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. 2023 Jan 20;13(2):177.
doi: 10.3390/brainsci13020177.

Changes in ImPACT Cognitive Subtest Networks Following Sport-Related Concussion

Grace J Goodwin  1 , Samantha E John  2 , Bradley Donohue  1 , Jennifer Keene  3 , Hana C Kuwabara  1 , Julia E Maietta  4 , Thomas F Kinsora  5 , Staci Ross  5 , Daniel N Allen  1
Affiliations

Changes in ImPACT Cognitive Subtest Networks Following Sport-Related Concussion

Grace J Goodwin et al. Brain Sci. .

Abstract

Objective: High school athletes are administered ImPACT at the start of the academic year or sport season and again after suspected concussion. Concussion management involves the comparison of baseline and post-injury cognitive scores with declines in scores providing evidence for concussive injury. A network framework may provide additional information about post-concussive cognitive changes and expand characterization of sport-related concussion (SRC) recovery.

Design: Retrospective cohort study.

Setting: High school.

Participants: High school athletes (n = 1553) were administered ImPACT at baseline (T1), post-SRC (T2 = 72 h of injury), and prior to return to play (T3 = within two weeks post-injury).

Independent variables: ImPACT cognitive subtest scores.

Main outcome measures: Cognitive networks were calculated and compared over three time points. Centrality indices were calculated to determine the relative importance of cognitive variables within networks.

Results: Network connectivity increased from T1 to T2 and remained hyperconnected at T3. There was evidence of network reorganization between T1 and T3. Processing speed was central within each network, and visual memory and impulsivity became more central over time.

Conclusions: The results suggest potential evidence of cognitive network change over time. Centrality findings suggest research specific to visual memory and impulse control difficulties during the post-concussion recovery period is warranted. Network analysis may provide additional information about cognitive recovery following SRC and could potentially serve as an effective means of monitoring persisting cognitive symptoms after concussion.

Keywords: ImPACT; concussion; network analysis; neuropsychology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
ImPACT Cognitive Subtest Networks and Node Labels. Note. (A) T1 (top), T2 (middle), and T3 (bottom) networks with unconstrained layout. (T1 = baseline assessment, T2 = initial administration of ImPACT within 72 h of suspected concussion, T3 = second administration of ImPACT within 14 days of suspected concussion). Highest node strength outlined in green, highest expected influence outlined in orange. (B) Node numbers and corresponding variable names for the 24 cognitive variables.
See this image and copyright information in PMC

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