This study explored the diagnostic utility of the composite scores of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Post Concussion Symptom Scale scores (PCSS). Recently concussed high school athletes (N=72) were tested within 72 h of sustaining a concussion, and data were compared to non-concussed high school athletes with no history of concussion (N=66). Between-groups MANOVA revealed a significant multivariate effect of concussion on test performance (p<.001); univariate ANOVAS revealed all six measures contributed to the between-groups differences. A discriminant function analyses was conducted to measure the ability of the five ImPACT composite scores, as well as the PCSS to classify concussion status. One discriminant function was identified that consisted of the Visual Memory, Processing Speed, and Impulse Control composite scores PCSS, which correctly classified 85.5% of the cases. Approximately 82% of participants in the concussion group and 89% of participants in the control group were correctly classified. Using these data, the sensitivity of ImPACT was 81.9%, and the specificity was 89.4%. As part of a formal concussion management program, ImPACT is a useful tool for the assessment of the neurocognitive and neurobehavioral sequelae of concussion, and can also provide post-injury cognitive and symptom data that can assist a practitioner in making safer return to play decisions.

The current findings reveal different symptom factors at baseline and postinjury and several age and sex differences on the symptom factors. At postconcussion, symptoms aggregated into a global concussion factor including cognitive, fatigue, and migraine symptoms. Symptoms reported at baseline are not the same as those reported after injury. The presence of a global postconcussion symptom comprising the fatigue factor highlights the importance of physical and cognitive rest during the first week after a concussion. Although headache was the most commonly reported symptom, it was not the greatest contributor to the global postconcussion symptom factor.

Neurocognitive differences may be associated with the loss of neuromuscular control and coordination errors, predisposing certain intercollegiate athletes to noncontact anterior cruciate ligament injuries.

OBJECTIVE:Our purpose was to determine whether sex differences exist with respect to post-concussion symptoms and neurocognitive function in concussed collegiate athletes. METHODS: A prospective dependent-sample cohort design was used to compare baseline and post-concussion neuropsychological test scores and endorsed symptoms as functions of serial post-concussion assessment with respect to time and sex. The Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) battery was administered to a multicenter analysis group of 79 concussed athletes. This computerized neuropsychological test was given to the athletes during the preseason and, on average, 2 and 8 days postinjury. RESULTS: Multivariate analyses revealed no significant between-group differences on baseline test performance with respect to sex on any of the ImPACT composite scores or on the total symptom score. Multivariate analyses of post-concussion data revealed a significant main effect of time on ImPACT scores, but no main effect of sex was identified, and no time-by-sex interaction existed. Post hoc analysis revealed that concussed female athletes performed significantly worse than concussed male athletes on visual memory tasks (P ϭ 0.001), and analysis of endorsed post-concussion symptoms revealed that concussed men were significantly more likely than concussed women to report post-concussion symptoms of vomiting (P ϭ 0.001) and sadness (P ϭ 0.017). Athletes' scores were examined individually using the reliable-change methodology. At 2 days post-injury, 58% of concussed athletes had one or more reliable incidents of performance decline or increases in symptom reporting. At 8 days post-concussion, 30% of concussed athletes were still showing one or more reliable change from preseason values. CONCLUSIONS: College athletes exhibit differences on visual memory composite scores and symptoms post-concussion as a function of sex. These data support the importance of evaluating neuropsychological status and post-concussion symptoms in concussed athletes. In addition, these data illustrate the importance of analyzing an individual athlete's recovery pattern, because individual differences in recovery trajectories may be overshadowed by global norm-group comparisons. A pproximately 300,000 sport-related concussions are reported each year (40). To date, literature reporting concussions in athletes has been primarily concentrated on men's sports such as football, ice hockey, boxing, and soccer, with few comparisons with regard to sex in concussed athletes (2, 3, 10, 37). However, female athletes have been found to be at a greater risk for concussion in basketball and soccer than male athletes (10). Broshek et al. (6) reported significant declines on measures of simple and complex reaction times relative to preseason baseline values in female athletes. Because women's sports participation has expanded significantly during the last decade and brain function differs between the sexes, a comparison of baseline neuropsychological function and post-concu...