Objective Determine if current methods for identifying neurocognitive dysfunction correlate with Academic Activity Time Loss (AATL) or Cognitive Cluster Symptom Burden (CCSb) on the Post-Concussion Symptom Scale (PCSS).

Design Prospective cohort study.

Setting Single centre, UK University, ongoing since July 2021.

Participants Rugby student-athletes (n=28).

Interventions As part of an ongoing study, participants exercised daily at 80% of their symptom-threshold and followed the Rugby Football Union (RFU) community pathway.

Outcome Measures Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was used as the traditional assessment of neurocognitive function. A revised Perceived Academic Impairment Tool (rPAIT) questionnaire (self-rated academic performance on a 0–6 Likert Scale over 23 questions) assessed self-reported academic performance. Cognitive related symptoms on the PCCS was collated into a CCSb. The battery was completed at baseline, and repeated with the addition of percentage of AATL missed specifically due to SRC at 2, 4, 8 and 14 days post-SRC and prior to Return To Play (RTP). Change from baseline was used for the analyses.

Main Results AATL was reported by 60.7%, 64.3%, 42.9%, 28.6% and 7.1% of participants at 2, 4, 8 and 14 days and at RTP. CCSb was reported by 67.9%, 32.1%, 35.7%, 10.7% and 0% at the same time points. Performance on ImPACT or rPAIT was not significantly different between those with or without AATL or CCSb at any time point.

Conclusions Presence of CCSb and AATL did not affect performance on ImPACT or rPAIT. Therefore, to identify those with academic impairment a battery including CCSb and AATL is required.