Relationship between Postconcussion Headache and Neuropsychological Test Performance in High School Athletes

2003 ◽  
Vol 31 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Michael W. Collins ◽  
Melvin Field ◽  
Mark R. Lovell ◽  
Grant Iverson ◽  
Karen M. Johnston ◽  
...  
Keyword(s):  
High School ◽  
Test Performance ◽  
Neuropsychological Test ◽  
Anterograde Amnesia ◽  
Test Results ◽  
High School Athletes ◽  
Symptom Scale ◽  
Neurocognitive Test ◽  
Composite Scores ◽  
Study Participants

Background: The relevance of headache to outcome after sports-related concussion is poorly understood. Hypotheses: High school athletes reporting headache approximately 1 week after injury will have significantly more other concussion symptoms and will perform more poorly on neuropsychological tests than athletes not experiencing headache. Study Design: Prospective cohort study. Methods: Study participants included 109 high school athletes who had sustained concussion and who were divided into two groups: those reporting headache 7 days after injury and those reporting no headaches. The two groups were compared regarding on-field markers of concussion severity at the time of injury and symptoms and neurocognitive test results collected via ImPACT, a computerized neuropsychological test battery and postconcussion symptom scale, at a mean of 6.8 days after injury. Results: Athletes reporting posttraumatic headache demonstrated significantly worse performance on reaction time and memory ImPACT neurocognitive composite scores. These athletes also reported significantly more symptoms other than headache and were more likely to have demonstrated on-field anterograde amnesia. Conclusions: Findings suggest that any degree of postconcussion headache in high school athletes 7 days after injury is likely associated with an incomplete recovery after concussion.

scholarly journals Supervision and Computerized Neurocognitive Baseline Test Performance in High School Athletes: An Initial Investigation

2014 ◽  
Vol 49 (6) ◽  
pp. 800-805 ◽  
Author(s):  
Andrew Warren Kuhn ◽  
Gary S. Solomon
Keyword(s):  
High School ◽  
Confidence Interval ◽  
Test Performance ◽  
Sports Medicine ◽  
High School Athletes ◽  
Motor Processing ◽  
Baseline Testing ◽  
Baseline Test ◽  
Composite Scores ◽  
Visual Motor Processing

Context:Computerized neuropsychological testing batteries have provided a time-efficient and cost-efficient way to assess and manage the neurocognitive aspects of patients with sport-related concussion. These tests are straightforward and mostly self-guided, reducing the degree of clinician involvement required by traditional clinical neuropsychological paper-and-pencil tests.Objective:To determine if self-reported supervision status affected computerized neurocognitive baseline test performance in high school athletes.Design:Retrospective cohort study.Settings:Supervised testing took place in high school computer libraries or sports medicine clinics. Unsupervised testing took place at the participant's home or another location with computer access.Patients or Other Participants:From 2007 to 2012, high school athletes across middle Tennessee (n = 3771) completed computerized neurocognitive baseline testing (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]). They reported taking the test either supervised by a sports medicine professional or unsupervised. These athletes (n = 2140) were subjected to inclusion and exclusion criteria and then matched based on age, sex, and number of prior concussions.Main Outcome Measure(s):We extracted demographic and performance-based data from each de-identified baseline testing record. Paired t tests were performed between the self-reported supervised and unsupervised groups, comparing the following ImPACT baseline composite scores: verbal memory, visual memory, visual motor (processing) speed, reaction time, impulse control, and total symptom score. For differences that reached P < .05, the Cohen d was calculated to measure the effect size. Lastly, a χ2 analysis was conducted to compare the rate of invalid baseline testing between the groups. All statistical tests were performed at the 95% confidence interval level.Results:Self-reported supervised athletes demonstrated better visual motor (processing) speed (P = .004; 95% confidence interval [0.28, 1.52]; d = 0.12) and faster reaction time (P < .001; 95% confidence interval [−0.026, −0.014]; d = 0.21) composite scores than self-reported unsupervised athletes.Conclusions:Speed-based tasks were most affected by self-reported supervision status, although the effect sizes were relatively small. These data lend credence to the hypothesis that supervision status may be a factor in the evaluation of ImPACT baseline test scores.

Recovery from mild concussion in high school athletes

2003 ◽  
Vol 98 (2) ◽  
pp. 296-301 ◽  
Author(s):  
Mark R. Lovell ◽  
Michael W. Collins ◽  
Grant L. Iverson ◽  
Melvin Field ◽  
Joseph C. Maroon ◽  
...  
Keyword(s):  
High School ◽  
Mental Status ◽  
Test Performance ◽  
Neuropsychological Test ◽  
Return To Play ◽  
Control Group ◽  
High School Athletes ◽  
Post Injury ◽  
Content Type ◽  
Fine Print

Object. A computerized neuropsychological test battery was conducted to evaluate memory dysfunction and self-reporting of symptoms in a group of high school athletes who had suffered concussion. Methods. Neuropsychological performance prior to and following concussion was compared with the test performance of an age-matched control group. Potentially important diagnostic markers of concussion severity are discussed and linked to recovery within the 1st week of injury. Conclusions. High school athletes who had suffered mild concussion demonstrated significant declines in memory processes relative to a noninjured control group. Statistically significant differences between preseason and postinjury memory test results were still evident in the concussion group at 4 and 7 days postinjury. Self-reported neurological symptoms such as headache, dizziness, and nausea resolved by Day 4. Duration of on-field mental status changes such as retrograde amnesia and posttraumatic confusion was related to the presence of memory impairment at 36 hours and 4 and 7 days post-injury and was also related to slower resolution of self-reported symptoms. The results of this study suggest that caution should be exercised in returning high school athletes to the playing field following concussion. On-field mental status changes appear to have prognostic utility and should be taken into account when making return-to-play decisions following concussion. Athletes who exhibit on-field mental status changes for more than 5 minutes have longer-lasting postconcussion symptoms and memory decline.

scholarly journals A Comparative Meta-Analysis of the Effects of Concussion on a Computerized Neurocognitive Test and Self-Reported Symptoms

2017 ◽  
Vol 52 (9) ◽  
pp. 834-846 ◽  
Author(s):  
Bara Alsalaheen ◽  
Kayla Stockdale ◽  
Dana Pechumer ◽  
Steven P. Broglio ◽  
Gregory F. Marchetti
Keyword(s):  
Test Performance ◽  
Fixed Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Fixed Effects Model ◽  
Symptom Scale ◽  
Additional Information ◽  
Neurocognitive Test

Context:  Meta-analyses examining construct-specific cognitive impairment concurrently with self-reported symptoms postconcussion are sparse. Objective:  To review the literature on the effects of concussion on construct-specific neurocognitive declines and to compare them with self-reported symptoms before 1 week and between 1 and 3 weeks postconcussion. Data Sources:  Relevant studies in PubMed, CINAHL, and PsycINFO published from January 1, 1999 through November 30, 2015. Study Selection:  Studies were included if participants completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) before and after concussion and if test performance and Postconcussion Symptom Scale (PCSS) scores were reported at both times. Data Extraction:  After reviewing the full texts, we extracted data from 17 studies consisting of 29 independent samples; therefore, this meta-analysis consisted of 1777 unique participants. Data Synthesis:  The Hedges g effect size (ES) was estimated. A random-effects or fixed-effects model was used based on heterogeneity findings. When heterogeneity was present, we used meta-regression to assess unexplained between-studies variance. Within the first week of injury, the ESs were small to moderate for cognitive declines, ranging from −0.43 (95% confidence interval [CI] = −0.52, −0.35) to −0.67 (95% CI = −0.77, −0.58), and large for the PCSS score (Hedges g = −0.81; 95% CI = −0.91, −0.71). After 1 week, the ESs for cognitive declines (Hedges g range = −0.25 [95% CI = −0.35, −0.15] to −0.37 [95% CI = −0.55, −0.19]) and PCSS score (Hedges g = −0.38; 95% CI = −0.53, −0.22) were also small. Within 2 weeks of injury, PCSS score and time since injury weakly moderated the cognitive ES. Conclusions:  When a neurocognitive test was administered within 1 week of injury, the ES was larger for self-reported symptoms than for ImPACT scores generated at the same session. After 1 week of injury, the ESs for ImPACT and PCSS scores were comparable. If the athlete reports symptoms within 1 week of injury, administering a cognitive test does not appear to offer additional information to the clinician. However, if the athlete does not report symptoms postconcussion, cognitive testing may inform the clinical management of the injury.

BDNF and DISC1 are associated with cognitive dysfunction but not with schizophrenia in a hungarian sample

2011 ◽  
Vol 26 (S2) ◽  
pp. 805-805
Author(s):  
K. Farkas ◽  
J. Réthelyi ◽  
P. Polgár ◽  
J. Benkovits ◽  
Á. Fábián ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Candidate Genes ◽  
Psychotic Disorders ◽  
Disease Risk ◽  
Neuropsychological Test ◽  
Healthy Controls ◽  
Symptom Scale ◽  
Homogeneous Sample ◽  
Deficit Syndrome ◽  
Composite Scores

IntroductionPrevious studies have found association between several schizophrenia candidate genes and neurocognition in schizophrenia patients and healthy individuals. Both brain-derived neurotrophic factor (BDNF) and disrupted in schizophrenia 1 (DISC1) are important for neurodevelopmental processes and have been implicated as schizophrenia candidate genes, as well as genes influencing neurocognition.Objectives and aimsTo test for the previously described association of these genes with schizophrenia and neurocognition.MethodsDNA samples from a homogeneous sample of 280 schizophrenia patients and 230 healthy controls were genotyped for polymorphisms in schizophrenia candidate genes DISC1 (rs821597 and rs821616) and BDNF (rs6265). Clinical assessment was performed using the Schedule for Deficit Syndrome and the Positive and Negative Symptom Scale. Neurocognitive functioning was assessed in a subsample of 263 patients and 135 healthy controls by a comprehensive neuropsychological test-battery. Based on the raw neuropsychological measures we calculated a global index of cognitive impairment and domain-specific composite z-scores. Association between the above composite scores and the SNPs was examined using GLM and GENMOD analysis.ResultsThe investigated SNPs were not associated with schizophrenia, nor with the deficit or non-deficit subgroups. However we found significant association between global cognitive impairment and rs821616 in DISC1 (F = 3.02, p = 0.05) and rs6265 in BDNF (F = 4.47, p = 0.01); moreover rs6265 was associated with working memory (F = 6.22, p = 0.002) and attention (F = 7.27, p = 0.0074)ConclusionUsing neurocognition as an endophenotype for psychotic disorders in genetic studies has the potential to determine common and separate genetic factors influencing disease risk and neurocognition.

scholarly journals Age-Related Differences in Neuropsychological Testing Among High School Athletes

2009 ◽  
Vol 44 (4) ◽  
pp. 405-409 ◽  
Author(s):  
Tamerah N. Hunt ◽  
Michael S. Ferrara
Keyword(s):  
High School ◽  
Test Scores ◽  
Neuropsychological Tests ◽  
Neuropsychological Test ◽  
Trail Making Test ◽  
High School Athletes ◽  
Neuropsychological Test Battery ◽  
9Th Grade ◽  
Trail Making ◽  
Baseline Testing

Abstract Clinicians have questioned the need to obtain annual baseline neuropsychological tests in high school athletes. If no difference among academic grades exists, annual baseline testing may not be necessary.Context: To examine differences at baseline testing on pencil-and-paper neuropsychological tests among grade levels in high school athletes.Objective: Cross-sectional, between-groups design.Design: Schools participating in a Georgia high school athletics association.Setting: High school football players (n  =  198) in the 9th through 12th grades, with a mean age of 15.78 ± 1.16 years.Patients or Other Participants: Participants were divided into 4 groups by grade and were administered a symptom checklist and brief neuropsychological test battery. Grade level served as the independent variable. Symptom and individual test scores within the neuropsychological test battery served as dependent variables.Main Outcome Measure(s): Differences were noted among grades on the Trail Making Test A (F3,194  =  3.23, P  =  .024, η2  =  0.048), Trail Making Test B (F3,194  =  3.93, P  =  .009, η2  =  0.057), Symbol Digit Modalities Test (F3,194  =  4.38, P  =  .005, η2  =  0.064), dominant tap (F3,194  =  3.14, P  =  .026, η2  =  0.046), and nondominant tap (F3,194  =  4.902, P  =  .003, η2  =  0.070). Using the Bonferroni correction (P ≤ .00625), we found differences between the 9th grade and 11th and 12th grades.Results: Baseline neuropsychological test scores in high school athletes improved as a function of age, with differences between the 9th grade and 11th and 12th grades. Because the differences were driven by 9th-grade test scores, baseline testing should be completed, at minimum, upon entrance into 9th and 10th grades; however, annual testing is still recommended until additional research is conducted.Conclusions:

Comparison of neuropsychological test scores of high school athletes in high and low contact sports: A replication study

2016 ◽  
Vol 7 (1) ◽  
pp. 14-20 ◽  
Author(s):  
William T. Tsushima ◽  
Andrea M. Siu ◽  
Nozomi Yamashita ◽  
Ross S. Oshiro ◽  
Nathan M. Murata
Keyword(s):  
High School ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Replication Study ◽  
High School Athletes ◽  
Contact Sports

scholarly journals An Examination of Adolescent Athletes and Nonathletes on Baseline Neuropsychological Test Scores

2018 ◽  
Vol 53 (4) ◽  
pp. 404-409 ◽  
Author(s):  
Christopher P. Tomczyk ◽  
Megan Mormile ◽  
Megan S. Wittenberg; ◽  
Jody L. Langdon ◽  
Tamerah N. Hunt
Keyword(s):  
High School ◽  
High School Students ◽  
High Schools ◽  
Reaction Time ◽  
Verbal Memory ◽  
Visual Memory ◽  
Neuropsychological Test ◽  
Test Battery ◽  
Cognitive Test ◽  
High School Athletes

Context:  An estimated 15.3 million adolescent students are enrolled in US high schools, with approximately 7.8 million participating in athletics. Researchers have examined various demographics in high school athletes; however, athletic participation may play a larger role in test performance than previously thought. Currently, investigations of concussion assessment may rely on uninjured athletes as controls. However, due to the intense nature of athletics, this may not be an appropriate practice. Objective:  To examine differences between athletes and nonathletes using a common computerized neuropsychological test. Design:  Retrospective cross-sectional study. Setting:  High schools from a school district in Columbus, Ohio. Patients or Other Participants:  A total of 662 adolescent high school students (athletes: n = 383, female n = 18; nonathletes: n = 279, female n = 193). Main Outcome Measure(s):  Participants were administered a computerized neuropsychological test battery (Immediate Post-Concussion Assessment and Cognitive Test [ImPACT]) during baseline concussion assessment. Differences between groups were established for output composite scores. Results:  Differences were found between athletes and nonathletes in composite reaction time (F1,522 = 14.855, P < .001) and total symptom score (F1,427 = 33.770, P < .001). Nonathletes reported more symptoms, whereas athletes had faster reaction times. No differences were present in composite verbal memory, composite visual memory, composite visual motor speed, or composite impulse control (P > .05). Conclusions:  Symptom reporting and reaction time differed between high school athletes and nonathletes. Participation in extracurricular activities may lead to cognitive differences in adolescents that can influence performance on the Immediate Post-Concussion Assessment and Cognitive Test battery. Researchers should account for these differences in baseline performance when making concussion diagnostic and management decisions.

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