Administering Computerized Neurocognitive Testing Does Not Increase Symptoms Following Sport-Related Concussion

Abstract

Computerized neurocognitive testing (CNT) is an important component for the management of sport-related concussion (SRC). The cognitive demands required to complete CNT may exacerbate SRC symptoms. PURPOSE: To prospectively examine changes in post-concussion symptom reporting after completing CNT. METHODS: One hundred forty-five athletes (15.72 ± 1.78 years) with a medically diagnosed SRC completed the Post-Concussion Symptom Scale (PCSS) before and after completing a CNT (e.g., The Immediate Post-Concussion Assessment and Cognitive Testing: ImPACT). Changes in total PCSS symptoms and symptom clusters (somatic, affective, and cognitive-migraine-fatigue) were examined with a series of paired samples t-tests. Participants were also assigned to groups based on the time elapsed from injury until their first clinical visit: 0-7, 8-14, and 15-21 days. A series of 3 (time since injury group) X 2 time (pre, post) analysis of variance were performed on symptom totals and clusters. Statistical significance was set at a Bonferroni-corrected p < .01. RESULTS: There were no significant differences in total (t (145) = -.69, p = .49), somatic, (t (145) = -1.02, p = .31), or cognitive-migraine-fatigue symptoms (t (145) = -1.75, p = .08) before and after CNT. There was a significant difference for affective symptoms (t (145) = 2.51, p = .01). Affective symptoms were significantly higher before CNT (M = 2.19, SD = 3.15) compared to after CNT (M = 1.80, SD = 2.89). There were no between-subjects or within-subjects main effects for total, somatic, affective, or cognitive-migraine-fatigue symptom clusters (p > .05). There were also no significant group x time interactions for total symptoms (Wilks λ =.99, F [1, 142] = 0.20, p = .40, η2 = .01), somatic, (Wilks λ =1.00, F [2, 142] = .30, p =.74, η2 = .004), affective (Wilks λ =.99, F [2, 142] = 0.89, p =.43, η2 = .01), or cognitive-migraine-fatigue symptom clusters (Wilks λ =.99, F [2, 141] = 0.41, p =.67, η2 = .01). CONCLUSIONS: The administration of CNT during recovery from SRC does not increase concussion symptoms. Sports medicine professionals should administer CNT to concussed athletes even when symptomatic, to more accurately identify neurocognitive impairment, which will help determine targeted treatment options.