Neuropsychological Assessment of Sports-Related Mild Traumatic Brain Injury: A Prospective Multi-Sport Study.

Principle Investigator: Ruben J. Echemendia, Ph.D.

Institution: Pennsylvania State University, Department of Psychology

Title: Neuropsychological Assessment of Sports-Related Mild Traumatic Brain Injury: A Prospective Multi-Sport Study


Abstract: Mild Traumatic Brain Injuries (mTBI) are serious, at times catastrophic, injuries which pose risks to athletes as all levels of competition. The Penn State Cerebral Concussion Program was developed in 1995 as a multi-sport (both sexes) prospective state-of-the-art neuropsychological assessment program. Recognize as a model for neuropsychological testing programs, baseline assessments have been conducted with 476 athletes in football, ice hockey, men’s and women’s soccer, men’s and women’s basketball. Swim teams serve as controls. This proposal requests funds to continue and improve the program. The overall goal of the project is to prevent catastrophic injury by determining when it is safe to return a player to competition. Specific aims include: (1) assessing the sensitivity of neuropsychological tests in detecting mTBI, (2) determining which combination of tests or techniques has the greatest sensitivity of mTBI, (3) assessing the recovery timeline for cognitive and neurobehavioral symptoms, (4) assessing the practice effects of neuropsychological tests, (5) testing the sensitivity of the Standardized Assessment of Concussion (SAC) and its relationship to well-established neuropsychological measures, (6) assessing the sensitivity of a clinical measure of postural stability, (7) empirically evaluating the AAN practice parameters, and (8) examining the suitability of a non-athlete control group.

Baseline neuropsychological data will be collected on all new players in ice hockey, football, men’s/women’s soccer, men’s/women’s basketball, and men’s/women’s swimming. Twenty five percent of previously tested players will be re-examined to assess maturation. Wrestling and women’s lacrosse teams will be added to the project. Baseline postural stability and SAC scores will be collected on all athletes. Injured athletes will be evaluated at 2 hours, 24-48 hours, one week, and one month post-injury. Post Concussion Symptoms Checklist will be tested at the same time intervals as mTBI athletes. The comprehensive screening battery of neuropsychological instruments will assess orientation, memory, attention/concentration, speed of information processing, new learning, and reaction time.

Neuropsychological testing programs such as the one proposed above are practical and easily transferred across institutions. For example, all NHL teams undergo pre-season neuropsychological testing (Echemendia is co-director of the project). The NFL is expected to have 20-25 teams tested by next season. Many colleges and high schools have started neuropsychological testing programs based on Penn State’s model.