Effects of mTBI with loss of consciousness on neurobehavioral symptoms, depression, and insomnia in former collegiate and NFL football athletes

Authors

Sarah Laskowitz, Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina, USA.
C Lexi Baird, Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina, USA.
Ashley Huggins, Department of Psychology, The University of Arizona, Tucson, Arizona, USA.
Nino Nadareishvili, School of Medicine and Health Sciences, Department of Clinical Research and Leadership, George Washington University, Washington, District of Columbia, USA.
Jessica Bride, School of Medicine and Health Sciences, Department of Clinical Research and Leadership, George Washington University, Washington, District of Columbia, USA.
H Ryan Wagner, Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA.
Melvin Briggs, Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina, USA.
Rajendra A. Morey, Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA.
Robert W. Turner, Department of Clinical Research & Leadership, School of Medicine & Health Sciences, The George Washington University, Washington, USA.

Document Type

Journal Article

Publication Date

5-10-2024

Journal

Brain injury

DOI

10.1080/02699052.2024.2347552

Keywords

American Football; Mild traumatic brain injury; depression; insomnia; loss of consciousness; neurobehavioral symptoms

Abstract

OBJECTIVE: Considering that diagnostic decisions about mTBI are often predicated on clinical symptom criteria, it is imperative to determine which initial presentation features of mTBI have prognostic significance for identifying those at high risk for long-term functional impairment. SETTING: Zoom interview Participants: Male, former NCAA Division I, and professional-level National Football League (NFL) athletes ( = 177) between the ages of 27 and 85 ( = 54.1, SD = 14.7). DESIGN: Cross-sectional case-control. Main Measures: History of mild TBI, history of loss of consciousness (LOC), depression symptoms, insomnia, neurobehavioral symptoms. RESULTS: Number of mTBI exposures did not predict neurobehavioral symptoms (B = 0.21, SE = 0.18,  = 0.23), but number of mTBI + LOC events did (B = 2.27, SE = 0.64,  = <.001). Further analysis revealed that the number of mTBI + LOC events predicted neurobehavioral symptoms indirectly through both depression (B = 0.85, 95% CI = [0.27, 1.52) and insomnia (B = 0.81, 95% CI = [0.3, 1.4]). Further, the direct effect of mTBI + LOC events on neurobehavioral symptoms became non-significant when depression and insomnia were added to the model (B = 0.78, SE = 0.45,  = 0.08). CONCLUSIONS: Findings support LOC at time of injury as an important predictor of long-term outcomes. Additionally, results suggest depression and insomnia as potential mediators in the association between mTBI + LOC and neurobehavioral symptoms. These findings provide justification for early depression and insomnia symptom monitoring following mTBI + LOC.

APA Citation

Laskowitz, Sarah; Baird, C Lexi; Huggins, Ashley; Nadareishvili, Nino; Bride, Jessica; Wagner, H Ryan; Briggs, Melvin; Morey, Rajendra A.; and Turner, Robert W., "Effects of mTBI with loss of consciousness on neurobehavioral symptoms, depression, and insomnia in former collegiate and NFL football athletes" (2024). GW Authored Works. Paper 4953.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4953

Department

Clinical Research and Leadership