Age-Related Differences in Neuropsychological Testing Among High School Athletes (Original Research) (Report‪)‬

An estimated 63 000 concussions occur annually in high school athletes. (1) McCrea et al (2) found an incidence rate in high school athletes (15.3%) that was nearly 3 times that originally suggested (5.5%). A variety of theories have been offered to explain why the younger brain is more vulnerable to concussion. Possibilities include less extensive myelination, a greater head-to-body ratio, and thinner cranial bones, all of which provide less protection to the developing nervous system. (3) However, cognitive immaturity has been suspected as the primary factor for increased incidence of concussion in high school athletes. (3,4) According to the Luria (4,5) theory of brain organization and function, the sequence of cognitive development depends on the changes (both physiologic and functional) that occur with normal maturation of various cortical areas. Progression through each stage is paralleled by qualitative organizational changes in the child's adaptive intellectual abilities. Most researchers have argued that cognitive development of primary, secondary, and tertiary brain regions becomes functional by age 12 years. (5,6) Cognitive maturity, however, continues to develop through adulthood. This cognitive growth period may directly affect both the recovery rate after injury and the appropriate assessment tools for baseline concussion assessment.