Computerized neurocognitive testing

Scientific evaluation

Other programs available Headminder Most research done more than 10yrs ago Being used for dementia and other medical conditions- not specialized just for concussion Cogstate Sport Developed in Australia Much fewer data elements Markedly less research Limited use compared to others

ImPACT: A TOOL FOR EVALUATING CONCUSSION (Immediate Post-Concussion Assessment and Cognitive Testing)  Computerized test developed by clinical researchers at the University of Pittsburgh Medical Center (UPMC)  Developed to allow for a more objective assessment of concussion and recovery  Accounts for individual differences in cognitive ability and symptom reporting through the use of baseline testing  Provides a common metric which allows for effective collaboration between athletic trainers, coaches, physicians, and neuropsychologists in concussion management  Utilized throughout professional and amateur sports across the country and internationally

How does is help?  Quantify the injury with a highly sensitive measure of brain function  Protect the student athlete.  Help determine safe return to play.  Help prevent cumulative effects of multiple concussions  Provides objective data to help determine athlete’s injury status  Prevent lingering effects of concussion and potential catastrophic injury

Decreased Processing Speed Short-Term Memory Impairment Concentration Deficit Irritability/Depression Fatigue/Sleep Disturbance General Feeling of “Fogginess” Academic Difficulties LATER SIGNS OF CONCUSSION: Post-Concussion Syndrome

WHAT DOES ImPACT MEASURE?  Demographic/Concussion History Questionnaire  Concussion Symptom Scale - 21 Item Likert scale (e.g. headache, dizziness, nausea, etc)  Eight Neurocognitive Measures - Measures domains of Memory, Working Memory, Attention, Reaction Time, Mental Speed, Verbal Memory, Visual Memory, Reaction Time, Processing Speed - Summary Scores  Detailed Clinical Report - Automatically computer scored - Outlines demographic, symptom, neurocognitive data

IS ImPACT SENSITIVE? (2003 ImPACT Data) CONCUSSED CONTROL CONCUSSED 93% 7% (107) (8) CONTROL 12% 88% (6) (43) F=25.2, p<.000 (Discriminant function analysis-classification) Variables in Equation: ImPACT MEM, Processing, RT and Symptoms Composite and Concussion HX N=115 concussed N=49 controls

24-72 Hours y Day 5-10 Concussion Beyond (if necessary) Baseline Testing (Normative data available for decision making when baseline data not available) Clinical Studies

CASE 1: KICK-OFF RETURNER Exertion DAY

N=410. p.< N.S. p.<.0001p.<.03 Significant difference between groups out to at least 8 days post-injury Collins MW, Lovell MR, Maroon et al. Medicine and Science in Sports Exercise, 34:5;2002 ImPACT MEMORY COMPOSITE Control vs. Concussed Athletes *Lower score indicates poorer performance

ImPACT REACTION TIME COMPOSITE Control vs. Concussed Athletes Significant difference between groups out to 5 days post-injury N=410. p.<.005 N.S. p.<.0004N.S. Lovell MR, Collins MW, Maroon et al. Medicine and Science in Sports Exercise, 34:5;2002 *Higher score indicates poorer performance

UNIQUE CONTRIBUTION OF ImPACT TO CONCUSSION MANAGEMENT N=115 MANOVA p< ImPACT reveals cognitive deficits in asymptomatic athletes within 4 days post-injury

If Used Correctly, ImPACT will… -Help determine severity of concussion -Provide valuable information to the athlete, parents, athletic trainers, physicians -Provide information on academic deficits associated with concussion -Promote safe return to play - Reduce liability for school districts

ImPACT will NOT….. - Prevent a concussion from occurring - Eliminate the risk of concussion

Let’s take a test!!!