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Concussion Effects Found More Severe in Teens Than Children, Adults

Teenagers (ages 13-16) feel the effects of concussions more severely than younger children (ages 9-12) and adults, according to a new study from the Université de Montréal.

The study, published online Tuesday in the journal Brain Injury, examined 96 athletes (roughly an equal number of children, teenagers, and adults), half of whom had suffered a sports-related concussion in the previous year but were currently asymptomatic. The researchers used a group of neuropsychological tests (used by the National Hockey League) and compared the results to electrophysiological examinations of working memory and attention (called the "visual oddball task").

Athletes of all ages experienced continued neuropsychological deficits six months after their injury, with some lasting a full year, the researchers discovered. In other words, even when someone stops feeling symptoms of a concussion, there's no guarantee that his or her brain has fully healed.

Concussions largely affected the athletes' working memory, which helps the brain process short-term tasks. The teenagers were the only group found to have deficits in working memory through the neuropsychological tests, but all three groups had deficits in working memory based on the electrophysiological tasks.

"The frontal regions of the brain are more vulnerable to concussions. These areas oversee executive functions responsible for planning, organizing, and managing information. During adolescence, these functions are developing rapidly, which makes them more fragile to stress and trauma," said Dr. Dave Ellemberg, a professor at the university's Department of Kinesiology, in a statement.

The fact that children and adults appear normal on neuropsychological tests but still have deficits suggests that concussion recovery may occur in two phases, the researchers argue.

In the initial recovery phase, the brain goes through "function recovery in which compensatory mechanisms... allow the athletes to perform normally on standard clinical assessments," according to the study. Afterwards, the authors suggest the brain endures a prolonged recovery phase, where "subtle deficits in brain functioning" linger, despite not appearing on certain tests.

"The situation is more serious than we think," said Ellemberg. "Contrarily to professional athletes, youngsters don't have a medical doctor and a protocol in place for becoming active again. However, for me, their brain is more important than the brain of a famous football player. It needs to be protected with the right diagnostic tools and an adapted framework."

"Obviously, concussions are a part of sport, but we can reduce their occurrence by limiting dangerous situations," he continued. "Youngsters must pursue their activities in a secure environment where people know how to treat concussions."

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