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3rd International Conference on Concussion in Sport 2008 abstracts

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CLINICAL UTILITY OF A WORKING MEMORY AND INHIBITORY CONTROL BATTERY FOR USE IN PAEDIATRIC CONCUSSION EVALUATION

1C. G. Vaughan, 1D. T. Vincent, 1E. Leaffer, 1J. C. Schneider, 2R. M. Roth, 2P. K. Isquith, 1G. A. Gioia. 1Children’s National Medical Center, Washington, DC, USA; 2Department of Psychiatry, Dartmouth Medical School, Hanover, NH, USA

Objective: Evaluate validity of a novel test of working memory and inhibitory control for children with concussion.

Design: Clinical versus matched control group repeated measures.

Setting: Clinical participants were seen in the CNMC Safe Concussion Outcome Recovery and Education (SCORE) clinic in Washington DC. Controls were recruited from the eastern USA.

Participants: 25 boys, 10 girls aged 9–18 years with concussion matched by age, sex and race/ethnicity to typically developing children.

Intervention: Participants completed two alternative forms serially (median days from injury: time 1  =  10.0; time 2  =  17.0) of a visual task parametrically combining an N-back paradigm (0, 1, 2-back) to assess working memory with a go/no-go paradigm to assess inhibitory control.

Outcome Measures: Response accuracy, reaction time (RT), RT standard deviation and intra-individual coefficient of variability.

Results: A 3 (0, 1, 2-back) by 2 (go, no-go) by 2 (first, second evaluation) repeated measures multivariate analysis of variance with clinical vs control group as the between-subjects factor revealed an overall main effect (p<0.005) with concussion/mild traumatic brain injury (mTBI) having slower RT (η2  =  0.11) and greater variability (η2  =  0.12) across all levels of working memory and inhibitory control. The mTBI group showed a normal pattern of decreased accuracy (η2  =  0.58) and increased variability (η2  =  0.17) with increased working memory load and slower RT (η2  =  0.12) with the addition of the inhibit demand.

Conclusions: The working memory/inhibitory control battery demonstrated sensitivity to the effects of paediatric concussion with reduced response speed and increased response …

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