The role of anxiety and sleep on ImPACT Test scores

Archives of Clinical Neuropsychology -


Kumbhani, S., A. C. Maerlender, L. A. Flashman, R. Greenwald and T. W. McAllister.



Objective: Research has validated ImPACT as a useful tool for assessing neurocognitive sequelae of concussion. It is widely known that current symptoms of anxiety can worsen performance on neuropsychological measures of cognitive processing speed. There is also evidence that sleep disruption can have a detrimental effect on cognitive processing. The current study investigated whether severity of anxiety symptoms and/or fewer hours of sleep are associated with increased impairment in the Processing Speed and Reaction Time composite scores on ImPACT testing. Method: Participants included 26 collegiate football players, all of whom completed a baseline concussion-assessment battery and the State-Trait Anxiety Inventory (STAI). Sleep data was self-reported for the previous night as part of the ImPACT protocol. Bivariate correlations were used to examine the association between symptoms of anxiety, hours of sleep, and ImPACT scores. Bivariate correlations were also used to investigate the association between current symptoms of anxiety and typical symptoms associated with concussion. Results: Increased symptoms of current anxiety were associated with slower reaction times, with a trend noted for slower processing speed. Correlations between sleep hours and ImPACT composite scores were not significant. State anxiety was correlated with a need for longer hours of sleep, but was not otherwise correlated with concussion symptoms. Conclusions: The present results support the existing literature which indicates that performance on tasks of reaction time and processing speed decrease as current symptoms of anxiety increase. These findings highlight the importance of specifically assessing symptoms of anxiety when evaluating athletes with ImPACT.

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