Available online 21 January 2026, 101259

Author links open overlay panelRachael S. Mathew a, Caitlin Segura a, Abigail Lemons a, Alcy R. Torres bShow moreAbstract

Each year, millions of children are diagnosed with concussions. This review summarizes current evidence on the long-term effects of pediatric concussion into adulthood. Findings regarding long-term neuropsychiatric outcomes are heterogeneous. Advanced neuroimaging studies provide limited evidence of lasting neurobiological alterations, and long-term studies remain scarce. Rodent models that mimic adolescent mild traumatic brain injury consistently demonstrate chronic neuroinflammation, neuronal loss, and memory deficits. Overall, conclusions are constrained by substantial methodological heterogeneity. Further high-quality longitudinal studies are needed to clarify the long-term impact of pediatric concussion.

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Access through your organizationSection snippetsEpidemiology and definitions

Mild traumatic brain injuries (mTBIs), or concussions, occur at high rates within the pediatric population. A concussion is defined as a blunt force injury to the head or body that transmits impulsive forces to the head, resulting in symptoms including but not limited to: alteration in mental status, headaches, dizziness, nausea/vomiting, fatigue/drowsiness, blurred vision, or difficulty concentrating.1,2 While the terms concussion and mTBI are often used interchangeably, concussion represents

Cognition

The existing evidence regarding the association between pediatric concussion and adult cognitive outcomes is inconsistent. Although some studies demonstrate domain-specific deficits, most notably in working memory, other studies report no long-term cognitive effects.15, 16, 17 A study conducted by Fox et al. found that participants with a history of mTBI had a decrease in verbal working memory performance in adulthood.15 This study examined participants who sustained an mTBI at a mean age of

White matter

Evidence related to long term changes in white matter microstructure after pediatric concussion is limited.13 There is some evidence that suggests that pediatric concussions may lead to subacute alterations in white matter microstructure, however the evidence of long-term alterations is scarce. Existing studies suggest that alterations in white matter microstructure and diffusivity predominantly emerge within the initial six months after injury.31, 32, 33 One longitudinal study by Manning et

Animal model evidence

Research done in rodent models provides key insights into the long-term effects of concussions on the cellular and behavioral changes following head injuries during childhood and adolescence. While a variety of rodent TBI models have been studied, their collective results demonstrate evidence of lasting increases in neuroinflammation and cognitive deficits following TBIs during the adolescent period of brain development. One study conducted by Izzy et al. investigated the long term effects of

Cross-cutting methodological limitations

Interpretation of the existing literature is constrained by several methodological limitations. Inconsistent use of the terms “concussion” and “mTBI” complicates comparison across studies.41,42 Substantial variability in age at injury, follow-up duration, and testing batteries further limits synthesis of findings. Many studies rely on retrospective, cross sectional designs, or self-reported injury histories introducing recall bias. Additionally, there are a number of confounding variables

Clinical and public health implications

Given the high prevalence of pediatric concussion, even modest long-term effects may have important public health implications. Though current evidence is heterogenous and limited, there may be evidence that demonstrates that some children may experience persistent psychiatric or behavioral consequences.12,21 These potential findings underscore the importance of education and policy initiatives aimed at reducing concussion risk in youth sports and recreational activities, especially given the

Conclusion

The existing literature examining the long-term consequences of pediatric concussion yields inconsistent findings. While some investigations report neuropsychological or neurobiological alterations, these findings are not consistently replicated and frequently appear limited to subacute or early adult time points. Animal models help provide complementary evidence, suggesting that brain injury during critical periods of neurodevelopment can lead to lasting neuroinflammatory, cellular, and

Funding

This research received no external funding

CRediT authorship contribution statement

Rachael S. Mathew: Writing – review & editing, Writing – original draft, Project administration, Methodology, Investigation, Data curation, Conceptualization. Caitlin Segura: Methodology, Investigation, Data curation. Abigail Lemons: Writing – review & editing, Writing – original draft, Formal analysis. Alcy R. Torres: Supervision.

Declaration of competing interest

The authors declare that they have no known financial, personal, or professional conflicts of interest that could have appeared to influence the work reported in this paper.

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