The Influence Of Mood State On ImPACT Baseline Test Performance

Journal of Athletic Training.. 2013 Jun;


Resch, J. E., C. N. Brown, T. A. Baumgartner, K. Walpert, S. N. Macciocchi and M. S. Ferrara.



Context: Baseline assessments using computerized neuropsychological (CNP) testing has been advocated for the management of sport concussion. ImPACT is a commonly used CNP test used in sport concussion management protocols. A potential extraneous variable which may influence baseline ImPACT test performance is mood. Sources of random error such as mood may limit the clinical utility of the baseline ImPACT assessment following sport concussion. Objective: To examine the effect of mood state on ImPACT performance in a healthy collegiate sample. Design: Repeated Measures. Setting: Research laboratory. Patients or Other Participants: One hundred and four (32 males and 72 females) healthy college students aged 20.9 + 1.45 years participated in this study. Interventions: Participants completed the Profile of Mood States Brief Form (POMS-B) prior to completing ImPACT at three clinically relevant time points (days 1, 45, and 50). The Green’s Word Memory Test (WMT) was also delivered to assess effort. Main Outcome Measure: Pearson correlation coefficients were calculated for each of the seven POMS-B factors (fatigue-inertia, vigor-activity, tension-anxiety, depression-dejection, confusion-bewilderment, anger-hostility and total mood disturbance) and ImPACT composite and symptom scores. Repeated measures analysis of variance (ANOVA) was used to determine significant differences across time in regards to POMS-B, ImPACT, and Green’s WMT composite scores. Greenhouse-Geisser corrections were used to correct for violations of sphericity. Post-hoc analyses were performed using dependent t tests. All analyses were performed with = .05. Results: Our analyses revealed significant differences across time for composite ImPACT verbal memory (Wilk’s = .824, F(2,214) = 10.86, p < .001) and visual motor speed (Wilk’s = .867 F(2,214) = 7.80, p = .001). Post hoc analyses revealed significant improvements between day 1 and day 45 (t(103) = -4.0, p < .001) and day 1and day 50 (t(103) = -4.39, p < .001). Significant improvements were also observed for visual motor speed between day 1 and day 45 (t(103) = -2.00, p =.05),day1andday50(t(103) =3.965, p < .001) and between day 45 and 50 (t(103) = -2.378, p = .02). At time point 1 ImPACT impulse control was significantly correlated to POMS-B fatigue-inertia (-.228, p = .02). ImPACT’s total symptom score was most consistently correlated to multiple POMS-B factors with correlations coefficients ranging from -.23 to .57. No additional significant correlations were observed between the remaining ImPACT composite scores and the varying mood states. Conclusions: Our results suggest that although mood factors as measured by the POMS-B were significantly correlated to total symptom score of ImPACT, performance remained either consistent or improved over time. Future research is needed in a collegiate athlete sample to determine if potentially higher mood state values influence computerized neuropsychological test results.

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