Relationship Between the King-Devick Test and Commonly Used Concussion Tests at Baseline

Context Comprehensive assessments are recommended to evaluate sport-related concussion (SRC). The degree to which the King-Devick (KD) test adds novel information to an SRC evaluation is unknown. Objective To describe relationships at baseline among the KD and other SRC assessments and explore whether the KD provides unique information to a multimodal baseline concussion assessment. Design Cross-sectional study. Setting Five National Collegiate Athletic Association institutions participating in the Concussion Assessment, Research and Education (CARE) Consortium. Patients or Other Participants National Collegiate Athletic Association student-athletes (N = 2258, age = 20 ± 1.5 years, 53.0% male, 68.9% white) in 11 men's and 13 women's sports. Main Outcome Measure(s) Participants completed baseline assessments on the KD and (1) the Symptom Inventory of the Sport Concussion Assessment Tool–3rd edition, (2) the Brief Symptom Inventory-18, (3) the Balance Error Scoring System, (4) the Standardized Assessment of Concussion (SAC), (5) the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test battery, and (6) the Vestibular/Ocular Motor Screening tool during their first year in CARE. Correlation coefficients between the KD and the 6 other concussion assessments in isolation were determined. Assessments with ρ magnitude >0.1 were included in a multivariate linear regression analysis to evaluate their relative association with the KD. Results Scores for SAC concentration, ImPACT visual motor speed, and ImPACT reaction time were correlated with the KD (ρ = −0.216, −0.276, and 0.164, respectively) and were thus included in the regression model, which explained 16.8% of the variance in baseline KD time (P < .001, Cohen f2 = 0.20). Better SAC concentration score (β = −.174, P < .001), ImPACT visual motor speed (β = −.205, P < .001), and ImPACT reaction time (β = .056, P = .020) were associated with faster baseline KD performance, but the effect sizes were small. Conclusions Better performance on cognitive measures involving concentration, visual motor speed, and reaction time was weakly associated with better baseline KD performance. Symptoms, psychological distress, balance, and vestibular-oculomotor provocation were unrelated to KD performance at baseline. The findings indicate limited overlap at baseline among the CARE SRC assessments and the KD.

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Effect of Head Impact Exposures on Changes in Cognitive Testing

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118761031 ◽

2018 ◽

Vol 6 (3) ◽

pp. 232596711876103 ◽

Cited By ~ 2

Author(s):

Eleni Diakogeorgiou ◽

Theresa L. Miyashita

Keyword(s):

Reaction Time ◽

National Collegiate Athletic Association ◽

Assessment Tool ◽

Vital Signs ◽

Head Impact ◽

Cognitive Testing ◽

Repeated Impact ◽

Level Of Evidence ◽

Head Impacts ◽

Significant Difference

Background: Gaining a better understanding of head impact exposures may lead to better comprehension of the possible effects of repeated impact exposures not associated with clinical concussion. Purpose: To assess the correlation between head impacts and any differences associated with cognitive testing measurements pre- and postseason. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 34 National Collegiate Athletic Association Division I men’s lacrosse players wore lacrosse helmets instrumented with an accelerometer during the 2014 competitive season and were tested pre- and postseason with the Sport Concussion Assessment Tool (SCAT 3) and Concussion Vital Signs (CVS) computer-based neurocognitive tests. The number of head impacts >20 g and results from the 2 cognitive tests were analyzed for differences and correlation. Results: There was no significant difference between pre- and postseason SCAT 3 scores, although a significant correlation between pre- and postseason cognitive scores on the SCAT 3 and total number of impacts sustained was noted ( r = –0.362, P = .035). Statistically significant improvements on half of the CVS testing components included visual reaction time ( P = .037, d = 0.37), reaction time ( P = .001, d = 0.65), and simple reaction time ( P = .043, d = 0.37), but no correlation with head impacts was noted. Conclusion: This study did not find declines in SCAT 3 or CVS scores over the course of a season among athletes who sustained multiple head impacts but no clinical concussion. Thus, it could not be determined whether there was no cognitive decline among these athletes or whether there may have been subtle declines that could not be measured by the SCAT 3 or CVS.

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

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.138 ◽

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.

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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.

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Estimated age of first exposure to American football and outcome from concussion

Neurology ◽

10.1212/wnl.0000000000010672 ◽

2020 ◽

Vol 95 (21) ◽

pp. e2935-e2944 ◽

Cited By ~ 1

Author(s):

Jaclyn B. Caccese ◽

Zac Houck ◽

Thomas W. Kaminski ◽

James R. Clugston ◽

Grant L. Iverson ◽

...

Keyword(s):

National Collegiate Athletic Association ◽

Brief Symptom Inventory ◽

Baseline Data ◽

Cognitive Testing ◽

American Football ◽

Football Players ◽

Childhood And Adolescence ◽

Motor Speed ◽

Research And Education ◽

Composite Scores

ObjectiveTo examine the association between estimated age at first exposure (eAFE) to American football and clinical measures throughout recovery following concussion.MethodsParticipants were recruited across 30 colleges and universities as part of the National Collegiate Athletic Association (NCAA)–Department of Defense Concussion Assessment, Research and Education Consortium. There were 294 NCAA American football players (age 19 ± 1 years) evaluated 24–48 hours following concussion with valid baseline data and 327 (age 19 ± 1 years) evaluated at the time they were asymptomatic with valid baseline data. Participants sustained a medically diagnosed concussion between baseline testing and postconcussion assessments. Outcome measures included the number of days until asymptomatic, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores, Balance Error Scoring System (BESS) total score, and Brief Symptom Inventory 18 (BSI-18) subscores. The eAFE was defined as participant's age at the time of assessment minus self-reported number of years playing football.ResultsIn unadjusted regression models, younger eAFE was associated with lower (worse) ImPACT Visual Motor Speed (R2 = 0.031, p = 0.012) at 24–48 hours following injury and lower (better) BSI-18 Somatization subscores (R2 = 0.014, p = 0.038) when the athletes were asymptomatic. The effect sizes were very small. The eAFE was not associated with the number of days until asymptomatic, other ImPACT composite scores, BESS total score, or other BSI-18 subscores.ConclusionEarlier eAFE to American football was not associated with longer symptom recovery, worse balance, worse cognitive performance, or greater psychological distress following concussion. In these NCAA football players, longer duration of exposure to football during childhood and adolescence appears to be unrelated to clinical recovery following concussion.

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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.

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Using Acute Performance on a Comprehensive Neurocognitive, Vestibular, and Ocular Motor Assessment Battery to Predict Recovery Duration After Sport-Related Concussions

The American Journal of Sports Medicine ◽

10.1177/0363546516685061 ◽

2017 ◽

Vol 45 (5) ◽

pp. 1187-1194 ◽

Cited By ~ 23

Author(s):

Alicia M. Sufrinko ◽

Gregory F. Marchetti ◽

Paul E. Cohen ◽

R.J. Elbin ◽

Valentina Re ◽

...

Keyword(s):

Recovery Time ◽

Symptom Assessment ◽

Cognitive Testing ◽

Ocular Motor ◽

Motor Speed ◽

Multinomial Regression ◽

Symptom Scale ◽

Level Of Evidence ◽

Recovery Times ◽

Visual Motor

Background: A sport-related concussion (SRC) is a heterogeneous injury that requires a multifaceted and comprehensive approach for diagnosis and management, including symptom reports, vestibular/ocular motor assessments, and neurocognitive testing. Purpose: To determine which acute (eg, within 7 days) vestibular, ocular motor, neurocognitive, and symptom impairments predict the duration of recovery after an SRC. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: Sixty-nine patients with a mean age of 15.3 ± 1.9 years completed a neurocognitive, vestibular/ocular motor, and symptom assessment within 7 days of a diagnosed concussion. Patients were grouped by recovery time: ≤14 days (n = 27, 39.1%), 15-29 days (n = 25, 36.2%), and 30-90 days (n = 17, 24.6%). Multinomial regression was used to identify the best subset of predictors associated with prolonged recovery relative to ≤14 days. Results: Acute visual motor speed and cognitive-migraine-fatigue symptoms were associated with an increased likelihood of recovery times of 30-90 days and 15-29 days relative to a recovery time of ≤14 days. A model with visual motor speed and cognitive-migraine-fatigue symptoms within the first 7 days of an SRC was 87% accurate at identifying patients with a recovery time of 30-90 days. Conclusion: The current study identified cognitive-migraine-fatigue symptoms and visual motor speed as the most robust predictors of protracted recovery after an SRC according to the Post-concussion Symptom Scale, Immediate Post-concussion Assessment and Cognitive Testing, and Vestibular/Ocular Motor Screening (VOMS). While VOMS components were sensitive in identifying a concussion, they were not robust predictors for recovery. Clinicians may consider particular patterns of performance on clinical measures when providing treatment recommendations and discussing anticipated recovery with patients.

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FRAX® Fracture Risks Are Associated with Coronary Artery Calcification Score

Disease Markers ◽

10.1155/2017/1592598 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Tzyy-Ling Chuang ◽

Yi-Da Li ◽

Fu-Tsung Hsiao ◽

Mei-Hua Chuang ◽

Yuh-Feng Wang

Keyword(s):

Regression Analysis ◽

Coronary Artery ◽

Linear Regression ◽

Fracture Risk ◽

Coronary Artery Calcification ◽

Assessment Tool ◽

Clinical Laboratory ◽

Linear Regression Analysis ◽

Multivariate Linear Regression Analysis ◽

Mineral Density

Purpose. To examine the association between fracture risk assessment tool (FRAX) scores and coronary artery calcification (CAC) score in adults. Methods. The medical records of 81 adults who underwent both coronary computed tomography and bone mineral density (BMD) studies in a package during their health exams were reviewed at a regional hospital in Southern Taiwan. Data collected included health history, anthropomorphic characteristics, clinical laboratory results, and BMD. Fracture risk was determined using FRAX. Univariate and multivariate linear regression analysis were used to assess the association between CAC score and 10-year probability of hip fracture (HF) and major osteoporotic fracture (MOF) determined by FRAX. Results. The mean age of the patients was 55.8 years, and 63.0% were male. Univariate linear regression analysis showed that increases in MOF and HF risks, as measured by FRAX, were significantly and positively associated with CAC score. Multiple linear regression analysis adjusting for potential confounders showed that CAC score remained significantly associated with four FRAX indicators, including right MOF (r=0.45, P<0.001), left MOF (r=0.31, P=0.021), right HF (r=0.38, P=0.001), and left HF (r=0.23, P=0.049). Conclusions. Increased risks of MOF and HF as determined by FRAX were significantly and independently associated with CAC score.

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Age of First Exposure to Contact Sports and Neurocognitive Performance in U.S. Service Academy Athletes

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz026.23 ◽

2019 ◽

Vol 34 (5) ◽

pp. 753-753

Author(s):

J B Caccese ◽

G L Iverson ◽

K L Cameron ◽

M N Houston ◽

G T McGinty ◽

...

Keyword(s):

Reaction Time ◽

Symptom Severity ◽

Sports Participation ◽

Ice Hockey ◽

Motor Speed ◽

Neurocognitive Performance ◽

Contact Sports ◽

Visual Motor ◽

Service Academy ◽

The Impact

Abstract Purpose To examine the association between estimated age of first exposure (eAFE) to contact sports and neurocognitive performance and symptom ratings in collegiate U.S. Military Service Academy athletes. We hypothesized that contact-sports participation before the age of 12 would not be associated with worse neuropsychological test performance or greater symptom reporting. Methods Male cadets (N=891) who participated in contact sports [i.e., in lacrosse (n=211), wrestling (n=170), ice hockey (n=81), soccer (n=119), rugby (n=10)], or non-contact sports (n=298), completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test before the season. Generalized linear modeling was used to predict each cognitive domain score and the symptom severity score. Predictor variables were entered in the following order: group (contact vs. non-contact), eAFE (eAFE<12 vs. eAFE≥12), group-by-eAFE, and covariates for learning accommodation status, concussion history, and age. Results The group-by-eAFE interaction was not significant for any of the ImPACT composite scores (Verbal Memory, Wald Χ2=.073, p=.788; Visual Memory, Wald Χ2=2.71, p=.100; Visual Motor Speed, Wald Χ2=.078, p=.780; Reaction Time, Wald Χ2=.003, p=.955; Symptom Severity, Wald Χ2=2.87, p=.090). Learning accommodation history was associated with lower scores on Visual Motor Speed (Χ2=6.19, p=.013, B=-2.97). Older age was associated with faster reaction time (Χ2=4.40, p=.036, B=-.006) and lesser symptom severity (Χ2=5.55, p=.019, B=-.068). No other parameters were significant. Conclusion We observed no association between eAFE, contact-sport participation, cognitive functioning, or subjectively-experienced symptoms in this cohort. Earlier eAFE to RHI is not related to worse neurocognitive performance or greater subjectively-experienced symptoms in collegiate student-athletes enrolled in military academies.

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A - 27 The Clinical Utilization of SWAY and mBESS for Post-Trauma and Follow-up Concussion Evaluations

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab035.27 ◽

2021 ◽

Vol 36 (4) ◽

pp. 667-667

Author(s):

Sohoni R ◽

Gorres K ◽

Sibol M ◽

Yousif M ◽

LoGalbo A

Keyword(s):

Reaction Time ◽

Assessment Tool ◽

Postural Sway ◽

Cognitive Testing ◽

Sports Concussion ◽

Clinical Utilization ◽

Paired Samples ◽

Significant Difference ◽

Before And After

Abstract Objective SWAY is a mobile software system using an accelerometer designed to measure postural sway and reaction time in the context of concussion. This study examined the efficacy of SWAY in detecting changes in balance and reaction time before and after concussion. Methods College athletes (N = 30, 10 females) underwent baseline, post-trauma, and follow-up evaluations following a concussion including SWAY, mBESS, Sports Concussion Assessment Tool 5th Edition (SCAT-5), and Immediate Post Concussion Assessment and Cognitive Testing (ImPACT). Results Paired-samples t-tests revealed a decline in SWAY balance from baseline (M = 82.65, SD = 14.48) to post-trauma (M = 74.61, SD = 17.41), t(29) = 2.99, p = 0.006, but no significant difference was observed in reaction time (M = 5.07, SD = 13.61), t(29) = 2.04, p = 0.050. Meanwhile, balance improved at follow-up (M = 78.93, SD = 15.32), and was no longer discrepant from baseline (M = 81.97, SD = 14.51), t(21) = 1.03, p = 0.316. Similarly, there was a significant decline in mBESS scores from baseline (M = 2.88, SD = 3.62) to post-trauma (M = 5.68, SD = 5.32), t(24) = −3.51, p = 0.002, followed by a return to baseline at follow up (M = 4.22, SD = 4.95), t(22) = −1.60, p = 0.124. Conclusions Although challenges were apparent in obtaining an optimal baseline, current results appear to support the clinical utility of SWAY for assessing balance in the context of concussion evaluations. Further research appears warranted to support SWAY as a method of diagnosing concussion and monitoring return to baseline.

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A Cohort Study of the Temporal Stability of ImPACT Scores Among NCAA Division I Collegiate Athletes: Clinical Implications of Test–Retest Reliability for Enhancing Student Athlete Safety

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa047 ◽

2020 ◽

Vol 35 (7) ◽

pp. 1131-1144

Author(s):

Sara J Mason ◽

Bradley S Davidson ◽

Marybeth Lehto ◽

Aurélie Ledreux ◽

Ann-Charlotte Granholm ◽

...

Keyword(s):

Reaction Time ◽

Ncaa Division I ◽

Verbal Memory ◽

Temporal Stability ◽

Division I ◽

Cognitive Test ◽

Motor Speed ◽

Visual Motor ◽

Composite Scores ◽

The Impact

Abstract Objective In this study we examined the temporal stability of the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) within NCAA Division I athletes across various timepoints using an exhaustive series of statistical models. Methods Within a cohort design, 48 athletes completed repeated baseline ImPACT assessments at various timepoints. Intraclass correlation coefficients (ICC) were calculated using a two-way mixed effects model with absolute agreement. Results Four ImPACT composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, and Reaction Time) demonstrated moderate reliability (ICC = 0.51–0.66) across the span of a typical Division I athlete’s career, which is below previous reliability recommendations (0.90) for measures used in individual decision-making. No evidence of fixed bias was detected within Verbal Memory, Visual Motor Speed, or Reaction Time composite scores, and minimal detectable change values exceeded the limits of agreement. Conclusions The demonstrated temporal stability of the ImPACT falls below the published recommendations, and as such, fails to provide robust support for the NCAA’s recommendation to obtain a single preparticipation cognitive baseline for use in sports-related concussion management throughout an athlete’s career. Clinical interpretation guidelines are provided for clinicians who utilize baseline ImPACT scores for later performance comparisons.

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