TY - JOUR
T1 - Gender and age predict outcomes of cognitive, balance and vision testing in a multidisciplinary concussion center
AU - Benedict, Peter A.
AU - Baner, Natali V.
AU - Harrold, G. Kyle
AU - Moehringer, Nicholas
AU - Hasanaj, Lisena
AU - Serrano, Liliana P.
AU - Sproul, Mara
AU - Pagnotta, Geraldine
AU - Cardone, Dennis A.
AU - Flanagan, Steven R.
AU - Rucker, Janet
AU - Galetta, Steven L.
AU - Balcer, Laura J.
N1 - Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2015/6/15
Y1 - 2015/6/15
N2 - Objective This study examined components of the Sports Concussion Assessment Tool, 3rd Edition (SCAT3) and a vision-based test of rapid number naming (King-Devick [K-D]) to evaluate sports and non-sports concussion patients in an outpatient, multidisciplinary concussion center. While the Symptom Evaluation, Standardized Assessment of Concussion (SAC), modified Balance Error Scoring System (BESS), and K-D are used typically for sideline assessment, their use in an outpatient clinical setting following concussion has not been widely investigated. Methods K-D, BESS, SAC, and SCAT3 Symptom Evaluation scores were analyzed for 206 patients who received concussion care at the Concussion Center at NYU Langone Medical Center. Patient age, gender, referral data, mechanism of injury, time between concussive event and first concussion center appointment, and the first specialty service to evaluate each patient were also analyzed. Results In this cohort, Symptom Evaluation scores showed a higher severity and a greater number of symptoms to be associated with older age (r = 0.31, P = 0.002), female gender (P = 0.002, t-test), and longer time between the concussion event and first appointment at the concussion center (r = 0.34, P = 0.008). Performance measures of K-D and BESS also showed associations of worse scores with increasing patient age (r = 0.32-0.54, P 0.001), but were similar among males and females and across the spectrum of duration since the concussion event. Patients with greater Symptom Severity Scores also had the greatest numbers of referrals to specialty services in the concussion center (r = 0.33, P = 0.0008). Worse Immediate Memory scores on SAC testing correlated with slower K-D times, potentially implicating the dorsolateral prefrontal cortex as a commonly involved brain structure. Conclusion This study demonstrates a novel use of sideline concussion assessment tools for evaluation in the outpatient setting, and implicates age and gender as predictors of outcomes for these tests.
AB - Objective This study examined components of the Sports Concussion Assessment Tool, 3rd Edition (SCAT3) and a vision-based test of rapid number naming (King-Devick [K-D]) to evaluate sports and non-sports concussion patients in an outpatient, multidisciplinary concussion center. While the Symptom Evaluation, Standardized Assessment of Concussion (SAC), modified Balance Error Scoring System (BESS), and K-D are used typically for sideline assessment, their use in an outpatient clinical setting following concussion has not been widely investigated. Methods K-D, BESS, SAC, and SCAT3 Symptom Evaluation scores were analyzed for 206 patients who received concussion care at the Concussion Center at NYU Langone Medical Center. Patient age, gender, referral data, mechanism of injury, time between concussive event and first concussion center appointment, and the first specialty service to evaluate each patient were also analyzed. Results In this cohort, Symptom Evaluation scores showed a higher severity and a greater number of symptoms to be associated with older age (r = 0.31, P = 0.002), female gender (P = 0.002, t-test), and longer time between the concussion event and first appointment at the concussion center (r = 0.34, P = 0.008). Performance measures of K-D and BESS also showed associations of worse scores with increasing patient age (r = 0.32-0.54, P 0.001), but were similar among males and females and across the spectrum of duration since the concussion event. Patients with greater Symptom Severity Scores also had the greatest numbers of referrals to specialty services in the concussion center (r = 0.33, P = 0.0008). Worse Immediate Memory scores on SAC testing correlated with slower K-D times, potentially implicating the dorsolateral prefrontal cortex as a commonly involved brain structure. Conclusion This study demonstrates a novel use of sideline concussion assessment tools for evaluation in the outpatient setting, and implicates age and gender as predictors of outcomes for these tests.
KW - Cognition
KW - Concussion
KW - King-Devick test
KW - SCAT2
KW - Saccades
KW - Sports
UR - https://www.scopus.com/pages/publications/84929511316
U2 - 10.1016/j.jns.2015.04.029
DO - 10.1016/j.jns.2015.04.029
M3 - Article
C2 - 25953343
AN - SCOPUS:84929511316
SN - 0022-510X
VL - 353
SP - 111
EP - 115
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
IS - 1-2
ER -