INS NYC 2024 Program

Poster	Poster Session 10 Program Schedule 02/17/2024 09:00 am - 10:15 am Room: Majestic Complex (Posters 61-120) Poster Session 10: Neurodevelopmental \| Congenital Conditions Final Abstract #83 Evaluating if Stimulant Medication Use for Athletes with ADHD Levels the Playing Field on Baseline ImPACT® Scores Alexis Rosen, Nova Southeastern University, Fort Lauderdale, United States Christina Nuñez, Nova Southeastern University, Fort Lauderdale, United States Sophia Perez, Nova Southeastern University, Fort Lauderdale, United States Ryan Bennett, Nova Southeastern University, Fort Lauderdale, United States Category: ADHD/Attentional Functions Keyword 1: computerized neuropsychological testing Keyword 2: attention deficit hyperactivity disorder Keyword 3: stimulants Objective: To compare student athletes who reported having ADHD and are using stimulant medication versus student athletes who endorsed no ADHD and are not using stimulant medication on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) baseline composite scores and total symptom score. Participants and Methods: Participants were selected from a de-identified ImPACT database. Athletes were grouped into those who endorsed ADHD and were using stimulants (M_age= 14.88, SD_age= 1.654, M_Edu= 8.73, SD_Edu= 1.413, female= 36.4%, previous concussed=6.1%) and those who denied ADHD and were not using stimulant medications (M_age= 15.33 SD_age= 1.633, M_Edu= 9.15, SD_Edu= 1.278, female= 39.4%, previous concussed=9.1%). Stimulant medications included dexmethylphenidate, amphetamine-dextroamphetamine, amphetamine, methylphenidate, and lisdexamfetamine. Groups were evaluated for group differences on age, education, gender, race, number of previous concussions, the presence of learning disabilities, treatment for psychiatric condition (anxiety/depression), and those receiving speech therapy. Groups were significantly different on the presence of learning disabilities and therefore the variable was included as a covariate in the analyses. ANOVAs were used to assess composite scores which met underlying assumptions. Mann Whitney U tests were used as nonparametric equivalents. To evaluate for underlying assumptions, descriptive analyses of outcomes were observed using Skewness, Kurtosis, and the Schapiro Wilks test. Results: There was a significant difference on the Impulse Control Composite score F(1,64)=7.006, p=.010, ηp²=.108. Those with ADHD and using stimulant medications had higher means when compared to those without ADHD and not using stimulant medications. Conclusions: The assumption that stimulant medication use will neutralize deficits in individuals with ADHD when compared to those who do not require stimulants is problematic given these findings. Findings suggest that those diagnosed with ADHD and are using stimulants had significantly worse performance in impulse control at baseline when compared to those who do not have ADHD and denied medication use. This has implications for concussion monitoring for individuals who endorse having ADHD and are using stimulant medication. If these athletes do not have ImPACT® baseline scores they are then compared to the normative data which can be problematic when making decisions regarding return to play as these athletes may be held back. These individuals will struggle to return to baseline according to the normative data given that on average this group produces lower scores in the impulse control domain. This highlights the importance of baseline testing for concussion monitoring as individuals will be compared to themselves and their unique abilities rather than normative data. Limitations to this study include the reliance on self-reported data. Future investigations should consider more rigorous stimulant medication details such as dosing and medication adherence as well as investigate the unique presentations of ADHD and stimulant medication use independently.

Poster

02/17/2024
09:00 am - 10:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 10: Neurodevelopmental | Congenital Conditions

Final Abstract #83

Evaluating if Stimulant Medication Use for Athletes with ADHD Levels the Playing Field on Baseline ImPACT® Scores

Alexis Rosen, Nova Southeastern University, Fort Lauderdale, United States
Christina Nuñez, Nova Southeastern University, Fort Lauderdale, United States
Sophia Perez, Nova Southeastern University, Fort Lauderdale, United States
Ryan Bennett, Nova Southeastern University, Fort Lauderdale, United States

Category: ADHD/Attentional Functions

Keyword 1: computerized neuropsychological testing
Keyword 2: attention deficit hyperactivity disorder
Keyword 3: stimulants

Objective:

To compare student athletes who reported having ADHD and are using stimulant medication versus student athletes who endorsed no ADHD and are not using stimulant medication on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) baseline composite scores and total symptom score.

Participants and Methods:

Participants were selected from a de-identified ImPACT database. Athletes were grouped into those who endorsed ADHD and were using stimulants (M_age= 14.88, SD_age= 1.654, M_Edu= 8.73, SD_Edu= 1.413, female= 36.4%, previous concussed=6.1%) and those who denied ADHD and were not using stimulant medications (M_age= 15.33 SD_age= 1.633, M_Edu= 9.15, SD_Edu= 1.278, female= 39.4%, previous concussed=9.1%). Stimulant medications included dexmethylphenidate, amphetamine-dextroamphetamine, amphetamine, methylphenidate, and lisdexamfetamine. Groups were evaluated for group differences on age, education, gender, race, number of previous concussions, the presence of learning disabilities, treatment for psychiatric condition (anxiety/depression), and those receiving speech therapy. Groups were significantly different on the presence of learning disabilities and therefore the variable was included as a covariate in the analyses. ANOVAs were used to assess composite scores which met underlying assumptions. Mann Whitney U tests were used as nonparametric equivalents. To evaluate for underlying assumptions, descriptive analyses of outcomes were observed using Skewness, Kurtosis, and the Schapiro Wilks test.

Results:

There was a significant difference on the Impulse Control Composite score F(1,64)=7.006, p=.010, ηp²=.108. Those with ADHD and using stimulant medications had higher means when compared to those without ADHD and not using stimulant medications.

Conclusions:

The assumption that stimulant medication use will neutralize deficits in individuals with ADHD when compared to those who do not require stimulants is problematic given these findings. Findings suggest that those diagnosed with ADHD and are using stimulants had significantly worse performance in impulse control at baseline when compared to those who do not have ADHD and denied medication use. This has implications for concussion monitoring for individuals who endorse having ADHD and are using stimulant medication. If these athletes do not have ImPACT® baseline scores they are then compared to the normative data which can be problematic when making decisions regarding return to play as these athletes may be held back. These individuals will struggle to return to baseline according to the normative data given that on average this group produces lower scores in the impulse control domain. This highlights the importance of baseline testing for concussion monitoring as individuals will be compared to themselves and their unique abilities rather than normative data. Limitations to this study include the reliance on self-reported data. Future investigations should consider more rigorous stimulant medication details such as dosing and medication adherence as well as investigate the unique presentations of ADHD and stimulant medication use independently.