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Comment & Response |

Attribution of Concussion-Like Symptoms and History of Collision Sports Exposure—Reply

Noah D. Silverberg, PhD1,2,4,6,7; Rebekah Mannix, MD, MPH3; Grant L. Iverson, PhD4,5,6,7
[+] Author Affiliations
1Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
2G. F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
3Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts
4Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
5Spaulding Rehabilitation Hospital, Boston, Massachusetts
6Massachusetts General Hospital for Children Sports Concussion Program, Boston
7Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts
JAMA Pediatr. 2016;170(4):400. doi:10.1001/jamapediatrics.2015.4649.
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In Reply In a study published in the December 2015 issue of JAMA Pediatrics,1 we aimed to document concussion-like symptoms in high school athletes with no recent concussion during their preseason baseline evaluation and identify health history variables associated with symptom reporting. We reported that concussion history was associated with concussion-like symptoms in high school athletes, but its effect was small relative to certain preexisting learning, psychiatric, and headache disorders. In a letter to the editor,2 Mr Comrie proposed that prior concussion(s) and/or repetitive head trauma through participation in collision sports may be responsible for both the symptoms and the preexisting conditions themselves, suggesting that the effect of prior (documented or undocumented) neurotrauma may be much larger than represented in our study.

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