Exploring Differences in Computerized Neurocognitive Concussion Testing Between African American and White Athletes

• Published in: Archives of clinical neuropsychology Vol. 25; no. 8; pp. 734 - 744
• Main Authors: Kontos, Anthony P., Elbin, Robert J., Covassin, Tracey, Larson, Elizabeth
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-12-2010
• Subjects: Adolescent; Adult and adolescent clinical studies; African Americans - psychology; Analysis of Variance; Assessment; Athletes - psychology; Biological and medical sciences; Brain Concussion - diagnosis; Brain Concussion - physiopathology; Brain Concussion - psychology; Case-Control Studies; Cognition - physiology; Cross-cultural/minority; Databases, Factual; European Continental Ancestry Group - psychology; Female; Head injury; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Memory - physiology; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reaction Time - physiology; Traumas. Diseases due to physical agents; Traumatic brain injury; Young Adult; Social environment; Human; Evaluation; Nervous system diseases; Crosscultural study; Traumatic brain injury; Assessment; Psychometrics; Cognition; Athlete; Ethnic group; Test administration; Head injury; Minority; Cross-cultural/minority; Head trauma; Caucasoid; Computer aid; African American
• ISSN: 0887-6177; 1873-5843
• DOI: 10.1093/arclin/acq068

The purpose of the current study was to explore potential differences in pre- and post-concussion performance on a computerized neurocognitive concussion test between African American and White high-school and collegiate student-athletes. A prospective case–control design was used to compare baseline and 2- and 7-day post-concussion computerized neurocognitive performance and symptoms between 48 White and 48 African American athletes matched for age, gender, and concussion history. The Immediate Post-Concussion Assessment Cognitive Test (ImPACT) version 2.0 (NeuroHealth System, LLC, Pittsburgh, PA, USA) computer software program was used to assess neurocognitive function (i.e., verbal and visual memory, motor processing speed, and reaction time) and concussion symptoms. Regardless of race/ethnicity, there were significant decrements in computerized neurocognitive performance and increased symptoms following a concussion for the entire sample. African Americans and Whites did not differ significantly on baseline or post-concussion verbal memory, visual memory, reaction time, and total reported symptoms. However, African American participants were 2.4× more likely to have at least one clinically significant cognitive decline on ImPACT at 7 days post-concussion and scored lower at 7 days post-concussion compared with baseline on processing speed than White participants. The authors concluded that the baseline ImPACT test was culturally equivalent and construct valid for use with these two racial/ethnic groups. However, in contrast, the findings support deleterious performance for the African American athletes compared with the White athletes on the ImPACT post-concussion evaluation that is of critical clinical relevance and warrants further research.