title: Concussion Baseline Testing: Preexisting Factors, Symptoms, and Neurocognitive Performance.
abstract: BACKGROUND
  Neurocognitive test scores are often considered an important aspect of concussion management. To best use these data, clinicians must understand potential factors that may influence baseline performance on these tests.
  
  
  OBJECTIVE
  To determine preexisting factors that may influence performance on the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Research laboratory.
  
  
  METHODS
  A total of 486 National Collegiate Athletic Association Division I collegiate student-athletes.
  
  
  METHODS
  To determine neurocognitive functioning and total symptom score at baseline, ImPACT was administered. Outcomes were verbal memory, visual memory, visual motor speed, reaction time, and total symptom score. A self-report demographic section at the beginning of ImPACT was used to gather information concerning previous treatment for headaches, migraines, and psychiatric conditions; diagnosis of attention-deficit/hyperactivity disorder; and exposure to previous strenuous exercise. We conducted multivariate analyses of variance to determine if the ImPACT composite and total symptom scores differed according to preexisting factors (P < .0083).
  
  
  RESULTS
  Sex showed an effect on verbal memory (P = .001), visual motor speed (P < .001), and reaction time (P = .006), with women performing better than men. A previous diagnosis of attention-deficit/hyperactivity disorder affected visual motor speed (P = .008). Previous treatment for headaches (P < .001), migraines (P = .001), a psychiatric condition (P < .001), or a diagnosis of attention-deficit/hyperactivity disorder (P < .001) all showed effects on the total symptom score. Strenuous exercise did not affect neurocogntive performance or total symptom score.
  
  
  CONCLUSIONS
  Based on our findings and the previous literature, we suggest that many preexisting factors influence baseline neurocognitive data. Baseline testing is an important aspect of concussion management. Sports medicine professionals should be cognizant of these factors when developing concussion-management protocols.
authors.affiliation: Department of Exercise Science, Elon University, NC.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Cottle
authors.affiliation: Department of Exercise Science, Elon University, NC.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Hall
authors.affiliation: Department of Exercise Science, Elon University, NC.
authors.forename: Kirtida
authors.initials: K
authors.lastname: Patel
authors.affiliation: Department of Exercise Science, Elon University, NC.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Barnes
authors.affiliation: Department of Exercise Science, Elon University, NC.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Ketcham
mesh_terms: D001265:Athletic Injuries / Q000175:diagnosis*; D001924:Brain Concussion / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D011930:Reaction Time; D057566:Self Report; D012737:Sex Factors
keywords: ImPACT; neurocognitive testing; return to play