Title: Youth with Elevated ADHD or Lower Inhibitory Control are at Increased Risk Following TBI in Early Adolescence

Poster Session A - Saturday, April 13, 2024, 2:30 – 4:30 pm EDT, Sheraton Hall ABC

Jacob Franzen¹ (jfranzen113@gmail.com), Stephanie Hartling¹, Katherine Luking¹; ¹Saint Louis University Psychology Department

Background: Traumatic Brain Injuries (TBIs) have been associated with ADHD, but specific symptoms remain understudied. Inhibitory control, critical in early adolescence, shows impairment in ADHD. This study aims to explore the impact of TBIs on neurocognitive abilities, focusing on ADHD symptoms and inhibitory control. Methods: Data from the Adolescent Brain and Cognitive Development (ABCD) study were utilized. Caregivers reported youth TBI history, ADHD symptoms, internalizing symptoms, and demographics at baseline (ages 9-10) and a 2-year follow-up. Mixed models, considering family structure and study site, analyzed relationships between youth TBI history, ADHD symptoms, and neurocognition at baseline (N=11,518). Additional models assessed the impact of new TBIs, baseline ADHD symptoms, baseline inhibitory control, and their interaction on longitudinal changes in ADHD symptoms (N=7,862). Results: TBI prior to baseline correlated with increased ADHD symptom severity (B=1.51, p<0.001), but not inhibitory control (B=0.65, p=0.302). New TBIs predicted a rise in ADHD symptoms, notably in youth with higher pre-existing ADHD symptoms (B=0.13, p=0.034) and poorer baseline inhibitory control (B=-0.07, p=0.02). White matter tracts, measured by mean diffusivity in specific tracts, did not mediate these effects. Conclusion: ADHD symptom severity and inhibitory control emerge as unique risk factors for worsening post-TBI symptoms in early adolescence. Despite statistical significance, effects are small and necessitate replication. The ABCD study offers an opportunity for longitudinal exploration. Investigating neural mechanisms underlying these risk effects is crucial for a comprehensive understanding of post-TBI symptomatic changes, especially in inhibitory control across various metrics.

Topic Area: EXECUTIVE PROCESSES: Monitoring & inhibitory control