Preliminary Comparison Of Symptom Networks Between Athletes With And Without Sport-related Concussions

PURPOSE: Sport-related concussions (SRC) are linked to a variety of post-injury dysfunctions spanning neurocognitive, neurological, and postural stability domains, among others. Due to the heterogeneous nature of SRC outcomes, network analysis has been proposed as a tool to explore complex interrelationships. This secondary analysis, using data from the NCAA-DoD CARE Consortium, aimed to compare the outcome networks in SRC and control (CTL) groups both at baseline and during the acute post-concussion period. METHODS: Outcome networks were estimated using partial correlations for the SRC (n = 1,255) and CTL (n = 175) groups at baseline (T1) and between 24 to 48 hours post-injury (T2). Significant interconnections were identified using 95% non-parametric bootstrapped confidence intervals. Network structure, edge strength, and nodal importance were compared between the two groups using permutation tests. RESULTS: At T1, the network structure and global network strength did not differ between the SRC and CTL groups. However, stronger connections between visual memory and reaction time (E = 0.15, p < .05) and between somatization and anxiety (E = 0.25, p < .05) were observed in the SRC group compared to the CTL group at T1. At T2, although the network structures remained similar between the two groups, the SRC group displayed a more interconnected network (S = 1.22, p < .05). Additionally, stronger connections between visual memory and reaction time (E = 0.25, p < .01) and between somatization and anxiety (S = 0.22, p < .05) persisted in the SRC group. Somatization also emerged as a more central symptom in the SRC network (C = 0.47, p < .05). CONCLUSIONS: While the overall network structures were similar between SRC and control groups, the SRC group exhibited significantly stronger interrelationships between symptoms and cognitive measures during the acute post-concussion period. Specific connections, particularly those related to cognitive performance and emotional symptoms (e.g., somatization and anxiety), were more pronounced in the SRC group. The central role of somatization in the SRC network may highlight the increased prominence of physical symptoms in concussed athletes during the acute post-injury period. Supported by: upported by NCAA and DoD Award# W81XWH-14-2-0151