Effects of mTBI with loss of consciousness on neurobehavioral symptoms, depression, and insomnia in former collegiate and NFL football athletes.
Sarah Laskowitz, C Lexi Baird, Ashley Huggins and 6 others
PMID 38727539WHAT IT FOUND
In former football players, more concussions with loss of consciousness were linked to more current symptoms such as poor concentration and slowed thinking.
Depression and insomnia also tracked with these symptoms, but the data were collected at a single time and cannot show cause.
Key findings
01In 177 former elite football athletes, a higher number of concussions with loss of consciousness was associated with higher current neurobehavioral symptom severity.
02A higher number of concussions with loss of consciousness was associated with higher current depression and insomnia symptom scores.
03Adding depression and insomnia scores to the model made the direct association with neurobehavioral symptoms non-significant, but the cross-sectional design cannot prove mediation.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study was cross-sectional, so it cannot show that concussions with loss of consciousness caused later symptoms, or that depression and insomnia caused the symptoms. mTBI history was self-reported and not confirmed by medical records, and the reliability of retrospective self-report is controversial. The sample was male former elite football athletes aged 27 to 85, so results may not apply to current players, women, or non-athlete populations. Pre-injury neurobehavioral, depressive, and sleep symptoms were not assessed, and other conditions such as post-traumatic stress, psychiatric symptoms, and headaches or migraines were not controlled for. The depression, insomnia, and neurobehavioral questionnaires share some items, which could inflate the observed associations. The insomnia measure was modified by error, omitting one item, which may affect replicability. Cognitive findings are subjective symptom reports; the authors note objective cognitive testing is needed.
Declared interests
The supplied text does not include a conflicts or funding statement. The article is tagged as Research Support, N.I.H., Extramural.
The easy way to misread this
Do not conclude that concussions with loss of consciousness caused later symptoms, or that treating depression or insomnia will improve them. The data were collected at a single time from retired players, and the authors state that causal inference is not possible.