Abstract Details

Title Association between Concussion Profiles and Neurocognitive Functioning

Topic Neuro Trauma and Sports Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-1:15 PM)

Poster/Presentation
Number 013

Objective

To examine the relationship between concussion profiles and neurocognitive functioning, as measured by CNS Vital Signs (CNSVS)

Background

The heterogeneity of clinical presentation following concussion poses a challenge for treating clinicians. Kontos and Collins proposed a model in which initial global symptoms delineate into specific clinical trajectories, termed concussion profiles.

Design/Methods

The study was a retrospective, blind review of patient data from a concussion specialty clinic. Clinicians determined if patients met criterion for a profile, and identified the primary profile. One-way ANOVA’s were used to determine the overall effect of concussion profile on CNSVS multi-test domains. Omega-squared (ω2) was used as an estimate of the overall effect size: .01 (small), .06 (medium), .14 (large). Hedge’s g was used post-hoc to determine the effect size of mean differences between profiles on each domain: 0.2 (small), 0.5 (medium), 0.8 (large).

Results

Data consisted of 88 participants obtained from the UF Concussion and Sports program (median age = 26.5; IQR, 18.0-51.8; 90% Caucasian; Median days since injury = 71, IQR, 38-155). Headache/migraine was the most prevalent primary profile (23%), while cognitive was the least prevalent (8%). The cognitive profile was associated with worse scores on the neurocognitive index (ω2=.008; g=0.71-1.04), reaction time (ω2=.081; g=.60-1.21), memory (ω2=.016; g=.50-.96), psychomotor speed (ω2=.023; g=.34-.62), complex attention (ω2=.026; g=.30-.72), and cognitive flexibility (ω2=.029; g=.36-.65) domains relative to other profiles. The vestibular (g=.39-.83) and anxiety/mood profiles (g=.33-.76) were associated with worse reaction time relative to all other profiles except cognitive. Lastly, the headache/migraine profile was associated with worse complex attention (g=.26-.53) and cognitive flexibility (g=.29-.65) relative to other profiles except cognitive.

Conclusions

The cognitive profile is characterized by global cognitive deficits, while deficits in other profiles are domain-specific. Clinicians should consider the role of non-cognitive profiles when interpreting neurocognitive scores.

Authors/Disclosures
Shaetu Datta, MD (NYU Langone, Long Island, Dept of Neurology) PRESENTER	Dr. Datta has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Qunol.
James Clugston, MD, MS, CAQSM	James Clugston, MD, MS, CAQSM has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for National Football League. James Clugston, MD, MS, CAQSM has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Pittsburgh Medical Center. James Clugston, MD, MS, CAQSM has received publishing royalties from a publication relating to health care.
Russell M. Bauer, PhD, ABPP (University of Florida Dept of Clinical and Health Psychology)	No disclosure on file
	No disclosure on file
Michael S. Jaffee, MD, FAAN (University of Florida)	Dr. Jaffee has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Massachusetts Medical Society / New England Journal of Medicine Group. Dr. Jaffee has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for McDermott, Will, and Emery on behalf of NCAA. The institution of Dr. Jaffee has received research support from NIH. Dr. Jaffee has received personal compensation in the range of $10,000-$49,999 for serving as a Director with American Board of Psychiatry and Neurology. Dr. Jaffee has received personal compensation in the range of $5,000-$9,999 for serving as a DoD study section member with Leidos in support of CDMRP.
	No disclosure on file

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