Concussion History and Postconcussion Neurocognitive Performance and Symptoms in Collegiate Athletes

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Abstract
Context: Athletes are at an inherent risk for sustaining concussions. Research examining the long-term consequences of sport-related concussion has been inconsistent in demonstrating lingering neurocognitive decrements that may be associated with a previous history of concussion. Objective: To determine the relationship between concussion history and postconcussion neurocognitive performance and symptoms in collegiate athletes. Design: Repeated-measures design. Setting: Multi-center analysis of collegiate athletes. Patients or Other Participants: Fifty-seven concussed collegiate athletes (36 without concussion history, 21 with a history of 2 or more concussions). Intervention(s): All subjects were administered an Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neurocognitive test battery, which measures verbal memory, visual memory, reaction time, and visual processing speed and 22 concussion symptoms. Main Outcome Measure(s): Subjects who sustained a concussion were administered 2 follow-up tests at days 1 and 5 postinjury. Independent variables were history of concussion (no history of concussion, 2 or more concussions) and time (baseline, day 1 postconcussion, or day 5 postconcussion). Results: A within-subjects effect (time) on ImPACT performance (P < .001), a between-subjects multivariate effect of group (P < .001), and a group-by-time interaction (P = .034) were noted. Athletes with a concussion history performed significantly worse on verbal memory (P = .01) and reaction time (P = .023) at day 5 postconcussion compared with athletes who did not report a previous concussion. No significant group differences were seen at day 5 postinjury on visual memory (P = .167), processing speed (P = .179), or total concussion symptoms (P = .87). Conclusions: Concussed collegiate athletes with a history of 2 or more concussions took longer to recover verbal memory and reaction time than athletes without a history of concussion.