Abstract:
Objective: Current international guidelines for the management of sport-related concussion suggest that an athlete be withheld from contact sport until he or she is asymptomatic at rest, asymptomatic with graded exertion, and within expected levels (or back to baseline) on neurocognitive testing. This presentation reviews the relation between neuropsychological data, symptom data, and concussion recovery in the largest functional MRI study of concussed athletes to date. Participants and Methods: For the overall study, data were gathered from 155 concussed and 50 control student athletes (mean age = 17.25). Neurocognitive data was acquired through post-injury testing on the ImPACT computerized test battery, and symptom data was acquired through the Post-Concussion Symptom Scale. Athletes were evaluated, on average, 3.93 days after injury. Participants were re-evaluated at regular intervals until recovered. Results: Across all four ImPACT composites (verbal memory, visual memory, visual motor speed, and reaction time), concussed subjects demonstrated significantly lower scores and significantly higher symptom scores than did non-injured controls (p<.05). In addition, athletes demonstrated impairment relative to their own baselines (p<.05). Once recovered, athletes’ test scores were equivalent to those of their own baselines and controls. Control subjects demonstrated stability across two assessment periods for neuropsychological testing and symptom scores. Conclusions: The current sample demonstrated typical concussion-related cognitive deficits on neuropsychological testing, as well as increased symptom scores. Upon recovery, their scores were equivalent to scores of control athletes and their own baselines. Therefore, fMRI and MEG findings from this sample should be generalizable to concussed high school and collegiate athletes.