Abstract:
Objective: The objective of this study was to establish whether there were indications of permanent neuropsychological sequelae in respect of (i) cognitive test performance and (ii) self-reported postconcussive symptoms (PCS) amongst Grade 12 male students, due to repetitive concussive episodes sustained during participation in a contact sport throughout their school years. Participants and Methods: Over a two year period all Grade 12 sports players in a South African high school were targeted. Following exclusions for prior neurological or psychiatric disorder, learning disability and substance abuse, the final sample included 189 Grade 12 boys at pre-season, and 154 Grade 12 boys at post-season (age range 16-18 years). The samples were divided into comparative groups of contact (predominantly rugby) and noncontact sport, with equivalence for age and WAIS-III Vocabulary score (a control for premorbid IQ). There was a significantly higher reported incidence of prior concussions amongst the contact compared with the noncontact sports groups. Measures included the ImPACT computerized test, Digit Symbol Substitution and Recall, and two PCS scales. Independent t-test analyses at pre- and post-season, and dependent t-test comparisons pre- versus post-season, were conducted. Results: All significant effects and predominant trends were in the direction of contact sports players performing more poorly, or presenting with more symptoms, than noncontact sports players. Conclusions: It is suggested that these effects implicate deleterious neuropsychological consequences of cumulative concussive events due to sustained participation in a contact sport in a significant proportion of high school boys by the end of their high school years.