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

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.

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). 

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. 

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.