Sicard, V., Moore, R.D. & Ellemberg, D. Département de kinésiologie, Université de Montréal, Qc. Brain Injury Canada Montreal (2015)

Transcription

1 DOES THE COGSTATE TEST BATTERY HAVE THE REQUISITE SENSITIVITY TO DETECT PERSISTENT COGNITIVE DEFICITS IN COLLEGIATE ATHLETES WITH A HISTORY OF CONCUSSIONS? Sicard, V., Moore, R.D. & Ellemberg, D. Département de kinésiologie, Université de Montréal, Qc Brain Injury Canada Montreal (2015)

2 INTRODUCTION Significant impairments in cognitive functions immediately following a concussion (Belanger & Vanderploeg, 2005) Serial assessments of cognition typically indicate deficit resolution within 7-10 days following injury (Echemendia et al., 2001 ; Broglio et al., 2008) Cumulative research suggests persistent deficits in aspects of higher cognition (Ellemberg et al., 2007 ; Moore et al., 2014 ; Ozen et al., 2013) Identifying assessment tools that are sensitive to these persistent cognitive-deficits is of critical importance

3 COGSTATE TEST BATTERY Detection (Simple reaction time) Identification (Choice reaction time) One card learning (Learning) 1-back (Working memory & Sustained attention) 2-back ** (Working memory)

4 OUTCOME MEASURES CogState clinical variables Automated output Standard scientific variables Computed from raw data Log10 (RT) Mean RT, target RT, non-target RT Arcsin (prop. good resp) Mean ACC, target ACC, non-target ACC Omission and commission errors Sensivity index d

5 SENSITIVITY Sensitive to deficits in acute period of injury (Makdissi, 2001 ; Garner et al., 2012 ; Louey et al., 2014) Athletes with moderate post-concussion symptoms exhibited cognitive deficits one month after injury (Chen et al., 2007) Ability of the CogState for detecting long-term concussionrelated deficits remains untested

6 AIMS Verify whether 1. The CogState battery contains the requisite sensitivity to detect persistent cognitive deficits stemming from sport-related concussions 2. These deficits are selective for measures of higher cognition 3. A difference the two output variables types can be observed

7 HYPOTHESIS Persistent deficits can be observed in aspects of higher cognition in athletes with a history of concussion These deficits can be observed with both sets of output variables

8 1 PARTICIPANTS Table 1. Participants demographic information (± ES) Measure Concussed Controls n=71 n=49 Age (years) (0.2) (0.3) Education (years) (0.2) (0.2) Weight (kg) (7.4) (4.2) Height (cm) (1.0) (1.1) Handedness 61R/10L 43R/6L Number of concussions 2.03 (1.8) N/A Months since last concussion (0.16) N/A Loss of Consciousness 8 N/A Post Traumatic Amnesia 17 N/A Note : Min time since injury = 8 months ; max time since injury = 5 years

9 Log(RT) Arcsin(acc) RESULTS CLINICAL VARIABLES No group difference Clinical Reaction times 2.00 Clinical Accuracy DET IDN OCL ONB TWOB 0.00 DET IDN OCL ONB TWOB CogState task CogState task HOC athletes Control athletes

10 RT (ms) % RESULTS SCIENTIFIC VARIABLES No group difference 1400 Scientific Reaction times Scientific Accuracy DET IDN OCL CogState task 70 DET IDN OCL CogState task HOC athletes Control athletes

11 # # RESULTS SCIENTIFIC VARIABLES 4 1-back errors 4 *** 2-back errors 3 *** 3 2 *** * 2 ** * Total Omissions Commissions 0 Total Omissions Commissions HOC athletes Control athletes

12 d' RESULTS SCIENTIFIC VARIABLES Sensitivity index d 4 3 *** * back 2-back HOC athletes Control athletes

13 RESULTS SUMMARY No difference was observed with the evaluation of clinical variables No difference was observed with the evaluation of scientific variables on tasks measuring low level cognition Multiple group differences were observed on the 1- and 2-back conditions

14 DISCUSSION Persistent cognitive deficits are observed in athletes with a history of concussion These deficits were selective for measures of higher cognition These deficits would have gone unobserved with the clinical output variables provided by the CogState

15 AKNOWLEDGEMENT Alexander Antoniazzi Guy Ann Bach William Sauvé Christophe Alarie Dr. Robert Davis Moore Dr. Dave Ellemberg