Concussion History Does Not Adversely Affect Trail Making Test Performance

Abstract

To determine the effect of concussion history on the electronic version of the Trail Making Test (TMT) A and TMT-B performance. The effects of concussion history on cognitive performance when the individual is still young has received limited attention. There are inconsistent results in prior studies using computerized neurocognitive tests however the TMT assesses divergent neurologic systems including working memory, horizontal and vertical saccades, attention, cognitive processing, and executive function. While the TMT has routinely identified deficits acutely post-concussion, the long-term effect of prior concussions has not been established. This study utilized a cross-sectional design of 50 current intercollegiate division I athletes (56% female, age: 19.8 ± 1.3 y.o.). Participants completed a reliable concussion history questionnaire as well as the TMT-A and TMT-B on an iPad at baseline. The independent variable was concussion history and the dependent variables were total time on TMT-A and TMT-B which were compared by independent samples t-tests or Mann-Whitney U test. Of the 50 student athletes 26 (52%) reported at least one previously diagnosed concussion. There was no significant difference between groups for the TMT-A (No prior concussion: 22.9 + 6.1 sec and Concussion history: 19.7 + 4.1, U = 227.0, p = 0.10) or TMT-B (No prior concussion: 42.1 + 13.2 sec and concussion history: 38.1 + 11.3, t = 1.17, p = 0.25). The results of this study suggest that while still in college, a history of one or more prior concussions, did not adversely affect neurocognitive performance on either the TMT-A or B test. As concussion history is sometimes associated with later life neurocognitive performance, future studies should assess TMT-A and B across the lifespan.