Sports-related concussion not associated with long-term cognitive or behavioural deficits: the PROTECT-TBI study

Matthew Joseph Lennon; Grant Rigney; Byron Creese; Dag Aarsland; Adam Hampshire; Clive Ballard; Anne Corbett; Vanessa Raymont

doi:10.1136/jnnp-2024-334039

Sports-related concussion not associated with long-term cognitive or behavioural deficits: the PROTECT-TBI study

Matthew Joseph Lennon, Grant Rigney, Byron Creese, Dag Aarsland, Adam Hampshire, Clive Ballard, Anne Corbett, Vanessa Raymont^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background The cognitive effects of sports-related concussion (SRC) have been the subject of vigorous debate but there has been little research into long-term outcomes in non-athlete populations. Methods This cohort study of UK community-dwelling adults (aged 50–90 years) was conducted between November 2015 and November 2020, with up to 4 years annual follow-up (n=15 214). Lifetime history of concussions was collected at baseline using the Brain Injury Screening Questionnaire. The first analysis grouped participants by type of concussion (no concussion, only SRC, only non-SRC (nSRC), mixed concussions (both SRC and nSRC)) and the second grouped the participants by number (0, 1, 2 or 3+ SRCor nSRC). Mixed models were used to assess the effect of concussion on outcomes including four cognitive domains and one behavioural measure (Mild Behavioural Impairment-C). Results Analysis of the included participants (24% male, mean age=64) at baseline found that the SRC group had significantly better working memory (B=0.113, 95% CI 0.038, 0.188) and verbal reasoning (B=0.199, 95% CI 0.092, 0.306) compared with those without concussion. Those who had suffered one SRC had significantly better verbal reasoning (B=0.111, 95% CI 0.031, 0.19) and attention (B=0.115, 95% CI 0.028, 0.203) compared with those with no SRC at baseline. Those with 3+ nSRCs had significantly worse processing speed (B=−0.082, 95% CI −0.144 to –0.019) and attention (B=−0.156, 95% CI −0.248 to –0.063). Those with 3+ nSRCs had a significantly worse trajectory of verbal reasoning with increasing age (B=−0.088, 95% CI −0.149 to –0.026). Conclusions Compared with those reporting no previous concussions, those with SRC had no cognitive or behavioural deficits and seemed to perform better in some tasks. As indicated by previous studies, sports participation may confer long-term cognitive benefits.

Original language	English
Journal	Journal of Neurology, Neurosurgery and Psychiatry
Early online date	3 Sept 2024
DOIs	https://doi.org/10.1136/jnnp-2024-334039
Publication status	E-pub ahead of print - 3 Sept 2024

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@article{6d9fb99c0a384d7cb8ecede46acf9a83,

title = "Sports-related concussion not associated with long-term cognitive or behavioural deficits: the PROTECT-TBI study",

abstract = "Background The cognitive effects of sports-related concussion (SRC) have been the subject of vigorous debate but there has been little research into long-term outcomes in non-athlete populations. Methods This cohort study of UK community-dwelling adults (aged 50–90 years) was conducted between November 2015 and November 2020, with up to 4 years annual follow-up (n=15 214). Lifetime history of concussions was collected at baseline using the Brain Injury Screening Questionnaire. The first analysis grouped participants by type of concussion (no concussion, only SRC, only non-SRC (nSRC), mixed concussions (both SRC and nSRC)) and the second grouped the participants by number (0, 1, 2 or 3+ SRCor nSRC). Mixed models were used to assess the effect of concussion on outcomes including four cognitive domains and one behavioural measure (Mild Behavioural Impairment-C). Results Analysis of the included participants (24% male, mean age=64) at baseline found that the SRC group had significantly better working memory (B=0.113, 95% CI 0.038, 0.188) and verbal reasoning (B=0.199, 95% CI 0.092, 0.306) compared with those without concussion. Those who had suffered one SRC had significantly better verbal reasoning (B=0.111, 95% CI 0.031, 0.19) and attention (B=0.115, 95% CI 0.028, 0.203) compared with those with no SRC at baseline. Those with 3+ nSRCs had significantly worse processing speed (B=−0.082, 95% CI −0.144 to –0.019) and attention (B=−0.156, 95% CI −0.248 to –0.063). Those with 3+ nSRCs had a significantly worse trajectory of verbal reasoning with increasing age (B=−0.088, 95% CI −0.149 to –0.026). Conclusions Compared with those reporting no previous concussions, those with SRC had no cognitive or behavioural deficits and seemed to perform better in some tasks. As indicated by previous studies, sports participation may confer long-term cognitive benefits.",

author = "Lennon, {Matthew Joseph} and Grant Rigney and Byron Creese and Dag Aarsland and Adam Hampshire and Clive Ballard and Anne Corbett and Vanessa Raymont",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2024.",

year = "2024",

month = sep,

day = "3",

doi = "10.1136/jnnp-2024-334039",

language = "English",

journal = "Journal of Neurology, Neurosurgery and Psychiatry",

issn = "0022-3050",

publisher = "BMJ Publishing Group Ltd",

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T1 - Sports-related concussion not associated with long-term cognitive or behavioural deficits

T2 - the PROTECT-TBI study

AU - Lennon, Matthew Joseph

AU - Rigney, Grant

AU - Creese, Byron

AU - Aarsland, Dag

AU - Hampshire, Adam

AU - Ballard, Clive

AU - Corbett, Anne

AU - Raymont, Vanessa

PY - 2024/9/3

Y1 - 2024/9/3

N2 - Background The cognitive effects of sports-related concussion (SRC) have been the subject of vigorous debate but there has been little research into long-term outcomes in non-athlete populations. Methods This cohort study of UK community-dwelling adults (aged 50–90 years) was conducted between November 2015 and November 2020, with up to 4 years annual follow-up (n=15 214). Lifetime history of concussions was collected at baseline using the Brain Injury Screening Questionnaire. The first analysis grouped participants by type of concussion (no concussion, only SRC, only non-SRC (nSRC), mixed concussions (both SRC and nSRC)) and the second grouped the participants by number (0, 1, 2 or 3+ SRCor nSRC). Mixed models were used to assess the effect of concussion on outcomes including four cognitive domains and one behavioural measure (Mild Behavioural Impairment-C). Results Analysis of the included participants (24% male, mean age=64) at baseline found that the SRC group had significantly better working memory (B=0.113, 95% CI 0.038, 0.188) and verbal reasoning (B=0.199, 95% CI 0.092, 0.306) compared with those without concussion. Those who had suffered one SRC had significantly better verbal reasoning (B=0.111, 95% CI 0.031, 0.19) and attention (B=0.115, 95% CI 0.028, 0.203) compared with those with no SRC at baseline. Those with 3+ nSRCs had significantly worse processing speed (B=−0.082, 95% CI −0.144 to –0.019) and attention (B=−0.156, 95% CI −0.248 to –0.063). Those with 3+ nSRCs had a significantly worse trajectory of verbal reasoning with increasing age (B=−0.088, 95% CI −0.149 to –0.026). Conclusions Compared with those reporting no previous concussions, those with SRC had no cognitive or behavioural deficits and seemed to perform better in some tasks. As indicated by previous studies, sports participation may confer long-term cognitive benefits.

AB - Background The cognitive effects of sports-related concussion (SRC) have been the subject of vigorous debate but there has been little research into long-term outcomes in non-athlete populations. Methods This cohort study of UK community-dwelling adults (aged 50–90 years) was conducted between November 2015 and November 2020, with up to 4 years annual follow-up (n=15 214). Lifetime history of concussions was collected at baseline using the Brain Injury Screening Questionnaire. The first analysis grouped participants by type of concussion (no concussion, only SRC, only non-SRC (nSRC), mixed concussions (both SRC and nSRC)) and the second grouped the participants by number (0, 1, 2 or 3+ SRCor nSRC). Mixed models were used to assess the effect of concussion on outcomes including four cognitive domains and one behavioural measure (Mild Behavioural Impairment-C). Results Analysis of the included participants (24% male, mean age=64) at baseline found that the SRC group had significantly better working memory (B=0.113, 95% CI 0.038, 0.188) and verbal reasoning (B=0.199, 95% CI 0.092, 0.306) compared with those without concussion. Those who had suffered one SRC had significantly better verbal reasoning (B=0.111, 95% CI 0.031, 0.19) and attention (B=0.115, 95% CI 0.028, 0.203) compared with those with no SRC at baseline. Those with 3+ nSRCs had significantly worse processing speed (B=−0.082, 95% CI −0.144 to –0.019) and attention (B=−0.156, 95% CI −0.248 to –0.063). Those with 3+ nSRCs had a significantly worse trajectory of verbal reasoning with increasing age (B=−0.088, 95% CI −0.149 to –0.026). Conclusions Compared with those reporting no previous concussions, those with SRC had no cognitive or behavioural deficits and seemed to perform better in some tasks. As indicated by previous studies, sports participation may confer long-term cognitive benefits.

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U2 - 10.1136/jnnp-2024-334039

DO - 10.1136/jnnp-2024-334039

M3 - Article

C2 - 39231581

AN - SCOPUS:85204804151

SN - 0022-3050

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

ER -

Sports-related concussion not associated with long-term cognitive or behavioural deficits: the PROTECT-TBI study

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