Beyond the stereotype: a comparison of concussion assessments and 3D-MOT performance in individuals with and without...

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that exhibits significant symptom overlap with concussion. While ADHD diagnosis is often considered a confounding factor in concussion evaluation, its impact on performance on standard assessment tools is not well understood. This cross-sectional analysis examined 45 participants with a self-reported doctors' diagnosis of ADHD and 45 matched controls. Performance on the King-Devick (KD) test, SCAT6 symptoms, Vestibular Oculomotor Screening (VOMS), and 3D-MOT was first compared between ADHD and control participants in independent baseline and post-injury cohorts, and secondarily, between independent baseline and post-injury cohorts within ADHD and control groups. The Mann-Whitney U test and effect size analysis revealed higher symptoms as measured by SCAT6 and VOMS in post-injury cohorts compared to baseline cohorts in both ADHD and control groups. No differences were seen between the ADHD and control groups in the baseline or post-injury cohort on any assessment tool. A forward stepwise regression indicated ADHD diagnosis did not significantly predict overall concussion symptom severity as measured by SCAT6 symptom severity. The findings suggest that ADHD diagnoses do not appear to confound performance on concussion assessment tools when analysed in a heterogenous sample. Post-injury cohorts show higher concussion symptoms compared to control cohorts, regardless of ADHD status. The wide variability in symptom presentation and lack of detected differences between ADHD and control groups in this heterogenous sample suggest that factors beyond ADHD, such as age, sex, and injury history, may play a more prominent role in assessment outcomes.