Cross-cultural exploration of baseline ImPACT Quick Test performance among football athletes in Zambia

iPad-Based Neurocognitive Testing (ImPACT-QT) in Acute Adult Mild Traumatic Brain Injury/Concussion: Study on Practicality and Bedside Cognitive Scores in a Level-1 Trauma Center

BACKGROUND

There lacks rapid standardized bedside testing to screen cognitive deficits following mild traumatic brain injury (mTBI). Immediate Post-Concussion Assessment & Cognitive Testing-Quick Test (ImPACT-QT) is an abbreviated-iPad form of computerized cognitive testing. The aim of this study is to test ImPACT-QT utility in inpatient settings. We hypothesize ImPACT-QT is feasible in the acute trauma setting.

METHOD

Trauma patients ages 12-70 were administered ImPACT-QT (09/2022-09/2023). Encephalopathic/medically unstable patients were excluded. Mild traumatic brain injury was defined as documented-head trauma with loss-of-consciousness <30 minutes and arrival Glasgow Coma Scale 13-15. Patients answered Likert-scale surveys. Bivariate analyses compared demographics, attention, motor speed, and memory scores between mTBI and non-TBI controls. Multivariable logistic regression assessed memory score as a predictor of mTBI diagnosis.

RESULTS

Of 233 patients evaluated (36 years [IQR 23-50], 71% [166/233] female), 179 (76%) were mTBI patients. For all patients, mean test-time was 9.3 ± 2 minutes with 93% (73/76) finding the test "easy to understand." Mild traumatic brain injury patients than non-TBI control had lower memory scores (25 [IQR 7-100] vs 43 [26-100], P = .001) while attention (5 [1-23] vs 11 [1-32]) and motor score (14 [3-28] vs 13 [4-32]) showed no significant differences. Multivariable-regression (adjustment: age, sex, race, education level, ISS, and time to test) demonstrated memory score predicted mTBI positive status (OR .96, CI .94-.98, P = .004).

DISCUSSION

Immediate Post-Concussion Assessment & Cognitive Testing-Quick Test is feasible in trauma patients. Preliminary findings suggest acute mTBIs have lower memory but not attention/motor scores vs non-TBI trauma controls.

Brief iPad-Based Assessment of Cognitive Functioning with ImPACT® Quick Test: Prevalence of Low Scores Using Multivariate Base Rates

OBJECTIVE

The ImPACT® Quick Test is a brief iPad-based battery of neurocognitive tests that has been standardized on a sample of children, adolescents, and adults (ages 12-70). This study provides information on the prevalence of ImPACT® Quick Test scores falling below specific percentiles in the normative sample to aid in clinical interpretation and reduce the risk of over-interpreting, or misinterpreting, a single low score.

METHOD

Participants were 683 individuals ranging in age from 12 to 70, who were assessed individually. The ImPACT® Quick Test includes five subtests, contributing to three factor scores: motor speed, memory, and attention tracker. The prevalence of low factor scores, stratified by age and sex, were calculated using multivariate base rates.

RESULTS

In the total sample, obtaining 1 or more scores below the 25th percentile was common (base rate, BR = 47.2%), but obtaining 2 or more scores in this range was uncommon (BR = 15.3%). Similarly, obtaining 1 or more scores below the 16th percentile was common (BR = 31.4%), but obtaining two or more scores in this range was uncommon (BR = 6.9%). There were small differences in BRs between sexes and the number of low scores was fairly similar across the age groups.

CONCLUSION

Results from this study parallel previous work illustrating that a substantial percentage of healthy individuals will obtain one or more low test scores when administered a brief battery of cognitive tests. Given that some healthy individuals will obtain a single score below expected cut-offs, clinicians should caution against overinterpreting a single low test score.