Neuropsychological evaluation in the diagnosis and management of sports-related concussion

RSM Psychology Center, LLC, USA.
Archives of Clinical Neuropsychology (Impact Factor: 1.92). 12/2007; 22(8):909-16. DOI: 10.1016/j.acn.2007.09.004
Source: PubMed

ABSTRACT A mild traumatic brain injury in sports is typically referred to as a concussion. This is a common injury in amateur and professional athletics, particularly in contact sports. This injury can be very distressing for the athlete, his or her family, coaches, and school personnel. Fortunately, most athletes recover quickly and fully from this injury. However, some athletes have a slow recovery, and there are reasons to be particularly concerned about re-injury during the acute recovery period. Moreover, some athletes who have experienced multiple concussions are at risk for long-term adverse effects. Neuropsychologists are uniquely qualified to assess the neurocognitive and psychological effects of concussion. The National Academy of Neuropsychology recommends neuropsychological evaluation for the diagnosis, treatment, and management of sports-related concussion at all levels of play.

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    ABSTRACT: Abstract Although the medical literature has a long history of description and comment on concussion, the occurrence of concussion within the context of sports other than boxing was not judged to be problematic until the 1980s. Neuropsychological assessment played a critical and integral role in identifying the cognitive sequelae of concussion and mapping out the short- and long-term vagaries in recovery. This paper captures that history and expands upon current applications of neuropsychological assessment in the diagnosis and management of sport-related concussion.
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    ABSTRACT: Objective: This study examined seven topics relating to neuropsychological assessment following sport-related concussion: (i) traditional vs. computerized tests; (ii) the value of baseline, pre-season testing; (iii) invalid baseline scores and poor effort; (iv) when to assess following injury; (v) the reliability of neuropsychological tests; (vi) reliable change methodology; and (vii) new methods for identifying cognitive impairment. Main results: Baseline testing can be helpful for quantifying cognitive deficits following injury and for assessing recovery. At present, however, there is insufficient evidence to conclude that having baseline test results is clearly superior to not having baseline test results. Although invalid baseline test performance can be detected in some athletes, validity indicators cannot determine the extent to which the results were due to deliberately poor performance, confusion or misunderstanding regarding some aspect of the test, distractions in group testing environments or some combination of factors. When interpreting baseline and post-injury data, sophisticated psychometric methods (e.g. reliable change, multivariate base rates) are available to assist with more accurate identification of cognitive impairment and the serial monitoring of recovery. Conclusions: The value of neuropsychological assessment in the management of sport-related concussion has a strong empirical foundation. Additional research is needed, however, to refine its use.
    Brain Injury 10/2014; 29(2). DOI:10.3109/02699052.2014.965214 · 1.86 Impact Factor

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