Test-Retest Reliability of ImPACT Across a Two-Year Interval in Collegiate Athletes

Abstract Purpose To examine the two-year test-retest reliability of Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) in a sample of collegiate athletes. Methods A total of 163 college athletes (63.8% female) completed two pre-season baseline assessments two years apart as mandated by their athletic programs. Participants completed the first baseline prior to their first year of competition (M age=18.38, M edu=12.13). Individuals with baselines flagged as invalid by ImPACT were excluded. No diagnosed concussions occurred between baseline assessments. Results Pearson r correlations for ImPACT composite scores between assessments ranged from .32 to .70. Paired samples t-tests indicated significant differences between verbal memory (t(162)=-4.61, p<.001, MD=-3.6) and visual-motor speed (t(162)=-4.10, p<.001, MD=-1.5) at time 1 and time 2. Intraclass correlation coefficients (ICCs) with a “two-way mixed” model and “consistency” type indicated higher reliability for all composite scores. Visual-motor speed (mean ICC=.83; .76–.87 95% confidence interval [CI]) was the most reliable composite score, followed by visual memory (.66; 95% CI .53-.75), impulse control (.62; 95% CI .48–.72), verbal memory (.58; 95% CI .43–.69), and reaction time (.49; 95% CI .30-.62). The total symptom score showed moderate reliability (.63; 95% CI .50–.73). Conclusion Overall, ImPACT composite and total symptom scores appear to maintain relative long-term stability in a collegiate sample across a two-year period. ImPACT composite scores showed moderate to good reliability, and total symptom scores showed moderate reliability. Results of this study corroborate previous research indicating moderately stable ImPACT scores across a 2-year test-retest period in collegiate athletes (Schatz, 2010).

Download Full-text

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

Neurology ◽

10.1212/01.wnl.0000801956.01474.ba ◽

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.

Download Full-text

B-44 An Examination of Balance Measurements in Predicting Post-Concussion Neurocognitive Dysfunction

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.127 ◽

2019 ◽

Vol 34 (6) ◽

pp. 990-990

Author(s):

A DaCosta ◽

A Crane ◽

M Fasciana ◽

A LoGalbo

Keyword(s):

Reaction Time ◽

Verbal Memory ◽

Visual Memory ◽

Clinical Utility ◽

Collegiate Athletes ◽

Motor Speed ◽

Balance Performance ◽

Neurocognitive Dysfunction ◽

Balance Deficits ◽

Visual Motor

Abstract Objective Previous research indicates that athletes experiencing concussions demonstrate acute balance deficits (Guskiewicz, 2011). Although it is hypothesized that balance performance is related to neurocognitive function in athletes experiencing a concussion (Guskiewicz, Ross, & Marshall, 2001; Broglio, Sosnoff, Ferrara, 2009), limited research exists regarding the clinical utility of baseline measures. Method 68 collegiate athletes (ages 18-23; M = 19.62, SD = 1.44) were evaluated using the Balance error scoring system (BESS) and ImPACT at baseline and post-concussion. Multiple linear regressions were used to determine how BESS performance change across evaluations predicted post-concussion neurocognitive dysfunction compared to post-concussion performance alone. Results BESS performance changes from baseline to post-concussion significantly predicted post-concussion Verbal Memory (R² = .06, p = .05), Visual Memory (R² = .135, p = .002), Visual-Motor Speed (R² = .146, p = .001), Reaction Time (R² = .156, p = .001), and Total Symptom Scores (R² = .112, p = .005); while post-concussion BESS scores predicted Visual Memory (R² = .138, p = .002), Visual-Motor Speed (R² = .137, p = .002), and Reaction Time (R² = .145, p = .001). Therefore, assessing change in BESS performance is a more comprehensive predictor of neurocognitive dysfunction than solely post-concussion BESS performance. Conclusions Changes in BESS performance from baseline to post-concussion was found to be a more comprehensive predictor of neurocognitive dysfunction than post-concussion BESS scores alone. Therefore, our results support the clinical utility of evaluating balance at pre-participation to better understand neurocognitive risk factors.

Download Full-text

Variability in ImPACT Baseline Scores in Adolescent Athletes

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz026.49 ◽

2019 ◽

Vol 34 (5) ◽

pp. 779-779

Author(s):

R Bennett ◽

A Datoc ◽

L Stebbins ◽

L Lashley ◽

A Posey

Keyword(s):

Visual Memory ◽

Reliable Change Index ◽

Adolescent Athletes ◽

Retest Reliability ◽

Symptom Scores ◽

Composite Scores ◽

Test Retest Reliability ◽

The Impact ◽

One Way Anova ◽

Over Time

Abstract Purpose The purpose of this study was to observe the test-retest-reliability of adolescent athlete Baseline ImPACT scores over a one and two-year interval. Methods Participants were selected from an archival de-identified sports medicine ImPACT database in Florida. The sample (N=4,044) consisted of primarily male (62.2%), adolescent athletes aged (Mage= 15.45, SD=1.291). Athletes were included in the study if they completed an initial and follow-up baseline ImPACT between 2016 and 2019, and if they had no history of concussion. One-Way ANOVA was conducted to determine the relationship between overall mean composite and total symptom scores between baseline tests. Results One-Way ANOVA revealed Verbal Memory (F[2,4041])=16.231, p<.001), Visual Memory (F[2,4041])=23.528, p<.001), and Visual Motor (F[2,4041)=46.111, p<.001) composite scores significantly differed over time. While these results yielded statistical significance over time, further descriptive statistics showed that the mean differences for these composite scores did not fall outside of the ImPACT Reliable Change Index (RCI) criteria. Conclusion Assuming no significant physical or cognitive changes between baseline administrations, ImPACT composite and total symptom scores are expected to be consistent over time. Results indicate that ImPACT composite and total symptom scores are reliable in an adolescent sample across one and two-year time periods. Previous literature regarding test-retest reliability of composite and total symptom scores on ImPACT in youth and adolescent athletes has been inconsistent, which has caused researchers and clinicians to question the clinical utility of this assessment. Future research is needed to highlight the utilization of clinical judgement and clarify the psychometric properties of this measure.

Download Full-text

High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-51.2.12 ◽

2016 ◽

Vol 51 (2) ◽

pp. 136-141 ◽

Cited By ~ 17

Author(s):

Aimee Custer ◽

Alicia Sufrinko ◽

R. J. Elbin ◽

Tracey Covassin ◽

Micky Collins ◽

...

Keyword(s):

High School ◽

Verbal Memory ◽

Repeated Measures ◽

Visual Memory ◽

Collegiate Athletes ◽

Cognitive Test ◽

Symptom Scale ◽

Symptom Scores ◽

High Level ◽

Composite Scores

Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined.Context: To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC.Objective: Cohort study.Design: High school and collegiate athletic programs.Setting: A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0, n = 247) or a high level of baseline symptoms (PCSS score > 18 [top 10% of sample], n = 68).Patients or Other Participants: Participants were evaluated at baseline and 2 to 7 days after SRC with the Immediate Post-concussion Assessment and Cognitive Test and PCSS. Outcome measures were Immediate Post-concussion Assessment and Cognitive Test composite scores (verbal memory, visual memory, visual motor processing speed, and reaction time) and total symptom score on the PCSS. The groups were compared using repeated-measures analyses of variance with Bonferroni correction to assess interactions between group and time for symptoms and neurocognitive impairment.Main Outcome Measure(s): The no-symptoms group represented 38% of the original sample, whereas the high-symptoms group represented 11% of the sample. The high-symptoms group experienced a larger decline from preinjury to postinjury than the no-symptoms group in verbal (P = .03) and visual memory (P = .05). However, total concussion-symptom scores increased from preinjury to postinjury for the no-symptoms group (P = .001) but remained stable for the high-symptoms group.Results: Reported baseline symptoms may help identify athletes at risk for worse outcomes after SRC. Clinicians should examine baseline symptom levels to better identify patients for earlier referral and treatment for their injury. Additional investigation of baseline symptoms is warranted to help delineate the type and severity of premorbid symptoms.Conclusions:

Download Full-text

A-38 A Different Approach for Examining Gender Differences on Computerized Neurocognitive Testing: Percentile Ranks Versus Composite Scores

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa036.38 ◽

2020 ◽

Vol 35 (5) ◽

pp. 634-634

Author(s):

P Schatz ◽

K Slicer ◽

R J Elbin

Keyword(s):

Gender Differences ◽

Reaction Time ◽

Verbal Memory ◽

Visual Memory ◽

Motor Speed ◽

Age And Gender ◽

Visual Motor ◽

Gender Based ◽

And Gender ◽

Composite Scores

Abstract Objective ImPACT is a popular tool used to assess neurocognitive function after concussion. Age- and gender-based percentile ranks are provided as part of the ImPACT clinical report, but only raw composite scores are provided for research. Percentile ranks may provide an alternate look at gender differences on neurocognitive testing. We sought to compare the use of percentile ranks versus composite scores when comparing neurocognitive performance between male and females. Method Pre-season baseline data from 3,238 collegiate athletes were exported from a larger multi-site database, 1,714 male (53%) and 1,524 female (47%), ages 18–22 (Mean = 19.3, SD = 1.2). ImPACT composite scores were extracted (Verbal Memory, Visual Memory, Visual Motor Speed, Reaction Time) and Percentile Ranks were calculated using age- and gender-based reference tables in the ImPACT 2017–2012 Technical Manual. One-way analyses of variance (ANOVA) were conducted with gender as the IV and the four composite scores and their associated percentile ranks as the DVs. Bonferroni correction for 8 comparisons set the alpha level to p < .006. Results ANOVAs revealed a significant effect of gender on ImPACT Verbal Memory [F(1,3236) = 16.32, p < .001], Visual Memory [F(1,3236) = 66.06, p < .001], Visual Motor Speed [F(1,3236) = 15.61,p < .001] but not Reaction Time [F(1,3236) = 2.59, p = .11]. When using percentile ranks, ANOVAs revealed a significant effect of gender on only Visual Motor Speed [F(1,3236) = 31.07, p < .001], but not Verbal Memory [F(1,3236) = 2.43, p = .12], Visual Memory [F(1,3236) = 0.48, p = .49], or Reaction Time [F(1,3236) = 0.61, p = .44]. Conclusions Use of ImPACT Composite Scores in concussion research may exaggerate or inappropriately promote gender differences on computerized neurocognitive testing. Given that age- and gender-based normative data are available, use of percentile ranks is recommended.

Download Full-text

Baseline Neurocognitive Performance and Clearance for Athletes to Return to Contact

Journal of Athletic Training ◽

10.4085/1062-6050-51.12.27 ◽

2017 ◽

Vol 52 (1) ◽

pp. 51-57 ◽

Cited By ~ 2

Author(s):

Breton M. Asken ◽

James R. Clugston ◽

Aliyah R. Snyder ◽

Russell M. Bauer

Keyword(s):

Cognitive Decline ◽

Verbal Memory ◽

Visual Memory ◽

Sport Participation ◽

Collegiate Athletes ◽

Composite Score ◽

Cognitive Test ◽

Motor Speed ◽

Neurocognitive Performance ◽

Composite Scores

Context: Computerized neurocognitive assessments are commonly used to manage sport-related concussion. Variations in baseline performance may influence neurocognitive performance after injury as well as the amount of time needed for an athlete to be cleared for return to sport participation.Objective: To investigate the relationship between mean baseline Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) scores and postconcussion reliable decline as well as the association between postconcussion cognitive decline and days missed after injury.Design: Cross-sectional study.Setting: University concussion databank.Patients or Other Participants: A total of 84 collegiate athletes who sustained a concussion between 2008 and 2015 were studied. For each ImPACT composite score (verbal memory, visual memory, visual motor speed, reaction time), athletes were grouped based on the presence or absence of reliable decline and on the presence of reliable decline in 0, 1, 2, 3, or 4 cognitive domains.Main Outcome Measure(s): Outcome measures were baseline ImPACT composite scores and days missed due to concussion.Results: Athletes with a reliable decline in visual memory scored higher on baseline visual memory than did athletes with no decline or an improvement (t82 = −2.348, P = .021, d = 0.65). When comparing athletes who displayed a reliable decline with those who showed no change or an improvement in any composite score, days missed did not differ. The number of composite scores with a reliable decline demonstrated no main effect on days missed (P = .530).Conclusions: Athletes who exhibited cognitive decline in most or all of the composite scores did not miss more days after injury than athletes with a decline in fewer or none of the composite scores. Athletes should be educated regarding the lack of association between baseline neurocognitive scores and the presence or absence of a reliable decline after concussion, as well as the fact that, on average, individuals with a reliable decline across multiple domains did not miss more time after concussion.

Download Full-text

A-28 Updated Baselines Show Improvement, Even When Athletes Sustain A Concussion Between Assessments

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa036.28 ◽

2020 ◽

Vol 35 (5) ◽

pp. 624-624

Author(s):

S O'Connor ◽

T Dean ◽

P Schatz

Keyword(s):

Verbal Memory ◽

Visual Memory ◽

Motor Speed ◽

Change Scores ◽

Visual Motor ◽

Gender Based ◽

And Gender ◽

Percentile Scores ◽

Composite Scores

Abstract Objective To explore change across repeated baseline assessments using raw scores and percentile scores, for athletes sustaining and not sustaining a concussion between baselines. Method Athletes (12–23 years) completed two valid, baseline neurocognitive test sessions using ImPACT. Participants were divided into independent groups based on having sustained a concussion between annual baselines (CONCUSSION; N = 269) or no concussion (NO CONCUSSION; N = 270) between baselines. Raw change scores were calculated between the first and follow-up baseline for both groups by subtracting the first baseline score from the updated baseline score on the four ImPACT composite scores. Age- and gender-based percentile scores were then applied for all participants, and percentile change scores were calculated in the same manner. Raw change scores and percentile change scores between groups were compared using 4 ANOVAs with a Bonferroni-corrected p-value of (p < .0125). Results Using raw scores ANOVAs revealed that athletes in the CONCUSSION group showed significantly greater improvement on follow-up testing than athletes in the NO CONCUSSION group on Verbal Memory (p < .001) and Visual Motor Speed (p = .001), but not on Visual Memory (p = .41) and Reaction Time (p = .04). Using percentile ranks, ANOVAs revealed significantly greater improvement in CONCUSSION group on Verbal Memory (p < .001), but not on Visual Memory (p = .34), Visual Motor Speed (p = .03), or Reaction Time (p = .014). Conclusions Athletes sustaining a concussion between annual baseline assessments show increases on Verbal Memory and Visual Motor Speed follow-up testing when using raw composite scores, but only on Verbal Memory when using age- and gender-based percentile ranks.

Download Full-text

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00191 ◽

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.

Download Full-text

The stability of ImPACT baseline test performance over a 3-year period in high school athletes

Neurology ◽

10.1212/01.wnl.0000550636.18771.12 ◽

2018 ◽

Vol 91 (23 Supplement 1) ◽

pp. S7.2-S7

Author(s):

Nicholas Erdman ◽

Samuel Walton ◽

Jeremy Eith ◽

Lizzie Leitch ◽

Joanna Shutzer ◽

...

Keyword(s):

High School ◽

Verbal Memory ◽

Repeated Measures ◽

Visual Memory ◽

Intraclass Correlation ◽

Baseline Assessment ◽

Motor Speed ◽

Group Setting ◽

The Stability ◽

Subject Differences

PurposeAnnual baseline assessment using computerized neurocognitive tests have been recommended by governing healthcare bodies for the management of sport-related concussion but is supported by limited evidence. The current study examined the stability of ImPACT performance across three-successive years in adolescent athletes.MethodThis prospective cohort included 229 (117 male, 112 female) high school student-athletes from 2 private high schools. ImPACT was administered in a controlled group setting (1–17 participants) at years 1 (T1; n = 229), 2 (T2; n = 101) and 3 (T3; n = 47). Repeated measures analyses of variance (ANOVA 4 × 3) were used to examine performance on ImPACT's Verbal Memory (VEM), Visual Memory (VIS), Visual Motor Speed (VMS), and Reaction Time (RT) composite scores. Paired t-tests were used for post-hoc analyses. Two-way mixed intraclass correlation coefficients (ICC [3,1]) with 95% confidence intervals (CI) were calculated between time points. Group mean and within-subject differences between each time point for ImPACT scores were analyzed using manufacturer provided reliable change indices (RCI). All analyses were performed with alpha = 0.05.ResultsA significant main effect was observed for VMS (F [2,92] = 27.90, p = 0.001) across time. Participants significantly improved on VMS between T2 and T1 (t [100] = 4.15, p = 0.001), T3 and T2 (t [46] = 7.19, p = 0.001), and T3 and T1 (t [46] = 3.85, p < 0 .001). Weak (VEM: ICC = 0.37, CI = 0.19, 0.55) to strong (VMS: ICC = 0.83, CI = 0.74, 0.90) ICCs were observed for ImPACT scores. No group mean differences exceeded the 80% CI for ImPACT's RCI, although within-subject differences for at least 1 score exceeded the 80% CI between T2 and T1 (24%–39%), T3 and T2 (26%–45%), and T3 and T1 (32%–51%).ConclusionsOverall, statistically significant improvement was observed for VMS, however, the magnitude of the change may not be clinically meaningful. Similar to previous research, reliability of ImPACT scores ranged from weak to strong. Our results support annual baseline assessment of young athletes for progression of neurocognitive functioning.

Download Full-text

Exposure to Serial Post-Concussion Neurocognitive Testing Does not Affect Future “Updated” Baseline Neurocognitive Performance in Adolescent Athletes

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz026.27 ◽

2019 ◽

Vol 34 (5) ◽

pp. 757-757

Author(s):

S O'Connor ◽

T Dean ◽

R J Elbin ◽

P Schatz

Keyword(s):

Dose Response ◽

Visual Memory ◽

Impact Testing ◽

Motor Speed ◽

Neurocognitive Testing ◽

Symptom Scores ◽

Baseline Testing ◽

Visual Motor ◽

Response Groups ◽

The Impact

Abstract Purpose We investigated a dose response for serial post-concussion neurocognitive testing exposure on updated post-concussion baseline testing performance. Methods Athletes (13-18 yrs) that completed two, valid baseline neurocognitive testing (ImPACT) sessions approximately 1-3 years apart participated in this study. A sub-sample of athletes that sustained a SRC between baseline sessions were categorized into dose-response groups based on the number of serial, post-concussion neurocognitive tests completed following SRC: ONE (n=76), TWO (n=99), and THREE OR MORE (n=111). Athletes that did not sustain a SRC comprised the ZERO group (n=289). Change scores between the first to the second baseline were calculated for the ImPACT Composite and Symptom Scores and compared between the dose-response groups and controls with 5 ANOVAs, with a Bonferroni-corrected p-value of (p<.01). Baseline testing was administered using ImPACT stimuli within the “Baseline” administration, and all post-concussion ImPACT testing was administered using alternate-form associated with that specific post-injury assessment (Post-Injury1, Post-Injury2, etc). Results ANOVAs revealed no effect of number of post-concussion assessments (0, 1, 2, or 3+) on magnitude of the change between first and final baselines, for Verbal Memory (p=.08), Visual Memory (p=.96), Visual Motor Speed (p=.47), Reaction Time (p=.91), or Total Symptom Scores (p=.86). Conclusion Repeated exposure to neurocognitive testing has revealed improvements in Visual Motor Speed among normal controls, across test-retest intervals of 1-month, 1-year, and 2-years. However, in this study, exposure to post-concussion, serial neurocognitive testing had no effect on future performance on post-concussion baseline neurocognitive testing.

Download Full-text