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Guty E, Riegler K, Meyer J, Walter AE, Slobounov SM, Arnett P. Symptom Factors and Neuropsychological Performance in Collegiate Athletes with Chronic Concussion Symptoms. Arch Clin Neuropsychol 2021; 36:746-756. [PMID: 33140096 DOI: 10.1093/arclin/acaa092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/07/2020] [Accepted: 09/25/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The present study explored the relationship between specific types of postconcussion symptoms and cognitive outcomes in student-athletes with chronic concussion symptoms. METHOD Forty student-athletes with chronic concussion symptoms were given a battery of neuropsychological tests and rated themselves on a variety of postconcussion symptoms, which included the following factors derived from prior work: Physical, Sleep, Cognitive, Affective, and Headache. Cognitive outcomes included performance on composites for the memory and attention/executive functioning speed tests, respectively. The following covariates were also explored: Sex, depression symptoms, number of previous concussions, and time since injury. RESULTS Headache was the only individual symptom factor that significantly (p < .05) predicted worse attention/executive functioning performance. None of the symptom factors were significantly related to memory performance over and above the variable of time since injury, such that longer time since injury was related to worse memory performance. CONCLUSION Comparable to work examining symptom predictors of cognitive outcomes in acutely concussed samples, headache predicted worse attention/executive functioning performance. Additionally, we found that the longer athletes had been symptomatic since injury, the "worse" their memory functioning. Understanding how headache and the length of time an individual is symptomatic are related to cognitive outcomes can help inform treatment and recommendations for athletes with prolonged symptom recovery.
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Affiliation(s)
- Erin Guty
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Kaitlin Riegler
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Jessica Meyer
- Department of Behavioral Health, Summa Health System, Akron, OH, USA
| | - Alexa E Walter
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Semyon M Slobounov
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Peter Arnett
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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Ryan J, Woods RL, Britt CJ, Murray AM, Shah RC, Reid CM, Wolfe R, Nelson MR, Orchard SG, Lockery JE, Trevaks RE, Storey E. Normative Data for the Symbol Digit Modalities Test in Older White Australians and Americans, African-Americans, and Hispanic/Latinos. J Alzheimers Dis Rep 2020; 4:313-323. [PMID: 33024939 PMCID: PMC7504980 DOI: 10.3233/adr-200194] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Processing speed, which can be assessed using the Symbol Digit Modalities Test (SDMT), is central to many brain functions. Processing speed declines with advanced age but substantial impairments are indicative of brain injury or disease. Objective The purpose of this study was to provide SDMT normative data for older community-dwelling individuals in the U.S. and Australia. Methods The ASPREE trial recruited 19,114 relatively healthy older men and women in Australia and the U.S. from the general community. All participants were without a diagnosis of dementia and with a Modified Mini-Mental State examination score of 78 or more at enrolment. The SDMT was administered at baseline as part of a neuropsychological test battery. Results The median age of participants was 74 years (range 65-99), and 56% were women. The median years of education was 12. Ethno-racial differences in SDMT performance were observed and normative data were thus presented separately for 16,289 white Australians, 1,082 white Americans, 891 African-Americans, and 316 Hispanic/Latinos. There were consistent positive associations found between SDMT and education level, and negative associations between SDMT and age. Mean scores for women were consistently higher than men with the exception of Hispanic/Latinos aged ≥70 years. Conclusion This study provides comprehensive SDMT normative data for whites (Australian and U.S.), Hispanic/Latinos, and African-Americans, according to gender, age, and education level. These norms can be used clinically as reference standards to screen for cognitive impairments in older individuals.
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Affiliation(s)
- Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Carlene J Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Health Research Institute and Division of Geriatrics, Department of Medicine, Hennepin HealthCare and University of Minnesota, MN, USA
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jessica E Lockery
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ruth E Trevaks
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Haran FJ, Schumacher P, Markwald R, Handy JD, Tsao JW. Relationships Between Sleepiness, Mood, and Neurocognitive Performance in Military Personnel. Front Neurol 2019; 10:674. [PMID: 31316453 PMCID: PMC6610493 DOI: 10.3389/fneur.2019.00674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022] Open
Abstract
Neurocognitive computerized assessment tools (NCATs) were developed to assist military clinicians with the tracking of recovery from injury and return to full duty decisions with a recent focus on the setting of post-concussion evaluations. However, there is limited data on the impact of deployment on neurocognitive functioning, sleepiness, and mood in healthy, non-concussed Service members. Automated Neuropsychological Assessment Metrics version 4 TBI Military (ANAM) data was obtained for a sample of active duty deployed personnel (n = 72) without recent history of mild traumatic brain injury (mTBI). A linear regression was conducted to examine the effects of sleepiness and mood state on neurocognitive performance. The overall multivariate regression was statistically significant. Negative mood states were the most salient predictors of neurocognitive performance with higher levels of endorsement associated with lower scores. The findings support measures of negative mood state, but not sleepiness, as relevant predictors of neurocognitive performance as measured by the ANAM. These results indicate that mood needs to be considered when reviewing neurocognitive data to ensure that appropriate clinical decisions are made; in particular for return-to-duty decisions in deployed settings after concussion recovery.
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Affiliation(s)
- F. J. Haran
- Naval Medical Research Center, Silver Spring, MD, United States
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Patrick Schumacher
- University of Tennessee–Knoxville, Knoxville, TN, United States
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States
| | | | - Justin D. Handy
- Stress and Motivated Behavior Institute, Syracuse, NY, United States
| | - Jack W. Tsao
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- University of Tennessee–Knoxville, Knoxville, TN, United States
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States
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