Long term consequences of concussion: Sensitivity and specificity measures of deficits in a dual task paradigm


Background: Detecting long-term consequences of concussions is paramount for understanding the full implications of a concussion. Current neurocognitive tests, such as Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), have shown to be very sensitive to acute (24h to 72h) deficits resulting from concussions; however, ImPACT does not dissociate between people who never had a concussion from those who did when administered years later. Other research has shown long term consequences of a concussion. Hypotheses: 1) There are no long-term consequences of concussions, or 2) more sensitive measures are needed to detect persistent problems. Method: Two separate cohorts of athletes were tested: 1) 26 non varsity hockey athletes (18 with history of concussion); and 2) 29 varsity collegiate ice hockey athletes (18 with history of concussion). All participants were tested using a dual task paradigm involving a visuospatial working memory task (Corsi task) and an auditory task. Results: Athletes with prior history of concussion perform worse in dual task performance (lower accuracy scores, greater drop in speed) than those without a prior history of concussion in both cohort groups. Sensitivity of the test is increased when testing the homogenous (varsity hockey players) cohort (from 24% to 94%). Conclusion: Individuals with a history of concussion have long lasting problems that can be measured with resource taxing tasks (i.e., complex tasks that require attention allocation skills needed for dual task performance). Further, sensitive measures such as those requiring dual task performance are greatly improved when comparing similar cohorts rather than across sports teams.

Acknowledgments: Partial funding provided through a grant from Chronic Disease Prevention Initiative, Propel Centre, and University of Waterloo