Baseline cognitive test performance and concussion-like symptoms among adolescent athletes with ADHD: examining differences based on medication use

Abstract

Contrary to our hypothesis, we found medication use had only a subtle effect on cognitive performance and no significant effect on concussion-like symptom reporting. Student athletes reporting medication use for ADHD performed comparably to student athletes with no ADHD on baseline testing.

Current Evidence in Management of Concussion Baseline Testing in ADHD and Learning Difficulties Patients: A Critically Appraised Topic

“…7 Cook et al looked at ImPACT results and ADHD but also at the role that medication played on the scores for individuals with ADHD who did and did not have medication. 8 The group with ADHD and medication did not have significant differences in any composite scores from controls. However, the ADHD and no medication and no ADHD but medication groups for boys scored lower visual memory and visual motor speed (d = .31 and .37).…”

“…Three cross-sectional studies 5,6,7 received a 14/22 using the PEDro scale. The cohort studies assessed with the STROBE scale had the following results: Iverson et al 3 = 4/5, Cook et al 8 = 4/5, and Biederman et al 4 = 5/5. All reviewed studies completed baseline testing, followed by data review by an examiner to ensure that all relevant health and medical history were completed, and no previous history of epilepsy, brain surgery, or seizure disorders were occurring.…”

“…Invalid protocols occur when the composite scores are lower than the normal scores for the related population at optimal cognitive function. 8 This indicates that the ADHD and/ or LD populations may require different normal protocols to compare against when they are injured. According to the Strength of Recommendation Taxonomy (SORT), there is level B evidence to support the need for understanding of appropriate baseline Nelson et al 7 Cook et al 8 Biederman et al 4 Study mTBI subjects had significantly higher rate of ADHD than controls without mTBI (31% vs. 9%, p < .012).…”

“…3,4 When assessing baseline scores using ImPACT as a neurocognitive battery, the composite scores in verbal memory and visual-motor speed are significantly lower in individuals with both ADHD and LD. 5,7,8 Symptoms that have a higher frequency and severity level that are associated with ADHD and LD at baseline are fatigue, difficulty remembering, difficulty concentrating, trouble sleeping, and balance problems.…”

“…Biederman et al, Nelson et al, and Cook et al looked at invalid protocols of ImPACT composite scores for individuals with ADHD and/or LD and controls. 4,7,8 Bierderman et al found that verbal memory (72.3 vs. 72.1), visual motor speed (62.9 vs. 54.3), and reaction time (60.4 vs. 44.8) composites were substantially worse in individuals with mTBI and ADHD than those with mTBI and no ADHD, but it did not attain statistical significance. 4 As a useful test battery, there is information lacking about how it should be used to assess the ADHD or LD population accurately.…”