{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:07:52Z","timestamp":1779527272761,"version":"3.53.1"},"reference-count":106,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,4]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Sport-related concussion (SRC) has emerged as a public health problem, especially among student-athletes. Whereas most concussions resolve by 2 weeks, a minority of patients experience postconcussion syndrome (PCS), in which symptoms persist for months. The objective of this study was to elucidate factors predictive of PCS among a sample of National Collegiate Athletic Association (NCAA) student-athletes in the academic years 2009\u20132010 to 2014\u20132015.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The SRC data originated from the NCAA Injury Surveillance Program (ISP) in the 2009\u20132010 to 2014\u20132015 academic seasons. The NCAA ISP is a prospective database made up of a convenience sample of schools across all divisions. All SRCs are reported by certified athletic trainers. The PCS group consisted of concussed student-athletes with concussion-related symptoms that lasted \u2265 4 weeks. The non-PCS group consisted of concussed student-athletes with symptom resolution in \u2264 2 weeks. Those with symptoms that resolved in the intermediate area of 2\u20134 weeks were excluded. Odds ratios (ORs) were estimated using logistic regression.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n During the 2009\u20132010 to 2014\u20132015 seasons, 1507 NCAA student-athletes sustained an SRC, 112 (7.4%) of whom developed PCS (i.e., concussion-related symptoms that lasted \u2265 4 weeks). Men's ice hockey contributed the largest proportion of concussions to the PCS group (28.6%), whereas men's football contributed the largest proportion of concussions in the non-PCS group (38.6%). In multivariate analysis, recurrent concussion was associated with increased odds of PCS (OR 2.08, 95% CI 1.28\u20133.36). Concussion symptoms that were also associated with increased odds of PCS included retrograde amnesia (OR 2.75, 95% CI 1.34\u20135.64), difficulty concentrating (OR 2.35, 95% CI 1.23\u20134.50), sensitivity to light (OR 1.97, 95% CI 1.09\u20133.57), and insomnia (OR 2.19, 95% CI 1.30\u20133.68). Contact level, sex, and loss of consciousness were not associated with PCS.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Postconcussion syndrome represents one of the most impactful sequelae of SRC. In this study of exclusively collegiate student-athletes, the authors found that recurrent concussions and various concussion-related symptoms were associated with PCS. The identification of initial risk factors for the development of PCS may assist sports medicine clinicians in providing timely interventions and treatments to prevent morbidity and shorten recovery time after SRC.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.1.focus15593","type":"journal-article","created":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T03:55:26Z","timestamp":1459482926000},"page":"E13","source":"Crossref","is-referenced-by-count":79,"title":["Predictors of postconcussion syndrome in collegiate student-athletes"],"prefix":"10.3171","volume":"40","author":[{"given":"Scott L.","family":"Zuckerman","sequence":"first","affiliation":[{"name":"Vanderbilt Sports Concussion Center and"},{"name":"Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Yengo-Kahn","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Applied Physiology, University of Delaware, Newark; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary S.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center and"},{"name":"Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen K.","family":"Sills","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center and"},{"name":"Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary Y.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15593","series-title":"J Pediatr","first-page":"394","article-title":"Postconcussion symptoms are associated with cerebral cortical thickness in healthy collegiate and preparatory school ice hockey players","volume":"166","author":"Albaugh","year":"2015"},{"key":"b2-focus15593","series-title":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders","year":"2000"},{"key":"b3-focus15593","series-title":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"b4-focus15593","series-title":"Clin Pediatr (Phila)","first-page":"961","article-title":"Factors associated with problems for adolescents returning to the classroom after sport-related concussion","volume":"54","author":"Baker","year":"2015"},{"key":"b5-focus15593","series-title":"Am J Sports 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Psychiatry","first-page":"75","article-title":"Emotional, neuropsychological, and organic factors: their use in the prediction of persisting postconcussion symptoms after moderate and mild head injuries","volume":"61","author":"King","year":"1996"},{"key":"b18-focus15593","series-title":"J Neurotrauma","first-page":"38","article-title":"Noninvasive brain stimulation for persistent postconcussion symptoms in mild traumatic brain injury","volume":"32","author":"Koski","year":"2015"},{"key":"b19-focus15593","series-title":"Arch Clin Neuropsychol","first-page":"7","article-title":"Diffusion tensor imaging findings and postconcussion symptom reporting six weeks following mild traumatic brain injury","volume":"30","author":"Lange","year":"2015"},{"key":"b20-focus15593","series-title":"J Head Trauma Rehabil","first-page":"375","article-title":"The epidemiology and impact of traumatic brain injury: a brief 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symptoms?","volume":"47","author":"Makdissi","year":"2013"},{"key":"b25-focus15593","series-title":"J Neurotrauma","first-page":"642","article-title":"Preinjury resilience and mood as predictors of early outcome following mild traumatic brain injury","volume":"30","author":"McCauley","year":"2013"},{"key":"b26-focus15593","series-title":"J Int Neuropsychol Soc","first-page":"22","article-title":"Incidence, clinical course, and predictors of prolonged recovery time following sport-related concussion in high school and college athletes","volume":"19","author":"McCrea","year":"2013"},{"key":"b27-focus15593","series-title":"Br J Sports Med","first-page":"250","article-title":"Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012","volume":"47","author":"McCrory","year":"2013"},{"key":"b28-focus15593","series-title":"Neuropsychology","first-page":"1","article-title":"Injury versus noninjury factors as predictors of post-concussive symptoms following mild traumatic brain injury in children","volume":"27","author":"McNally","year":"2013"},{"key":"b29-focus15593","series-title":"Am J Sports Med","first-page":"2405","article-title":"High school concussions in the 2008\u20132009 academic year: mechanism, symptoms, and management","volume":"38","author":"Meehan","year":"2010"},{"key":"b30-focus15593","series-title":"Neurology","first-page":"2204","article-title":"Early symptom burden predicts recovery after sport-related concussion","volume":"83","author":"Meehan","year":"2014"},{"key":"b31-focus15593","series-title":"J Pediatr","first-page":"721","article-title":"Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not","volume":"163","author":"Meehan","year":"2013"},{"key":"b32-focus15593","series-title":"Childs Nerv Syst","first-page":"2305","article-title":"Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging","volume":"31","author":"Morgan","year":"2015"},{"key":"b33-focus15593","series-title":"J Neurosurg Pediatr","first-page":"589","article-title":"Predictors of postconcussion syndrome after sports-related concussion in young athletes: a matched case-control study","volume":"15","author":"Morgan","year":"2015"},{"key":"b34-focus15593","series-title":"2013\u201314 NCAA Sports Medicine Handbook","author":"National Collegiate Athletic Association","year":"2013"},{"key":"b35-focus15593","series-title":"Brain Inj","first-page":"145","article-title":"Predictors of child post-concussion symptoms at 6 and 18 months following mild traumatic brain injury","volume":"27","author":"Olsson","year":"2013"},{"key":"b36-focus15593","series-title":"Clin J Sport Med","article-title":"Return to learning after a concussion and compliance with recommendations for cognitive rest","author":"Olympia","year":"2015"},{"key":"b37-focus15593","series-title":"Behav 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injury","volume":"31","author":"Reuben","year":"2014"},{"key":"b41-focus15593","series-title":"Pediatrics","first-page":"841","article-title":"Medical conditions affecting sports participation","volume":"121","author":"Rice","year":"2008"},{"key":"b42-focus15593","series-title":"Brain Inj","first-page":"798","article-title":"How long is too long? The lack of consensus regarding the post-concussion syndrome diagnosis","volume":"29","author":"Rose","year":"2015"},{"key":"b43-focus15593","series-title":"Brain Inj","first-page":"551","article-title":"Miserable minority: emotional risk factors that influence the outcome of a mild traumatic brain injury","volume":"10","author":"Ruff","year":"1996"},{"key":"b44-focus15593","series-title":"Br J Sports Med","first-page":"730","article-title":"Sport concussion assessment tool: baseline values for varsity collision sport athletes","volume":"43","author":"Shehata","year":"2009"},{"key":"b45-focus15593","series-title":"J Neurotrauma","first-page":"517","article-title":"Systematic review of multivariable prognostic models for mild traumatic brain injury","volume":"32","author":"Silverberg","year":"2015"},{"key":"b46-focus15593","series-title":"J Surg Orthop Adv","first-page":"193","article-title":"Pharmacologic treatment of sport-related concussion: a review","volume":"22","author":"Solomon","year":"2013"},{"issue":"Suppl 4","key":"b47-focus15593","series-title":"Neurosurgery","first-page":"S106","article-title":"The postconcussion syndrome in sports and recreation: clinical features and demography in 138 athletes","volume":"75","author":"Tator","year":"2014"},{"key":"b48-focus15593","series-title":"Am J Sports Med","first-page":"226","article-title":"Epidemiology of sports-related concussions in National Collegiate Athletic Association athletes from 2009\u20132010 to 2013\u20132014 symptom prevalence, symptom resolution time, and return-to-play time","volume":"44","author":"Wasserman","year":"2016"},{"key":"b49-focus15593","series-title":"Clin Pediatr (Phila)","first-page":"228","article-title":"Heads up: communication is key in school nurses' preparedness for facilitating \u201creturn to learn\u201d following concussion","volume":"55","author":"Wing","year":"2015"},{"key":"b50-focus15593","series-title":"Int J Dev Neurosci","first-page":"231","article-title":"Premorbid child and family functioning as predictors of post-concussive symptoms in children with mild traumatic brain injuries","volume":"30","author":"Yeates","year":"2012"},{"key":"b51-focus15593","series-title":"JAMA Pediatr","first-page":"259","article-title":"Prognosticators of persistent symptoms following pediatric concussion: a systematic review","volume":"167","author":"Zemek","year":"2013"},{"key":"b52-focus15593","series-title":"Am J Sports Med","first-page":"2654","article-title":"Epidemiology of sports-related concussion in NCAA athletes from 2009\u20132010 to 2013\u20132014 incidence, recurrence, and mechanisms","volume":"43","author":"Zuckerman","year":"2015"},{"key":"b53-focus15593","series-title":"Int J Sports Med","first-page":"419","article-title":"Sports-related concussion in helmeted vs. unhelmeted athletes: who fares worse?","volume":"36","author":"Zuckerman","year":"2015"},{"key":"b1-focus15593","series-title":"J Pediatr","first-page":"394","article-title":"Postconcussion symptoms are associated with cerebral cortical thickness in healthy collegiate and preparatory school ice hockey players","volume":"166","author":"Albaugh","year":"2015"},{"key":"b2-focus15593","series-title":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders","year":"2000"},{"key":"b3-focus15593","series-title":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"b4-focus15593","series-title":"Clin Pediatr (Phila)","first-page":"961","article-title":"Factors associated with problems for adolescents returning to the classroom after sport-related concussion","volume":"54","author":"Baker","year":"2015"},{"key":"b5-focus15593","series-title":"Am J Sports Med","first-page":"47","article-title":"Concussion management in United States college sports: compliance with National Collegiate Athletic Association concussion policy and areas for improvement","volume":"43","author":"Baugh","year":"2015"},{"key":"b6-focus15593","series-title":"Acad Emerg Med","first-page":"788","article-title":"Predicting postconcussion syndrome after minor traumatic brain injury","volume":"8","author":"Bazarian","year":"2001"},{"key":"b7-focus15593","series-title":"Brain Inj","first-page":"173","article-title":"Epidemiology and predictors of post-concussive syndrome after minor head injury in an emergency population","volume":"13","author":"Bazarian","year":"1999"},{"key":"b8-focus15593","series-title":"Clin Neuropsychol","first-page":"343","article-title":"Postconcussive symptom complaints and potentially malleable positive predictors","volume":"27","author":"Belanger","year":"2013"},{"key":"b9-focus15593","series-title":"Can Fam Physician","first-page":"e310","article-title":"Premature return to play and return to learn after a sport-related concussion: physician's chart review","volume":"60","author":"Carson","year":"2014"},{"key":"b10-focus15593","series-title":"Brain Inj","first-page":"249","article-title":"Neuropsychological and psychological rehabilitation interventions in refractory sport-related post-concussive syndrome","volume":"29","author":"Conder","year":"2015"},{"key":"b11-focus15593","series-title":"Clin Sports Med","first-page":"1","article-title":"The epidemiology of sport-related concussion","volume":"30","author":"Daneshvar","year":"2011"},{"key":"b12-focus15593","series-title":"J Neurosurg Pediatr","first-page":"709","article-title":"Psychiatric outcomes after pediatric sports-related concussion","volume":"16","author":"Ellis","year":"2015"},{"key":"b13-focus15593","series-title":"J Head Trauma Rehabil","first-page":"E34","article-title":"Factor analysis of persistent postconcussive symptoms within a military sample with blast exposure","volume":"30","author":"Franke","year":"2015"},{"key":"b14-focus15593","series-title":"J Adolesc Health","first-page":"91","article-title":"The effectiveness of a web-based resource in improving postconcussion management in high schools","volume":"56","author":"Glang","year":"2015"},{"key":"b15-focus15593","series-title":"J Neurol Neurosurg Psychiatry","first-page":"217","article-title":"When a minor head injury results in enduring symptoms: a prospective investigation of risk factors for post-concussional syndrome after mild traumatic brain injury","volume":"83","author":"Hou","year":"2012"},{"key":"b16-focus15593","series-title":"J Athl Train","first-page":"552","article-title":"National collegiate athletic association injury surveillance system: review of methods for 2004\u20132005 through 2013\u20132014 data collection","volume":"49","author":"Kerr","year":"2014"},{"key":"b17-focus15593","series-title":"J Neurol Neurosurg Psychiatry","first-page":"75","article-title":"Emotional, neuropsychological, and organic factors: their use in the prediction of persisting postconcussion symptoms after moderate and mild head injuries","volume":"61","author":"King","year":"1996"},{"key":"b18-focus15593","series-title":"J Neurotrauma","first-page":"38","article-title":"Noninvasive brain stimulation for persistent postconcussion symptoms in mild traumatic brain injury","volume":"32","author":"Koski","year":"2015"},{"key":"b19-focus15593","series-title":"Arch Clin Neuropsychol","first-page":"7","article-title":"Diffusion tensor imaging findings and postconcussion symptom reporting six weeks following mild traumatic brain injury","volume":"30","author":"Lange","year":"2015"},{"key":"b20-focus15593","series-title":"J Head Trauma Rehabil","first-page":"375","article-title":"The epidemiology and impact of traumatic brain injury: a brief overview","volume":"21","author":"Langlois","year":"2006"},{"key":"b21-focus15593","series-title":"Neurosurgery","first-page":"371","article-title":"Cutoff scores in neurocognitive testing and symptom clusters that predict protracted recovery from concussions in high school athletes","volume":"70","author":"Lau","year":"2012"},{"key":"b22-focus15593","series-title":"Clin J Sport Med","first-page":"76","article-title":"Concussion reporting rates at the conclusion of an intercollegiate athletic career","volume":"24","author":"Llewellyn","year":"2014"},{"key":"b23-focus15593","series-title":"Brain Inj","first-page":"565","article-title":"Clinical correlates of retrograde amnesia in mild traumatic brain injury","volume":"29","author":"Luoto","year":"2015"},{"key":"b24-focus15593","series-title":"Br J Sports Med","first-page":"308","article-title":"The difficult concussion patient: what is the best approach to investigation and management of persistent (>10 days) postconcussive symptoms?","volume":"47","author":"Makdissi","year":"2013"},{"key":"b25-focus15593","series-title":"J Neurotrauma","first-page":"642","article-title":"Preinjury resilience and mood as predictors of early outcome following mild traumatic brain injury","volume":"30","author":"McCauley","year":"2013"},{"key":"b26-focus15593","series-title":"J Int Neuropsychol Soc","first-page":"22","article-title":"Incidence, clinical course, and predictors of prolonged recovery time following sport-related concussion in high school and college athletes","volume":"19","author":"McCrea","year":"2013"},{"key":"b27-focus15593","series-title":"Br J Sports Med","first-page":"250","article-title":"Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012","volume":"47","author":"McCrory","year":"2013"},{"key":"b28-focus15593","series-title":"Neuropsychology","first-page":"1","article-title":"Injury versus noninjury factors as predictors of post-concussive symptoms following mild traumatic brain injury in children","volume":"27","author":"McNally","year":"2013"},{"key":"b29-focus15593","series-title":"Am J Sports Med","first-page":"2405","article-title":"High school concussions in the 2008\u20132009 academic year: mechanism, symptoms, and management","volume":"38","author":"Meehan","year":"2010"},{"key":"b30-focus15593","series-title":"Neurology","first-page":"2204","article-title":"Early symptom burden predicts recovery after sport-related concussion","volume":"83","author":"Meehan","year":"2014"},{"key":"b31-focus15593","series-title":"J Pediatr","first-page":"721","article-title":"Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not","volume":"163","author":"Meehan","year":"2013"},{"key":"b32-focus15593","series-title":"Childs Nerv Syst","first-page":"2305","article-title":"Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging","volume":"31","author":"Morgan","year":"2015"},{"key":"b33-focus15593","series-title":"J Neurosurg Pediatr","first-page":"589","article-title":"Predictors of postconcussion syndrome after sports-related concussion in 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