Effects of Concussion on Attention and Executive Function in Adolescents

HOWELL, DAVID1; OSTERNIG, LOUIS1; VAN DONKELAAR, PAUL2; MAYR, ULRICH3; CHOU, LI-SHAN1

Medicine & Science in Sports & Exercise: June 2013 - Volume 45 - Issue 6 - p 1030–1037
doi: 10.1249/MSS.0b013e3182814595
Clinical Sciences

Background: Head trauma in adolescents has been linked with deficits in attention and executive function that can compromise the performance of everyday tasks. Although previous research has examined this issue using computerized neuropsychological testing, little work has been done using laboratory-based measurements of attention and executive function in this population. A longitudinal analysis of recovery patterns of these measures among adolescents is central to understanding the effects of concussions across the age spectrum.

Purpose: This study prospectively and longitudinally examined laboratory-based measures of attention and executive function in concussed adolescents sequentially during a 2-month period after injury.

Methods: Two measures of attention and executive function, the Attentional Network Test and the Task-Switching Test, were administered to 20 concussed adolescents within 72 h postinjury as well as at 1 wk, 2 wk, 1 month, and 2 months postinjury. Twenty healthy, matched control subjects were similarly assessed at the same time intervals. Data were analyzed by two-way, mixed-effects ANOVA to determine the effect of group and time on the dependent variables.

Results: Compared with control subjects, the concussed group exhibited a significantly greater switch cost on the Task-Switching Test (P = 0.038, mean difference value = 38 ms) and a significantly greater reaction time for the Attentional Network Test conflict effect component (P = 0.015, mean difference value = 34 ms) for up to 2 months after injury.

Conclusions: Concussed adolescents have difficulty recovering executive function after injury and may require extended recuperation time before full recovery is achieved. Evaluations focusing on attention and executive function can be useful additions in the assessment and follow-up after head injury.

1Department of Human Physiology, University of Oregon, Eugene, OR; 2School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, CANADA; and 3Department of Psychology, University of Oregon, Eugene, OR

Address for correspondence: Li-Shan Chou, Ph.D., Department of Human Physiology, 122 Esslinger Hall, 1240 University of Oregon, Eugene, OR 97403; E-mail: chou@uoregon.edu.

Submitted for publication August 2012.

Accepted for publication November 2012.

©2013The American College of Sports Medicine