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The Relationship between executive function and concussion symptom history in Brazilian professional mixed martial arts athletes


  • Gabrielle Barcelos Rio de Janeiro State University
  • Isabela Jessula Rio de Janeiro State University
  • Gustavo Apulcro Rio de Janeiro State University
  • Raquel Melo Rio de Janeiro State University
  • Matthew A. Stults-Kolehmainen Yale New Haven Hospital; Teachers College – Columbia University
  • Erin M. Barry Teachers College – Columbia University
  • Alberto Filgueiras Rio de Janeiro State University; University of Gloucestershire



concussion, cognition, executive function, mixed martial arts, professional athlete


Introduction: A concussion is a trauma caused by the impact of the brain against the skull, which can result in minor injuries with significant physiological and psychological consequences. Symptoms observed include sleep disturbance, vertigo, headache, and photophobia. In the psychological context, perturbations are observed, such as, depression and anxiety and altered mood. Changes in attention, concentration, language, and executive function (EF), which can be divided into working memory, inhibitory control, and cognitive flexibility.

Objective: The aim of this study was to investigate which executive functions are associated with concussions symptoms reported by mixed martial arts (MMA) athletes.

Method: The Five Points Test and the Trail Making Test were used to evaluate cognitive flexibility. Inhibitory control, solving problem, and working memory were evaluated using the Stroop Test, the Tower of Hanoi, and Digit Span tasks, respectively. Self-reported concussion symptom history was assessed using the Sport Concussion Assessment Tool (SCAT); athletes reported post-concussion symptoms for early and later phases. Tests were administered to 16 professional MMA athletes. A stepwise multiple linear regression was calculated to predict combined concussion symptom history using EF test scores as the independent variables.

Results: The Five Points Test, the Tower of Hanoi, and the Trail Making Tests were strongly related to concussion symptom history. The model explained 61.4% of the variance in symptom history. The strongest correlation between symptoms history and EF was with the Trail Making test (Part B).

Conclusion: Frontal regions of the brain are responsible for cognitive flexibility and problem solving. Therefore, it makes sense that these executive functions are two of the most affected as MMA athletes receive a large number of impacts in this area.


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2023-10-07 — Updated on 2023-10-19