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Neuropsychological performance following a history of multiple self-reported concussions: A meta-analysis

  • HEATHER G. BELANGER (a1) (a2) (a3), ERIC SPIEGEL (a1) and RODNEY D. VANDERPLOEG (a1) (a2) (a4) (a3)
Abstract
Abstract

Debate continues about the long-term neuropsychological impact of multiple mild traumatic brain injuries (MTBI). A meta-analysis of the relevant literature was conducted to determine the impact of having a history of more than one self-reported MTBI (versus just one MTBI) across seven cognitive domains, as well as symptom complaints. The analysis was based on 8 studies, all conducted with athletes, involving 614 cases of multiple MTBI and 926 control cases of a single MTBI. The overall effect of multiple MTBI on neuropsychological functioning was minimal and not significant (d = 0.06). However, follow-up analyses revealed that multiple self-reported MTBI was associated with poorer performance on measures of delayed memory and executive functioning. The implications and limitations of these findings are discussed. (JINS, 2010, 16, 262–267.)

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Corresponding author
*Correspondence and reprint requests to: Heather Belanger, James A. Haley Veterans’ Hospital, Mental Health & Behavioral Sciences – 116B, 13000 Bruce B. Downs Blvd., Tampa, FL 33612. E-mail: heather.belanger@va.gov
References
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*References marked with an asterisk indicate studies included in the meta-analysis.

Abreau F., Templer D.I., Schuyler B.A., & Hutchison H.T. (2000). Neuropsychological assessment of soccer players. Neuropsychology, 4, 175181.
Baddeley A., Emslie H., & Nimmo-Smith I. (1992). The Speed and Capacity of Language Processing Test: Manual. Bury St Edmunds, UK: Thames Valley Test Company.
Belanger H.G., Curtiss G., Demery J.A., Lebowitz B.K., & Vanderploeg R.D. (2005). Factors moderating neuropsychological outcome following mild traumatic brain injury: A meta-analysis. Journal of the International Neuropsychological Society, 11, 215227.
Belanger H.G., & Vanderploeg R.D. (2005). The neuropsychological impact of sports-related concussion: A meta-analysis. Journal of the International Neuropsychological Society, 11, 345357.
Benedict R.D. (1997). Brief Visuospatial Memory Test – Revised. Lutz, FL: Psychological Assessment Resources.
Benedict R.H., Schretlen D.J., Groninger L., & Brandt J. (1998). Hopkins Verbal Learning Test-Revised: Normative data and analysis of inter-form and test-retest reliability. The Clinical Neuropsychologist, 12, 4355.
Benton A.L., & Hamsher K.D. (1976). Multilingual Aphasia Examination. Iowa City, Iowa: University of Iowa.
Boake C., McCauley S.R., Pedroza C., Levin H.S., Brown S.A., & Brundage S.I. (2005). Lost productive work time after mild to moderate traumatic brain injury with and without hospitalization. Neurosurgery, 56, 9941003.
Borg J., Holm L., Cassidy J.D., Peloso P.M., Carroll L.J., von Holst H., et al. (2004). Diagnostic procedures in mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43(Suppl.), 6175.
Brandt J. (1991). The Hopkins Verbal Learning Test: Development of a new verbal memory test with six equivalent forms. The Clinical Neuropsychologist, 5, 125142.
*Broglio S.P., Ferrara M.S., Piland S.G., Anderson R.B., & Collie A. (2006). Concussion history is not a predictor of computerised neurocognitive performance. British Journal of Sports Medicine, 40, 802805.
*Bruce J.M., & Echemendia R.J. (2009). History of multiple self-reported concussions is not associated with reduced cognitive abilities. Neurosurgery, 64, 100106.
Capruso D.X., & Levin H.S. (1992). Cognitive impairment following closed head injury. Neurologic Clinics, 10, 879893.
Centers for Disease Control (CDC). (2003). Report to Congress on Mild Traumatic Brain Injury in the United States: Steps to Prevent a Serious Public Health Problem. Atlanta, GA: National Center for Injury Prevention and Control.
Centers for Disease Control (CDC). (2007). National Center for Injury Prevention and Control: Traumatic Brain Injury. http://www.cdc.gov/ncipc/factsheets/tbi.htm (accessed February 15, 2009).
Cohen J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Mahwah, New Jersey: Lawrence Erlbaum.
Collie A., Maruff P., Makdissi M., McCrory P., McStephen M., & Darby D. (2003). CogSport: Reliability and correlation with conventional cognitive tests used in postconcussion medical evaluations. Clinical Journal of Sport Medicine, 13, 2832.
*Collie A., McCrory P., & Makdissi M. (2006). Does history of concussion affect current cognitive status? British Journal of Sports Medicine, 40, 550551.
*Collins M.W., Grindel S.H., Lovell M.R., Dede D.E., Moser D.J., Phalin B.R., et al. (1999). Relationship between concussion and neuropsychological performance in college football players. Journal of the American Medical Association, 282, 964970.
Creeley C.E., Wozniak D.F., Bayly P.V., Olney J.W., & Lewis L.M. (2004). Multiple episodes of mild traumatic brain injury result in impaired cognitive performance in mice. Academic Emergency Medicine, 11, 809819.
D’Elia L.F., & Satz P. (1989). Colour Trails 1 and 2. Odessa, FL: Psychological Assessment Resources.
*De Beaumont L., Brisson B., Lassonde M., & Jolicoeur P. (2007). Long-term electrophysiological changes in athletes with a history of multiple concussions. Brain Injury, 21, 631644.
DeRoss A.L., Adams J.E., Vane D.W., Russell S.J., Terella A.M., & Wald S.L. (2002). Multiple head injuries in rats: Effects on behavior. Journal of Trauma, 52, 708714.
Downs D.S., & Abwender D. (2002). Neuropsychological impairment in soccer athletes. Journal of Sports Medicine & Physical Fitness, 42, 103107.
Drew R.H., Templer D.I., Schuyler B.A., Newell T.G., & Cannon W.G. (1986). Neuropsychological deficits in active licensed professional boxers. Journal of Clinical Psychology, 42, 520525.
Erlanger D.M., Feldman D.J., & Kutner K. (1999). Concussion Resolution Index. New York, NY: Headminder, Inc.
Gaetz M., Goodman D., & Weinberg H. (2000). Electrophysiological evidence for the cumulative effects of concussion. Brain Injury, 14, 10771088.
Galarneau M.R., Woodruff S.I., Dye J.L., Mohrle C.R., & Wade A.L. (2008). Traumatic brain injury during Operation Iraqi Freedom: Findings from the United States Navy-Marine Corps Combat Trauma Registry. Journal of Neurosurgery, 108, 950957.
Gronwall D., & Wrightson P. (1975). Cumulative effect of concussion. Lancet, 2, 995997.
Guskiewicz K.M., McCrea M., Marshall S.W., Cantu R.C., Randolph C., Barr W., et al. (2003). Cumulative effects associated with recurrent concussion in collegiate football players: The NCAA Concussion Study. Journal of the American Medical Association, 290, 25492555.
Hunter J.E., & Schmidt F.L. (1990). Methods of Meta-analysis: Correcting Error and Bias in Research Findings. Newbury Park, CA: Sage.
Iverson G. (2007). Predicting slow recovery from sport-related concussion: The new simple-complex distinction. Clinical Journal of Sport Medicine, 17, 3137.
Iverson G.L., Brooks B.L., Collins M.W., & Lovell M.R. (2006). Tracking neuropsychological recovery following concussion in sport. Brain Injury, 20, 245252.
*Iverson G.L., Brooks B.L., Lovell M.R., & Collins M.W. (2006). No cumulative effects for one or two previous concussions. British Journal of Sports Medicine, 40, 7275.
Lafayette Instrument Company. (Undated). Instructions for the Grooved Pegboard. Lafayette, IN: Lafayette Instrument Company.
Lezak M.D. (2004). Neuropsychological Assessment (4th ed.). Oxford, UK: Oxford University Press.
Lovell M.R., & Collins M.W. (1998). Neuropsychological assessment of the college football player. Journal of Head Trauma Rehabilitation, 13, 926.
Macciocchi S.N., Barth J.T., Littlefield L., & Cantu R.C. (2001). Multiple concussions and neuropsychological functioning in collegiate football players. Journal of Athletic Training, 36, 303306.
Maroon J.C., Lovell M.R., Norwig J., Podell K., Powell J.W., & Hartl R. (2000). Cerebral concussion in athletes: Evaluation and neuropsychological testing. Neurosurgery, 47, 659669; discussion 669–672.
McKee A.C., Cantu R.C., Nowinski C.J., Hedley-Whyte E.T., Gavett B.E., Budson A.E., et al. (2009). Chronic traumatic encephalopathy in athletes: Progressive tauopathy after repetitive head injury. Journal of Neuropathology and Experimental Neurology, 68, 709735.
*Moser R.S., & Schatz P. (2002). Enduring effects of concussion in youth athletes. Archives of Clinical Neuropsychology, 17, 91100.
Moser R.S., Schatz P., & Jordan B.D. (2005). Prolonged effects of concussion in high school athletes. Neurosurgery, 57, 300306.
Murelius O., & Haglund Y. (1991). Does Swedish amateur boxing lead to chronic brain damage? 4. A retrospective neuropsychological study. Acta Neurologica Scandinavica, 83, 913.
Okie S. (2005). Traumatic brain injury in the war zone. New England Journal of Medicine, 352, 20432047.
Randolph C. (1998). Repeatable Battery for the Assessment of Neuropsychological Status. San Antonio, TX: The Psychological Corporation.
Reitan R.M., & Wolfson D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychology Press.
Schmidt F.L., & Hunter J.E. (2003). Meta-analysis. In Schinka J.S., & Velicer W.F. (Eds.), Handbook of Psychology (Vol. 2, pp. 533554). Hoboken, NJ: John Wiley & Sons.
Smith A. (1973). Symbol Digit Modalities Test. Los Angeles: Western Psychological Services.
Strauss E., Sherman E., & Spreen O. (2006). A Compendium of Neuropsychological Tests: Administration, Norms and Commentary (3rd ed). London: Oxford University Press.
Thornton A.E., Cox D.N., Whitfield K., & Fouladi R.T. (2008). Cumulative concussion exposure in rugby players: Neurocognitive and symptomatic outcomes. Journal of Clinical & Experimental Neuropsychology, 30, 398409.
Thurman D.J. (2001). The epidemiology and economics of head trauma. In Miller L., & Hayes R. (Eds.), Head Trauma: Basic, Preclinical, and Clinical Directions. New York: John Wiley & Sons.
Trenerry M.R., Crosson B., DeBoe J., & Leber W.R. (1989). The Stroop Neuropsychological Screening Test. Odessa, FL: Psychological Assessment Resources.
*Wall S.E., Williams W.H., Cartwright-Hatton S., Kelly T.P., Murray J., Murray M., et al. (2006). Neuropsychological dysfunction following repeat concussions in jockeys. Journal of Neurology, Neurosurgery, and Psychiatry, 77, 518520.
Wechsler D. (1997). Wechsler Adult Intelligence Scale - Third Edition: Administration and Scoring Manual. San Antonio, Texas: Harcourt Brace.
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Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
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