A - 40 Does a Prolonged Recovery From Sport-Related Concussion Influence Neurologic and Mental Health Symptoms 5 Years Post-Injury?

Abstract Purpose To assess the relationship between prolonged sport-related concussion (SRC) recovery and neurologic and mental health symptoms in former athletes at least 5 years post-injury. Method A retrospective cohort study was conducted of athletes treated at a regional sports concussion center from 2010–17 with a minimum of 5-year follow-up. In 2022, a survey was distributed to collect data on demographics, health and family history, and current neurologic and mental health symptoms. Participants were dichotomized into having a prolonged recovery (return to learn > = 7 days, symptom resolution > = 14 days, or return to play > = 28 days) or a normal recovery. Primary outcomes included Neurobehavioral Symptom Inventory (NSI), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scores. Multivariable regression determined whether a prolonged recovery predicted these outcomes after controlling for demographic, family health, and concussion history factors. Results The sample included 94 participants (median age 24 years; mean follow-up time 8.5 ± 1.4 years). Sixty (63.8%) athletes experienced prolonged recovery, while 34 (36.2%) had a normal recovery. More individuals in the prolonged recovery group experienced amnesia at initial injury (χ2 = 5.11, p = 0.024). Prolonged recovery predicted lower NSI scores (B = -9.552, p = 0.029), but did not predict GAD-7 (B = -1.894, p = 0.256) or PHQ-9 (B = -2.056, p = 0.121) scores. Conclusions In concussed athletes at an average of 8.5 years follow-up, a prolonged recovery was not associated with increased anxiety or depressive symptoms and was associated with better neurobehavioral symptoms. These findings suggest prolonged concussion recovery may not adversely affect long-term neurologic or mental health, prompting further study of its mechanisms.