History of undiagnosed concussions may yield worse neurocognitive outcomes
Published results showed military cadets and athletes who reported a history of undiagnosed concussions had greater baseline symptom severity scores and psychological distress, as well as worse neurocognitive outcomes.
“These findings may provide insight into subtle lingering concussion-related deficiencies in those who sustain a concussion that goes undiagnosed,” the authors wrote.
Researchers collected self-reported concussion history with diagnosis status and completed standard baseline concussion assessments, including assessments for symptoms, mental status, balance and neurocognition, among 29,934 participants in the Concussion Assessment, Research, and Education Consortium. Researchers categorized participants into the following three groups based on concussion history: no concussion history (n=23,037), all previous concussions diagnosed (n=5,315) and one or more previous concussions undiagnosed (n=1,582). Researchers used multiple linear regression models to estimate mean differences and 95% confidence intervals among concussion history groups at baseline for all outcomes except symptom severity and Brief Symptom Inventory-18 (BSI-18) score. Researchers adjusted all models for sex, race, ethnicity, sport contact level and concussion count.
Compared with participants with no concussion history and participants who had all previous concussions diagnosed, results showed participants with one or more previously undiagnosed concussions had significantly greater symptom severity scores and BSI-18 scores. Participants who reported one or more previously undiagnosed concussions also performed significantly worse on six neurocognitive assessments and performed better on two neurocognitive assessments vs. participants with no concussion history and participants who had all previous concussions diagnosed, according to researchers. Researchers noted no between group differences on mental status or balance assessments.
“These findings add to a growing body of literature suggesting that early concussion diagnosis, often facilitated by honest and timely care seeking by the injured individual, is critical to maximize recovery and increase positive health outcomes after concussion,” the authors wrote. “Interventions are needed to increase the proportion of concussions that are diagnosed.”
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