Abstract:
Objective: To examine and describe the changes in performance on cognitive tests (paper-and-pencil and computerized) and changes in driving performance, at two time points – immediately after concussion, and after medical clearance was given for return-to-play. Participants and Methods: Prospective design, with consecutive referrals from the athletic trainer were assessed immediately after the concussion (x=3 days), and again after medical clearance was given for return to play. All data were collected in an outpatient research setting. Participants were college students (N=9; 5 males, 4 females) with clinically diagnosed concussion. Mean age was 20 years, and 90% of them were Caucasians. All were active drivers with greater than 2 years driving experience. The mean number of previously reported concussions was two. MAIN OUTCOME MEASURES: Participants were administered neuropsychological measures of attention, working memory and processing speed [parallel forms of the Symbol Digit Modalities Test (SDMT), Trails A and B and Digit Span], the Immediate Post-Concussion Assessment and Cognitive Testing (the ImPACT test), and a behind-the wheel (BTW) driving simulator evaluation. For the driving performance, center lane deviation and velocity (speed) were examined for simple straight lane segments without distractions. Results: Preliminary examination indicated that almost 90% of the participants had improved performance on the relatively less complex tests (Trails A, and composite Speed measures from the ImPACT). Comparatively only 63% showed improvements on the complex measures of working memory. Driving performance improvement was observed in 66% of the participants. Conclusions: This preliminary evaluation of cognitive and driving performance suggests that changes in performance can be measured as recovery from concussion occurs. Greater variability in observed improvement in cognitively complex tasks and driving measures may suggests less recovery in these higher order domains and functional task.