Biology subjects

Higgins, K. L.

Publications and source records attributed to Higgins, K. L..

2 recordsLinked to original sources

bioRxiv2023

Is it sandbagging or is it just apathy? Baseline ImPACT and external validity indicators in collegiate athletes

ObjectiveBaseline cognitive testing is important for sport concussion management. Assessing baseline data for both the validity and reliability is vital to ensuring its utility. Stand-alone performance validity tests (PVT) and embedded validity indicators (EVI) (collectively called "validity measures" hereafter) are commonly used in neuropsychological testing and screening. This study further investigates efficient ways to assess validity of baseline cognitive testing. Methods231 NCAA athletes completed baseline assessment with ImPACT and one of two PVTs: Medical Symptom Validity Test or Rey Dot Counting Test. The relationship between scores on validity measures and cognitive performance, symptoms, and sleep was assessed. ResultsAthletes who failed two or more validity measures performed worse on the Visual Motor Speed Composite while athletes failing three or more measures performed worse on the Reaction Time Composite. Those athletes who failed validity measures and also reported poor sleep performed worse on both composites. Self-reported symptoms and hours of sleep were not independently associated with failing validity measures. Lastly, athletes with self-reported ADHD and/or LD were more likely to fail two+ validity measures (46% versus 27% of neurotypical athletes). ConclusionsConsistent with previous research, ImPACT Baseline++ only identified 1.7% of the samples data as invalid despite 4.8% of the dataset failing a combination of PVT and EVI and an additional 42.9% failing at least EVI alone. Results suggest that assessing validity on a continuum and using multiple validity measures may be useful to identify data validity that falls in the middle of the continuum. Public Significance StatementBaseline concussion testing is common and often mandated prior to sport participation, however, a baseline only has utility if it is both a reliable and valid representation of the athletes healthy and optimal functioning. This study adds to the growing body of literature demonstrating that baseline testing may frequently have questionable validity. It also provides support to the value of conceptualizing validity as a spectrum, rather than dichotomy and is the first to apply the concept to baseline concussion testing data.

animal behavior and cognition↗

bioRxiv2023

Concussion-related disruptions to hub connectivity in the default mode network are related to symptoms and cognition

Concussions present with a myriad of symptomatic and cognitive concerns; however, the relationship between these functional disruptions and the underlying changes in the brain are not yet well understood. Hubs, or brain regions that are connected to many different functional networks, may be specifically disrupted after concussion. Given the implications in concussion research, we quantified hub disruption within the default mode network (DMN) and between the DMN and other brain networks. We collected resting-state functional magnetic resonance imaging data from collegiate student-athletes (n = 44) at three timepoints: baseline (prior to beginning their athletic season), acute post-injury (approximately 48 hours after a diagnosed concussion), and recovery (after starting return-to-play progression, but prior to returning to contact). We used self-reported symptoms and computerized cognitive assessments collected across similar timepoints to link these functional connectivity changes to clinical outcomes. Concussion resulted in increased connectivity between regions within the DMN compared to baseline and recovery, and this post-injury connectivity was more positively related to symptoms and more negatively related to visual memory performance compared to baseline and recovery. Further, concussion led to decreased connectivity between DMN hubs and visual network non-hubs relative to baseline and recovery, and this post-injury connectivity was more negatively related to somatic symptoms and more positively related to visual memory performance compared to baseline and recovery. Relationships between functional connectivity, symptoms, and cognition were not significantly different at baseline versus recovery. These results highlight a unique relationship between self-reported symptoms, visual memory performance and acute functional connectivity changes involving DMN hubs after concussion in athletes. This may provide evidence for a disrupted balance of within- and between-network communication highlighting possible network inefficiencies after concussion. These results aid in our understanding of the pathophysiological disruptions after concussion and inform our understanding of the associations between disruptions in brain connectivity and specific clinical presentations acutely post-injury.

neuroscience↗