Detecting cognitive impairment after concussion: sensitivity of change from baseline and normative data methods using the CogSport/Axon cognitive test battery

Arch Clin Neuropsychol. 2014 Aug;29(5):432-41. doi: 10.1093/arclin/acu020. Epub 2014 May 9.


Concussion-related cognitive impairments are typically evaluated with repeated neuropsychological assessments where post-injury performances are compared with pre-injury baseline data (baseline method). Many cases of concussions, however, are evaluated in the absence of baseline data by comparing post-injury performances with normative data (normative method). This study aimed to compare the sensitivity and specificity of these two methods using the CogSport/Axon test battery. Normative data and reliable change indices were computed from a non-injured athlete sample (n = 235). Test-retest data from non-injured (n = 260) and recently concussed (n = 29) athlete samples were then used to compare the two methods. The baseline method was found to be more sensitive than the normative method, and both methods had high specificity and overall correct classification rates. This suggests that while the normative method identifies most cases of recent concussions, the baseline method remains a more precise approach to assessing concussion-related cognitive impairments.

Keywords: Assessment; Cognition; Concussion; Injury management; Neuropsychological evaluation; mTBI.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Athletic Injuries / complications
  • Brain Concussion / complications*
  • Case-Control Studies
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology*
  • Comprehension
  • Diagnosis, Computer-Assisted
  • Humans
  • Male
  • Neuropsychological Tests* / standards
  • Psychomotor Performance
  • Reaction Time
  • Reference Values
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Young Adult