The Relation Between Test Performance and Changes in Post-Concussion Symptoms following Cognitive Exertion

J Int Neuropsychol Soc. 2011 Mar;


Henry, L., D. Lugarich, D. Pardini and J. Pardini.



Objective: This study examined the association between neurocognitive test performance and acute symptom changes following completion of cognitive testing in a sample of concussed individuals. Participants and Methods: 110 participants (39% male; mean age = 18.5) diagnosed with mTBI were evaluated at the University of Pittsburgh Medical Center Sports Concussion Program. All participants reported persistent concussion symptoms at the time of evaluation. Participants completed the ImPACT computerized test battery and the post-concussion symptom scale (PCSS) as a routine part of concussion evaluation. To reflect acute changes in symptoms, participants completed an abbreviated PCSS immediately before and after completing computerized testing. Results: After controlling for pre-test symptoms, regression analysis indicated significant associations between post-test symptoms and composite scores on ImPACT. Lower verbal memory scores were associated with higher total symptoms and with higher symptom scores in three of four symptom clusters (cognitive, somatic, affective clusters; all ps < 05). Slower visuomotor speed was associated with higher somatic symptoms. Lower visual memory scores were related to higher affective symptoms. Reaction time scores were not associated with post-test symptom scores. The findings were not accounted for by gender or time since sustaining the injury. Conclusions: Results reveal an association between post-test symptom severity and performance on neurocognitive testing in individuals with concussion, suggesting acute changes in symptoms following cognitive exertion may be an indicator of injury severity.

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