Athlete characteristics and outcome scores for computerized neuropsychological assessment: a preliminary analysis

Cathleen N Brown, Kevin M Guskiewicz, Joseph Bleiberg
Journal of Athletic Training 2007, 42 (4): 515-23

CONTEXT: Computerized neuropsychological testing is used in athletics; however, normative data on an athletic population are lacking.

OBJECTIVE: To investigate factors, such as sex, SAT score, alertness, and sport, and their effects on baseline neuropsychological test scores. A secondary purpose was to begin establishing preliminary reference data for nonsymptomatic collegiate athletes.

DESIGN: Observational study.

SETTING: Research laboratory.

PATIENTS OR OTHER PARTICIPANTS: The study population comprised 327 National Collegiate Athletic Association Division I athletes from 12 men's and women's sports.

MAIN OUTCOME MEASURE(S): Athletes were baseline tested before their first competitive season. Athletes completed demographics forms and self-reported history of concussion (1 or no concussion and 2 or more concussions) and SAT scores (<1000, 1000 to 1200, and >1200). The 108 women had a mean age of 18.39 +/- 0.09 years, height of 167.94 +/- 0.86 cm, and mass of 62.36 +/- 1.07 kg. The 219 men had a mean age of 18.49 +/- 0.07 years, height of 183.24 +/- 1.68 cm, and mass of 88.05 +/- 1.82 kg. Sports participation included women's soccer, lacrosse, basketball, and field hockey; men's football, soccer, lacrosse, and wrestling; and women's and men's track and cheerleading. We used the Automated Neuropsychological Assessment Metrics (Army Medical Research and Materiel Command, Ft Detrick, MD) and measured throughput scores (the number of correct responses per minute) as the dependent variable for each subtest, with higher scores reflecting increased speed and accuracy of responses. Subsets included 2 simple reaction time (SRT) tests, math processing (MTH), Sternberg memory search (ST6), matching to sample pairs (MSP), procedural reaction time (PRO), code digit substitution (CDS), and the Stanford sleep scale Likert-type score.

RESULTS: Women scored better than men on the ST6 (P < .05), while men scored significantly better than women on the SRT and MSP tests. The highest-scoring SAT group performed better than other SAT groups on selected subtests (SRT, MTH, ST6, MSP, and CDS) (P < .05), and athletes tested during their season were more likely to score lower on the alertness scale (chi(2) (2)[n = 322] = 11.32, P = .003). The lowest alertness group performed worse on the MSP and CDS subtests (P < .05). No differences were found between the group with a history of 1 or no concussion and the group with a history of 2 or more concussions (P > .05).

CONCLUSIONS: Performance on computerized neuropsychological tests may be affected by a number of factors, including sex, SAT scores, alertness at the time of testing, and the athlete's sport. To avoid making clinical misinterpretations, clinicians should acknowledge that individual baselines vary over time and should account for this variation.

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