© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com. doi:10.1093/arclin/acaa086 Advance Access publication 17 October 2020 Archives of Clinical Neuropsychology 36 (2021) 554–560 Differences in Adolescent Symptom Reporting Following Motor Vehicle Accident Versus Sport-Related Concussion Tahnae Tarkenton 1 , Todd Caze II 1 , Cheryl H. Silver 1 , Linda S. Hynan 1,2 , Nyaz Didehbani 1,5 , Shane Miller 3,4,8 , Hunt Batjer 7 , Kathleen Bell 5 , C. Munro Cullum 1,6,7, * 1 University of Texas Southwestern Medical Center, Departments of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA 2 University of Texas Southwestern Medical Center, Departments of Population and Data Sciences, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA 3 University of Texas Southwestern Medical Center, Departments of Orthopedic Surgery, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA 4 University of Texas Southwestern Medical Center, Department of Pediatrics, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA 5 University of Texas Southwestern Medical Center, Department of Physical Medicine & Rehabilitation, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA 6 University of Texas Southwestern Medical Center, Department of Neurology and Neurotherapeutics, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA 7 University of Texas Southwestern Medical Center, Department of Neurological Surgery, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA 8 Scottish Rite for Children Orthopedic and Sports Medicine Center, 5700 Dallas Pkwy, Frisco, TX 75034, USA *Corresponding author at: University of Texas Southwestern Medical Center, Psychology Division, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390-9044, USA. Tel: 214-648-5277; fax: 214-648-4660. E-mail address: Munro.Cullum@UTSouthwestern.edu Received 6 April 2020; revised 21 August 2020; Editorial Decision 15 September 2020; Accepted 15 September 2020 Abstract Objective: To characterize potential differences in youth concussion sustained in motor vehicle accident (MVA) versus sport- related concussion (SRC), hypothesizing that youth who sustain concussion in a MVA would endorse higher initial and persistent symptom scores compared to those with SRC, despite similar injury severity levels. Methods: Participants age 12–18 who sustained a concussion (i.e., Glasgow Coma Scale = 13–15) in a MVA (n = 35) were matched with SRC participants (n = 35) by sex, age, and days since injury. ANCOVA comparing initial postconcussion total symptom scores between the MVA and SRC groups were performed. Chi-square analysis with injury group by recovery time was used to determine whether youth who sustained concussion from MVA were more likely to endorse symptoms persisting >30 days at 3 months postinjury, and ANCOVA compared 3-month total symptom scores. Results: On average, the MVA group reported significantly higher initial postconcussion and more frequent persistent symptom scores compared to the SRC group. Conclusions: This is the first known study to examine context of injury in youth concussion while matching for injury severity, age, sex, and days since injury. Findings suggest the context of injury is an important clinical variable related to initial reporting of symptoms and endorsement of symptoms lasting more than 30 days. Tailored interventions that consider the context of injury may facilitate symptom resolution. Keywords: Concussion; Mild traumatic brain injury; Motor vehicle accident; Sport-related concussion; Rehabilitation; Pediatrics Annually in the USA, at least 700,000 people under the age of 19 sustain traumatic brain injuries, with an estimated 80%– 90% of these injuries being mild in severity (Faul et al., 2010). Worldwide, approximately 4 million children with concussion present to emergency departments each year (Crowe et al., 2009; Lyttle et al., 2012; Peden, et al., 2008). Because not all youth report to an emergency department following concussion, this is presumed to be only 12% of children with concussion (Arbogast et al., 2016), suggesting that up to 33 million children worldwide acquire a concussion annually (Davis et al., 2017). Recovery from concussion symptoms occurs within a few days to several weeks after injury for most children and adolescents (Nelson et al., 2016); however, a subgroup continues to experience symptoms longer than expected, sometimes referred to as persistent postconcussion symptoms (PPCS) (Barlow et al., 2010). Current literature considers “prolonged” recovery time from concussion as greater than 1 month and suggests up to 40% of children report symptoms lasting longer than 1 month (McCrory et al., 2017; Zemek et al., 2016). Downloaded from https://academic.oup.com/acn/article/36/4/554/5926573 by guest on 29 June 2022