Acute cognitive postconcussive symptoms follow longer recovery trajectories than somatic postconcussive symptoms in young children

ABSTRACT

Objective: To investigate somatic and cognitive postconcussive symptoms (PCS) using the symptom evaluation subtest (cSCAT3-SE) of the Child Sports Concussion Assessment Tool 3 (Child SCAT) in tracking PCS up to 2 weeks postinjury.

Methods: A total of 96 participants aged 5 to 12 years (M_age = 9.55, SD = 2.20) completed three assessment time points: 48 h postinjury (T0), 2 to 4 days postinjury (T1), and 2 weeks postinjury (T2). The Wilcoxon signed-rank test was used to analyze differences between cognitive and somatic symptoms over time, while the Friedman test was used to analyze differences within symptom type over time.

Results: Cognitive PCS were found to be significantly higher than somatic PCS at all assessment time points and were also found to significantly decline from 4 days onwards postinjury; in contrast, somatic PCS significantly declined as early as 48 hpostinjury.

Discussion: Differences between cognitive and somatic PCS emerge as early as a few days postinjury, with cognitive PCS being more persistent than somatic PCS across 2 weeks. Research in symptom-specific interventions may be of benefit in helping young children manage severe PCS as early as 2 weeks postinjury.

KEYWORDS:

• Pediatric concussion
• mild TBI
• Child SCAT 3
• postconcussive symptoms
• recovery trajectories

Disclosure statement

GAD is an honorary member of the Australian Football League Concussion Working Group and has attended meetings organized by sporting organizations including the National Football League (NFL; USA), National Rugby League (Australia), and FIFA (Switzerland); however, he has not received any payment, research funding, or other monies from these groups other than for travel costs, and is a co-author of the Child SCAT3 and Child SCAT5. All authors declare that they have no financial relationships relevant to this article to disclose.

Additional information

Funding

This study was funded by the Royal Children’s Hospital Research Foundation and the Victorian Government Operational Infrastructure Scheme. Hearps was funded by an Australian National Health and Medical Research Council (NHMRC) Development grant; Babl was funded by the Royal Children’s Hospital Research Foundation, an NHMRC Practitioner Fellowship, and a Melbourne Campus Clinician Scientist Fellowship; and Anderson by an NHMRC Senior Practitioner Fellowship. The funding organizations did not have a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.