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Beyond Measures of Central Tendency: Novel Methods to Examine Sex Differences in Neuropsychological Performance Following Sports-Related Concussion in Collegiate Athletes

Published online by Cambridge University Press:  03 September 2019

Victoria C. Merritt Open the ORCID record for Victoria C. Merritt [Opens in a new window] ,
Liora S. Greenberg ,
Erin Guty ,
Megan L. Bradson ,
Amanda R. Rabinowitz  and
Peter A. Arnett
Victoria C. Merritt*
Affiliation:
VA San Diego Healthcare System, San Diego, CA 92161, USA
Liora S. Greenberg
Affiliation:
The Pennsylvania State University, PA 16801, USA
Erin Guty
Affiliation:
The Pennsylvania State University, PA 16801, USA
Megan L. Bradson
Affiliation:
The Pennsylvania State University, PA 16801, USA
Amanda R. Rabinowitz
Affiliation:
Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
Peter A. Arnett
Affiliation:
The Pennsylvania State University, PA 16801, USA
*
*Correspondence and reprint requests to: Victoria C. Merritt, VA San Diego Healthcare System (151B), 3350 La Jolla Village Drive, San Diego, CA 92161, USA. Phone: 858-558-8585 x2670, Fax: 858-642-6340. E-mail: victoria.merritt@va.gov
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Abstract

Objective:

The purpose of this study was to examine sex differences in neuropsychological functioning after sports-related concussion using several approaches to assess cognition: mean performance, number of impaired scores, and intraindividual variability (IIV).

Method:

In the study, 152 concussed college athletes were administered a battery of neuropsychological tests, on average, 10 days post-concussion (SD = 12.75; Mdn = 4 days; Range = 0–72 days). Mean performance was evaluated across 18 individual neuropsychological variables, and the total number of impaired test scores (>1.5 SD below the mean) was calculated for each athlete. Two measures of IIV were also computed: an intraindividual standard deviation (ISD) score and a maximum discrepancy (MD) score.

Results:

Analyses of covariance revealed that, compared with males, females had significantly more impaired scores and showed greater variability on both IIV indices (ISD and MD scores) after adjusting for time since injury and post-concussive symptoms. In contrast, no significant effects of sex were found when examining mean neuropsychological performance.

Conclusion:

Although females and males demonstrated similar mean performance following concussion, females exhibited a greater level of cognitive impairment and larger inconsistencies in cognitive performance than males. These results suggest that evaluating cognitive indices beyond mean neuropsychological scores may provide valuable information when determining the extent of post-concussion cognitive dysfunction.

Keywords

CognitionCognitive impairmentIntraindividual variabilityCognitive dispersionSports concussionGender differences
Type
Brief Communication
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 10 , November 2019 , pp. 1094 - 1100
Copyright
Copyright © INS. Published by Cambridge University Press, 2019 

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