHD的青少年有更高的脑震荡终生病史（ADHD患者的患病率约为其两倍）。与我们对患有ADHD的青少年的假设相反，家长报告的ADHD严重程度和当前用药状况与脑震荡终生病史无关。
