{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T08:41:20Z","timestamp":1783240880192,"version":"3.54.6"},"reference-count":37,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Adolescent participation in athletics continues to grow, leading to an increasing incidence of sports-related concussion (SRC). The current literature suggests that a greater number of prior concussions positively correlates with a greater number of total symptoms, but the specific concussion-related symptoms are not as well defined. The current study investigated the effects of prior recurrent head injury on the symptom profiles of student-athletes after another suspected concussion.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A multicenter database consisting of 25,815 Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) results was filtered for student-athletes aged 12\u201322 years old who competed in 21 different sports. Patients were separated into 2 cohorts: athletes reporting a single prior concussion (SRC1) and athletes reporting 2 or more prior concussions (SRC2+). Comparisons were assessed for differences in 22 symptoms and 4 symptom clusters at baseline, first postinjury test (PI1), and second postinjury test (PI2) by using univariate and multivariate analyses.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>No differences were seen between SRC1 (n = 2253) and SRC2+ (n = 976) at baseline. At PI1, the SRC2+ group (n = 286) had lower severity of headaches (p = 0.04) but increased nervousness (p = 0.042), irritability (p = 0.028), sadness (p = 0.028), visual problems (p = 0.04), and neuropsychiatric symptoms (p = 0.009) compared with SRC1 (n = 529). Multivariate analysis revealed decreased headache severity with increased prior concussion (\u03b2 = \u22120.27,95% CI \u22120.45 to \u22120.09, p = 0.003). Multivariate analysis at PI2 demonstrated the SRC2+ cohort (n = 130) had increased cognitive (\u03b2 = 1.22, 95% CI 0.27\u20132.18, p = 0.012), sleep (\u03b2 = 0.63, 95% CI 0.17\u20131.08, p = 0.007), and neuropsychiatric (\u03b2 = 0.67,95% CI 0.14\u20131.2,0.014) symptoms compared with SRC1 (n = 292).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>At longitudinal follow-up, patients with a history of recurrent concussions reported greater symptom burden in cognitive, sleep, and neuropsychiatric symptom clusters but not migraine symptoms. This is an important distinction because migraine symptoms are often more easily distinguishable to patients, parents, and physicians. Careful assessment of specific symptoms should be considered in patients with a history of recurrent head injury prior to return to play.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.2.peds237","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T20:01:47Z","timestamp":1684180907000},"page":"133-140","source":"Crossref","is-referenced-by-count":6,"title":["Effects of repetitive head trauma on symptomatology of subsequent sport-related concussion"],"prefix":"10.3171","volume":"32","author":[{"given":"Addison","family":"Quinones","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tirone","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Schupper","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene I.","family":"Hrabarchuk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin D.","family":"Lamb","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Genadry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshini","family":"Kalagara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zerubabbel K.","family":"Asfaw","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Gometz","sequence":"additional","affiliation":[{"name":"Concussion Management of New York, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lovell","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvir F.","family":"Choudhri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Int J Behav Nutr Phys Act","first-page":"98","article-title":"A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport","volume":"10","author":"Eime RM","year":"2013","unstructured":"Eime RM, Young JA, Harvey JT, Charity MJ, Payne WR. A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport. Int J Behav Nutr Phys Act. 2013;10(1):98.23945179"},{"issue":"4","key":"b2","series-title":"Concussion","first-page":"CNC93","article-title":"Parent knowledge of and attitudes towards youth sport-related concussion and associations with child and parent factors","volume":"6","author":"Roberts SD","year":"2022","unstructured":"Roberts SD, Schatz P, Register-Mihalik J, Wojtowicz M. Parent knowledge of and attitudes towards youth sport-related concussion and associations with child and parent factors. Concussion. 2022;6(4):CNC93.35433025"},{"key":"b3","article-title":"Youth Sports Facts. Participation Rates. The Aspen Institute Project Play","unstructured":"Youth Sports Facts. Participation Rates. The Aspen Institute Project Play. 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Brain Res Brain Res Rev. 2001;36(2-3):169\u2013174.11690613"},{"issue":"5","key":"b35","series-title":"J Sci Med Sport","first-page":"507","article-title":"The underreporting of self-reported symptoms following sports-related concussion","volume":"18","author":"Meier TB","year":"2015","unstructured":"Meier TB, Brummel BJ, Singh R, Nerio CJ, Polanski DW, Bellgowan PSF. The underreporting of self-reported symptoms following sports-related concussion. 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