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

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.