Recovery from Sport-Related Concussion in Athletes with Attention-Deficit/Hyperactivity Disorder: a Systematic Review

Area of Science:

• Neurology
• Sports Medicine
• Psychiatry

Background:

• Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
• Sport-related concussions (SRC) are prevalent in athletes, with recovery varying.
• The potential impact of ADHD on SRC recovery remains an area of active research.

Purpose of the Study:

• To systematically review and synthesize existing research on the relationship between ADHD and recovery outcomes after SRC.
• To evaluate the current evidence regarding ADHD's influence on post-concussion symptoms, return-to-learn (RTL), and return-to-play (RTP).

Main Methods:

• A comprehensive literature search was conducted across PubMed, PsycINFO, and Web of Science from January 2019 to December 2024.
• Included studies focused on ADHD, concussion, and recovery, analyzing outcomes like post-concussion symptoms, RTL, and RTP.
• Nineteen studies involving 32,554 participants (8.65% with ADHD) met the inclusion criteria.

Main Results:

• The majority of studies (19) did not find a statistically significant association between ADHD and worse SRC recovery outcomes.
• Only four studies reported a significant negative association, while one reported a favorable association.
• Few studies (8) specifically investigated ADHD as the primary independent variable influencing recovery.

Conclusions:

• Current scientific evidence does not conclusively demonstrate an association between ADHD and poorer recovery following SRC.
• Significant research gaps persist, including inconsistent ADHD characterization, limited focus on ADHD as a primary factor, and inadequate control for medication status.
• Further high-quality research is needed to definitively understand the complex interplay between ADHD and SRC recovery.