Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-05T15:29:44.309Z Has data issue: false hasContentIssue false
  • English
  • Français

Double Concussions and Cognitive Dysfunction: A Population Study of Young Men

Published online by Cambridge University Press:  09 October 2012

Thomas W. Teasdale ,
Aase W. Engberg  and
Linda G. Holte
Thomas W. Teasdale*
Affiliation:
Department of Psychology, University of Copenhagen, Denmark
Aase W. Engberg
Affiliation:
Department of Neurorehabilitation, Copenhagen University Hospital, Hvidovre, Denmark
Linda G. Holte
Affiliation:
Department of Psychology, University of Copenhagen, Denmark
*
Address for correspondence: Associate Professor T.W. Teasdale, PhD Dr.Med.Sci., Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark. E-mail: [email protected]
Get access

Abstract

Aims: To determine whether double concussions can result in longer-lasting cognitive dysfunctioning than a single concussion and/or whether cognitive dysfunction is a greater risk factor for double concussions than for a single concussion.

Method: Through a national hospitalisation database, 2753 men were found who, at ages between infancy and early adulthood, had, on two separate occasions, been briefly hospitalised after a concussion. This cohort was compared with a previously obtained and comparable sample of men who had suffered a single concussion. From Draft Board records a dichotomised index was obtained indicating whether or not they had performed at or above a cut-off total score on a cognitive screening test involving four timed subtests, below cut-off being considered as dysfunctional.

Findings: For all age groups, double concussions were associated with higher rates of cognitive dysfunction than single concussions. This was especially true where the concussion(s) had occurred after cognitive testing [odds ratio = 2.53, 95% confidence interval (CI) = 1.92–3.36]. Where double concussions had occurred before cognitive testing but after age 12, cognitive dysfunction was more prevalent when the interval between concussions was less than 1 month than at longer intervals (odds ratio = 3.91, 95%CI = 1.14–13.34). It is concluded that cognitive dysfunction in young men is a risk factor for repeat concussions; at the same time cognitive dysfunction can also be a long-term consequence of two concussions occurring in close temporal proximity.

Keywords

concussioncognitive dysfunction
Type
Articles
Information
Brain Impairment , Volume 13 , Issue 2 , September 2012 , pp. 197 - 202
Copyright
Copyright © The Authors 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andersen, T.F., Madsen, M., Jorgensen, J., Mellemkjær, L., & Olsen, J.H. (2006). The Danish National Hospital Register. A valuable source of data for modern health sciences. Danish Medical Bulletin, 46, 263–268.Google Scholar
Anderson, V., Heitger, M., & Macleod, A.D. (2006). Concussion and mild head injury. Practical Neurology, 6, 342–357.CrossRefGoogle Scholar
Bigler, E.D. (2008). Neuropsychology and clinical neuroscience of persistent post-concussive syndrome. Journal of the International Neuropsychological Society, 14, 1–22.CrossRefGoogle ScholarPubMed
Collins, M.W., Lovell, M.R., Iverson, G.L., Cantu, R.C., Maroon, J.C., & Field, M. (2002). Cumulative effects of concussion in high school athletes. Neurosurgery, 51, 1175–1179.CrossRefGoogle ScholarPubMed
Covassin, T., Schatz, P., & Swanik, C.B. (2007). Sex differences in neuropsychological function and post-concussion symptoms of concussed collegiate athletes. Neurosurgery, 61, 345–350.CrossRefGoogle ScholarPubMed
De Beaumont, L., Brisson, B., Lassonde, M., & Jolicoeur, P. (2007). Long-term electrophysiological changes in athletes with a history of multiple concussions. Brain Injury, 21, 631–644.CrossRefGoogle ScholarPubMed
Engberg, A.W., Liebach, A., & Nordenbo, A. (2006). Centralized rehabilitation after severe traumatic brain injury – a population-based study. Acta Neurologica Scandinavica, 113, 178–184.CrossRefGoogle ScholarPubMed
Gaetz, M., Goodman, D., & Weinberg, H. (2000). Electrophysiological evidence for the cumulative effects of concussion. Brain Injury, 14, 1077–1088.Google ScholarPubMed
Gronwall, D., & Wrightson, P. (1975). Cumulative effect of concussion. Lancet, 2, 995–997.CrossRefGoogle ScholarPubMed
Guskiewicz, K.M., McCrea, M., Marshall, S.W., Cantu, R.C., Randolph, C., Barr, W., . . . Kelly, J.P. (2003). Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA, 290, 2549–2555.CrossRefGoogle ScholarPubMed
Iverson, G.L., Brooks, B.L., Lovell, M.R., & Collins, M.W. (2006). No cumulative effects for one or two previous concussions. British Journal of Sports Medicine, 40, 72–75.CrossRefGoogle ScholarPubMed
Kibby, M.Y., & Long, C.J. (1996). Minor head injury: Attempts at clarifying the confusion. Brain Injury, 10, 159–186.CrossRefGoogle ScholarPubMed
Lezak, M.D., Howieson, D.B., Loring, D.W., & Hannay, H.J. (2004). Neuropsychological assessment. London: Oxford University Press.Google Scholar
Macciocchi, S.N., Barth, J.T., Littlefield, L., & Cantu, R.C. (2001). Multiple concussions and neuro-psychological functioning in collegiate football players. Journal of Athletic Training, 36, 303–306.Google Scholar
McCrory, P. (2001a). Does second impact syndrome exist? Clinical Journal of Sport Medicine, 11, 144–149.CrossRefGoogle ScholarPubMed
McCrory, P. (2001b). When to retire after concussion? British Journal of Sports Medicine, 35, 380–382.CrossRefGoogle ScholarPubMed
McCrory, P.R., & Berkovic, S.F. (1998). Second impact syndrome. Neurology, 50, 677–683.CrossRefGoogle ScholarPubMed
Moser, R.S., Schatz, P., & Jordan, B.D. (2005). Prolonged effects of concussion in high school athletes. Neurosurgery, 57, 300–306.CrossRefGoogle ScholarPubMed
Stein, D.G. (2007). Sex differences in brain damage and recovery of function: experimental and clinical findings. Progress in Brain Research, 161, 339–351.CrossRefGoogle ScholarPubMed
Swaine, B.R., Tremblay, C., Platt, R.W., Grimard, G., Zhang, X., & Pless, I.B. (2007). Previous head injury is a risk factor for subsequent head injury in children: A longitudinal cohort study. Pediatrics, 119, 749–758.CrossRefGoogle ScholarPubMed
Teasdale, T.W., & Engberg, A. (1997). Duration of cognitive dysfunction after concussion, and cognitive dysfunction as a risk factor: a population study of young men. BMJ, 315, 569–572.CrossRefGoogle ScholarPubMed
Teasdale, T.W., & Engberg, A.W. (2003). Cognitive dysfunction in young men following head injury in childhood and adolescence: a population study. Journal of Neurology, Neurosurgery and Psychiatry, 74, 933–936.CrossRefGoogle ScholarPubMed
Teasdale, T.W., & Owen, D.R. (2000). Forty-year secular trends in cognitive abilities. Intelligence, 28, 115–120.CrossRefGoogle Scholar
Teasdale, T.W., & Owen, D.R. (2008). Secular declines in cognitive test scores: A reversal of the Flynn Effect. Intelligence, 36, 121–126.CrossRefGoogle Scholar
Wall, S.E., Williams, W.H., Cartwright-Hatton, S., Kelly, T.P., Murray, J., Murray, M., . . . Turner, M. (2006). Neuropsychological dysfunction following repeat concussions in jockeys. Journal of Neurology, Neurosurgery and Psychiatry, 77, 518–520.CrossRefGoogle ScholarPubMed
Zemper, E.D. (2003). Two-year prospective study of relative risk of a second cerebral concussion. American Journal of Physical Medicine and Rehabilitation, 82, 653–659.CrossRefGoogle ScholarPubMed