Neuropsychological test performance prior to and following sports-related mild traumatic brain injury

Objective: To examine the utility of neuropsychological tests in assessing college athletes prior to and following a sports-related mild Traumatic Bra in Injury (mTBI). Design: A prospective study of college athletes who sustained mTBI while en gaged in sport. Preinjury baseline neuropsychological test data were obtain ed for athletes at risk for mTBI. Following an mTBI, the athlete and his or her matched noninjured control were evaluated at 2 hours, 48 hours, 1 week , and 1 month postinjury. Setting: Male and female athletes from a Division I college. Participants: Male and female athletes from the football, men's ice hockey, men's and women's soccer, and men's and women's basketball teams at Penn S tate University. A total of 29 injured and 20 noninjured athletes participa ted in the study. Interventions: Neuropsychological test batteries were administered at basel ine and serially following mTBI. Main Outcome Measures: Post-Concussion Symptom Checklist, Hopkins Verbal Le arning Test, Symbol Digit Modalities Test, Stroop Color-Word Test, Trail Ma king Test, VIGIL/W, List Learning, Digit Span, Penn State Cancellation Test , and Controlled Oral Word Association. Results: Neuropsychological test data yielded significant differences betwe en injured athletes and controls at 2 hours and 48 hours following cerebral concussion; injured athletes performing significantly worse than controls. Injured athletes reported a significantly greater number of postconcussion symptoms 2 hours following injury but not at the 48-hour assessment. No mu ltivariate group differences were found at 1 week, but univariate analyses suggested significant differences on a few measures. At I month postinjury, a statistically significant difference was found on one measure with injur ed athletes marginally outperforming controls. Conclusions: Neuropsychological tests are useful in the detection of cognit ive impairment following mTBI. The test data appear to be more effective th an subjective report of symptoms in differentiating between injured and non injured athletes at 48 hours postinjury. Although significant individual va riability existed, most injured athletes recovered within 1 week of injury. A battery of tests, rather than any single test. is necessary to capture t he variability that exists among injured athletes.