Differential Effect of Recurrent Concussions on Symptom Clusters in Sport Concussion Assessment Tool

Context: Symptom checklist in Sport Concussion Assessment Tool has been widely used in preseason assessment and in concussion diagnosis, but the impact of prior concussions on the graded symptoms after a new concussion has not been evaluated. Objective: This study was undertaken to examine reported symptoms associated with recurrent concussions using data of a comprehensive survey among athletes. Design: Retrospective survey and cross-sectional study. Setting: College athletes. Participants: Student athletes who sustained one or more concussions. Main Outcome Measures: Concussion history and graded symptoms of the most recent concussion at time of the survey were surveyed. The impact of prior concussions was examined over symptoms and aggregated symptoms. Results: Multiple concussions were associated with greater reporting of individual symptoms related to emotion and physical symptoms of sensitivity to light and noise: more emotional (z = 2.3, P =.02); sadness (z = 2.4, P =.02); nervousness (z = 2.4, P =.02); irritability (z = 3.6, P =.01); sensitivity to light (z = 2.6, P =.01); and sensitivity to noise (z = 2.4, P =.04). The composite scores of emotional symptom and sensitivity symptom clusters were significantly higher: t = 2.68 (P <.01) and t = 3.35 (P <.01), respectively. Conclusions: The significant rises in emotional and sensitivity symptoms may be an important additive effect of concussive injury. Closer attention should be given to these symptom clusters when evaluating concussion injury and recovery.