Hostname: page-component-5d84bcc8dc-2jfv9 Total loading time: 0 Render date: 2026-09-09T07:43:21.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Computerized Neurocognitive Testing within 1 Week of Sport-Related Concussion: Meta-analytic Review and Analysis of Moderating Factors

Published online by Cambridge University Press:  13 February 2014

Anthony P. Kontos ,
Rock Braithwaite ,
Scott Dakan  and
R.J. Elbin
Anthony P. Kontos*
Affiliation:
Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania
Rock Braithwaite
Affiliation:
Department of Kinesiology and Recreation Administration, Humboldt State University, Arcata, California
Scott Dakan
Affiliation:
Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania
R.J. Elbin
Affiliation:
Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas
*
Correspondence and reprint requests to: Anthony P. Kontos, UPMC Sports Medicine Concussion Program, Department of Orthopedic Surgery, University of Pittsburgh, UPMC Center for Sports Medicine, 3200 South Water Street, Pittsburgh, Pennsylvania 15203. E-mail: akontos@pitt.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

The purpose of this study is to perform a meta-analysis assessing the effects of sport-related concussion as measured by computerized neurocognitive tests (NCT) 1-week post injury. Thirty-seven studies involving 3960 participants between 2000 and 2011 were included. Hedge's g provides an adjusted effect size for smaller sample sizes and was calculated for overall and cognitive task effects, and subgroup analyses were conducted for age, type of NCT, and sport. Concussions had a low negative effect (g = −0.16; p < .001) across all groups, outcomes, and time points. Code substitution (g = −0.27; p < .05), visual memory (g = −0.25; p < .05), processing speed (g = −0.18; p < .05), and memory (g = −0.21; p < .05) tasks demonstrated negative effects for concussion. Younger adolescents had lower (g = −0.29; p < .05) NCT performance than older adolescents (g = −0.01) and college aged athletes (g = −0.11). ImPACT studies (g = −0.19; p < .05) demonstrated a negative effect for concussion as did those involving contact sports (g = −0.20; p < .05). A low to moderate overall effect size of concussion on neurocognitive performance was supported. Subgroup analyses revealed different effect sizes for specific cognitive tasks, types of NCTs, age, and type of sport. (JINS, 2014, 20, 1–9)

Keywords

ANAMCogSportHeadminderImPACTNeuropsychologyMild traumatic brain injury

Information

Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 3 , March 2014 , pp. 324 - 332
Copyright
Copyright © The International Neuropsychological Society 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Aubry, M., Cantu, R., Dvorak, J., Graf-Baumann, T., Johnston, K., Kelly, J., Schamasch, P. (2002). Summary and agreement statement of the first international conference on concussion in sport, vienna 2001. Physician and Sportsmedicine, 30, 5 7–63.CrossRefGoogle ScholarPubMed
Belanger, H.G., Spiegel, E., Vanderploeg, R.D. (2010). Neuropsychological performance following a history of multiple self-reported concussions: A meta-analysis. Journal of the International Neuropsychological Society, 16, 262–267.Google Scholar
Borenstein, M., Hedges, L., Higgins, J.P., Rothstein, H.R. (2005). Comprehensive meta-analysis version 2. Engelwood, NJ: Biostat.Google Scholar
Borenstein, M., Hedges, L.V., Higgins, J.P.T., Rothstein, H.R. (2009). Introduction to meta-analysis. Chichester, UK: Wiley.Google Scholar
Borenstein, M., Hedges, L.V., Higgins, J.P.T., Rothstein, H.R. (2010). A basic introduction to fixed effect and random effects models for meta-analysis. Research Synthesis Methods, 1, 97–111.Google Scholar
Broglio, S.P., Puetz, T.W. (2008). The effect of sport concussion on neurocognitive function, self-report symptoms and postural control: A meta-analysis. Sports Medicine, 38, 53–67.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawerence Erlbaum Associates.Google Scholar
Collins, M.W., Iverson, G.L., Lovell, M.R., McKeag, D.B., Norwig, J., Maroon, J. (2003). On-field predictors of neuropsychological and symptom deficit following sports-related concussion. Clinical Journal of Sport Medicine, 13, 222–229.CrossRefGoogle ScholarPubMed
Dougan, B.K., Horswill, M.S., Geffen, G.M. (2013). Athletes’ age, sex, and years of education moderate the acute neuropsychological impact of sports-related concussion: A meta-analysis. Journal of the International Neuropsychological Society, 1–17.Google Scholar
Duval, S., Tweedie, R. (2000). Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56, 455–463.CrossRefGoogle ScholarPubMed
Egger, M., Davey Smith, G., Schneider, M., Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315, 629–634.Google Scholar
Fazio, V.C., Lovell, M.R., Pardini, J.E., Collins, M.W. (2007). The relation between post concussion symptoms and neurocognitive performance in concussed athletes. Neurorehabilitation, 22, 207–216.Google Scholar
Field, A.P. (2001). Meta-analysis of correlation coefficients: A Monte Carlo comparison of fixed- and random-effects methods. Psychological Methods, 6, 161–180.CrossRefGoogle ScholarPubMed
Field, A.P. (2003). Can meta-analysis be trusted? The Psychologist, 16, 642–645.Google Scholar
Field, M., Collins, M.W., Lovell, M.R., Maroon, J. (2003). Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. Journal of Pediatrics, 142, 546–553.Google Scholar
Guskiewicz, K., Weaver, N.L., Padua, D.A., Garrett, W.E. (2000). Epidemiology of concussion in collegiate and high school football players. American Journal of Sports Medicine, 28, 643–650.CrossRefGoogle ScholarPubMed
Hedges, L.V. (1981). Distribution theory for glass's estimator of effect size and related estimators. Journal of Educational Statistics, 6, 107–128.Google Scholar
Hedges, L.V., Olkin, I. (1985). Statistical methods for meta-analysis. Orlando, FL: Academic Press.Google Scholar
Higgins, J.P., Thompson, S.G., Deeks, J.J., Altman, D.G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327, 557–560.Google Scholar
Hunter, J.E., Schmidt, F.L. (2000). Fixed effects vs. random effects meta-analysis models: Implications for cumulative knowledge in psychology. International Journal of Selection and Assessment, 8, 275–292.CrossRefGoogle Scholar
Johnson, E.W., Kegel, N.E., Collins, M.W. (2011). Neuropsychological assessment of sport-related concussion. Clinics in Sports Medicine, 30, 73–88.Google Scholar
Langlois, J.A., Rutland-Brown, W., Wald, M.M. (2006). The epidemiology and impact of traumatic brain injury: A brief overview. Journal of Head Trauma Rehabilitation, 21, 375–378.Google Scholar
Light, R.J., Pillemer, D.B. (1984). Summing up: The science of reviewing research. Cambridge, MA: Harvard University Press.Google Scholar
Mayers, L.B., Redick, T.S. (2012). Clinical utility of ImPACT assessment for postconcussion return-to-play counseling: Psychometric issues. Journal of Clinical and Experimental Neuropsychology, 34, 235–242.Google Scholar
McCrory, P., Meeuwisse, W., Johnston, K., Dvorak, J., Aubry, M., Molloy, M., Cantu, R. (2009). Consensus statement on Concussion in Sport 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Clinical Journal of Sport Medicine, 19, 185–200.CrossRefGoogle ScholarPubMed
Randolph, C. (2011). Baseline neuropsychological testing in managing sport-related concussion: Does it modify risk? Current Sports Medicine Reports, 10, 21–26.Google Scholar
Report on Trends and Participation in Youth Sports. (2001). Stuart, FL: National Council of Youth Sports.Google Scholar
Rosenthal, R. (1979). The “File Drawer Problem” and tolerance for null results. Psychological Bulletin, 86, 638–641.Google Scholar
Rothstein, H.R., Sutton, A.J., Borenstein, M. (2005). Publication bias in meta-analysis: Prevention assessment and adjustments. Chichester, UK: John Wiley.Google Scholar
Schatz, P., Kontos, A., Elbin, R. (2012). Response to Mayers and Redick: “Clinical utility of ImPACT assessment for postconcussion return-to-play counseling: Psychometric issues”. Journal of Clinical and Experimental Neuropsychology, 34, 428–434.Google Scholar
Shaddish, W.R., Sweeney, R.B. (1991). Mediators and moderators in meta-analysis: There's a reason we don't let dodo birds tell us which psychotherapies should have prizes. Journal of Consulting and Clinical Psychology, 59, 883–893.Google Scholar