Cumulative Effects of Concussion History on Baseline Computerized Neurocognitive Test Scores: Systematic Review and Meta-analysis

Sports Health. 2017 Jul/Aug;9(4):324-332. doi: 10.1177/1941738117713974.


Context: It is unclear whether individuals with a history of single or multiple clinically recovered concussions exhibit worse cognitive performance on baseline testing compared with individuals with no concussion history.

Objective: To analyze the effects of concussion history on baseline neurocognitive performance using a computerized neurocognitive test.

Data sources: PubMed, CINAHL, and psycINFO were searched in November 2015. The search was supplemented by a hand search of references.

Study selection: Studies were included if participants completed the Immediate Post-concussion Assessment and Cognitive Test (ImPACT) at baseline (ie, preseason) and if performance was stratified by previous history of single or multiple concussions.

Study design: Systematic review and meta-analysis.

Level of evidence: Level 2.

Data extraction: Sample size, demographic characteristics of participants, as well as performance of participants on verbal memory, visual memory, visual-motor processing speed, and reaction time were extracted from each study.

Results: A random-effects pooled meta-analysis revealed that, with the exception of worsened visual memory for those with 1 previous concussion (Hedges g = 0.10), no differences were observed between participants with 1 or multiple concussions compared with participants without previous concussions.

Conclusion: With the exception of decreased visual memory based on history of 1 concussion, history of 1 or multiple concussions was not associated with worse baseline cognitive performance.

Keywords: concussion; mild traumatic brain injury; neurocognitive.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Athletic Injuries / complications
  • Athletic Injuries / psychology*
  • Brain Concussion / complications
  • Brain Concussion / psychology*
  • Cognition*
  • Humans
  • Memory
  • Neuropsychological Tests*
  • Reaction Time