by Phil Ko
Young athletes who experience a sports-related concussion are more likely to suffer a prolonged period of symptoms if they also have a family history of mood disorders, psychiatric illnesses or migraines, according to a study from the Vanderbilt Sports Concussion Center (VSCC) published in Journal of Neurosurgery: Pediatrics.
The study is among the first of an emerging field of research focusing on young athletes who suffered a sports-related concussion and consequently experienced post-concussion syndrome (PCS), a condition characterized by prolonged concussion symptoms.
“We could find very few specific studies of pediatric sports-related concussions … looking at risk factors of who is more likely to have a protracted recovery time,” said Clint Morgan, M.D., the first author of the study and a recent graduate of Vanderbilt University School of Medicine who will soon begin his neurosurgery residency at the Barrow Neurological Institute in Phoenix.
A major finding was that merely having a family history of certain conditions could predispose a young athlete to PCS.
“You can have an athlete who has no neurologic issues such as depression, anxiety or migraines themselves, but if their brother or father has it, then it puts them at a slightly increased risk for PCS,” said Scott Zuckerman, M.D., a resident in Neurosurgery and co-author of the study.
Patients with PCS were also more likely to have previously suffered multiple concussions and have problems with mood or psychiatric illnesses themselves. These findings highlight the importance of making a patient’s medical and family history known to clinicians for an accurate prognosis.
Generally, concussions can result in headache, problems with memory and attention, disrupted sleep and emotional problems. These symptoms usually subside about one to two weeks following the concussion, but they can be experienced for several months by those suffering from PCS, which can have devastating consequences on the patients.
“They can’t go back to their sport; they can’t go back to school or their job,” said Zuckerman. “It’s a significant diagnosis with a lot of impacts throughout life, not just sports.
Aided by co-authors Susan Beaird, R.N., a nurse practitioner in Pediatric Neurology, and Lauren King, MSN, an instructor in Pediatric Neurology, the researchers identified two groups of young athletes between ages 9-18 who suffered sports-related concussions, a PCS group whose symptoms endured for more than three months and a control group whose symptoms subsided within three weeks. These two groups were matched on age and sex, and were compared on their demographics, personal and family history of mood disorders and psychiatric illnesses and types of concussion symptoms.
Patients with PCS also reported their concussion symptoms later than control cases.
“That speaks to the importance of an immediate recognition of a concussion event, both by the athlete and by the athletic trainers they’re around,” Morgan said.
“The one thing I would encourage athletes is to be forthcoming with your symptoms. It’s not a weakness if you’re having concussion symptoms; it’s something you want to tell people for your own safety and so others can help,” Zuckerman said. “And when recovering from a sports concussion, the wrong thing to do is to stay in prolonged isolation. A graduated return to activity, school and then sport under the supervision of a health care provider knowledgeable about sports concussions is recommended.”
The authors were also surprised to find no differences in the types of symptoms experienced by patients with PCS and the control group.
“We found no differences in the initial symptoms that an athlete experienced in risk of post-concussion syndrome,” Morgan said. “And we also saw no difference in how your symptoms evolved in the first two weeks after an injury and risk of PCS.”
As a next step, the research group is currently working to better characterize sports-related concussions by specifying the means of injury and site of the concussion.
