Cognitive testing important for athletes with head injuries

Whenever athletes are involved in sports that include physical contact, there is a dramatic increase in the rate of injury. The more contact that occurs, the greater the frequency and severity of injury.

Coaches, athletic trainers and parents have recently become more aware of traumatic brain injury. Among the symptoms of even mild brain trauma are amnesia and difficulty processing new information. The athlete begins to do poorly in class, has personality changes and slower motor responses.

These symptoms relate to an athlete’s cognitive ability and indicate a serious concussion. Unfortunately, these deficits can become permanent.

One challenge facing physicians has been finding a diagnostic tool to assess these deficits. Imaging studies like a CT scan or MRI are often normal. Typical neuropsychometric testing involves the administration of a series of IQ tests over several hours.

Today there are two diagnostic series that can be administered quickly and with accurate results:

• IMPACT, designed by neuropsychologists at the University of Pittsburgh, has been used for several years in the United States and has a large database.
• CogSport, developed by a group of Australian behavioral neurologists, can be administered from any Internet-accessible computer and takes only eight minutes.

CogSport is based on the use of playing cards, thus it is not language-dependent. This is a big advantage when working with non-English-speaking athletes.

Dr. Jeffrey Kutcher, Director of Michigan NeuroSport, is responsible for the evaluation and treatment of neurologic injuries involving athletes at the University of Michigan.

“Obtaining a pre-season baseline test on every athlete is crucial to the validity of any cognitive testing,” Kutcher said. The University of Michigan recently converted from IMPACT to CogSport because of its ease of use.

Parents should inquire whether these tests are being utilized as part of their children’s athletic programs.

These new methods of cognitive testing add a significant piece to the puzzle of when an athlete should return to contact sports, if ever.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at aalessi@wwbh.org. If you wish to learn more about sports health topics, listen to the podcast or go to the Healthy Sports blog at backushospital.org.