Effects of Sleep Loss on Subjective Complaints and Objective Neurocognitive Performance as Measured by the Immediate Post-Concussion Assessment and Cognitive Testing

Stocker, Ryan; Khan, Hassen; Henry, Luke C.; Germain, Anne

doi:10.1093/arclin/acx003

Cited by 20 publications

(15 citation statements)

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“…Our results are in accordance with a relatively scarce literature showing an association between sleep problems and SCD (Kang et al., ; Stocker et al., ; Vaessen et al., ). Socioeconomic factors could play a significant role in the above association.…”

Section: Discussionsupporting

confidence: 94%

“…Of the studies that have examined sleep in relation to SCD, one study using both sleep questionnaire and polysomnography, as well as an extensive evaluation for SCD and the Immediate‐Post‐Concussion Assessment and Cognitive Testing battery showed that sleep loss was associated with increased severity of SCD (Stocker, Khan, Henry, & Germain, ). Poor sleep quality and daytime sleepiness were also linked to SCD in older adults, in two different studies: one using an objective neuropsychological battery (CERAD‐KN), a subjective memory complaints questionnaire, and a subjective sleep questionnaire (Pittsburg sleep index; Kang et al., ); and the other using both objective and subjective sleep measurement, a cognitive neuropsychological assessment and an SCD scale (Tardy, Gonthier, Barthelemy, Roche, & Crawford‐Achour, ).…”

Section: Introductionmentioning

confidence: 99%

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Sleep and subjective cognitive decline in cognitively healthy elderly: Results from two cohorts

Tsapanou

Vlachos

Cosentino

et al. 2018

Journal of Sleep Research

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Subjective cognitive decline (SCD) may reflect a dementia prodrome or modifiable risk factor such as sleep disturbance. What is the association between sleep and SCD? Cross-sectional design, from two studies of older adults: the WHICAP in the USA, and the HELIAD in Greece. 1576 WHICAP and 1456 HELIAD participants, without mild cognitive impairment, dementia, or severe depression/anxiety were included. Participants were mostly women, with 12 (WHICAP) and 8 (HELIAD) mean years of education. Sleep problems were estimated using the Sleep Scale from the Medical Outcomes Study. SCD was assessed using a structured complaint questionnaire that queries for subjective memory and other cognitive symptoms. Multinomial or logistic regression models were used to examine whether sleep problems were associated with complaints about general cognition, memory, naming, orientation, and calculations. Age, sex, education, sleep medication, use of medications affecting cognition, comorbidities, depression and anxiety were used as covariates. Objective cognition was also used estimated by summarizing neuropsychological performance into composite z-scores. Sleep problems were associated with two or more complaints; WHICAP:β=1.93(95%CI: 1.59–2.34),p≤0.0001, HELIAD:β=1.48(95%CI:1.20–1.83),(p≤0.0001). Sleep problems were associated with complaints in all the cognitive sub-categories except orientation for the WHICAP. The associations were noted regardless of objective cognition. At any given level of objective cognition, sleep disturbance is accompanied by subjective cognitive impairment. The replicability in two ethnically, genetically, and culturally different cohorts adds validity to our results. Results have implications for the correlates, and potential etiology of SCD, which should be considered in the assessment and treatment of older adults with cognitive complaints.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Sleep and subjective cognitive decline in cognitively healthy elderly: Results from two cohorts

Tsapanou

Vlachos

Cosentino

et al. 2018

Journal of Sleep Research

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“…Similarly, the King-Devick test, a measure of eye tracking, has been reported at ICC = 0.95 in a collegiate athlete sample [ 8 ]. Variable test performance can be associated with a number of factors including sleep [ 9 ], testing environment [ 10 ], and the test-retest interval [ 5 ]. While useful, each of the aforementioned studies has analyzed performance from relatively small cohorts and failed to include athletes from varying sexes, a wide breadth of sports, or skill levels.…”

Section: Introductionmentioning

confidence: 99%

Test-Retest Reliability and Interpretation of Common Concussion Assessment Tools: Findings from the NCAA-DoD CARE Consortium

et al. 2017

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BackgroundConcussion diagnosis is typically made through clinical examination and supported by performance on clinical assessment tools. Performance on commonly implemented and emerging assessment tools is known to vary between administrations, in the absence of concussion.ObjectiveTo evaluate the test-retest reliability of commonly implemented and emerging concussion assessment tools across a large nationally representative sample of student-athletes.MethodsParticipants (n = 4874) from the Concussion Assessment, Research, and Education Consortium completed annual baseline assessments on two or three occasions. Each assessment included measures of self-reported concussion symptoms, motor control, brief and extended neurocognitive function, reaction time, oculomotor/oculovestibular function, and quality of life. Consistency between years 1 and 2 and 1 and 3 were estimated using intraclass correlation coefficients or Kappa and effect sizes (Cohen’s d). Clinical interpretation guidelines were also generated using confidence intervals to account for non-normally distributed data.ResultsReliability for the self-reported concussion symptoms, motor control, and brief and extended neurocognitive assessments from year 1 to 2 ranged from 0.30 to 0.72 while effect sizes ranged from 0.01 to 0.28 (i.e., small). The reliability for these same measures ranged from 0.34 to 0.66 for the year 1–3 interval with effect sizes ranging from 0.05 to 0.42 (i.e., small to less than medium). The year 1–2 reliability for the reaction time, oculomotor/oculovestibular function, and quality-of-life measures ranged from 0.28 to 0.74 with effect sizes from 0.01 to 0.38 (i.e., small to less than medium effects).ConclusionsThis investigation noted less than optimal reliability for most common and emerging concussion assessment tools. Despite this finding, their use is still necessitated by the absence of a gold standard diagnostic measure, with the ultimate goal of developing more refined and sound tools for clinical use. Clinical interpretation guidelines are provided for the clinician to apply with a degree of certainty in application.Electronic supplementary materialThe online version of this article (10.1007/s40279-017-0813-0) contains supplementary material, which is available to authorized users.

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“…Many medical conditions present with postconcussive-type complaints at levels that equal or even exceed the level observed in patients with concussion. Those conditions that have been directly evaluated for the presence of postconcussive complaints include: chronic pain ( Gasquoine, 2000 ; Smith-Seemiller et al, 2003 ) stress ( Machulda, Bergquist, Ito, & Chew, 1998 ) depression ( Donnell et al, 2012 ; Garden, Sullivan, & Lange, 2010 ; Trahan, Ross, & Trahan, 2001 ) anxiety ( Donnell et al, 2012 ; Garden et al, 2010 ; Lagarde et al, 2014 ) chronic fatigue syndrome ( Tiersky, Cicerone, Natelson, & DeLuca, 1998 ) orthopedic injuries ( Laborey et al, 2014 ; Landre et al, 2006 ; Losoi et al, 2016 ; Mickeviciene et al, 2004 ) sleep disruption ( Stocker, Khan, Henry, & Germain, 2017 ) …”

Section: Introductionmentioning

confidence: 99%

Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review

Pertab

Merkley

Cramond³

et al. 2018

NRE

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BACKGROUND:Recent evidence suggests that autonomic nervous dysfunction may be one of many potential factors contributing to persisting post-concussion symptoms.OBJECTIVE:This is the first systematic review to explore the impact of concussion on multiple aspects of autonomic nervous system functioning.METHODS:The methods employed are in compliance with the American Academy of Neurology (AAN) and PRISMA standards. Embase, MEDLINE, PsychINFO, and Science Citation Index literature searches were performed using relevant indexing terms for articles published prior to the end of December 2016. Data extraction was performed by two independent groups, including study quality indicators to determine potential risk for bias according to the 4-tiered classification scheme of the AAN.RESULTS:Thirty-six articles qualified for inclusion in the analysis. Only three studies (one Class II and two Class IV) did not identify anomalies in measures of ANS functioning in concussed populations.CONCLUSIONS:The evidence supports the conclusion that it is likely that concussion causes autonomic nervous system anomalies. An awareness of this relationship increases our understanding of the physical impact of concussion, partially explains the overlap of concussion symptoms with other medical conditions, presents opportunities for further research, and has the potential to powerfully inform treatment decisions.

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Effects of Sleep Loss on Subjective Complaints and Objective Neurocognitive Performance as Measured by the Immediate Post-Concussion Assessment and Cognitive Testing

Cited by 20 publications

References 68 publications

Sleep and subjective cognitive decline in cognitively healthy elderly: Results from two cohorts

Sleep and subjective cognitive decline in cognitively healthy elderly: Results from two cohorts

Test-Retest Reliability and Interpretation of Common Concussion Assessment Tools: Findings from the NCAA-DoD CARE Consortium

Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review

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