Convergent and discriminant validity of the Immediate Postconcussion Assessment and Cognitive Testing Battery (ImPACT) in young athletes

Abstract

Sports concussions are recognized as significant injuries among young athletes. Research demonstrates that return-to-play prior to becoming asymptomatic has significant repercussions including sustained cognitive deficits. Many programs have begun to use computerized testing rather than traditional neuropsychological tests to (a) determine baseline performance, (b) track symptoms, and (c) measure symptoms following concussion. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is one such tool. The current study examined ImPACT's convergent and discriminant validity by comparing scores from sports-related concussion athletes (SRC) to those from nonconcussed controls (CTL). SRC included 29 athletes, ages 12-16, referred for neuropsychological assessment following sports-related concussions. CTL included 25 healthy athletes, ages 12-16, who were concussion-free in the past year. Overall, results showed general support for ImPACT, when used to screen cognition. In fact, all ImPACT domains successfully differentiated between SRC and CTL athletes. Evidence supporting appropriate convergent validity was best for the Visual Memory domain. Further, ImPACT domains demonstrated variable discriminant validity. Overall examination of validity demonstrated that ImPACT has some weaknesses but may have utility in detecting postconcussion cognitive impairment.

Sports-Related Concussion Affects Cognitive Function in Adolescents: A Systematic Review and Meta-analysis

“…Neurocognitive tests often are used to determine baseline performance, track symptoms, and measure symptoms after concussion. 74 Although normative reference values are available for the child-SCAT5 in 11- to 13-year-olds and the SCAT5 in adults, 46,66,71 normative reference values are needed for adolescents, who are in the period of rapid cognitive development. Controlling cognitive stress was found to be vital to post-SRC rehabilitation 91 and the influence of concussion history, which further indicates the important role of neurocognitive tests to assist with adolescent return-to-school and return-to-play decisions.…”

“…113 Another study tested the convergent and discriminant validity of ImPACT compared with other measurements, such as the Children's Memory Scale, Trail Making Test Parts A and B, and the Delis-Kaplan Executive Function System, indicating some weakness of convergent validity of ImPACT. 74 Neurocognitive assessment using virtual reality was found to be more sensitive to the subtle effects of SRC than traditional tests. 98 Sex was found to be a modifier of an acute concussion outcome, as concussed female athletes had significantly worse ImPACT results 32,110 and performed worse than male athletes regarding visual memory.…”

Interhemispheric transfer time and concussion in adolescents: A longitudinal study using response time and event-related potential measures

“…It also displays high test-retest reliability in adolescents with intraclass correlation coefficients ranging from 0.62 to 0.85 across the various composite scores produced by this measure ( Elbin et al, 2011 ). However, not all subscales of this measure display significant convergent and discriminant validity in adolescent populations ( Koehl et al, 2019 ).…”

Mechanism of olfactory deficit in neurotrauma and its related affective distress: A narrative review

“…TBI can range from mild effects, such as transient mental status changes, to lasting deficits in motor skills, sensory perception, and cognitive ability[ 1 , 2 , 4 ]. Because of the wide range in severity of TBI symptoms, there is an extensive amount of literature and research within the scientific community into the etiology, pathophysiology, symptoms, and treatment options for TBI.…”