Symptom Provocation Following Post-concussion Computerized Neurocognitive Testing and Its Relationship to Other Clinical Measures of Concussion

• Published in: Archives of clinical neuropsychology Vol. 38; no. 4; pp. 548 - 556
• Main Authors: Stephenson, Katie, Womble, Melissa N, Eagle, Shawn, Collins, Michael W, Kontos, Anthony P, Elbin, R J
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 22.05.2023
• Subjects: Adolescent; Athletes; Athletic Injuries - complications; Athletic Injuries - diagnosis; Brain Concussion - complications; Brain Concussion - diagnosis; Female; Humans; Mental Status and Dementia Tests; Neuropsychological Tests; Post-Concussion Syndrome - diagnosis; Post-Concussion Syndrome - etiology; Retrospective Studies; Concussion; Symptom provocation; Computerized neurocognitive testing
• ISSN: 1873-5843; 1873-5843
• DOI: 10.1093/arclin/acac103

Abstract Objective The objective of this study was to document the prevalence of post-computerized neurocognitive test (post-CNT) increases in symptoms in athletes with sport-related concussion, and to examine the effect of post-CNT symptom increases on concussion neurocognitive and vestibular/ocular motor clinical outcomes. Methods This was a retrospective analysis of medical records from a concussion specialty clinic. Two hundred and three athletes (M = 16.48 ± 1.97 years; 44% [90/203] female) completed a clinical visit for concussion within 30 days of injury (M = 7.73 ± 5.54 days). Computerized neurocognitive testing (the Immediate Post-concussion Assessment and Cognitive Testing: ImPACT), the Post-Concussion Symptom Scale (PCSS), and the Vestibular Ocular Motor Screening (VOMS) were the main outcome measures for the current study. Results Sixty-nine percent (141/203) of the sample did not report significant increases in PCSS scores following post-concussion CNT and were classified into a No Provocation (NO PROV) group. Thirty-one percent (62/203) of participants did report a significant increase in symptoms following post-concussion CNT and were classified into a Provocation (PROV) group. Neurocognitive performance was similar between groups. However, the PROV group reported significantly higher scores on the VOMS symptom items than the NO PROV group. Conclusions The majority of adolescent athletes can complete a post-concussion CNT without experiencing significant increases in concussion symptoms. Individuals that report symptom increases from completing a post-concussion CNT are more likely to exhibit increased vestibular/ocular motor symptoms. These findings underscore the relationship between the clinical findings from both CNT and vestibular/ocular motor measures following concussion.