Long-term consequences of recurrent sports concussion

Abstract

Background: Recurrent concussions are suspected to promote the development of long-term neurological disorders. The study was designed to assess the prevalence of major depressive disorder, mild cognitive disorders and headache in a population of retired high-level sportsmen and rugby players and to study the link between scores evaluating these disorders and the number of reported concussions (RCs).

Methods: A total of 239 retired rugby players (RRPs) and 138 other retired sportsmen (ORSs) who had reached the French national or international championship level between 1985 and 1990 filled in a self-administered questionnaire describing their sociodemographic data, comorbidities and reported history of RC. A phone interview was then conducted using validated questionnaires for the detection of major depressive disorder (PHQ-9), mild cognitive disorders (F-TICS-m) and headache (HIT-6).

Results: RRPs reported a higher number of RCs than ORSs (p < 0.001). A higher rate of major depressive disorder (PHQ-9 score >9) was observed among RRPs compared to ORSs (9% versus 6%) (p = 0.04), and the PHQ-9 score increased with the number of RCs regardless of the type of sport (p = 0.026). A higher rate of mild cognitive disorders (TICS-m score ≤30) was observed in RRPs compared to ORSs (57% versus 40%, p = 0.005), but no association was found with the number of RC. The HIT-6 score increased with the number of RCs (p = 0.019) CONCLUSIONS: More than 20 years after the end of their career, RRPs present higher rates of depression and lower F-TICS-m scores in favor of mild cognitive impairment compared with ORSs. PHQ-9 and HIT-6 scores were significantly associated with the number of RCs.

Keywords: Cognitive disorder; Concussion; Depression; Headache; Rugby.