Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000076.xml
Download PDF
Semin Speech Lang 2014; 35(03): 173-185
DOI: 10.1055/s-0034-1384679
DOI: 10.1055/s-0034-1384679
Clinical Test Instrument Development to Identify and Track Recovery from Concussion
Further Information
Publication History
Publication Date:
12 August 2014 (online)
Abstract
Over the past 25 years, neuropsychological assessment has been the prominent clinical method for evaluating neurocognitive functioning and monitoring recovery following mild traumatic brain injury (mTBI), or concussion. During this time, neuropsychological assessment of concussion has developed extensively starting from traditional paper-and-pencil tests to the more current computerized assessment batteries that are specifically designed for evaluating mTBI. Concussion assessment is complex and challenging due to the highly variable neurocognitive behavior and the wide range of diverse symptoms that follow an injury. Therefore, neuropsychological testing is only one component of a multifaceted, comprehensive assessment approach that also includes balance testing and symptom assessment. Because concussions may go undetected, more emphasis has been placed on objective and sensitive neuropsychological measures. Factors that could affect the validity of test performance include athletes not recognizing or intentionally hiding their symptoms or sandbagging their baseline performance. Due to the complex nature of identifying and evaluating mild head injuries, the purpose of this review is to discuss (1) the clinical use of neuropsychological testing in concussion management, (2) the methods used for evaluating and monitoring recovery following concussion, (3) the characteristics of current assessment instruments, and (4) additional clinical factors and approaches for concussion assessment and management.
-
References
- 1 French LM. Military traumatic brain injury: an examination of important differences. Ann NY Acad Sci 2010; 1208: 38-45
- 2 Berner O. Concussion of the head. Am J Surg 1935; 29 (2) 273-281
- 3 McCrory P, Berkovic SF. Concussion: the history of clinical and pathophysiological concepts and misconceptions. Neurology 2001; 57 (12) 2283-2289
- 4 Symonds C. Concussion and its sequelae. Lancet 1962; i: 1-5
- 5 MacFlynn G, Montgomery EA, Fenton GW, Rutherford W. Measurement of reaction time following minor head injury. J Neurol Neurosurg Psychiatry 1984; 47: 1326-1331
- 6 Conboy TJ, Barth J, Boll TJ. Treatment and rehabilitation of mild and moderate head trauma. Rehabilitation Psychology 1986; 31 (4) 203-215
- 7 Armstrong CL. Mild head injuries. Neuropsychology 1987; 1: 15-19
- 8 Stuss DT, Stethem LL, Hugenholtz H, Picton P, Pivic J, Richard MD. Reaction time after head injury: Fatigue, divided and focused attention, and consistency of performance. J Neurol Neurosurg Psychiatry 1989; 52: 742-748
- 9 Barth JT, Alves WM, Ryan TV, , et al. Mild head injury in sports: Neuropsychological sequelae and recovery of function. In: Levin HS, Eisenberg EH, Benton AL. , ed. Mild head injury. New York, NY: Oxford University Press; 1989: 257-275
- 10 Adams JH, Doyle D, Ford I, Gennarelli TA, Graham DI, McLellan DR. Diffuse axonal injury in head injury: definition, diagnosis and grading. Histopathology 1989; 15 (1) 49-59
- 11 Saunders R, Harbaugh R. The second impact in catastrophic contact-sports head trauma. JAMA 1984; 252: 538-539
- 12 Cantu RC. Second impact syndrome. Clin Sports Med 1998; 17 (1) 37-44
- 13 Cantu RC, Voy R. Second impact syndrome a risk in any contact sport. Phys Sportsmed 1995; 23: 27-34
- 14 Hinton-Bayre AD, Geffen G, McFarland K. Mild head injury and speed of information of processing: A prospective study of professional rugby league players. J Clin Exp Neuropsychol 1997; 19 (2) 275-289
- 15 Kane RL, Reeves DL, Computerized test batteries. In: Horton A. , ed. The neuropsychology handbook: New edition. New York: Springer; 1997
- 16 Reeves DL, Winter KP, Bleiberg J, Kane RL. ANAM Genogram: Historical perspectives, description and current endeavors. Arch Clin Neuropsychol 2007; 22S: S15-S37
- 17 Cernich A, Reeves D, Sun W, Bleiberg J. Automated neuropsychological assessment metrics sports medicine battery. Arch Clin Neuropsychol 2007; 22 (1) 101-114
- 18 Bleiberg J, Kane RL, Reeves DL, Garmoe WS, Halpern E. Factor analysis of computerized and traditional tests used in mild brain injury research. Clin Neuropsychol 2000; 14 (3) 287-294
- 19 Kabat MH, Kane RL, Jefferson AL, DiPino RK. Construct validity of selected Automated Neuropsychological Assessment Metrics (ANAM) battery measures. Clinical Neuropsychologist 2001; 15 (4) 498-507
- 20 Jones PW, Loe SA, Krach K, Rager RY, Jones HM. Automated Neuropsychological Assessment Metrics (ANAM) and Woodcock-Johnson III tests of cognitive ability: A concurrent validity study. Clinical Neurologist 2008; 22: 305-320
- 21 Segalowitz SJ, Mahaney P, Santesso DL, MacGregor L, Dywan J, Willer B. Retest reliability in adolescents of a computerized neuropsychological battery used to assess recovery from concussion. NeuroRehabilitation 2007; 22 (3) 243-251
- 22 Kaminski TW, Groff RM, Glutting JJ. Examining the stability of Automated Neuropsychological Assessment Metrics (ANAM) baseline test scores. J Clin Exp Neuropsychol 2009; 31 (6) 689-697
- 23 Levinson DM, Reeves DL. Monitoring recovery from traumatic brain injury using Automated Neuropsychological Assessment Metrics (ANAM V1.0). Arch Clin Neuropsychol 1997; 12 (2) 155-166
- 24 Collie A, Maruff P, Makdissi M, McCrory P, McStephen M, Darby D. CogSport: Reliability and correlation with conventional cognitive tests used in postconcussion medical evaluations. Clin J Sport Med 2003; 13 (1) 28-32
- 25 Collie A, Makdissi M, Maruff P, Bennell K, McCrory P. Cognition in the days following concussion: Comparison of symptomatic versus asymptomatic athletes. J Neurol Neurosurg Psychiatry 2006; 77 (2) 241-245
- 26 Falleti MG, Maruff P, Collie A, Darby DG. Practice effects associated with the repeated assessment of cognitive function using the CogState battery at 10-minute, one week and one month test-retest intervals. J Clin Exp Neuropsychol 2006; 28 (7) 1095-1112
- 27 Maruff P, Thomas E, Cysique L , et al. Validity of the CogState brief battery: Relationship to standardized tests and sensitivity to cognitive impairment in mild traumatic brain injury, schizophrenia, and AIDS dementia complex. Arch Clin Neuropsychol 2009; 24 (2) 165-178
- 28 Makdissi M, Darby D, Maruff P, Ugoni A, Brukner P, McCrory PR. Natural history of concussion in sport markers of severity and implications for management. Am J Sports Med 2010; 38 (3) 464-471
- 29 Gualtieri CT, Johnson LG. Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Arch Clin Neuropsychol 2006; 21 (7) 623-643
- 30 Jones R. Test-Retest Reliability and Effort on the CNS-Vital Signs Assessment [dissertation]. Virginia Beach, VA: Regent University; 2011
- 31 Lanting SC, Iverson GL, Lange RT. Concurrent validity of CNS Vital Signs in patients with mild traumatic brain injury. Paper presented at: American Congress of Rehabilitation Medicine Conference; October 9-13, 2012; Vancouver, Canada
- 32 Lanting SC, Iverson GL, Lange RT. Comparing patients with mild traumatic brain injury to trauma controls on CNS Vital Signs. Paper presented at: American Congress of Rehabilitation Medicine Conference; October 9-13, 2012; Vancouver, Canada
- 33 Erlanger D, Saliba E, Barth J, Almquist J, Webright W, Freeman J. Monitoring resolution of postconcussion symptoms in athletes: preliminary results of a web-based neuropsychological test protocol. J Athl Train 2001; 36 (3) 280
- 34 Erlanger D, Feldman D, Kutner K , et al. Development and validation of a web-based neuropsychological test protocol for sports-related return-to-play decision-making. Arch Clin Neuropsychol 2003; 18 (3) 293-316
- 35 Broglio SP, Ferrara MS, Macciocchi SN, Baumgartner TA, Elliott R. Test-retest reliability of computerized concussion assessment programs. J Athl Train 2007; 42 (4) 509-514
- 36 Broglio SP, Macciocchi SN, Ferrara MS. Sensitivity of the concussion assessment battery. Neurosurgery 2007; 60 (6) 1050-1058
- 37 Echemendia RJ, Iverson GL, McCrea M , et al. Advances in neuropsychological assessment of sport-related concussion. Br J Sports Med 2013; 47: 294-298
- 38 Iverson GL, Lovell MR, Collins MW. Interpreting change on ImPACT following sport concussion. Clinical Neuropsychologist 2003; 17 (4) 460-467
- 39 Iverson GL, Lovell MR, Collins MW. Reliable change in ImPACT version 2.0 following sports concussion. [Abstract] Arch Clin Neuropsych 2003; 18: 744
- 40 Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed following sports-related concussion. J Clin Exp Neuropsychol 2004; 27 (6) 683-689
- 41 Iverson GL, Gaetz M, Lovell MR, Collins MW. Cumulative effects of concussion in amateur athletes. Brain Injury 2004; 18 (5) 433-443
- 42 Lovell MR, Collins MW, Iverson GL , et al. Recovery from mild concussion in high school athletes. J Neurosurg 2003; 98: 295-301
- 43 McClincy MP, Lovell MR, Pardini J, Collins MW, Spore MK. Recovery from sports concussion in high school and collegiate athletes. Brain Injury 2006; 20 (1) 33-39
- 44 Schatz P, Pardini JE, Lovell MR, Collins MW, Podell K. Sensitivity and specificity of the ImPACT test battery for concussion in athletes. Arch of Clin Neuropsych 2006; 21 (1) 91-99
- 45 Elbin RJ, Schatz P, Covassin T. One-year test-retest reliability of the online version of ImPACT in high school athletes. Am J Sports Med 2011; 39: 2319-2324
- 46 Schatz P, Ferris CS. One-month test–retest reliability of the ImPACT test battery. Arch Clin Neuropsychol 2013; 28 (5) 499-504
- 47 Resch J, Driscoll A, McCaffrey N , et al. ImPACT test-retest reliability: Reliably unreliable?. J Athl Train 2013; 48 (4) 506-511
- 48 Cole WR, Arrieux JP, Schwab K, Ivins BJ, Qashu FM, Lewis SC. Test–retest reliability of four computerized neurocognitive assessment tools in an active duty military population. Arch Clin Neuropsychol 2013; 28 (7) 732-742
- 49 Bruce J, Echemendia R, Meeuwisse W, Comper P, Sisco A. One year test-retest reliability of ImPACT in professional ice hockey players. Clin Neuropsychol 2014; 28 (1) 14-25
- 50 Schatz P, Putz BO. Cross-validation of measures used for computer-based assessment of concussion. Appl Neuropsych 2006; 13 (3) 151-159
- 51 Maerlender A, Flashman L, Kessler A , et al. Examination of the construct validity of ImPACT™ computerized test, traditional, and experimental neuropsychological measures. Clinical Neuropsychologist 2010; 24 (8) 1309-1325
- 52 Echemendia RJ, Herring S, Bailes J. Who should conduct and interpret the neuropsychological assessment in sports-related concussion?. Br J Sports Med 2009; 43: i32-i35
- 53 Salvatore AP, Sirmon Fjordbak B. Concussion management: The speech-language pathologist's role. J Med Speech Lang Pathol 2011; 19 (1) 1-12
- 54 American Speech-Language-Hearing Association. Scope of practice in speech-language pathology [Scope of Practice]. 2007 . Available at: http://www.asha.org/policy/SP2007-00283/ . Accessed April 16, 2014
- 55 Salvatore AP, Bene ER, Fjordbak BS. Comparison of performance of concussed and non-concussed individuals on Subtest VIII of the C-RTT. Paper presented at: 43rd Clinical Aphasiology Conference; May 28-June 2, 2013; Tucson, Arizona
- 56 Collins MW, Grindel SH, Lovell MR , et al. Relationship between concussion and neuropsychological performance in college football players. JAMA 1999; 282 (10) 964-970
- 57 Guskiewicz KM, Marshall SW, Bailes J , et al. Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery 2005; 57 (4) 719-726
- 58 Field M, Collins MW, Lovell MR, Maroon J. Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. J Pediatr 2003; 142: 546-553
- 59 Covassin T, Schatz P, Swanik CB. Sex differences in neuropsychological function and post-concussion symptoms of concussed collegiate athletes. Neurosurgery 2007; 61 (2) 345-351
- 60 Colvin AC, Mullen JR, Lovell M, West RV, Collins MW, Groh M. The role of concussion history and gender in recovery from soccer-related concussion. Am J Sports Med 2009; 37 (9) 1699-1704
- 61 Erdal K. Neuropsychological testing for sports-related concussion: How athletes can sandbag their baseline testing without detection. Arch Clin Neuropsych 2012; 27: 473-479
- 62 Bailey CM, Echemendia RJ, Arnett PA. The impact of motivation on neuropsychological performance in sports-related mild traumatic brain injury. J Int Neuropsych Soc 2006; 12: 475-484
- 63 Bailey CM, Arnett PA. Motivation and the assessment of sports-related concussion. In: Slobounov SM, Sebastianelli WJ, (Eds.). Foundations of Sports-Related Concussion. Norwell, MA: Springer-Verlag; 2006: 171-195
- 64 LaBotz M, Martin MR, Kimura IF, Hetzler RK, Nichols AW. A comparison of a preparticipation evaluation history form and a symptom-based concussion survey in the identification of previous head injury in collegiate athletes. Clin J Sport Med 2005; 15 (2) 73-78
- 65 McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players. Clin J Sport Med 2004; 14 (1) 13-17
- 66 Valovich McLeod TC, Bay C, Heil J, McVeigh SD. Identification of sport and recreational activity concussion history through the preparticipation screening and a symptom survey in young athletes. Clin J Sport Med 2008; 18 (3) 235-240
- 67 McCrory P, Meeuwisse W, Aubry M , et al. Consensus statement on concussion in sport – the International Conference on Concussion in Sport held in Zurich, November 2012. Clin J Sport Med 2013; 23: 89-117
- 68 Iverson GL. Evidence-based neuropsychological assessment in sport-related concussion. In: Webbe FM, , ed. The handbook of sport neuropsychology. New York, NY: Springer Publishing Company; 2011: 131-154