scholarly journals Self-Reported History of Seizure, Baseline Neurocognitive Performance, and Symptoms Reported in High School Athletes

2019 ◽  
Vol 34 (5) ◽  
pp. 777-777
Author(s):  
A Datoc ◽  
L Lashley
Keyword(s):  
High School ◽  
Visual Memory ◽  
Cognitive Testing ◽  
Group Differences ◽  
Motor Speed ◽  
Neurocognitive Performance ◽  
High School Athletes ◽  
History Of ◽  
Visual Motor ◽  
Literature Highlight

Abstract Purpose To examine whether a self-reported history of seizure is associated with differences in baseline neurocognitive performance and total reported symptoms. Methods Data was derived from a de-identified Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) database of high school athletes in Florida. After inclusion and exclusion criteria were applied, athletes were separated into groups dependent on self-reported history of seizure. 260 athletes (Mage=15.49, SD=1.26; 57.1% male) reported a history of seizure, and 260 athletes were randomly selected from those with no such history (Mage=15.64, SD=1.22; 61.1% male). Results ANOVA (alpha=.05) revealed significant differences between groups on the visual memory composite (F[1,559]=4.915, p=.027) and total symptom score (F[1,559]=28.596, p<.001) at baseline. Athletes with a self-reported history of seizure performed significantly worse than athletes without on visual memory and reported significantly higher total symptom scores. No significant between-group differences were found on the other composites of ImPACT. Conclusion The association between seizure history and decreased neurocognitive performance has been documented in the neuropsychological literature, and may be explained by differences at a microstructural level such as differences in white matter integrity (Yassine et al., 2018). While these microstructural differences have implications on cognitive functioning and symptomatology, the present study surprisingly found comparable scores between athletes with a history of seizure and those without. Previous researchers published similar findings; however, differences were observed on the visual-motor speed composite of ImPACT (Zalneraitis et al., 2017). The inconsistencies and small effect sizes in the present literature highlight the need for investigators to determine the clinical significance of these results in concussion evaluations.

scholarly journals THE RELATIONSHIP BETWEEN ACUTE MOOD, SLEEP, AND SEX ON NEUROCOGNITIVE PERFORMANCE POST-CONCUSSION IN ADOLESCENTS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0019
Author(s):  
Sara Stremlau ◽  
Richard Cameron Allred ◽  
Richard Gerkin ◽  
Steven Erickson ◽  
Jamie Pardini
Keyword(s):  
Reaction Time ◽  
Verbal Memory ◽  
Visual Memory ◽  
Cognitive Testing ◽  
Motor Speed ◽  
Neurocognitive Performance ◽  
Symptom Report ◽  
Mood Symptoms ◽  
Visual Motor ◽  
And Performance

Background: Both sleep disturbance and mood changes are common symptoms post-concussion (Sell & Rubeor, 2017). Studies have found these symptoms are correlated with poorer performance on neurocognitive testing (Kontos et al., 2012 and Kostyun et al., 2015). In addition, Brown et al., (2015) showed that females report more symptoms at both baseline and post-concussion compared to males on the Post-Concussion Scale and the Sport Concussion Assessment Tool 2. Hypothesis/Purpose: The purpose of this study is to investigate how a patient’s sex, as well as self-reported acute mood and sleep symptoms are related to neurocognitive performance in individuals with concussion. Methods: Data were acquired through IRB-approved retrospective chart review. Composite scores from the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computerized evaluation and self-reported symptom scores on the Post-Concussion Symptom Scale were gathered for 1619 adolescents age 12-18 (49.3% female) who presented to a large metropolitan outpatient clinic for treatment of concussion. Results: Females endorsed higher overall symptoms (x=19.52, SD 19.37, median 13.0 for females; x=12.88, SD 15.89, median 7.0 for males; Mann-Whitney U Test p<0.001). This same pattern emerged for the mood and sleep symptom clusters (female mood mean=2.92, SD 4.51; male mood mean=1.64, SD 3.34; female sleep mean=1.59, SD 2.0; male sleep mean=1.11, SD 1.84; both Independent Samples Mann-Whitney U Tests ps<0.001). There were significant but modest negative correlations between mood symptoms and performance on verbal memory (r=-0.174), visual memory (r=-0.213), and visual motor speed (r=-0.146) composites (all ps<0.01). There was positive correlation between reaction time composite and mood symptoms (r=0.191). There were significant but modest negative correlations between sleep symptoms and performance on verbal memory (r=-0.171), visual memory (r=-0.184), and visual motor speed (r=-0.161) composites (all ps<0.01). There was a positive correlation between reaction time composite and sleep symptoms (r=0.196, p<0.01). Conclusion: Consistent with prior research, adolescent females reported more symptoms post-concussion, including total symptom score, mood symptoms, and sleep symptoms. Adolescents presenting with more mood and sleep symptoms demonstrated poorer performance on neurocognitive testing. However, given the modest nature of the correlation, a significant amount of variation in test performance is not explained by symptom report. Results from this study underscore the importance of a multidimensional concussion assessment that includes both symptom report and cognitive testing when working with pediatric athletes. This study also reinforces the importance of understanding potential effects of sleep, mood, and sex on concussion.

The Effect of Test Setting Upon Test-Retest Reliability of ImPACT Baseline Tests in High School Athletes

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S23.2-S23
Author(s):  
Mark Thomas William Roberts ◽  
Jonathan Danield Lichtenstein
Keyword(s):  
High School ◽  
Reaction Time ◽  
Verbal Memory ◽  
Visual Memory ◽  
Motor Speed ◽  
High School Athletes ◽  
Retest Reliability ◽  
Concussion Management ◽  
Visual Motor ◽  
Test Retest Reliability

ObjectiveTo determine the test-retest reliability of ImPACT baseline tests across different schools within the same larger concussion management program.BackgroundImPACT is the most widely used concussion management cognitive testing tool. Baseline testing is often required for high school sports participation. Typically, testing occurs every 2 years based on test-retest reliability statistics in previous studies. Demographic and environmental factors, such as age, sex, number of participants, and supervision, all impact baseline performance. Studies to date have not examined test-retest differences across testing sites, such as between school differences.Design/MethodsCross-sectional retrospective design. Valid baseline tests from high school athletes over a 2-year interval were included. Participants who experienced concussions prior to or between tests were excluded. A total of 979 student athletes from 5 schools were included. The Intra-class correlations were determined over a 2-year period for each ImPACT composite score and school.ResultsICC estimates averaged between schools reflected good reliability for visual-motor speed (0.833), visual memory (0.673) and reaction time (0.615) over the two-year period. Verbal memory (0.586) and impulse control (0.556) were less reliable. Between schools a greater range of composite reliability was observed for reaction time (0.484–0.730) and impulse control (0.461–0.655) compared to verbal memory (0.534–0.637), visual memory (0.61–0.719), and visual-motor speed (0.769–914).ConclusionsAs previously established, reliability of ImPACT baselines vary by composite. This study revealed that reliability also varies by setting, as different schools yielded different ICCs. Consistent with the literature, the most reliable measure was visual-motor speed. The greatest difference in reliability between schools was for reaction time. These results suggest that test setting and environment affect reliability of ImPACT baseline scores, with varying effects per composite. Attention must be paid to environmental setting to improve reliability of baseline cognitive test performance to maximize athlete safety.

A-120 Comparison of Baseline and Post-Concussion ImPACT Performance in Spanish-English Bilingual and English Monolingual Athletes

2021 ◽  
Vol 36 (6) ◽  
pp. 1170-1170
Author(s):  
Erick Rogers ◽  
Hana Kuwabara ◽  
Grace Goodwin ◽  
Sara Moore ◽  
Nia Hopkins ◽  
...  
Keyword(s):  
Reaction Time ◽  
Visual Memory ◽  
Cognitive Testing ◽  
English Speakers ◽  
Future Research ◽  
Motor Speed ◽  
Linear Modeling ◽  
Impact Performance ◽  
Sport Type ◽  
Visual Motor

Abstract Objective Research comparing English and Spanish administrations of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) have consistently found differences in performance on various cognitive composites. Few studies have examined the effect of bilingualism on baseline and post-concussion assessments. This study examined whether monolingual English-speakers (MO) and bilingual Spanish/English speakers (BI) differed in cognitive performance at baseline (BL) and post-concussion (PC). Methods Participants were selected from a larger database of high school athletes administered ImPACT in English at BL and PC. Participants included 86 BI athletes (Mage = 14.53; 65.10% male) and 86 MO athletes matched on age, gender, sport type, and probable concussion as defined by number of PC follow-up assessments (PCF; 0 vs. ≥1). To examine group differences and changes over time in cognitive composites, a general linear modeling approach was used with language and PCF as between-subjects factors and time as a within-subjects factor. Results There was a significant Language x Time x PCF interaction for Visual Memory (VM), Visual Motor Speed (VMS), and Reaction Time (RT). On VM and RT, MO with multiple PCF performed the worst at PC, while MO with 0 PCF performed the best at PC. On VMS, BI with 0 PCF performed the worst at BL. Conclusion Visual memory and reaction time were less affected in bilingual compared to monolingual athletes with probable concussion. However, at baseline, bilingual athletes had slower visual motor speed compared to monolingual athletes. Future research should focus on how bilingualism may serve as both a protective and risk factor for cognitive functioning after probable concussion.

One-Year Test-Retest Reliability of the Online Version of ImPACT in High School Athletes

2011 ◽  
Vol 39 (11) ◽  
pp. 2319-2324 ◽  
Author(s):  
R.J. Elbin ◽  
Philip Schatz ◽  
Tracey Covassin
Keyword(s):  
High School ◽  
Verbal Memory ◽  
Visual Memory ◽  
Online Version ◽  
Neurocognitive Performance ◽  
High School Athletes ◽  
Stable Measure ◽  
Motor Processing ◽  
Test Retest Reliability ◽  
The Impact

Background: The ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) neurocognitive testing battery is a popular assessment tool used for concussion management. The stability of the baseline neurocognitive assessment is important for accurate comparisons between postconcussion and baseline neurocognitive performance. Psychometric properties of the recently released online version of ImPACT have yet to be established; therefore, research evaluating the reliability of this measure is warranted. Purpose: The authors investigated the 1-year test-retest reliability of the ImPACT online version in a sample of high school athletes. Study Design: Case series; Level of evidence, 4 Methods: A total of 369 varsity high school athletes completed 2 mandatory preseason baseline cognitive assessments approximately 1 year apart as required by their respective athletics program. No diagnosed concussion occurred between assessments. Results: Intraclass correlation coefficients (ICCs) for ImPACT online indicated that motor processing speed (.85) was the most stable composite score, followed by reaction time (.76), visual memory (.70), and verbal memory (.62). Unbiased estimates of reliability were consistent with ICCs: motor processing speed (.85), reaction time (.76), visual memory (.71), and verbal memory (.62). Conclusion: The online ImPACT baseline is a stable measure of neurocognitive performance across a 1-year time period for high school athletes. These reliability data for online ImPACT are higher than the 2-year ICCs previously reported from the desktop version. Clinical Relevance: It is recommended that the ImPACT baseline assessment (both desktop and online) continue to be updated every 2 years. The online version of ImPACT appears to be a stable measure of neurocognitive performance over a 1-year period, and systematic evaluation of its stability over a 2-year period is warranted.

A - 08 Within Subjects Comparison of Clinical Outcomes After First, Second, and Third Concussions in Adolescents*

2021 ◽  
Vol 36 (4) ◽  
pp. 648-648
Author(s):  
Feder AH ◽  
French J ◽  
Blaney N ◽  
Eagle SR ◽  
Kontos AP
Keyword(s):  
Clinical Outcomes ◽  
Verbal Memory ◽  
Visual Memory ◽  
Recovery Time ◽  
Cognitive Test ◽  
Motor Speed ◽  
Neurocognitive Performance ◽  
Symptom Scale ◽  
Visual Motor ◽  
Improved Performance

Abstract Objective The objective of the current study was to examine differences in clinical outcomes between adolescents’ first, second, and third concussions. Methods We conducted a retrospective medical chart review of adolescents (n = 40) aged 10–19 years-old (M = 13.0;SD = 1.9;56% male) who presented for evaluation of concussion at a specialty clinic for their first (Concussion 1 = C1), second (C2), and third (C3) concussions. Clinical outcomes included Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Post-Concussion Symptom Scale (PCSS), Vestibular/Ocular-Motor Screening (VOMS) scores from the first clinic visit for each injury, recovery time, and days between injuries. Paired samples t-tests were conducted to compare outcomes between concussions. Results When comparing initial presentation between C1 and C2, participants demonstrated no significant differences in ImPACT, PCSS (t[38] = 0.85, p = 0.402) or VOMS (t[34] = −0.75, p = 0.461), with the exception of faster Visual Motor Speed for C2 (t[38] = −3.45, p = 0.001). Participants demonstrated improved performance from C1 to C3 on ImPACT composites of Verbal Memory (t[38] = −4.22, p &lt; 0.001), Visual Memory (t[38] = −2.99, p = 0.005), Visual Motor Speed (t[38] = −5.14, p &lt; 0.001) and Reaction Time (t[38] = 0.11, p = 0.001). Symptom report was consistent on PCSS (t[38] = 1.80, p = 0.081) and VOMS (t[30] = −0.12, p = 0.903) between C1 and C3. Recovery time was similar comparing C1 to C2 (t[36] = −0.35,p = 0.725) and C1 to C3 (t[34] = 1.74,p = 0.090). Conclusions The results suggest adolescents demonstrate similar levels of symptoms, VOMS, and recovery time after first, second, and third concussions. Neurocognitive performance improved across C1 to C3, suggesting possible learning effect or improved performance with cognitive development. These results provide additional support for similarity between an athlete’s first and second concussion with further initial evidence that a third concussion does not result in worse outcomes.

scholarly journals Acute Stimulant Ingestion and Neurocognitive Performance in Healthy Participants

2015 ◽  
Vol 50 (5) ◽  
pp. 453-459 ◽  
Author(s):  
Michael E. Powers
Keyword(s):  
Reaction Time ◽  
Attention Deficit Disorder ◽  
Visual Processing ◽  
Visual Memory ◽  
Efficiency Index ◽  
Cognitive Testing ◽  
Motor Speed ◽  
Neurocognitive Performance ◽  
Cognitive Efficiency ◽  
And Control

Context Concussion management has become an area of great concern in athletics, and neurocognitive tests, such as Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), are commonly used as management tools. Given the restrictive nature of current management plans, anecdotal concerns have been raised about athletes trying to cheat the assessments and return to participation sooner. Stimulants have been shown to improve neurocognitive measures similar to those used in ImPACT. Therefore, they could possibly improve performance during baseline and postinjury testing. Objective To examine the effects of a supplement containing stimulants on ImPACT performance. Design Crossover study. Setting Research laboratory. Patients or Other Participants A total of 5 men (age = 20.6 ± 1.5 years, height = 176.3 ± 9.6 cm, mass = 76.9 ± 18.6 kg) and 7 women (age = 20.6 ± 1.1 years, height = 162.9 ± 7.8 cm, mass = 60.9 ± 8.2 kg) with no histories of physician-diagnosed head injury, learning disability, or attention-deficit disorder. Intervention(s) Participants were assessed under supplement (5.5 g of Jacked 3D, which contains caffeine and 1,3-dimethylamylamine), placebo, and control conditions separated by 1 week. Main Outcome Measure(s) I compared ImPACT composite scores for verbal and visual memory, visual motor speed, reaction time, impulse control, and a cognitive-efficiency index under each of the 3 conditions and assessed them 30 minutes after ingestion. Results I observed a difference when comparing reaction times, as the participants reacted faster during the supplement condition (0.53 ± 0.03 seconds) than during the placebo (0.55 ± 0.03 seconds) and control (0.55 ± 0.03 seconds) conditions (F2,22 = 4.31, P = .03). A difference also was observed for the cognitive-efficiency index, as participants scored higher during the supplement condition (0.49 ± 0.09) than during the placebo (0.41 ± 0.10) and control (0.41 ± 0.12) conditions (F2,22 = 4.07, P = .03). Conclusions Stimulant ingestion 30 minutes before testing resulted in improved memory, visual processing speed, and reaction time. However, the improvements were relatively nominal, and the question of clinical importance remains. Thus, it is unclear if stimulant ingestion would affect the return-to-participation progression.

scholarly journals Correlations between qEEG volumetric analysis and computerized cognitive testing shortly after sport concussion injury in high school athletes

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S1.3-S2
Author(s):  
Harry Kerasidis ◽  
Paul David Ims ◽  
Stacie Rector
Keyword(s):  
High School ◽  
Pearson Correlation ◽  
Performance Testing ◽  
Volumetric Analysis ◽  
Cognitive Testing ◽  
Sentence Completion ◽  
Neurocognitive Performance ◽  
High School Athletes ◽  
Compensatory Mechanisms ◽  
Emotional Recognition

ObjectiveTo evaluate correlations between sLORETA quantitative electroencephalogram (qEEG) analysis and a computerized symptom and neurocognitive performance assessment.BackgroundWe previously reported results of sLORETA qEEG deregulation in recently concussed high school athletes. Correlations between this deregulation and concussion symptoms and neurocognitive performance have not been described in this population.Design/MethodsEEGs were analyzed in 61 high school athletes shortly after concussion injury using sLORETA imaging compared to a normative database (NYU/BrainDx). Concussion related symptoms and neurocognitive performance were assessed (XLNTbrain). Peak Z-score variation (PZV), and %volume of grey matter activity falling outside Z = −2.5 to 2.5 were calculated for 5 EEG frequency bands. Pearson correlation coefficients were calculated between the qEEG findings and the cognitive performance testing. Statistical comparisons were made between athletes endorsing high symptom scores vs. low scores.ResultsStatistically significant positive correlations were observed between performance on verbal go/nogo, emotional recognition of happy and angry faces and volume and severity of sLORETA deregulation suggesting a pathological relationship. This deregulation consisted primarily of deficient activity in the delta, theta, beta, and beta-gamma bands. Significant negative correlations were observed between performance on nonverbal go/nogo, emotional recognition of angry faces, motor tapping, sentence completion, facial recognition, and word recognition and volume and severity of sLORETA deregulation suggesting compensatory mechanisms. This deregulation consisted primarily of excess activity in the alpha and theta bands. Elevated scores for migraine, worry, and mood were associated with increased severity and volume of increased activity in the beta and beta-gamma bands. Athletes with elevated vestibular symptoms had lower theta band deregulation.ConclusionsThis study demonstrates correlations between performance on computerized neurocognitive tasks and changes in sLORETA qEEG analysis shortly after concussion injury in high school athletes. The data suggest some of these changes are pathological, while others are compensatory.

scholarly journals A-110 Are Invalid Baselines More Frequent in those with Concussion History?

2020 ◽  
Vol 35 (6) ◽  
pp. 903-903
Author(s):  
Maietta J ◽  
Hopkins N ◽  
Maietta L ◽  
Flood S ◽  
Johnson L ◽  
...  
Keyword(s):  
High School ◽  
Test Performance ◽  
Impact Testing ◽  
Cognitive Testing ◽  
Return To Play ◽  
Future Research ◽  
High School Athletes ◽  
History Of ◽  
Concussion History ◽  
The Impact

Abstract Objective The Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) is a commonly utilized measure for sports concussion. Across the literature we have reviewed there is an abundance of information that focuses on invalid baselines and the effects of concussions. Yet, no previous studies have investigated the effect of a history of concussion on frequency of invalid baselines. The current study examined these effects within high school athletes. Methods Participants included 47,874 high school athletes (mean age = 15.0, SD = 1.2; mean education = 9.0; SD = 1.5; 42.6% female). These athletes were selected from a larger database of athletes who completed baseline ImPACT testing from 2008–2016. Self-reported history of concussion (none vs. 1+) was obtained from the demographic section of the ImPACT. Invalid performance was based on standard ImPACT criteria (“Baseline++”). Results Chi-square tests of homogeneity were performed to assess differences in invalid baselines between those with and without a history of concussion. Results revealed significantly more invalid baselines for those with a history of concussion (p &lt; .01). Conclusions Results indicate that high school athletes with a self-reported history of concussion may be more likely to have invalid baseline test performance. Based on these preliminary results, clinicians who are managing return-to-play decisions may want to take into account concussion history when interpreting baseline data. Future research should, of course, investigate whether this result is consistent in other samples and, if so, whether alternative validity criteria may be needed. Future investigations of athletes with confirmed clinical diagnosis of concussion is an important next step in investigating differences in rates of invalid baselines.

scholarly journals Motion Sickness Susceptibility and Baseline Vestibular and Ocular-Motor Performance in Adolescent Athletes

2019 ◽  
Vol 54 (9) ◽  
pp. 939-944 ◽  
Author(s):  
R. J. Elbin ◽  
Anthony P. Kontos ◽  
Alicia Sufrinko ◽  
Mallory McElroy ◽  
Katie Stephenson-Brown ◽  
...  
Keyword(s):  
High School ◽  
Motion Sickness ◽  
Short Form ◽  
Ocular Motor ◽  
Neurocognitive Performance ◽  
High School Athletes ◽  
Symptom Scale ◽  
Convenience Sample ◽  
Symptom Scores ◽  
History Of

Context High school athletes with a history of motion sickness susceptibility exhibit higher baseline vestibular and ocular-motor scores than those without a history of motion sickness susceptibility. Objective To examine the effects of motion sickness susceptibility on baseline vestibular and ocular-motor functioning, neurocognitive performance, and symptom scores. Design Cross-sectional study. Setting Preseason concussion testing. Patients or Other Participants A convenience sample of high school athletes (N = 308, age = 15.13 ± 1.21 years) involved in a variety of sports. Main Outcome Measure(s) Vestibular/Ocular Motor Screening, computerized neurocognitive assessment, symptom scale, and Motion Sickness Susceptibility Questionnaire-Short Form (MSSQ-S). Results Participants were categorized into 3 groups based on a median split of the scores (eg, NONE, LOW, and HIGH). The LOW (n = 95) and HIGH (n = 92) groups (ie, MSSQ-S score &gt; 0) were 2.64 times more likely (χ21,257 = 7.94, P = .01, 95% confidence interval = 1.32, 5.26) to have baseline Vestibular/Ocular Motor Screening scores larger than the clinical cutoffs for the NONE group (n = 70). No between-groups main effects were present for the NONE (n = 52), LOW (n = 89), and HIGH (n = 90) MSSQ-S groups for verbal (F2,230 = .09, P = .91, η2 = .001) and visual (F2,230 = .15, P = .86, η2 = .001) memory, processing speed (F2,230 = .78, P = .46, η2 = .007), or reaction time (F2,230 = 2.21, P = .11, η2 = .002). The HIGH group exhibited higher total baseline symptom scores than the LOW (U = 3325.50, z = −1.99, P = .05, r = .15) and NONE (U = 1647.50, z = −2.83, P = .005, r = .24) groups. Conclusions Motion sickness should be considered a preexisting risk factor that might influence specific domains of the baseline concussion assessment and postinjury management.

scholarly journals Do Sideline Concussion Assessments Predict Subsequent Neurocognitive Impairment After Sport-Related Concussion?

2017 ◽  
Vol 52 (7) ◽  
pp. 676-681 ◽  
Author(s):  
Alicia Sufrinko ◽  
Jamie McAllister-Deitrick ◽  
Melissa Womble ◽  
Anthony Kontos
Keyword(s):  
High School ◽  
Verbal Memory ◽  
Visual Memory ◽  
Standard Of Care ◽  
Cognitive Testing ◽  
Assessment Tools ◽  
Motor Speed ◽  
Neurocognitive Testing ◽  
Symptom Scale ◽  
The Impact

Context:  Comprehensive, multidomain assessment is the standard of care after sport-related concussion. However, the relationship between performance on sideline concussion-assessment tools and in-office computerized neurocognitive testing has received little attention, and the prognostic utility of sideline measures is unknown. Objective:  To evaluate concurrent impairment on commonly used concussion measures 24 to 48 hours postinjury while also determining the predictive utility of sideline measures on computerized neurocognitive testing in the acute to subacute recovery periods postinjury. Design:  Case-control study. Setting:  High school and collegiate athletics. Patients or Other Participants:  A total of 125 high school and college-aged athletes (85 males, 40 females) 14 to 23 (16.8 ± 2.21) years old. Main Outcome Measure(s):  Participants were administered sideline concussion-assessment measures (ie, Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT], Standardized Assessment of Concussion [SAC], and Balance Error Scoring System [BESS]) 24 to 48 hours postinjury and completed ImPACT and the Post-Concussion Symptom Scale 5 to 7 and 10 to 14 days postinjury. Outcome measures were the ImPACT composite (verbal memory, visual memory, reaction time, visual-motor speed), SAC, and BESS scores and total symptom score on the Post-Concussion Symptom Scale. Results:  Participants demonstrated heterogeneous patterns of impairment on measures 24 to 48 hours postinjury, with the most common pattern being impairment on ImPACT and the SAC. Performance on the SAC and BESS at 24 to 48 hours after injury did not distinguish between those with and those without impairment on ImPACT at 5 to 7 days postinjury (χ2 = 5.076, P = .079) or 10 to 14 days postinjury (χ2 = 2.04, P = .361). Conclusions:  More than 90% of athletes were impaired on at least 1 sideline or neurocognitive measure 24 to 48 hours after sport-related concussion. Although sideline measures are useful for concussion diagnosis, they are not suitable for prognostication of impairment or the presence of symptoms 1 to 2 weeks postinjury.

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