ADHD News & Research

Study: ADHD May Diminish Brain Tolerance to Subconcussive Head Impacts

Repetitive subconcussive head impacts, or hits to the head that don’t result in overt concussion symptoms, may be more harmful to the brains of individuals with ADHD than they are to brains of those without the disorder.

November 13, 2020

Brain tolerance to repetitive subconcussive head impacts may be diminished by attention deficit hyperactivity disorder (ADHD or ADD), according to a study of soccer players recently published in the Journal of Attention Disorders.1 In high school and college athletes, ADHD increases the risk for concussion, “accompanied by amplified concussion symptoms, prolonged recovery, and impaired performance on working memory tasks.”2 The majority of college athletes with ADHD participate in contact sports, where they can “sustain several hundred to a thousand subconcussive head impacts per season.”3 Subconcussive head impacts are defined as hits to the head that don’t result in overt concussion symptoms.

Researchers conducted a case-control intervention study of 51 adults with ADHD who had at least 5 years of soccer heading experience, and a control cohort of similar athletes without ADHD. Cognitive assessment, using ImPACT, and plasma levels of neurofilament-light, Tau, glial-fibrillary-acidic protein (GFAP), and ubiquitin-C-terminal hydrolase-L1 (UCH-L1) were measured. Among the main findings were:

  • Researchers observed a higher degree of impairment in verbal memory function among participants with ADHD following 10 soccer headings
  • All domains of cognitive functions in participants without ADHD were able to tolerate 10 soccer headings
  • Plasma GFAP (a protein released only after cell death or injury) and UCH-L1 levels were acutely elevated after soccer headings endured by participants with ADHD only
  • Acute elevations of GFAP after soccer headings were correlated to acute verbal memory declines in the ADHD group

Though the study did not make any diagnostic claim of concussive or subconcussive injury after 10 soccer headings, the evidence was enough to lead researchers to conclude that ADHD may cause reduced tolerance to acute subconcussive head impacts.

View Article Sources

1Nowak MK, Ejima K, Quinn PD, et al. ADHD May Associate With Reduced Tolerance to Acute Subconcussive Head Impacts: A Pilot Case-Control Intervention Study. Journal of Attention Disorders. November 2020. doi:10.1177/1087054720969977

2Biederman, J., Feinberg, L., Chan, J., Adeyemo, B. O., Woodworth, K. Y., Panis, W., McGrath, N., Bhatnagar, S., Spencer, T. J., Uchida, M., Kenworthy, T., Grossman, R., Zafonte, R., Faraone, S. V. (2015). Mild traumatic brain injury and attention-deficit hyperactivity disorder in young student athletes. Journal of Nervous & Mental Disease, 203(11), 813−819. https://doi.org/10.1097/NMD.0000000000000375

3Bailes, J. E., Petraglia, A. L., Omalu, B. I., Nauman, E., Talavage, T. (2013). Role of subconcussion in repetitive mild traumatic brain injury. Journal of Neurosurgery, 119(5), 1235−1245. https://doi.org/10.3171/2013.7.JNS121822

1 Comments & Reviews

  1. I am a female with ADHD. I experienced multiple head hits from years of free style ice skate, some quite intense. In 2011 I had an ATV accident resulting in a Traumatic Brain Injury. I lost my sight which gradually returned. I was told I had a haematobia in the cerebral cortex of my brain. Since it was a slow bleed, no surgery was required. I was not given information regarding the injury or information regarding the possibility of future conditions that could evolve from this type of injury. I received a letter stating I had been put on the Traumatic Brain Injury List. This occurred out of town during job loss due to my company merging, and cobra had expired. I assumed the limited care and interest was due to that but it was a horrible patient experience. I was away from home, in a unfamiliar area, blind, alone without family or fiends and the staff was inconsiderate and uncompassionate. In reading this I learned how broad the injury can be depending on the extent of injury, location, etc. I also learned it is possible other conditions may evolve later in time. I am interested to know where I may find further information or if there are resources available that provide information regarding ADHD and Traumatic Brain Injury. I never mentioned ADHD. The Medical Community differ in their opinion of ADHD, often seeing it and the patient as “mental” or as a means to obtain drugs. Adderall and Klonopan were listed in the standard admissions form where any medications taken are listed. I was immediately told in a demeaning tone to not expect these prescriptions to be filled or prescribed. What? I did not expect nor ask anything. Nor even bring it up. If possible I would never list medications I take on medical forms to avoid the stigma that follows. Many members in my family are in the Medical Profession and have no idea I am ADHD. I don’t think they see it as a real condition. Many (Most) within the Medical community do not recognize ADHD. Since it is listed as a Mental Disorder there is an immediate stigma towards the patient. Unfortunately, especially for adults once listed on a patient’s record a visit to the ER for a sports fracture will include a call to psych. The ATV hit stacked logs previously not on the trail, I was thrown hitting my head, the ATV flipped over me landing several yards ahead. I did go to the ER and was released. It was about a week later when my sight quickly dissipated. I returned to the ER and was transferred. They said I had a brain bleed after a series of cat scans and MRIs.

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