{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:07:44Z","timestamp":1792066064083,"version":"4.4.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>\n                    While chronic neurological effects from concussion have been studied widely, little is known about possible links between concussion and long-term medical and behavioral comorbidities. We performed a retrospective cohort study of 9205 adult patients with concussion, matched to non-concussion controls from a hospital-based electronic medical registry. Patients with comorbidities before the index visit were excluded. Behavioral and medical comorbidities were defined by\n                    <jats:italic toggle=\"yes\">International Classification of Diseases, Ninth and Tenth Revision<\/jats:italic>\n                    codes. Groups were followed for up to 10 years to identify comorbidity incidence after a concussion. Cox proportional hazards models were used to calculate associations between concussion and comorbidities after multi-variable adjustment. Patients with concussion were 57% male (median age: 31; interquartile range [IQR]\u2009=\u200923\u201348 years) at enrollment with a median follow-up time of 6.1 years (IQR\u2009=\u20094.2\u20139.1) and well-matched to healthy controls. Most (83%) concussions were evaluated in outpatient settings (5% inpatient). During follow-up, we found significantly higher risks of cardiovascular risks developing including hypertension (hazard ratio [HR]\u2009=\u20091.7, 95% confidence interval [CI]: 1.5\u20131.9), obesity (HR\u2009=\u20091.7, 95% CI: 1.3\u20132.0), and diabetes mellitus (HR\u2009=\u20091.8, 95% CI: 1.4\u20132.3) in the concussion group compared with controls. Similarly, psychiatric and neurological disorders such as depression (HR\u2009=\u20093.0, 95% CI: 2.6\u20133.5), psychosis (HR\u2009=\u20096.0, 95% CI: 4.2\u20138.6), stroke (HR\u2009=\u20092.1 95% CI: 1.5\u20132.9), and epilepsy (HR\u2009=\u20094.4, 95% CI: 3.2\u20135.9) were higher in the concussion group. Most comorbidities developed less than five years post-concussion. The risks for post-concussion comorbidities were also higher in patients under 40 years old compared with controls. Patients with concussion demonstrated an increased risk of development of medical and behavioral health comorbidities. Prospective studies are warranted to better describe the burden of long-term comorbidities in patients with concussion.\n                  <\/jats:p>","DOI":"10.1089\/neu.2020.7484","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T23:55:41Z","timestamp":1610754941000},"page":"1834-1841","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":52,"title":["Concussion and Risk of Chronic Medical and Behavioral Health Comorbidities"],"prefix":"10.1177","volume":"38","author":[{"given":"Saef","family":"Izzy","sequence":"first","affiliation":[{"name":"Department of Neurology, Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zabreen","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Neurology, Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Grashow","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA."},{"name":"The Football Players Health Study at Harvard University, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Cote","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Al","family":"Jarrah","sequence":"additional","affiliation":[{"name":"Department of Neurology, Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Dhand","sequence":"additional","affiliation":[{"name":"Department of Neurology, Divisions of Stroke, Cerebrovascular, and Critical Care Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Network Science Institute, Northeastern University, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Taylor","sequence":"additional","affiliation":[{"name":"The Football Players Health Study at Harvard University, Boston, Massachusetts, USA."},{"name":"Morehouse School of Medicine, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Whalen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cardiovascular Performance Center, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"The Football Players Health Study at Harvard University, Boston, Massachusetts, USA."},{"name":"Diabetes Center, Cardiovascular Performance Center, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen K.","family":"Miller","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"The Football Players Health Study at Harvard University, Boston, Massachusetts, USA."},{"name":"Neuroendocrine Unit, Cardiovascular Performance Center, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Speizer","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Baggish","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"The Football Players Health Study at Harvard University, Boston, Massachusetts, USA."},{"name":"Department of Internal Medicine, Cardiovascular Performance Center, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G.","family":"Weisskopf","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, T.H. 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