title: A Retrospective Cross-Sectional and Longitudinal Study of the Effects of Age on CNS Vital Signs Scores in High-School Athletes.
abstract: BACKGROUND
  Current recommendations for concussion management acknowledge the importance of objective assessments of neuropsychological (NP) ability, and computerized NP assessments have been widely integrated into the concussion management protocols of high schools. The optimal intervals for baseline test administration in high-school athletes are currently uncertain. The ability to accurately detect subtle NP deficits is particularly important for high-school athletes, in which concussions are increasingly recognized for adverse effects to the developing brain.
  
  
  OBJECTIVE
  The aim of this study was to assess the pattern of change in neurocognitive test performance, as well as changes in different domains of NP functioning over time.
  
  
  METHODS
  Baseline computerized NP assessments were conducted at six high schools over 4 academic years using CNS Vital Signs, a battery consisting of seven well-established NP tests. Data were retrospectively examined for age differences in both cross-sectional (n = 3015) and longitudinal (n = 1221) analyses.
  
  
  RESULTS
  Moderate changes were observed across several NP domains over time (Cohen's d = 0.39-0.61), with the largest improvements observed in executive functioning (mean improvement 5.78, 95% confidence interval [CI] 5.41-6.14, p < 0.001), psychomotor speed (mean improvement 4.59, 95% CI 3.97-5.22, p < 0.001), cognitive flexibility (mean improvement 5.11, 95% CI 4.76-5.45, p < 0.001), and reaction time (mean improvement -12.44 ms, 95% CI -10.10 to -14.78, p < 0.001). Improvements in NP performance were most pronounced between the freshman and senior years.
  
  
  CONCLUSIONS
  There is an appreciable change that occurs each year of high school in one or more domains of an NP battery, with executive functioning indicating the greatest magnitude of change. Females performed better relative to males across all time points though males exhibited more substantial improvement over time.
authors.affiliation: East Carolina University, 245 Ward Sports Medicine Bldg, Greenville, NC, 27858, USA. rogerssh@ecu.edu.
authors.forename: Sharon D
authors.initials: SD
authors.lastname: Rogers
authors.affiliation: Duke University Medical Center, DUMC 3119, Durham, NC, 27710, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Smith
authors.affiliation: East Carolina University, 238 Rawl, Greenville, NC, 27858, USA.
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Stephenson
authors.affiliation: East Carolina University, 238 Rawl, Greenville, NC, 27858, USA.
authors.forename: D
authors.initials: D
authors.lastname: Erik Everhart
mesh_terms: D000293:Adolescent; D000367:Age Factors; D056352:Athletes / Q000523:psychology*; D001265:Athletic Injuries / Q000453:epidemiology / Q000523:psychology*; D001924:Brain Concussion / Q000453:epidemiology / Q000523:psychology*; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies
keywords: Cognitive Flexibility; Continuous Performance Test; Executive Functioning; Psychomotor Speed; Test Administration