Neuropsychological test performance prior to and following sports-related mild traumatic brain injury

R J Echemendia, M Putukian, R S Mackin, L Julian, N Shoss
Clinical Journal of Sport Medicine 2001, 11 (1): 23-31

OBJECTIVE: To examine the utility of neuropsychological tests in assessing college athletes prior to and following a sports-related mild Traumatic Brain Injury (mTBI).

DESIGN: A prospective study of college athletes who sustained mTBI while engaged in sport. Preinjury baseline neuropsychological test data were obtained for athletes at risk for mTBI. Following an mTBI, the athlete and his or her matched noninjured control were evaluated at 2 hours, 48 hours, 1 week, and I month postinjury.

SETTING: Male and female athletes from a Division I college.

PARTICIPANTS: Male and female athletes from the football, men's ice hockey, men's and women's soccer, and men's and women's basketball teams at Penn State University. A total of 29 injured and 20 noninjured athletes participated in the study.

INTERVENTIONS: Neuropsychological test batteries were administered at baseline and serially following mTBI.

MAIN OUTCOME MEASURES: Post-Concussion Symptom Checklist, Hopkins Verbal Learning Test, Symbol Digit Modalities Test, Stroop Color-Word Test, Trail Making Test, VIGIL/W, List Learning, Digit Span, Penn State Cancellation Test, and Controlled Oral Word Association.

RESULTS: Neuropsychological test data yielded significant differences between injured athletes and controls at 2 hours and 48 hours following cerebral concussion; injured athletes performing significantly worse than controls. Injured athletes reported a significantly greater number of postconcussion symptoms 2 hours following injury but not at the 48-hour assessment. No multivariate group differences were found at 1 week, but univariate analyses suggested significant differences on a few measures. At 1 month postinjury, a statistically significant difference was found on one measure with injured athletes marginally outperforming controls.

CONCLUSIONS: Neuropsychological tests are useful in the detection of cognitive impairment following mTBI. The test data appear to be more effective than subjective report of symptoms in differentiating between injured and noninjured athletes at 48 hours postinjury. Although significant individual variability existed, most injured athletes recovered within 1 week of injury. A battery of tests, rather than any single test, is necessary to capture the variability that exists among injured athletes.

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