The Effect of Youth Concussion History on Preseason Reaction Time Performance on a Computerized Neuropsychological Test Battery

This study examined reaction time (RT) as a measure to detect lasting cognitive changes in youth athletes with a concussion history. Eighty-two high school athletes were included (20 with a history of one concussion [HC1], 10 with two or more [HC2+], and 52 with no history of concussion [NHC]). Athletes completed the Automated Neuropsychological Assessment Metrics core battery. Performance (in milliseconds) on Simple Reaction Time (SRT) and Repeated Simple Reaction Time (RSRT) subtests were compared across groups using repeated measures ANOVA. Differences in change in RT were assessed with a one-way ANOVA and the relationship between SRT and RT was analyzed using hierarchical regression. Results showed significant group differences in RSRT, with the NHC group as the fastest and the HC2+ group the slowest. While 80.5% of athletes quickened their RT from SRT to RSRT, the HC2+ group showed significantly less change than the NHC group. The NHC and HC1 groups both showed a negative relationship between initial SRT and subsequent change in RT on the RSRT, but the HC2+ group exhibited a positive relationship, suggesting a potential deficit in dynamic performance. These findings demonstrate that RSRT may be more sensitive than SRT alone in detecting lasting cognitive differences among youth athletes with a concussion history. Specifically, athletes with multiple concussions demonstrated slower overall RTs and failed to benefit from practice on repeated assessment. Repeated testing of RT may be necessary to detect more subtle deficits and to potentially decrease the risk of long-term impairments and future injuries.