Obesity and neurocognitive recovery after sports-related concussion in athletes: a matched cohort study

Objectives: Sports-related concussions (SRCs) are a significant public health concern in athletes. Data exist suggesting a link between obesity and decreased neurocognitive function, yet the effect of body mass index (BMI) on neurocognitive function and recovery after a SRC is unknown. The goal of our study was to discern the effect of BMI on recovery after SRC.

Methods: This study was a retrospective observational cohort study. Between 2013 and 2014, 7,606 athletes between the ages of 13–20 years valid baseline neurocognitive testing performed at multiple regional concussion centers sustained a concussion. Out of these athletes, 711 normal weight athletes and 711 obese athletes were matched by age, gender, number of previous concussions, and sport. The proportions of athletes returning to baseline within two weeks between the groups were defined by using 80% confidence reliable change index (RCI) criteria and were compared using Fisher’s Exact Test. Kaplan-Meier survival curve analysis with log-rank test was used to compare the median time to neurocognitive recovery between groups.

Results: Fewer obese athletes returned to baseline within 2 weeks on measures of verbal memory, visual motor speed, reaction time, postconcussion symptom scale (PCSS), and overall recovery compared to normal weight athletes. Obese athletes also had greater median time of return to baseline with respect to reaction time, PCSS, and overall recovery.

Conclusion: Using RCI methodology, there exists an association between obesity and increased time to return to neurocognitive and symptom baseline after SRC in athletes, specifically reaction time, symptom scores, and overall recovery.