Changes in ImPACT Cognitive Subtest Networks Following Sport-Related Concussion

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.

Network Analysis of Neuropsychiatric Symptoms in Alzheimer’s Disease

“…37 Network analysis has been used to characterize symptom presentation and progression in schizophrenia, 38 depression, anxiety, 39 post-traumatic stress disorder, 40 and sport-related concussion. [41][42][43] A network perspective may be equally illuminating for characterizing neuropsychiatric symptoms in AD. Network analysis could provide unique insights into symptom maintenance and progression and identify central symptoms that may be e cient targets for widespread symptom reduction.…”

Network analysis of neuropsychiatric symptoms in Alzheimer’s disease

“…Central symptoms, or symptoms with a large number of connections to other symptoms in a network, represent core features of a syndrome [35], and can, theoretically, be considered targets for widespread symptom reduction [38]. Network analysis has been used to characterize symptom presentation and progression in schizophrenia [39], depression, anxiety [40], post-traumatic stress disorder [41], and sport-related concussion [42][43][44]. Three studies have used network analysis to characterize NPS within clinical memory samples [8,31,45], evaluating frequent and central symptoms [31], longitudinal stability of clinical presentation [45], and the relationship of NPS to adaptive functioning in AD [8].…”