TITLE OF PROJECT: Neuropsychological Assessment of Sports-Related Mild Traumatic Brain Injury: A prospective Multi-Sport Study

As was stated in the initial proposal, the primary purpose of this project was to continue and improve the prospective multi-sport neuropsychological assessment program at The Pennsylvania State University. Through systematic examination of neuropsychological test data prior to and following cerebral concussion, we can develop a better understanding of the ability of neuropsychological tests to detect cognitive impairment following concussion.

ACTIVITY SUMMARY: The project has achieved (and exceeded) all of its first year goals. Specifically, baseline evaluations were conducted on all new players in football (34), ice hockey (13), women’s basketball (7), men’s basketball (4), men’s soccer (11), and women’s soccer (10). As outlined in the proposal, women’s lacrosse and wrestling were added to the project this year with baselines on 23 and 11 players respectively. Although not originally proposed, NOCSAE funding of this project allowed us to add men’s and women’s rugby to our program with 17 men and 35 women tested. Similarly, the Princeton Ice Hockey team joined our program as did the Acadia University Ice Hockey team. A total of 25 players were tested in Princeton and 22 were tested in Acadia. In summary, a total of 212 new baseline assessments were conducted during this reporting period, bringing the total number of baseline tests for the project to 758 (representing 18 different teams).

During this reporting period a total of 14 cerebral concussions were diagnosed as follows by sport: football – 4, ice hockey – 4, men’s soccer – 1, women’s soccer – 1, men’s basketball –1, men’s rugby – 1, and women’s rugby – 2. These players underwent a total of 38 post-concussion evaluations. A total of 10 matched athlete controls were tested in the same time sequence as the injured players. With the addition of the injuries this reporting period, the total number of concussive events for which serial data are available has increased to 54.

The proposed assessment of non-athlete controls will commence on June 5, 2000.

RESULTS/PUBLICATIONS: A manuscript entitled “Neuropsychological test performance prior to and following sports-related mild traumatic brain injury” was submitted to Clinical Journal of Sport Medicine in March and is currently under review. The paper reports on the results of the first 29 injured athletes and 20 controls in this project. Using MANOVA, neuropsychological test data highlighted significant group differences between injured athletes and controls at 2 hours and 48 hours following cerebral concussion. Injured athletes performed significantly worse than controls. Injured athletes reported a significantly greater number of post-concussion symptoms 2 hours following injury but NOT at the 48 hour assessment. This is particularly interesting because it was also found that injured athletes, on average, perform worse at 48 hours than at 2 hours, on some measures. Although no multivariate differences were found between injured athletes and controls at one week, univariate analyses revealed significant differences on several measures. >At one month post injury, a statistically significant difference was found on one measure with injured athletes marginally outperforming controls.

The results of these analyses clearly underscore the utility of neuropsychological measures in the detection of cognitive impairment following cerebral concussion. The neuropsychological test data appear to be significantly better than a subjective report of symptoms in predicting injury status at 48 hours post injury. Although significant individual variability existed, most injured athletes recovered within one week of injury. The results also underscore the assertion that a battery of tests, rather than any single test, is necessary to capture the variability that exists among injured athletes.

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