Concussion-Like Symptom Reporting in Non-Concussed Collegiate Athletes

Abstract

Objective: Non-concussed individuals may report a variety of concussion-like symptoms even in the absence of a diagnosed brain injury. Previous studies described concussion-like symptom reporting in adolescent athletes. This study provides complementary data on concussion-like symptoms in collegiate athletes.

Methods: We analyzed baseline symptom scales from 738 collegiate athletes (452 men and 286 women) who completed either the Sport Concussion Assessment Tool, 3 Symptom Evaluation (S3SE; n = 377) or the Post-Concussion Scale (PCS; n = 361) and determined if subjects met criteria for diagnosis of International Classification of Diseases 10th Revision (ICD-10) postconcussional syndrome. Symptoms were grouped as somatic, cognitive, emotional, or sleep-related. We analyzed associations with medical history factors using chi-square analyses, and examined recovery time of a subset of concussed athletes based on baseline symptomatology (n = 117) with independent samples t-test.

Results: Across all athletes, 120 (16.3%) reported baseline symptoms meeting criteria for ICD-10 postconcussional syndrome. Women were 1.7 times more likely to meet these criteria (21.7% vs. 12.8%, p = .002). Athletes completing the S3SE were 1.5 times more likely to meet criteria than those completing the PCS (p = .011). Previously diagnosed psychiatric disorder was significantly associated with emotional domain symptom reporting, and attention deficit-hyperactivity disorder diagnosis was associated with cognitive domain symptom reporting. On average, athletes meeting ICD-10 postconcussional syndrome criteria at baseline experienced longer recovery from concussion (t[115] = 2.35, p = .020).

Conclusions: Non-concussed collegiate athletes report concussion-like symptoms at a clinically significant rate. Pre-injury medical history and reporting rates of concussion-like symptoms may explain variance in post-concussion symptom expression. Measured incidence of baseline postconcussional syndrome may, in part, depend on the symptom report measure that is used.

Keywords: Athlete; Brain injury; College; Post-Concussion Scale; Post-concussion syndrome; SCAT3.