BACKGROUND Athletes who are diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of concussion compared to other athletes. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a widely used concussion tool, but it relies on pre-injury baseline testing that can be affected by psychiatric conditions. This research aims to determine if there are differences in pre-injury testing composite scores in student-athletes with ADHD compared to those without ADHD diagnosis. METHODS We obtained 11,563 pre-season ImPACT assessments of 7,454 student-athletes (ages: 12-22) from 2009 to 2019. After exclusions, there were 6,920 control and 276 ADHD subjects. Multivariable linear regression analyses compared the independent effect of ADHD on the six ImPACT composite score metrics with Bonferroni correction for multiple comparisons with a = 0.008. RESULTS Univariate analyses indicated ADHD is associated with more symptoms as measured by the Post-Concussion Symptom Scale (PCSS) (β = 2.67, 95% CI: 1.47-3.87, p < .0001) and worse Impulse Control scores (β = 0.93, 95% CI: 0.33-1.53, p = .002). In multivariate analysis, this association was the same for symptom score (β = 2.48, 95% CI: 1.22-3.74, p < .0001), but Impulse Control was not significantly different after multiple comparison adjustment (β = 0.87, 95% CI: 0.22-1.15, p = .009). CONCLUSIONS The ADHD subjects reported worse symptoms at baseline and had worse Impulse Control in univariate analysis, but not multivariate analysis. These results can further guide clinicians in concussion diagnosis and test interpretations for student-athletes with ADHD, considering the symptom burden at baseline.

中文翻译：

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患有注意力缺陷/多动症的学生运动员的基线 ImPACT 综合得分。

背景技术与其他运动员相比，被诊断患有注意力缺陷/多动障碍（ADHD）的运动员发生脑震荡的风险更高。脑震荡后立即评估和认知测试 (ImPACT) 是一种广泛使用的脑震荡工具，但它依赖于可能受到精神状况影响的受伤前基线测试。本研究旨在确定患有 ADHD 的学生运动员与未诊断为 ADHD 的学生运动员在受伤前测试综合得分是否存在差异。方法 我们获得了 2009 年至 2019 年间 7,454 名学生运动员（年龄：12-22 岁）的 11,563 份季前 ImPACT 评估。排除后，有 6,920 名对照组和 276 名 ADHD 受试者。多变量线性回归分析将 ADHD 对 6 个 ImPACT 综合评分指标的独立影响与 Bonferroni 校正进行了多重比较，a = 0.008。结果 单变量分析表明 ADHD 与脑震荡后症状量表 (PCSS) 测量的更多症状相关 (β = 2.67, 95% CI: 1.47-3.87, p < .0001) 和较差的冲动控制评分 (β = 0.93, 95% CI：0.33-1.53​​，p = .002）。在多变量分析中，这种关联与症状评分相同（β = 2.48，95% CI：1.22-3.74，p < .0001），但多重比较调整后冲动控制没有显着差异（β = 0.87，95% CI） ：0.22-1.15，p = .009）。结论 ADHD 受试者在单变量分析中报告基线症状更差，冲动控制能力更差，但多变量分析则不然。考虑到基线症状负担，这些结果可以进一步指导临床医生对患有多动症的学生运动员进行脑震荡诊断和测试解释。