Objective Common computerized neurocognitive tests are widely used yet are limited by test re-test reliability as well as effort concerns, thus gamification of testing is an emerging approach. However, the critical determinant of sex and concussion history is unknown. Therefore, this study aimed to examine the relationship between concussion history and sex on a gamified neurocognitive assessment.

Design Cross-sectional.

Setting University.

Participants 45 males (age:21.3±1.4 years., and 36 females (age: 20.1±1.6 years, intercollegiate student athletes.

Interventions (or Assessment of Risk Factors) Participants completed three sets of five trials (n=15) on an iPad in which they were instructed to hit targets as quickly as possible. The game provided a unitless score to rate performance with a higher value indicating a greater number of targets hit which the manufacturer indicates reflects executive function and working memory performance. Additionally, all participants self-reported concussion history and sex. Two one-way ANOVAs compared game performance for 1) sex (M/F) and 2) concussion history (Yes/No) with Cohen’s d effect sizes.

Outcome Measures Game scores.

Main Results Males had significantly higher game scores than females (21,388.2 + 4,653.5 and 14633.3 + 3370.9 respectively, F =53.382, p<0.001, d=1.7) Those with a history of concussion had significantly higher scores than those without a history of concussion (17,321.0 + 4741.6 and 20,915.3 + 5846.1 respectively, F=8.429, p=0.005, d=0.68).

Conclusions Gamification of cognitive testing holds promise to address concerns on reliability and effort in baseline testing. However, both concussion history and sex need to be considered as important confounders in test performance.