Sex Differences in Effects of Concussion History on Select Subscales From the Automated Neuropsychological Assessment Metrics (ANAM): Preliminary Findings of Performance in High School and Collegiate Athletes.

Objectives: Sex differences have been identified in terms of post-concussion symptoms and recovery rate in athletes in high impact sports, although specific alterations in pre- and post-concussion cognitive measures have not been examined. Some studies show that either an acute concussion or a history of concussion can lead to cognitive impairment, with more pronounced long-term deficits observed in females. The objective in the current study was to examine differences in cognitive performance based on self-reported history of concussion and/or sex in NCAA Division 1 and high school athletes.

Participants: Participants in high impact sports at an NCAA Division I university and high school were recruited.

Method: Athletes completed 6 subscales from the Automated Neuropsychological Assessment Metrics (ANAM) UltraMobile as the primary outcome measure. Using a cross-sectional design, we investigated differences in cognitive performance based on sport-related concussion (SRC) history and potential interactions with biological sex using hierarchical regressions while accounting for age effects.

Results: Findings revealed significant differences in concussion recovery, with female athletes reporting longer recovery time than males. Results of regressions indicated biological sex as a moderator of developmental trends in cognitive inhibition, with history of concussion potentially impairing inhibition (increasing impulsivity) in males but increasing inhibition (increasing hypervigilance) in females. Athletes with a history of SRC showed less improvement in simple reaction time (SRT) over a single ANAM administration compared to athletes with no history of SRC. Sex differences, regardless of concussion history, were identified for working memory and variability ofSRT, with females having faster and less variable reaction times.

Conclusions: Potential implications include the use of the go-no/go, matching-to-sample, and SRT subscales on the ANAM UltraMobile along with calculating change in reaction time to detect prolonged deficits in cognitive performance following SRC which may vary by sex.