SELF-REPORTED SEVERITY OF MOOD SYMPTOMS IN PEDIATRIC PATIENTS WITH PERSISTENT POST-CONCUSSION SYMPTOMS (PPCS)

BACKGROUND: There are multiple subtypes identified in patients with Persistent Post Concussion symptoms (PPCS) in young athletes including mood subtype that is traditionally believed to be in higher incidence with PPCS. Although there may be an association of poor mood symptoms with worse PPCS outcomes, empirical analysis of patients’ mood symptoms and the duration of PPCS is scant. By better understanding the incidence of mood symptoms in pediatric PPCS, we may uncover other primary causes of ongoing brain dysfunction. PURPOSE: To explore the relationship between mood-symptom severity and the duration of PPCS. METHODS: A retrospective cohort study of pediatric PPCS patients (age < 18 years) treated at private concussion clinic in Tucson, AZ between 7/2018 to 7/2019. Based on written questionnaires completed by patients at office visits, patients were assigned a mood and anxiety score between 0 and 3, with 0 being the least severe and 1 being the most severe. Patients were also classified into stages 1 through 4 based on PPCS duration (see table). RESULTS: Data from 59 pediatric patients (ages ranged from 7 to 17 with a mean age of 13.9, 33:26 female to male) were included. ANOVA yielded p-value of 0.94. Average (mean) mood and anxiety scores for each PPCS substage were as follows: 0.9 for stage 1 (n=23); 0.8 for stage 2 (n=18); 0.8 for stage 3 (n=13); 0.6 for stage 4 (n=5). CONCLUSION: Our review data showed no significance between PPCS stages in regard to average self-reported mood symptoms. Contrary to traditional thinking this preliminary data in pediatric athletes illustrates that mood severity does not increase with increasing PPCS stage. This may suggest that other domains such as migraine or vestibulocular dysfunction may be the primary source of ongoing symptoms.