| Concussion in sport represents a significant source of disability, loss of time, and financial cost among collegiate athletes. The current paradigm for diagnosing and managing sport-related concussion requires baseline neuropsychological evaluation. Pre-injury performance levels are established against which post-injury recovery can be compared. The baseline testing paradigm assumes that healthy athletes will perform better than injured athletes on a battery of neuropsychological tests. However, this assumption has been challenged by recent research showing that abnormally low or discrepant scores on at least some tests in a neuropsychological assessment battery is normal for healthy individuals. To date, such research has focused on older adults and children rather than healthy younger adults such as collegiate athletes. The current study proposed to fill this gap by examining base rates and correlates of abnormally poor neuropsychological test performance on a baseline concussion assessment battery among a large sample of collegiate athletes. Consistent with studies looking at older adults and children, this study found that obtaining some abnormally low or discrepant scores on a multiple test battery is common among healthy collegiate athletes and is dependent upon the stringency of cutoff criteria. Factors correlated with abnormally poor neuropsychological test performance among healthy collegiate athletes at baseline assessment include gender, IQ, and time point in test battery. Information tables are provided, which include base rates for abnormally poor test performance across a multiple test battery among collegiate athletes by gender. Clinical examples illustrate how these information tables can be used in the interpretation of baseline and post-concussion test results. Incorporating such information will help to minimize misdiagnosis of cognitive impairment, refine clinical test inference, and improve return to play decisions for all collegiate athletes. |
