The Relationship of Athlete-Reported Concussion Symptoms and Objective Measures of Neurocognitive Function and Postural Control

Objective: Concussed athlete evaluations often include symptoms, balance, and neurocognitive assessments. We sought to identify the relationship between subjective symptom reports and objective clinical measures. Design: A retrospective assessment. Setting: A research laboratory. Patients: Concussed collegiate-level athletes (N = 32, 19.7 years) evaluated pre- and postinjury (less than 48 hours). Intervention: Each athlete completed an inventory of concussion-related symptoms, the NeuroCom Sensory Organization Test (SOT), and ImPACT neurocognitive assessment. Spearman correlations between balance symptoms and SOT scores and cognitive symptoms and ImPACT scores were completed. Main Outcome Measures: Symptoms related to balance and cognitive deficits, SOT composite balance and visual, vestibular, and somatosensory ratios, and ImPACT output scores. Results: Significant Spearman correlations were noted between reports of "dizziness" and the SOT composite balance (r(s) = -0.55) and vestibular ratio (r(s) = -0.50). Similarly, "balance problems" were significantly correlated with composite balance (r(s) = -0.52) and the somatosensory (r(s) = -0.41), visual (r(s) = -0.39), and vestibular ratios (r(s) = -0.57). The cognitive symptom of "feeling mentally foggy" and ImPACT variables of reaction time (r(s) = 0.36) and "difficulty concentrating" and verbal memory score (r(s) = -0.41) were significantly related. Finally, reports of "difficultly remembering" were significantly related to the verbal memory score (r(s) = -0.48) and reaction time (r(s) = 0.36). Conclusions: These findings indicate self-report symptoms are associated with athlete deficits in postural control and cognitive function. The moderate relationship between the symptom reports and the objective measures warrants the continued use of all measures. A reduction in the number of symptoms concussed athletes respond to may be justified to reduce redundancy.