Reported visual disturbance and post-concussion cognitive function in collegiate athletes: the relationship between symptom report and neurocognitive outcome

A current trend within the sports-related concussion research community is focused on the investigation of the relationship between post-concussive symptomatology and neurocognitive performance. The current investigation proposed to expand upon this literature by examining the relationship between reported visual disturbance and neurocognitive performance on computerized assessment in collegiate athletes. Two computerized concussion assessment protocols, the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and the Concussion Resolution Index (CRI) were utilized to evaluate the hypotheses of the study. Athletes were included in the VSR (visual symptom report) group if they reported any degree of post-concussive visual disturbance on self-report measures. Athletes were evaluated at three time-points: baseline, 0-72 hours post-concussively, and 72-144 hours post-concussively. A total of 62 student-athletes who sustained concussions met inclusion criteria on ImPACT. Group comparison revealed specific declines in visual motor speed and reaction time on ImPACT for VSR student-athletes, as well as an increase in total symptom score. Total symptom score and visual motor speed were identified as predictors of VSR group membership, with 75.8% of cases correctly classified. On CRI (n = 26), significant differences were detected between groups over time for simple reaction time and total symptom score. Simple reaction time and total symptom score were identified as predictors of VSR group membership, with 80.5% of cases correctly classified. Consistent with previously published research, results revealed significant neurocognitive decline from baseline in the post-concussive group. Group comparison revealed greater declines over time for those athletes who reported visual symptoms, particularly in the domains of visual motor speed and simple reaction time, as well as increased total symptom report. Results suggest a greater degree of severity of concussion in those student-athletes who report visual symptoms post-concussively in comparison to their non-visual-symptom reporting counterparts, both in terms of neurocognitive decline and increased post-concussive sequelae. This phenomenon was detected across testing paradigms, suggesting a true relationship between visual symptoms and concussion severity and recovery trajectory, rather than a task-specific finding. The potential for symptom report, and specifically the report of visual problems post-concussively, to serve as a useful basic heuristic in return-to-play decision-making is promising.Ph.D., Clinical Psychology -- Drexel University, 201