bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 20 Identifying Concussion in College-Aged Individuals Using a Multimodal Assessment of Vestibular and Oculomotor Function
Authors: Klein Lilian A , Zynda Aaron J , Loftin Megan C , Tracey Allie J , Pollard-McGrandy Alyssa M , Clark Haley , Davis E Reid , Covassin Tracey 
Published: July 2024

Abstract

Purpose
Vestibular and oculomotor assessments are fundamental tools to identify concussions. However, research is unclear on which vestibular and oculomotor assessment or combination of assessments best detect concussions. The purpose of this study was to assess the discriminant ability of the Vestibular/Ocular Motor Screening (VOMS), Balance Error Scoring System (BESS), modified BESS (mBESS), and High-Level Mobility Assessment Tool (HiMAT) to identify college-aged individuals with concussion from controls.

Method
A prospective study of college-aged individuals (18–30 years) diagnosed with concussion within 5 days of enrollment was conducted. Demographics, injury information, VOMS, BESS/mBESS, and HiMAT were completed at the initial visit. Logistic regressions (LR) and receiver operating characteristic (ROC) analyses of the area-under-the-curve (AUC) determined the ability of the VOMS, BESS/mBESS, and HiMAT to identify concussion from control. A total of 214 participants (mean age = 20.4¬ ± 2.5 years, 52.8% female) were enrolled, with 137 (64.0%) concussions and 77 (36.0%) controls.

Results
The VOMS total (AUC = 0.93, 95%CI = 0.90–0.97, p &lt; 0.001) and HiMAT total (AUC = 0.79, 95%CI = 0.65–0.93, p &lt; 0.001) significantly identified concussion from control, while the BESS (AUC = 0.58, 95%CI = 0.50–0.67, p = 0.05) and mBESS (AUC = 0.55, 95%CI = 0.47–0.64, p = 0.23) did not. A 2-factor model with combined VOMS and HiMAT totals did not improve identification (AUC = 0.92, 95%CI = 0.85–1.00, p &lt; 0.001).

Conclusions
The VOMS total score demonstrated outstanding discriminant ability, HiMAT total score demonstrated adequate discriminant ability, and BESS/mBESS total errors demonstrated unacceptable discriminant ability in identifying concussions from controls. Our findings suggest that the VOMS remains a preferred vestibular and oculomotor functioning assessment for identifying concussion. Furthermore, incorporating objective assessments with the VOMS, such as HiMAT, does not improve diagnostic yield.
A - 21 Attention-Deficit Hyperactivity Disorder and Post-Concussion Performance on the ImPACT
Authors: Stafford C , Slicer K , Bennett R 
Published: July 2024

Abstract

Purpose
To investigate whether there are differences between individuals with and without a diagnosis of ADHD on cognitive measures and symptom reporting post-concussion.

Method
Participants were selected from an archival de-identified database. The sample consisted of 198 (47.7% male, 52.3% female) student-athletes with a mean age of 19.67 years. All student-athletes were administered the ImPACT post-concussion. The student athletes were further divided into two groups: having a prior diagnosis of ADHD (N = 66 Mage = 19.55, 54.5% males, 59.1% females) and not having a prior diagnosis of ADHD (N = 66 Mage = 19.79, 40.9% males, 45.5% females). Multiple independent samples t-tests were utilized to compare symptom report scores between the two groups.

Results
No significant differences were found between the groups on measures of verbal memory [t(130) = −1.032, p = 0.304], visual memory [t(130) = −0.541, p = 0.589], visual motor function [t(130) = −0.833, p = 0.406], reaction time [t(130) = 1.302, p = 0.194], and impulse control [t(130) = 1.305, p = 0.194]. There were no differences in symptoms reported with the exception of difficulty concentrating [t(130) = 2.169, p = 0.032].

Conclusions
There were no differences in cognitive performance and symptom reporting between student athletes with and without ADHD. This suggests that there may be little to no influence of ADHD on post-concussion performance. Further research should be conducted to examine the effect of ADHD for athletes following SRC.
A - 22 Baseline testing for athletes: where are we now and where are we going?
Authors: Slicer K , Stafford C , Bennett R 
Published: July 2024

Abstract

Purpose
The purpose of this pilot study is to find out the current state of baseline neurocognitive testing for athletes across multiple ages and organizations, by gathering information from professionals in the field.

Method
16 sports neuropsychologists completed a one-time anonymous online survey that contained questions regarding concussion baseline testing practices and opinions.

Results
15 sports neuropsychologists answered “yes”to conducting baseline testing, with one responding “no.”Of those, 10 reported working with professional athletes, 8 with college athletes, 8 with adolescents aged 13–17, and 5 with children aged 8–12. All 15 sports neuropsychologists reported using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), in accordance with other measures such as the VOMS, sway, force platform, SCAT, and traditional paper and pencil measures, among other assessments. Baseline testing took place in the sports medicine clinic, at the sports facility, at the university, private office, or research lab. A majority of the sports neuropsychologists reported that testing was supervised by themselves, an athletic trainer, student trainee, and/or clinic staff. A portion (20%) of the sports neuropsychologists indicated they were not satisfied with their current method of baseline testing. One neuropsychologist reported that they currently conduct remote baseline testing and a minority of the respondents stated they would consider remote testing.

Conclusions
There was a consensus on the use of the ImPACT as the main baseline neurocognitive measure, among other assessments. This study should be expanded to include a larger sample size and variety of sports professionals to better understand the current state of sport concussion assessment.
A - 23 Interpretation Consideration: Serial Baseline Performances on Core Executive Function Measures in Healthy Youth Athletes
Authors: Ellis-Stockley M , Adler J , Forbes B , Summers K , Tupou T , Eve H , Hirst R 
Published: July 2024

Abstract

Purpose
Sports participation in youth has demonstrated better core executive function (EF) abilities compared to those who do not participate (Contreras-Osorio et al., 2021). However, previous research has not observed a pattern of improvement across all EF abilities (M√∂hring et al., 2022), indicating EF development in childhood is not linear (Anderson, 2002). The present study compared baseline scores of cognitive flexibility, working memory, and inhibition at two timepoints among youth athletes.

Method
Data from the Delis-Kaplan Executive Function System Trail Making Letter-Number Sequencing (cognitive flexibility), Wechsler Intelligence Scale for Children Fourth Edition Working Memory Index, and Golden Stroop Color-Word Inhibition test were analyzed in a sample of youth athletes (n = 32), aged 8–16 years. Mean age difference between time 1 and 2 was 1.86 years. Paired-samples t-test examined the difference in core EF scores at two timepoints.

Results
Performance on a measure of inhibition significantly improved over time (p = 0.02; effect size [d] = 0.43). Performances on measures of working memory and cognitive flexibility did not significantly differ over time (p = 0.16 and p = 0.61, respectively).

Conclusions
Healthy youth athletes performed significantly better only on a measure of inhibition at baseline two than baseline one, suggesting clinicians should anticipate variation in scores when re-examining core EF abilities after two years. Further, clinicians should exercise caution when interpreting variation in baseline scores because it could be due to sports participation. Future research should investigate whether inhibition continues to improve overtime and whether significant changes are observed in other core EFs.
A - 24 Acute SCAT-3 Symptom Clusters and Risk for Prolonged Recovery from Concussion in College Athletes
Authors: Thomas G , Bradson M , Sakamoto M , Berkey K , Arnett P 
Published: July 2024

Abstract

Purpose
More severe symptomatology post-concussion is predictive of prolonged recovery; however, it is unclear whether certain symptom clusters are associated with increased risk for protracted recovery. This study examined the relationship between five symptoms clusters on the SCAT-3 and risk for prolonged recovery from sports-related concussion.

Method
1444 (F = 619) collegiate athletes completed post-concussion neuropsychological evaluation within 24 to 48 hours following injury. SCAT-3 scores were separated into clusters based on previous research (Cognitive, Physical, Emotional, Insomnia, Ungrouped). Given that the clusters consisted of different numbers of items, an average item score was created for each cluster. Athletes were separated into two groups based on number of days to return-to-play, using 28 days as the cutoff. Logistic regression was conducted with recovery type (Typical/Prolonged) as the outcome, and the five SCAT-3 symptom clusters as predictors.

Results
Only the SCAT-3 Physical cluster was significantly associated with recovery (p &lt; 0.001). Specifically, athletes endorsing higher acute physical symptoms were at increased risk for prolonged return-to-play, such that a one-point increase in average item score on the SCAT-3 Physical symptom cluster was associated with 90.81% increased risk (O/R = 1.91) for prolonged recovery.

Conclusions
Athletes endorsing more severe physical symptoms 24 to 48 hours post-concussion were at significantly increased risk for prolonged recovery, though other symptom clusters did not infer the same risk. Findings suggest differential risk associated with symptom presentation; athletes endorsing significant physical symptoms in the acute phase of injury would likely benefit from targeted treatment to ameliorate these symptoms and, potentially, reduce risk for complicated recovery.
A - 25 Relationship between Post-Concussion Sleep Disturbances and Return-to-Play Timeline
Authors: Berkey K , Thomas G , Arnett P 
Published: July 2024

Abstract

Purpose
This study investigates whether post-concussion sleep symptoms affect return-to-play timelines following sports-related concussion. We predict that athletes in the prolonged recovery group will report higher sleep cluster (reflecting worse sleep) scores.

Method
53 athletes (F = 9.4%) completed a comprehensive neuropsychological battery within 14 days of being diagnosed with concussion. Symptomology was assessed using the Post- Concussion Symptom Scale (PCSS). Previous research demonstrated the utility of examining symptom clusters on the PCSS; PCSS Sleep Cluster was used to examine sleep disturbances in the current study. Athletes were divided into 3 groups based on their return-to-play timeline: Early (&lt;14 days), Normal (14–28 days), and Prolonged (&gt;28 days). Players were cleared to return-to-play by sports medicine.

Results
ANOVA results showed no differences between the Early, Normal, and Prolonged recovery groups in terms of sleep cluster symptoms, F(50) = 1.10, p = 0.34. These results are consistent with some previous research showing that athletes reporting high levels of sleep complaints do not perform worse on cognitive testing, which may explain, in part, why there are no differences in terms of return-to-play timelines.

Conclusions
Athletes with poor sleep at post-concussion did not show significant risk for an abnormal return-to-play time as there were no group differences. These findings are important as sleep complaints may not be a strong predictor for prolonged recovery. Instead, results suggest that poor sleep may influence symptom reporting but does not impede return-to-play timelines.
A - 26 A Survey of Sports Concussion Specialists’Clinical Criteria to Determine Concussion Recovery
Authors: Scolaro Moser R , Riegler K E , Uhrig C , Choi D , Broglio S , Mayer B , Boltz A , Master C L , Schatz P 
Published: July 2024

Abstract

Purpose
To identify criteria used by sports concussion specialists in determining recovery from sport-related concussion. We hypothesized differences in use of decision-making criteria among neuropsychologists, physicians, and certified athletic trainers (ATCs).

Method
143 sports concussion specialists (neuropsychologists = 45, physicians = 41, and certified athletic trainers (ATCs) = 57) completed a survey rating the importance of specific criteria for determining concussion recovery in youth and adult athletes. Differences between specialist groups were examined with Kruskal-Wallis tests.

Results
There were significant differences in criteria ratings across specialist groups regarding youth and adults for “use of neurocognitive test scores,”“balance testing,”“physical examination,”“no symptom provocation with neurocognitive testing,”“athlete report of anxiety about return to sport,“and “family member’s report of recovery,“all p’s &lt; 0.001. For youth and adults, physicians ranked “use of neurocognitive test scores”and “no symptom provocation with neurocognitive testing”as less important than other providers, while “physician examination”was ranked as more important. Neuropsychologists ranked “balance testing”and “athlete report of anxiety about return to sport”as less important than other providers; and ATCs ranked “family member’s report of recovery”as less important than other providers.

Conclusions
Our results advance understanding of multidisciplinary standards of care in determining recovery from sports concussion and suggest the importance of collaboration in establishing clinical criteria common to all sports concussion health care providers.
A - 27 A Preliminary Investigation of the Relationship between Sleep Symptoms and Post-Concussion Cognitive Performance in Adolescents
Authors: Riegler K E , Scolaro Moser R 
Published: July 2024

Abstract

Purpose
To explore the relationship between self-reported sleep symptoms and post-concussion cognitive test performance in adolescents on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).

Method
54 adolescents (ages 12–16) referred to a specialized sports concussion private practice completed post-concussion ImPACT. Five symptom clusters were derived from the post-concussion symptom scale: sleep, physical, cognitive, affective, and headache. Two-factor cognitive composites from the ImPACT (memory and speed) were the outcome variables. Multivariate linear regression was conducted to examine the relationship between cognitive variables and sleep symptoms. Post-hoc forward stepwise linear regressions were used to explore the following potential additional predictors of cognitive outcomes: age, number of previous concussions, sex, hours slept the night before, and five symptom clusters.

Results
Sleep symptoms were significantly associated with cognitive performance, F(1,52) = 9.95, p &lt; 0.001, ƞ2 = 0.28. Higher sleep symptom cluster scores were associated with worse memory, F(1,53) = 13.68, p &lt; 0.001, ƞ2 = 0.21, and speed performance, F(1,53) = 17.84, p &lt; 0.001, ƞ2 = 0.26. Results of post-hoc forward stepwise linear regressions revealed that a final model for speed performance included only the sleep symptom cluster, explaining 16.6% of the variance. The final model for memory performance included only the headache rating, explaining 20.1% of the variance.

Conclusions
Our results indicate that severity of self-reported sleep symptoms post-concussion are associated with cognitive performance in domains of memory and speed. After considering additional predictors, more severe sleep symptoms were significantly associated with worse speed performance and worse headache severity was significantly associated with memory performance.
A - 28 Relationship between Sleep and Symptom Severity during Initial Post-Injury Testing in High School Athletes
Authors: Volpe C , Trask C , Levings I , Jackson A 
Published: July 2024

Abstract

Purpose
Examine the relationship between reported symptom severity and hours of sleep the night before completing the ImPACT Post-Injury 1 (PI-1) Post-Concussion Symptom Checklist.

Method
A sample of 414 high school (ages 14–17) athletes (188 females, 226 males) who completed the PI-1 pre-test ImPACT Post-Concussion Symptom Checklist and reported hours of sleep the night before testing, from 2019 to present, was analyzed. Responses were divided into two groups, ‚â§8 hours sleep (n = 253) and ≥ 8 hours sleep (n = 246), and compared to ratings of pre-test total symptom score (TS) and 22 individual symptoms (IS) using a correlation test (Pearon’s r). A quadratic regression analysis was completed combining both sleep groups (n = 414) to assess for a curvilinear relationship between reported sleep, IS, and TSS.

Results
There was a statistically significant negative correlation between ‚â§8 hours sleep and 15 IS (r = −0.292 to −0.141, p = &lt;0.001 to 0.024) and TS (r = −0.272, p = &lt;0.001). A statistically significant positive correlation was found between ≥8 hours sleep and 10 IS (r = 0.138 to 0.261, p = &lt;0.001 to 0.030) and TS (r = 0.193, p = 0.002). A quadratic regression analysis confirmed a statistically significant quadratic relationship between hours of sleep and TSS (coefficient for the quadratic term was 1.030, p = &lt;0.001) and for 15 IS (all p = &lt;0.001).

Conclusions
A significant U-shaped relationship was found between high school athletes’reported hours of sleep and reported symptom severity at first post-concussion assessment. This is consistent with other research indicating that too much or too little sleep can be problematic.
A - 31 Relationship between Self-Reported Concussion History, Cognition, and Mood among Former Collegiate Athletes
Authors: Datoc A E , Sanders G D , Tarkenton Allen T , Schaffert J , Didehbani N , Cullum C M 
Published: July 2024

Abstract

Purpose
Long-term concussion sequelae have been increasingly studied in former professional athletes, and less is known about those who participated in sport at the collegiate level. This study explores the relationship between concussion history and cognition/mood in former collegiate athletes in middle-to-later adulthood.

Method
422 former collegiate athletes over age 50 (M = 61.5; 62% male) completed the College Level Aging Athlete Study (CLEAATS) including the Cognitive Function Instrument (CFI), Telephone Interview for Cognitive Status-Modified (TICSm), and self-report questionnaires including concussion history and current mood. Pearson correlations and multiple regression analyses examined the relationship between concussion history, subjective and objective cognitive status, and mood.

Results
54% of the sample reported a history of concussion (M = 1.2, SD = 1.7). Number of concussions was marginally associated with subjective cognitive complaints (r = 0.13, p = 0.004) and depression (r = 0.14, p = 0.002), but not objective cognition (p = 0.39) or anxiety (p = 0.33). Regression models including demographic factors and mood were significant and explained 32% and 17% of the variance in subjective and objective cognition, respectively. Concussion history was not a significant predictor in either model, whereas depression (Β = -0.12) was associated with poorer subjective cognition only.

Conclusions
Concussion history was not associated with subjective or objective cognitive changes in former collegiate athletes. Although a very small relationship between concussion history and depression was found, depression was associated with more subjective cognitive complaints. This suggests mood symptoms have greater impact on subjective cognitive status than concussion history. These findings highlight the importance of considering the effect of current mood symptoms when evaluating former athletes who present with cognitive complaints.
A - 33 Examining Neurocognitive Effects of Contact Exposure in High School Athletes
Authors: Hautmann A , Lemke J , Bailey C 
Published: July 2024

Abstract

Purpose
Concerns have been raised about the effect of repetitive head impacts and subconcussive blows in contact sports, though studies have largely focused on the effect in late-life or retired professional athletes. We examined the effect of extended participation (months-to-years) in low/non-contact vs high contact/collision sports within a sample of high school athletes on the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT).

Method
A multisport sample of 1650 athletes (34% Female; 1088 contact, 528 non-contact; age 14–18) without a history of concussion completed baseline ImPACT testing across two times points (time between administrations ranging from 7–45 months; M = 20.40), with active sport participation between administrations.

Results
Repeated mixed-measure ANOVA revealed increased performance across ImPACT administrations for all composites (p &lt; 0.001; partial Œ∑2 = 0.02–0.23). With the exception of a very small effect on Impulse Control composites (partial Œ∑2 = 0.003), there was no statistically significant difference between high contact and low contact sport groups across composite scores (p &lt; 0.05).

Conclusions
Our findings showed no meaningful changes in neurocognitive performance in high school athletes exposed to high degrees of contact sports for months/years, with both contact groups demonstrating a consistent mild–moderate practice effect over time. This also aligns with the recent systematic literature review finding no increased risk of neurological/neurocognitive disease in amateur contact athletes in later life (Iverson et al, 2023). Future prospective studies with longer follow up and incorporation of additional measures (e.g., mental health, expanded testing, and biomarkers) will be important to improve our understanding of the risk of contact exposure in athletes.
A - 34 Differences in Symptom and Well-Being Report at Initial Post-Injury Concussion Medical Evaluations
Authors: Naidu D , Mrazik M , David C V , Hansen J , Ree-Fedun Q 
Published: July 2024

Abstract

Purpose
To investigate differences in subjective symptom report and percentage ratings of subjective well-being (SWB) at initial post-injury concussion medical evaluations in professional football players.

Method
A retrospective, quasi-experimental design was used for the study. Participants included Canadian Football League players who underwent initial locker room post-injury medical evaluations. CFL concussion protocol requires any player suspected of a concussion to undergo a full evaluation including SCAT5. There were 2 groups including 43 players subsequently diagnosed with concussions who were compared with 22 players not diagnosed with concussion. Data included total symptom score from the SCAT5 and SWB (ratings out of 100%). T-tests and descriptive statistics evaluated differences between groups.

Results
At baseline, there were no significant differences on ratings of SWB between groups. In contrast, there was a significant difference in ratings of subjective well being between concussed players (M = 75.5%, SD = 19.5) and non concussed players (M = 92.7, SD = 7.7); t(63) = [3.8], p = [0.1]. Furthermore, significant differences on total symptom report from the SCAT5 were identified between concussed players (M = 16.9, SD = 15.4) and non concussed players (M = 3.5, SD = 5.7); t(63) - [3.9], p = [&lt;0.01]. The sensitivity was 85% with a specificity of 63% using a post-injury SWB score of 75%.

Conclusions
Results indicated that at initial post-injury concussion evaluations, players subsequently diagnosed with concussion have lower SWB. Further research is needed to determine whether this metric would be helpful in the diagnosis of concussion.