Mild Traumatic Brain Injury and ADHD: A Systematic Review of the Literature and Meta-Analysis
Abstract
Objective: This study investigated the association between mild traumatic brain injury (mTBI) and ADHD, which increases risk of injuries and accidents. Method: We conducted a systematic review and meta-analysis of studies that examined the relationship between mTBI and ADHD. Results: Five studies, comprising 3,023 mTBI patients and 9,716 controls, fit our a priori inclusion and exclusion criteria. A meta-analysis found a significant association between ADHD and mTBI, which was significant when limited to studies that reported on ADHD subsequent to mTBI and when the direction of the association was not specified, but not for studies that reported mTBI subsequent to ADHD. Heterogeneity of effect size and publication biases were not evident. Conclusion: The literature documents a significant association between mTBI and ADHD. Further clarification of the relationship and direction of effect between mTBI and ADHD and treatment implications could have large clinical, scientific, and public health implications.
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Biographies
Bamidele O. Adeyemo, MD, was a neurorehabilitation fellow and clinical neuromodulation research fellow in the Department of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital and Harvard Medical School in Charlestown, Massachusetts. He is currently working as an assistant professor at the Emory School of Medicine Department of Rehabilitation in Atlanta, Georgia. His research interests are in traumatic brain injury, assorted complications of neurological injury, global advocacy for rehabilitation, neuroplasticity, neuromodulation, and non-invasive brain stimulation for brain recovery.
Joseph Biederman, MD, is the chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, and director of the Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders, at Massachusetts General Hospital, Boston. He is a professor of psychiatry at Harvard Medical School, Boston, Massachusetts. He is board certified in general and child psychiatry. His clinical and research interests include ADHD in children and adults, and pediatric mood and anxiety disorders.
Ross Zafonte, DO, is the chairperson of the Department of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital, Harvard Medical School in Charlestown, Massachusetts, and the chief of Physical Medicine & Rehabilitation at Massachusetts General Hospital, Boston. He is known for his work in traumatic brain injury.
Elana Kagan, BA, worked as a clinical research coordinator in the Pediatric Psychopharmacology Program at the Massachusetts General Hospital, Boston. She is currently pursuing a graduate degree in clinical psychology at Temple University, Philadelphia, Pennsylvania. Her interests include improving treatments for psychological disorders.
Thomas J. Spencer, MD, is the assistant chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, Boston. He is also an associate professor at Harvard Medical School, Boston, Massachusetts. His interests have focused on the effectiveness and safety of standard and novel pharmacologic treatments of ADHD throughout the life cycle.
Mai Uchida, MD, is a staff child and adolescent psychiatrist in the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, and the Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders at Massachusetts General Hospital, Boston. She is also an instructor in psychiatry at Harvard Medical School, Boston, Massachusetts. Her career focus has been on the characteristics, longitudinal course, and treatment of childhood psychiatric conditions.
Tara Kenworthy, BA, is a clinical research coordinator in the Pediatric Psychopharmacology Program at the Massachusetts General Hospital, Boston. Her interests include early identification and treatment for psychiatric disorders in children.
Andrea E. Spencer, MD, is an assistant in psychiatry at Massachusetts General Hospital, Boston, and instructor at Harvard Medical School, Boston, Massachusetts. She currently treats patients at the MGH Chelsea Healthcare Center, where she serves as a consultant psychiatrist to the Pediatrics Unit, and at MGH in the Pediatric Psychopharmacology and Adult ADHD Program and the Alan and Lorraine Bressler Program for Autism Spectrum Disorders. Her research has focused on ADHD and its comorbidities.
Stephen V. Faraone, PhD, is the director of the Medical Genetics Research Center and distinguished professor of psychiatry and neuroscience and physiology at SUNY Upstate Medical University, Syracuse. He is also senior scientific advisor to the Pediatric Psychopharmacology and Adult ADHD program at Massachusetts General Hospital and a lecturer at Harvard Medical School, Boston, Massachusetts. His research contributions include psychiatric genetics, psychopharmacology, diagnostic issues, and methodology.
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Article first published online: July 21, 2014
Issue published: October 2014
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PubMed: 25047040
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