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Objective Older adults (OAs) with mild cognitive impairment (MCI) show disabilities in instrumental activities of daily living (IADLs), which have been linked to compromised cognitive functioning. However, it is unclear which cognitive functions are primarily involved. The present study sought to identify the cognitive function(s) most strongly associated with the IADL limitations in MCI. Method OAs with MCI (N  = 120) completed cognitive tasks measuring general cognitive processing speed, working memory (WM) maintenance and updating, inhibition, and shifting ability. IADL abilities were assessed through both self- and informant reports. Results Self-reported IADL abilities were positively associated with both cognitive processing speed and WM updating capacity. Informant-reported IADL abilities were also positively associated with processing speed and WM updating, in addition to cognitive shifting ability. Conclusion Both general processing speed and WM updating capacity were consistently predictive of IADL abilities. These results might inform the design of training programs aimed at maintaining or improving functional independence in individuals with MCI to focus more on these cognitive functions. However, the strength of the association between specific cognitive functions and IADL abilities in OAs with MCI depends on the source of the information about the IADL abilities, which highlights the need for gathering data from both the examinee and informants. [ABSTRACT FROM AUTHOR]

Objective The ImPACT® Quick Test is a brief iPad-based battery of neurocognitive tests that has been standardized on a sample of children, adolescents, and adults (ages 12–70). This study provides information on the prevalence of ImPACT® Quick Test scores falling below specific percentiles in the normative sample to aid in clinical interpretation and reduce the risk of over-interpreting, or misinterpreting, a single low score. Method Participants were 683 individuals ranging in age from 12 to 70, who were assessed individually. The ImPACT® Quick Test includes five subtests, contributing to three factor scores: motor speed, memory, and attention tracker. The prevalence of low factor scores, stratified by age and sex, were calculated using multivariate base rates. Results In the total sample, obtaining 1 or more scores below the 25th percentile was common (base rate, BR = 47.2%), but obtaining 2 or more scores in this range was uncommon (BR = 15.3%). Similarly, obtaining 1 or more scores below the 16th percentile was common (BR = 31.4%), but obtaining two or more scores in this range was uncommon (BR = 6.9%). There were small differences in BRs between sexes and the number of low scores was fairly similar across the age groups. Conclusion Results from this study parallel previous work illustrating that a substantial percentage of healthy individuals will obtain one or more low test scores when administered a brief battery of cognitive tests. Given that some healthy individuals will obtain a single score below expected cut-offs, clinicians should caution against overinterpreting a single low test score. [ABSTRACT FROM AUTHOR]

Background Obesity is linked to greater physical disability and increased comorbidities among patients with multiple sclerosis (MS). Its contribution to cognition in this group is unclear. This observational study examines the link between obesity and processing speed in a large sample of patients with MS (PwMS). Methods As part of routine clinical care at our center, PwMS completed the Processing Speed Test (PST), an electronic implementation of the Symbol Digit Modalities Test (SDMT). Height and weight were used to calculate body mass index (BMI). Bivariate correlations were conducted to examine the association between PST and BMI in the group overall and in subgroups based on demographic and clinical variables. A one-way ANOVA examined differences in PST by BMI categories (normal weight, overweight, obese). Results The sample included 8,713 patients. No association between PST and BMI was found in the entire sample (r  = .01), nor within subgroups based on demographic and disease variables. No difference in PST score was found between BMI categories. Conclusions No association between BMI and processing speed was found among PwMS regardless of demographic or disease-specific patient characteristics. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to provide regression-based normative data for the written, oral, and incidental recall trials of the Symbol Digit Modalities Test (SDMT). Method Regression-based normative equations for the written and oral trials were derived from 536 healthy men and women between the ages of 18 and 91. Normative equations for the incidental recall trial are provided for a subset of the normative sample (age range = 60–91). The clinical utility of the newly developed norms was examined by comparing mean performance and rates of impaired scores for participants with traumatic brain injury (TBI), mild cognitive impairment (MCI), and dementia. Within-group analyses were used to compare the new norms to the original published norms. Results Age, education, and sex were all significant predictors of written trial performance, age and education were significant predictors of oral trial performance, and only age predicted incidental recall trial performance. As expected, the TBI group demonstrated the highest rates of impaired performance on both written and oral trials. Participants with dementia showed the highest rate of impaired scores on the incidental recall trial, followed by participants with amnestic MCI. Compared to traditional norming methods, the regression-based norms classified more clinical participants as impaired on both the written and oral trials. Conclusions Comprehensive regression-based normative equations with demonstrated clinical utility are provided to improve the detection of cerebral dysfunction using the SDMT. A calculator with the normative equations is provided so that raw scores can be easily converted to demographically-corrected standardized scores. [ABSTRACT FROM AUTHOR]

Impairments in processing speed under conditions of increasing cognitive load have been reported in individuals with mild traumatic brain injury (mTBI). In other conditions that are also associated with white matter disruption, both psychological distress and fatigue have been shown to underlie this impairment. Objective: the current study aimed to investigate whether slowing of processing abilities under conditions of greater cognitive load is independent of fatigue and psychological status in premorbidly healthy individuals with subacute mTBI. Method: using a prospective observational design, we examined 84 individuals with mTBI approximately 8 weeks after injury and 47 healthy control (HC) participants. They were assessed with the Symbol Digit Modality Test, an n -back task and a rate of gain of information choice reaction time task that conforms to Hick's law. Participants were also assessed with measures of fatigue and psychological status. Results: as expected, findings revealed no group differences on simple reaction time tasks, but as task complexity increased, the mTBI group performed more slowly than the HC group. This group difference occurred independently of fatigue and psychological distress levels and was associated with a moderate effect size. Conclusions: during the subacute period after mTBI, premorbidly healthy individuals demonstrate impairment in their ability to rapidly process information as the cognitive load of the task increases beyond simple reaction time requirements. Examination of whether these changes affect resumption of premorbid roles is warranted. [ABSTRACT FROM AUTHOR]

Objective Neurocognitive dysfunction in patients with residual or emergent symptoms after treatment for Lyme Disease is often attributed to comorbid depression. In this study, patients with Post-Treatment Lyme Disease Syndrome (PTLDS) were compared to patients with Major Depressive Disorder (MDD), as well as healthy comparison subjects (HC), on neurocognitive measures administered through the same laboratory, to determine if patterns of performance were similar. Methods Two analyses were conducted. First, performance on the Wechsler Adult Intelligence Scale (WAIS-III) and on subtests from the Wechsler Memory Scale (WMS-III) was compared among the groups. Second, comparable subgroups of PTLDS and MDD patients with at least one low WMS-III score were compared on an additional set of measures assessing motor function, psychomotor performance, attention, memory, working memory, and language fluency, to determine if the overall profile of performance was similar in the two subgroups. Results In the first analysis, PTLDS patients performed more poorly than both MDD and HC on tasks assessing verbal abilities, working memory, and paragraph learning. Processing speed in the two patient groups, however, was equally reduced. In the second analysis, MDD patients with low WMS-III exhibited concomitantly greater difficulties in psychomotor speed and attention, while low-WMS-III PTLDS patients exhibited greater difficulties in language fluency. Conclusions MDD and PTLDS can be confused neuropsychologically because both exhibit similar levels of psychomotor slowing. However, problems on memory-related tasks, though mild, are more pronounced in PTLDS. PTLDS patients with poorer memory also exhibit poorer language fluency, and less deficit in processing speed and attention compared to MDD. [ABSTRACT FROM AUTHOR]

Objective The present study aimed to investigate the factor structure of a set of neurocognitive tests theoretically assessing executive functions (EF), verbal abilities (VA), and processing speed (PS). This study extended previous research by analyzing if each test is better explained by the specific factor to which it theoretically belongs or by a more general neurocognitive factor; and also by analyzing the relations between the neurocognitive factors. Methods Using confirmatory factor analysis (CFA) we examined the factor structure of nine neurocognitive tests (EF: Working Memory, Tower, Divided Attention, Stroop, and Verbal Fluency tests; VA: Word List and Confrontation Naming tests; PS: Coding and Telephone Search tests) in a nonclinical sample (N = 90; 18–33 years old, 76 women). We tested five factor models of neurocognitive functioning: a one-factor model; two models with two-correlated factors; and two models with three-correlated factors. Results A three-correlated-factor model, with EF, VA, and PS factors, was the most suitable for our neuropsychological data. The Verbal Fluency test was better explained by the VA factor rather than by the EF factor. The EF factor was correlated with the PS factor, but not with the VA factor. Conclusions Most of the neurocognitive measures used in the present study loaded in the expected factors (with the exception of the Verbal Fluency that was apparently more related to VA). EF and PS represent related but separable functions. Our results highlight the need for a careful interpretation of test scores since performance on one test usually requires multiple functions. [ABSTRACT FROM AUTHOR]

Objective Learning and memory impairments are common in multiple sclerosis (MS) and may be related to difficulty acquiring (encoding or consolidating) new information. We evaluate the role of retroactive interference and investigate whether minimizing interference immediately following encoding (early during consolidation) will improve MS participants' ability to remember new verbal information. Additionally, we investigate processing speed differences between memory-impaired and unimpaired participants and present an exploratory analysis of how the dual-components of working memory (capacity vs. processing) relate to memory impairment. Method MS memory-unimpaired (N = 12) and MS memory-impaired participants (N = 12) were compared to healthy controls (N = 15). Interference onset following encoding (early, mid, late, no interference) was manipulated over the retention interval of a verbal learning and memory task. Response times (RT) were recorded during interference trials. Results MS memory-impaired participants encoded less information and lost proportionally more information over the retention interval (weak consolidation). Lengthening the onset of interference did not benefit memory performance in this sample. Memory performance was unrelated to RT but was related to performance on the Symbol Digit Modalities Test. Primary capacity of working memory did not differ across groups; however, secondary memory processing was reduced for MS memory-impaired participants. Conclusion Minimizing interference following encoding did not improve memory in this sample. Both initial encoding and early consolidation were reduced for memory-impaired MS participants. Evidence for a relationship between processing speed and memory was mixed and depended on the processing speed assessment used. Memory impairment in MS may be partially due to inefficient processing within working memory. [ABSTRACT FROM AUTHOR]

Objective we sought to determine the degree to which cognitive reserve, as assessed by the Test of Premorbid Functioning in combination with demographic variables, could act as a buffer against the effect of traumatic brain injury (TBI) on cognitive test performance. Method retrospective analysis of a cohort of 121 persons with TBI who completed the Wechsler Adult Intelligence Scale—Fourth Edition (WAIS–IV) within 1–12 months after injury. Results regression analyses indicated that cognitive reserve was a statistically significant predictor of all postinjury WAIS–IV factor index scores, after controlling for various premorbid and comorbid confounding variables. Only for Processing Speed did injury severity make an additional statistically significant contribution to the prediction model. Conclusions cognitive reserve has a protective effect with regard to the impact of TBI on cognitive test performance but this effect is imperfect and does not completely negate the effect of injury severity. [ABSTRACT FROM AUTHOR]

Objective: A proportion of patients with major depressive disorder (MDD) show cognitive impairment that is associated with treatment nonresponse and poorer functional recovery. A broader range of cognitive dysfunction has been found to be associated with treatmentresistant depression (TRD) and with the presence of psychotic symptoms. Thus far, the effects of psychotic symptoms on the neuropsychological profile of patients with treatment-resistant MDD have not been investigated. Method: In the present study, 44 treatment-resistant MDD patients with (n = 12) or without (n = 32) psychotic symptoms--based on the Structured Clinical Interview (SCID I)--were compared with regard to their clinical status and performance in a neuropsychological test battery. The neuropsychological test battery assessed verbal skills, processing speed, executive functions and memory functions. Results: Patients with psychotic TRD displayed lower performance in processing speed than non-psychotic patients. The group differences were not associated with the severity or pervasiveness of depressive symptoms. The duration of depression (from the onset of depressive symptoms) was longer in the group of non-psychotic TRD patients, but no other group differences with respect to sociodemographic characteristics, age at the onset of symptoms or symptom severity were found. Conclusions: The results imply that among individuals suffering from MDD, patients with the psychotic subtype who are unresponsive to standard pharmacological and psychosocial treatments have an increased vulnerability to cognitive dysfunction in the area of processing speed. Further research with larger sample size is warranted to determine whether these group differences persist after remission. [ABSTRACT FROM AUTHOR]

The prevalence of late effects following allogeneic hematopoietic cell transplantation (HCT), a curative treatment for pediatric leukemia, is high:79%ofHCTrecipients experience chronic medical conditions. The fewextant studies of cognitive late effects have focused on intelligence and are equivocal about HCT neurotoxicity. In an archival study of 30 children (mean transplant age = 6 years), we characterize neuropsychological predictors of academic outcomes. Mean intellectual and academic abilities were average, but evidenced extreme variability, particularly on measures of attention and memory: ~25% of the sample exhibited borderline performance or lower. Medical predictors of outcome revealed paradoxically bettermemoryassociatedwithmore severe acute graft-versus-host disease(GVHD)and associatedwith steroid treatment. Processing speed and memory accounted for 69% and 61% of variance in mathematics and reading outcomes, respectively. Thus, our findings revealed neurocognitive areas of vulnerability in processing speed and memory following HCT that contribute to subsequent academic difficulties. [ABSTRACT FROM AUTHOR]

The NIH Toolbox Pattern Comparison Processing Speed Test was developed to assess processing speed. While initial validation work provides preliminary support for this test in both children and adults, more work is needed to ensure dependability and generalizability. Thus, this replication study examines descriptive data (including age effects), test-retest reliability, and construct validity in n = 4,859 participants ages 3-85 years (matched to 2010 census data). Although the Pattern Comparison was not appropriate for all 3 and 4 years old, by ages 5 and 6, more meaningful scores were apparent. There was evidence for convergent and discriminant validity. There was also a moderate practice effect (i.e., increase of 5.5 points) over a 1-week time frame. Pattern Comparison exhibits a number of strengths: it is appropriate for use across the lifespan (ages 5-85), it is short and easy to administer, and there is support for construct validity. [ABSTRACT FROM AUTHOR]

The association between speed of information processing and cognition has been extensively validated in normal aging and other neurocognitive disorders. Our aim was to determine whether such a relationship exists in stroke. Thirty patients and 30 age- and education-matched healthy individuals were administered a comprehensive battery of neuropsychological tests divided into the following six cognitive domains: processing speed (PS), verbal memory, visual memory, visuoperceptual function, language, and cognitive flexibility. The results demonstrate that stroke patients were characterized by cognitive deficits in almost all of these domains, but have the most pronounced deficits in PS. After adjusting for symbol digit modalities test score, all significant group differences in cognitive functioning disappeared. However, group differences remained significant after controlling for the influence of other cognitive factors. These findings suggest that decreased PS appears to underlie post-stroke cognitive dysfunction and may serve as a potential target for intervention. [ABSTRACT FROM PUBLISHER]

Data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey were used to calculate weighted norms for the written version of the Symbol Digits Modalities Test (SDMT) by gender, 5-year age groups and four levels of educational attainment. The sample comprised 14,456 Australians (47% male; age range 15–100), of whom 25% reported a tertiary qualification, 30% reported a technical qualification (diploma or trade certificate), 16% reported completing Year 12 (final year of high school), and 29% reported their highest level of educational attainment to be Year 11 or below. Participants were excluded if they reported physical or neurological conditions that limited performance. Age, gender, and education were all significantly associated with SDMT performance, as was poor health, and cultural background. The reported norms are of greater scope and precision than previously available and have utility in a range of clinical and research settings. Indeed, normative data for the SDMT that are representative of a national population have not previously been published. [ABSTRACT FROM AUTHOR]

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) demonstrate increased response variability compared with controls, which is thought to be associated with deficits in attention regulation and response control that subsequently affect performance of more cognitively demanding tasks, such as reading. The present study examined response variability during a computerized simple reaction time (RT) task in 67 children. Ex-Gaussian analyses separated the response time distribution into normal (mu and sigma) and exponential (tau) components; the association of each with reading fluency was examined. Children with ADHD had significantly slower, more variable, and more skewed RTs compared with controls. After controlling for ADHD symptom severity, tau (but not mu or mean RT) was significantly associated with reduced reading fluency, but not with single word reading accuracy. These data support the growing evidence that RT variability, but not simply slower mean response speed, is the characteristic of youth with ADHD and that longer response time latencies (tau) may be implicated in the poorer academic performance associated with ADHD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the possible additive neurocognitive deficits in adults with both attention-deficit/hyperactivity disorder (ADHD) and serious depressive symptoms. Participants were 54 university students who completed a psycho-educational assessment. Three groups were examined: a group with comorbid ADHD and elevated depressive symptoms (ADHD + DEP; N = 18); a group with ADHD only (N = 18); and a group with elevated depressive symptoms only (DEP; N = 18). Group differences were examined on a battery of neurocognitive tests. The ADHD + DEP group performed significantly worse than the other groups on processing speed tasks and delayed recall of conceptual verbal information and significantly worse than the ADHD group on shifting tasks. Depressive symptom severity was significantly correlated with processing speed, verbal memory performance, and shifting in the ADHD and ADHD + DEP groups. Results suggest that the co-occurrence of ADHD and depressive symptoms in adults is associated with additional neurocognitive impairment. [ABSTRACT FROM PUBLISHER]

In previous studies, children with both Attention-Deficit Hyperactivity Disorder (ADHD) and a Reading Disorder were found to have more difficulties with processing speed, working memory, and timed as opposed to non-timed executive functioning (EF) measures when compared with those with either disorder alone. The current study found that older adolescents and adults with both disorders also had more difficulties on processing speed and working memory measures than individuals who only had ADHD. There were no differences among non-timed EF scores. These results add support to the premise that common underlying features may be contributing to the high co-morbidity between these disorders and associated cognitive weaknesses. [ABSTRACT FROM PUBLISHER]

Studies have identified generalized slowing in information processing speed as the primary cognitive deficit in multiple sclerosis (MS). Similar changes are also commonly observed in healthy cognitive aging. The present study is the first to examine the combined impact of aging and disease on the course of cognitive slowing. MS patients (N = 245) and healthy controls (N = 188) were assessed using two measures of processing speed (the preliminary word reading and color naming trials of the Stroop). Participants ranging in age from 18 to 74 were grouped into five age cohorts. Slowing in processing speed was evident for patients vs. controls and for older vs. younger cohorts. The age-related declines in performance were parallel for patients and controls, indicating that the disease process in MS does not interact with general cognitive aging to effect a more rapid decline in functioning. [ABSTRACT FROM PUBLISHER]

Abstract: The aim of this study was to investigate the residual effects of concussion amongst players of Rugby Union from school through to the national adult level, with pre-season testing on tests of visuomotor processing speed (Digit Symbol; Trail Making Test A and B). Comparison groups included 124 male rugby players versus 102 non-contact sport controls; 71 forward versus 53 backline players. Across groups there was equivalence for age, education, estimated IQ, and hand motor dexterity. There was a significantly higher percentage of rugby players with 2+ concussions than controls. Poorer performance was in evidence for rugby players compared with controls on all tests of visuomotor speed, and for forward versus backline players on Digit Symbol, with clinically relevant medium effect sizes. The results implicate vulnerability amongst rugby players on the prototypically sensitive function of visuomotor processing in association with years of exposure to repetitive concussive and subconcussive injury. [Copyright &y& Elsevier]

Abstract: Various studies have reported deficits in frontal cognitive functions in patients with multiple sclerosis (MS). However, the frontal deficit is not uniform and is often very subtle. The aim of this study was to assess frontal functions in a broad sample of patients with relapsing–remitting multiple sclerosis at the mild-to-moderate stage. The sample included a series of 165 patients. We used a test battery covering the frontal functions that have been described as being altered in MS. Significant differences were found between the patient group and healthy controls on the WAIS Arithmetic subtest, the PASAT, category word recall and the number of trials required to reach the first category of the WCST. In conclusion, we observed significant differences with respect to the control group in terms of information processing speed and working memory. These functions involve connections between the frontal lobe and other brain regions. [Copyright &y& Elsevier]

Abstract: This study compared 19 older adults and 20 younger adults on the Groton Maze Learning Test© (GMLT), a novel computerized hidden maze learning test that assesses processing speed, spatial learning efficiency, and error monitoring. Convergent validity of this test was assessed by comparing GMLT scores to Paced Auditory Serial Addition Test (PASAT) and Tower of Toronto (TOT) scores. In the full sample, all GMLT measures correlated strongly with both PASAT and TOT scores (r''s=0.53 to 0.73). GMLT measures most sensitive to detecting between-group differences were the Timed Chase Test (TCT), legal errors, and perseverative errors (Cohen''s d''s=3.81, 2.40, and 2.40, respectively). Scores on the visuomotor processing speed subtest of the GMLT attenuated the relationship between age group and maze efficiency index scores, but not perseverative and “rule-break” errors. These results suggest that normal aging is associated with impaired performance on a novel computerized measure of spatial learning efficiency and error monitoring, and that processing speed attenuates the relationship between age and spatial learning efficiency. [Copyright &y& Elsevier]

Abstract: The Paced Auditory Serial Addition Task (PASAT) is a cognitive task purported to measure working memory, speed of information processing, and sustained and divided attention (Spreen, O. & Strauss, E. (1998). A compendium of neuropsychological tests: administration, norms, and commentary (2nd ed.). New York, NY: Oxford University Press.) The current study examined whether treating late responses on the PASAT as correct or as incorrect can significantly affect the outcome of the test in individuals with Multiple Sclerosis (MS). Subjects consisted of 59 individuals with MS and 37 healthy controls (HC). Scoring method was found to affect the number of individuals who were considered impaired on the PASAT. When participants were penalized for late responses significantly more participants, in both groups, were found to be impaired on the 2s trial of the task (MS: p <0.01; HC: p <0.05). Results indicate that that the specific scoring of the PASAT should be reported in studies that use the test. [Copyright &y& Elsevier]

Abstract: Information processing speed was assessed using the visual threshold serial addition test (VT-SAT), a computerized modification of the PASAT designed to assess processing speed by controlling for performance accuracy. Persons with MS (N =43) and healthy individuals (N =32) were administered the VT-SAT varying working memory loads (1-back versus 2-back). Results indicated that at the lower working memory load (1-back) all individuals with MS were able to achieve a working memory performance level equivalent to healthy individuals, but required significantly more processing time to do so. In contrast, at the higher working memory load (2-back), about 70% of MS participants were able to achieve a performance level equivalent to healthy individuals, but again required significantly more processing time. The results are discussed in the context of the dynamic nature of the relationship between processing speed and working memory performance, emphasizing the dependence of this relationship on other cognitive and disease-related factors. [Copyright &y& Elsevier]

Abstract: Information-processing speed (IPS) has been identified as an area of primary deficit in multiple sclerosis regardless of disease course. This study examines the extent to which information-processing speed contributes to quality of life (measured by the SF-36) in individuals with Multiple Sclerosis (MS), independent of level of neurological disability (measured by the Expanded Disability Status Scale (EDSS)). Fifty-two individuals with MS (29 relapsing-remitting and 23 primary-progressive) completed the SF-36 and neuropsychological measures related to speed of processing and were assessed using the EDSS. The EDSS was significantly related to all SF-36 scales except those measuring Mental Health and Role Limits—Emotional. While the EDSS contributed significantly to prediction of SF-36 component scores, addition of measures of IPS to the regression equation did not significantly improve prediction. It was noted, however, the effect size associated with addition of IPS scores were large, indicating that quality of life is indeed related to measures of IPS. [Copyright &y& Elsevier]

Abstract: This study explored the diagnostic utility of the composite scores of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Post Concussion Symptom Scale scores (PCSS). Recently concussed high school athletes (N =72) were tested within 72h of sustaining a concussion, and data were compared to non-concussed high school athletes with no history of concussion (N =66). Between-groups MANOVA revealed a significant multivariate effect of concussion on test performance (p <.001); univariate ANOVAS revealed all six measures contributed to the between-groups differences. A discriminant function analyses was conducted to measure the ability of the five ImPACT composite scores, as well as the PCSS to classify concussion status. One discriminant function was identified that consisted of the Visual Memory, Processing Speed, and Impulse Control composite scores PCSS, which correctly classified 85.5% of the cases. Approximately 82% of participants in the concussion group and 89% of participants in the control group were correctly classified. Using these data, the sensitivity of ImPACT was 81.9%, and the specificity was 89.4%. As part of a formal concussion management program, ImPACT is a useful tool for the assessment of the neurocognitive and neurobehavioral sequelae of concussion, and can also provide post-injury cognitive and symptom data that can assist a practitioner in making safer return to play decisions. [Copyright &y& Elsevier]

Abstract: The present study examined the enduring residual neuropsychological effects of head trauma in college athletes using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Postconcussion Syndrome Checklist, and the Stroop task. Based on a brief self-report concussion history survey, male and female athletes who participated in ice hockey, field hockey, lacrosse, and/or soccer were assigned to one of three concussion-history conditions: Non-concussed, Non-recent concussed (i.e., more than 2 years since last concussion), or Recent concussed (i.e., 2 years or less since last concussion). A fourth group of subjects consisting of non-concussed/non-athletes served in the control condition. Group differences emerged on the RBANS when immediate memory, delayed memory, and total scores were analyzed. Specifically, recent concussed athletes and, surprisingly, non-concussed athletes scored lower than control subjects in the two memory domains, whereas all three athlete groups had lower total RBANS scores than those of control subjects. Moreover, recent concussed athletes not only had lower immediate memory scores than control subjects, but also were impaired relative to non-recent concussed athlete subjects in this memory domain. No group differences were detected on the Stroop task or on the Postconcussion Syndrome Checklist. Interestingly, however, the severity of the Postconcussion Syndrome Checklist scores for the two athlete-concussed groups, taken in aggregate, correlated negatively with RBANS scores for attention (r =−.65) and delayed memory (r =−.61), and with the total RBANS score (r =−.59). In recent concussed athletes, lower delayed memory scores correlated with more severe Postconcussion Symptom Checklist scores (r =−.90), while more severe/higher number of concussions correlated with increased processing speed on the Stroop interference task (r =.90). These findings indicate that recent head injury produces alterations in neuropsychological function, especially that of memory, that resolve with time. More provocatively, the data also suggest that participation in contact sports may produce sub-clinical cognitive impairments in the absence of a diagnosable concussion presumably resulting from the cumulative consequences produced by multiple mild head trauma. [Copyright &y& Elsevier]