INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Shubert Complex (Posters 1-60) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #48 The Relationship Between Subjective Cognitive Function, Dispersion-Based Intra-Individual Variability and Estimated Head Impact Histories Among Former Collegiate Football Players Iris Yi Miao, Medical College of Wisconsin, Wauwatosa, United States Karen Martinez, Medical College of Wisconsin, Wauwatosa, United States Zachary Kerr, University of North Carolina at Chapel Hill, Chapel Hill, United States Wesley Cole, University of North Carolina at Chapel Hill, Chapel Hill, United States Kevin Guskiewicz, University of North Carolina at Chapel Hill, Chapel Hill, United States Michael McCrea, Medical College of Wisconsin, Wauwatosa, United States Benjamin Brett, Medical College of Wisconsin, Wauwatosa, United States Category: Concussion/Mild TBI (Adult) Keyword 1: brain injury Keyword 2: sports-related neuropsychology Keyword 3: quality of life Objective: The association between head injury history and subjective cognitive symptom endorsement among contact sport athletes has been robustly observed. Studies of head injury history and worse performance-based measures of cognitive functioning have been more variable, and subjective and objective cognition have not always aligned. Subjective difficulties may reflect subtle changes not captured by traditional measures of central tendency (e.g., impairment >1.5SD). Dispersion-based cognitive intra-individual variability (IIV) captures fluctuations in performance across different tasks of the same cognitive domain and may better align with subjective cognitive concerns. We examined associations between performance-based intraindividual variability, subjective cognition, and head injury history. Participants and Methods: Fifty-eight former collegiate football players (Mage=38, SD=1.47) completed evaluations approximately 15 years following sports retirement, including demographic/health history, self-report measures of cognitive functioning including the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) and Quality of Life in Neurological Disorders (Neuro-Qol) Cognitive Functioning Short-Form, and a battery of paper-pencil-based and computerized neuropsychological measures. All variables were converted to age-corrected norm-referenced standard scores. Three dispersion-based IIV indices reflecting the degree of dispersion across the same cognitive domains (i.e., attention/executive functioning-IIV, reaction time/processing speed-IIV, memory-IIV) were determined by calculating the standard deviation across standard scores within the cognitive domain. Linear regression models were fit to test associations between the IIV indices with subjective cognitive functioning and head injury history (Head Impact Estimate Index and concussion history as an ordinal variable; 0-1, 3-5, 6-9-10+). To examine the source of observed associations between subjective cognition and IIV, performance on individual computerized subtests and subjective cognition associations were examined via linear regression models. Models were fit with covariates of estimated abilities (WTAR), sleep quality (Pittsburgh Sleep Quality Index), and psychological distress (Brief Symptom Inventory-18). Results: Worse subjective Neuro-QoL Cognitive Function rating was significantly associated with greater IIV in reaction time/processing speed (B=-0.19, p<.001, η2=.202). Worse subjective report of domain-specific cognition (Metacognition on the BRIEF-A) was associated with greater memory-based IIV (B=0.342, p=.012, η2=.115). There were no significant associations between concussion history or estimated head impact exposure with the three IIVs. On the subtest level, subjective cognition was only significantly associated with two computerized subtests of processing speed, but in opposite directions (i.e., better CPT choice reaction time and worse Pattern Comparison performance). Estimated head impact exposure and concussion history were not significantly related to performance on computerized subtests (ps>.05). Conclusions: Subjectively rated cognitive function was inversely associated with performance variability within domains of cognitive functioning in this sample of former collegiate football players, even when controlling for factors commonly associated with performance variability in non-athlete cohorts. Among former contact sport athletes with a range of reported head injury history, IIV may serve as a more sensitive reflection of individuals’ subjective experiences of cognitive functioning. IIV may have clinical utility in supplementing standard scores derived from central tendency-based normative data in the comprehensive neuropsychological assessment of former contact sport athletes. Future longitudinal research is needed to determine the degree to which IIV might represent a risk factor for poor long-term outcomes.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Shubert Complex (Posters 1-60)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #48

The Relationship Between Subjective Cognitive Function, Dispersion-Based Intra-Individual Variability and Estimated Head Impact Histories Among Former Collegiate Football Players

Iris Yi Miao, Medical College of Wisconsin, Wauwatosa, United States
Karen Martinez, Medical College of Wisconsin, Wauwatosa, United States
Zachary Kerr, University of North Carolina at Chapel Hill, Chapel Hill, United States
Wesley Cole, University of North Carolina at Chapel Hill, Chapel Hill, United States
Kevin Guskiewicz, University of North Carolina at Chapel Hill, Chapel Hill, United States
Michael McCrea, Medical College of Wisconsin, Wauwatosa, United States
Benjamin Brett, Medical College of Wisconsin, Wauwatosa, United States

Category: Concussion/Mild TBI (Adult)

Keyword 1: brain injury
Keyword 2: sports-related neuropsychology
Keyword 3: quality of life

Objective:

The association between head injury history and subjective cognitive symptom endorsement among contact sport athletes has been robustly observed. Studies of head injury history and worse performance-based measures of cognitive functioning have been more variable, and subjective and objective cognition have not always aligned. Subjective difficulties may reflect subtle changes not captured by traditional measures of central tendency (e.g., impairment >1.5SD). Dispersion-based cognitive intra-individual variability (IIV) captures fluctuations in performance across different tasks of the same cognitive domain and may better align with subjective cognitive concerns. We examined associations between performance-based intraindividual variability, subjective cognition, and head injury history.

Participants and Methods:

Fifty-eight former collegiate football players (Mage=38, SD=1.47) completed evaluations approximately 15 years following sports retirement, including demographic/health history, self-report measures of cognitive functioning including the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) and Quality of Life in Neurological Disorders (Neuro-Qol) Cognitive Functioning Short-Form, and a battery of paper-pencil-based and computerized neuropsychological measures. All variables were converted to age-corrected norm-referenced standard scores. Three dispersion-based IIV indices reflecting the degree of dispersion across the same cognitive domains (i.e., attention/executive functioning-IIV, reaction time/processing speed-IIV, memory-IIV) were determined by calculating the standard deviation across standard scores within the cognitive domain. Linear regression models were fit to test associations between the IIV indices with subjective cognitive functioning and head injury history (Head Impact Estimate Index and concussion history as an ordinal variable; 0-1, 3-5, 6-9-10+). To examine the source of observed associations between subjective cognition and IIV, performance on individual computerized subtests and subjective cognition associations were examined via linear regression models. Models were fit with covariates of estimated abilities (WTAR), sleep quality (Pittsburgh Sleep Quality Index), and psychological distress (Brief Symptom Inventory-18).

Results:

Worse subjective Neuro-QoL Cognitive Function rating was significantly associated with greater IIV in reaction time/processing speed (B=-0.19, p<.001, η2=.202). Worse subjective report of domain-specific cognition (Metacognition on the BRIEF-A) was associated with greater memory-based IIV (B=0.342, p=.012, η2=.115). There were no significant associations between concussion history or estimated head impact exposure with the three IIVs. On the subtest level, subjective cognition was only significantly associated with two computerized subtests of processing speed, but in opposite directions (i.e., better CPT choice reaction time and worse Pattern Comparison performance). Estimated head impact exposure and concussion history were not significantly related to performance on computerized subtests (ps>.05).

Conclusions:

Subjectively rated cognitive function was inversely associated with performance variability within domains of cognitive functioning in this sample of former collegiate football players, even when controlling for factors commonly associated with performance variability in non-athlete cohorts. Among former contact sport athletes with a range of reported head injury history, IIV may serve as a more sensitive reflection of individuals’ subjective experiences of cognitive functioning. IIV may have clinical utility in supplementing standard scores derived from central tendency-based normative data in the comprehensive neuropsychological assessment of former contact sport athletes. Future longitudinal research is needed to determine the degree to which IIV might represent a risk factor for poor long-term outcomes.