@article{ref1,
title="Attention-deficit/hyperactivity disorder status and sex moderate mild traumatic brain injury symptom severity in children and adolescents: implications for clinical management",
journal="Clinical journal of sport medicine",
year="2020",
author="Orban, Sarah A. and Epstein, Jeffery N. and Carr, Devon and Logan, Kelsey and Gubanich, Paul J. and Sidol, Craig and Myer, Gregory D.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To investigate the impact of pediatric mild traumatic brain injury (mTBI), using a broad parent-reported measure, and to determine whether parent-ratings of mTBI symptoms are higher among those with premorbid attention-deficit/hyperactivity disorder (ADHD) and females. <br><br>DESIGN: Retrospective case-control. SETTING: Hospital-based sports medicine clinic. PARTICIPANTS: The retrospective chart review included 1346 (age: M = 13.11 years, SD = 2.6; 61.7% male) pediatric patients with (n = 209) and without (n = 1137) ADHD. INDEPENDENT VARIABLES: Group membership (ADHD vs non-ADHD) and sex (male vs female). MAIN OUTCOME MEASURES: Baseline and current Post-Concussion Symptom Inventory-Parent Report Form (PCSI-P) Physical, Emotional, Cognitive, and Fatigue subscale scores. This study used a retrospective chart review; therefore, the hypotheses reported for the current study were formed after data were collected. <br><br>RESULTS: Controlling for patient age and days from mTBI, patients with ADHD had significantly higher retrospective parent-reported pre-mTBI ratings of physical, emotional, and cognitive symptoms (ds = 0.17-0.62) and higher post-mTBI ratings across all 4 symptom domains (ds = 0.18-0.57) than those without ADHD. There was no group × time interaction for any of the PCSI-P subscales. Females overall had higher retrospective parent-reported pre-injury Fatigue and Emotional symptoms (ds = 0.13-0.19) and higher post-mTBI symptoms in all 4 PCSI-P symptom domains (ds = 0.23-0.35), relative to males. <br><br>CONCLUSIONS: Attention-deficit/hyperactivity disorder-related postinjury exacerbations in parent-reported symptoms can be explained, in part, by elevated retrospective parent-reported ADHD-related pre-mTBI ratings. These results highlight the importance of assessing a patient's baseline symptoms post-mTBI. These data also indicate that ADHD status and sex should be considered when interpreting mTBI symptom severity during clinical evaluation of concussion.<p /> <p>Language: en</p>",
language="en",
issn="1050-642X",
doi="10.1097/JSM.0000000000000821",
url="http://dx.doi.org/10.1097/JSM.0000000000000821"
}