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Purpose The purpose of this study was to explore if symptom factors are related to cognitive outcomes. Prior studies have examined the relationship of individual symptoms to cognition. However, the relation between empirically-derived symptom factors and cognitive outcomes has yet to be explored. Methods Data were extracted via retrospective chart review of 691 patients (aged 10–24, mean: 14.99±2.63). Participants completed ImPACT and the PCSS within 14 days of injury (mean: 9.27±3.37). Predictors were PCSS factor scores of Cognitive-Fatigue-Migraine (CFM), Affective (AFF), Somatic (SOM), and Sleep (SLP) (Kontos et al. 2012). Outcomes examined were ImPACT composite scores. Univariate analyses were performed and values with p < 0.10 were entered into stepwise linear regression (LR) models. Retained predictors in each LR model had p values <.05. Results Verbal memory was predicted by CFM, SOM, age, and gender. Visual memory was predicted by CFM and SOM. Visual motor speed was predicted by age, gender, CFM, SOM, and AFF. Reaction time was best predicted by SOM, CFM, and age. The variance explained was fairly small (0.08 to 0.21). SLP was not a significant predictor in any LR. Conclusion CFM and SOM factors were most predictive of lower cognitive performance, similar to prior studies linking dizziness to longer recovery and post-traumatic migraine to worse cognitive performance. These findings underscore the clinical importance of diverse symptom assessment and injury education. Higher CFM and SOM scores may also serve as proxy for injury severity, which we would expect to be associated with worse cognitive performance. [ABSTRACT FROM AUTHOR]