Effects of Persistent Concussion Symptoms on Executive Function in Working-aged Adults using a Novel Sensorimotor Assessment Tool

Abstract

To examine neurocognitive performance of persistent concussion symptom patients using a novel sensorimotor technology. In patients with persistent concussion symptoms, neurocognitive deficits have been routinely identified; however, most of the current literature focuses on athletes and military veterans. Middle aged community members face unique challenges related to jobs, family, and transportation which can all be adversely affected by neurocognitive deficits. Thirteen adults (44.3 ± 12.6 years) with self-reported persistent-concussion symptoms (PCS) at least 3 months post-injury, and thirteen sex and age matched healthy controls (37.5 ± 8.8 years) were recruited. Participants performed the Trail-Making Test A (TMT-A) and Trail-Making Test B (TMT-B) on a novel sensorimotor assessment tool, the KINARM (BKIN Technologies, Kingston, ON, Canada). Using their dominant hand, TMT-A required participants to connect numbered dots in ascending order as quickly as possible. TMT-B required connecting dots with either a number or letter inside, in an alternating number-letter fashion (i.e.,: 1-A-2-B-3-C…). Total number of symptoms and a symptom severity score were assessed using the Rivermead Post Concussion Symptoms Questionnaire (RPQ). An independent samples t-test was used to analyze group differences of total time to completion, dwell time, and number of errors. As expected, PCS patients had a significantly higher number of symptoms and severity score (PCS: 13.4 ± 2.3 and 36.2 ± 14.5, respectively; Controls: 3.4 ± 3.7 and 5.3 ± 5.6, respectively, p < 0.001). PCS patients were significantly slower on TMT-A (46.3 ± 20.1 sec; and 34.7 ± 6.5 sec respectively, p = 0.047). There were no group differences in TMT-B. Our results suggest that neurocognitive function may remain unaffected by persistent concussion symptoms in working-aged adults. The lack of task performance differences may be a result of neurocognitive function recovery, or the need for a more sensitive task to assess neurocognitive function in this population.