Abstract:
Current standards of the management of athletes following cerebral concussion are often based on subjective experiences and do not utilize neurocognitive measures for decisions regarding return-to-play. Although most concussed athletes recover, a significant number may experience chronic cognitive and behavioral symptoms that impair cognitive functions or affect personality. ImPACT is a battery of neuropsychological tests that can be administered on a computer, and can detect cognitive abnormalities associated with concussion. The purpose of the current study was to determine the sensitivity and specificity of the test battery in discriminating concussed and nonconcussed athletes. Data from 76 concussed high school athletes were compared to a control group, matched by age (N=71). All athletes were evaluated using the ImPACT computerized neuropsychological battery. This program yields composite scores derived from tests of reaction time, memory, and processing speed. For this study, total score on a post-concussion symptom index and performance on the five ImPACT composite scores were evaluated. A stepwise discriminant function analysis was conducted with symptom score and the five ImPACT composite scores. One discriminant function identified that the significant factors of symptom, processing speed, verbal memory, and impulse control scores correctly classified 85% of cases (79% of concussed, 92% of nonconcussed). The eigenvalue (.776) suggests high discrimination power, with a canonical correlation of .661. CONCLUSIONS: Results of the current study suggest that ImPACT scores, together with postconcussion symptoms, provide an accurate way to discriminate the performance of concussed from nonconcussed athletes. The findings add support for using ImPACT as a tool in the diagnosis and treatment of concussion, as well as in the decision process regarding return-to-play following concussion.