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

Systematically examine research reporting on the relationship between attention-deficit/hyperactivity disorder (ADHD) and recovery outcomes following sport-related concussion (SRC). A literature search was conducted for articles between January 2019 and December 2024 using: PubMed, PsycINFO, and Web of Science. Search terms included ADHD, concussion, and recovery. Eligible studies investigated recovery outcomes including post-concussion symptoms, return-to-learn (RTL), and return-to-play (RTP). Nineteen met inclusion criteria. The studies included 32,554 participants (Mage=16.27; SD = 2.44), of which 2,815 (8.65%) reported a diagnosis of ADHD. Approximately 50% of the studies examined individuals presenting to specialty clinics (47.4%). Athletes were predominantly competing at the high school or collegiate level (26.3% for each group, respectively). Only four studies reported a statistically significant association between ADHD and worse SRC outcomes; one study reported a favorable association. Among included studies, only eight examined ADHD as a primary contributor to recovery outcome. Despite an increase in peer-reviewed research examining SRC recovery among individuals with ADHD in recent years, the majority of evidence does not definitively support an association between ADHD and worse recovery outcome following SRC. Although study quality has improved, significant gaps and limitations remain including inconsistent characterization of ADHD, limited studies with ADHD as the primary independent variable, a lack of consistent reporting of descriptive data, and limited control of medication status. In sum, scientific research does not show evidence of an association between ADHD and worse clinical outcome following SRC, though these limitations continue to temper confidence in the conclusions that can be drawn.