Sensitivity and specificity of the ImPACT Test Battery for concussion in athletes

Abstract

This study explored the diagnostic utility of the composite scores of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Post Concussion Symptom Scale scores (PCSS). Recently concussed high school athletes (N=72) were tested within 72 h of sustaining a concussion, and data were compared to non-concussed high school athletes with no history of concussion (N=66). Between-groups MANOVA revealed a significant multivariate effect of concussion on test performance (p<.001); univariate ANOVAS revealed all six measures contributed to the between-groups differences. A discriminant function analyses was conducted to measure the ability of the five ImPACT composite scores, as well as the PCSS to classify concussion status. One discriminant function was identified that consisted of the Visual Memory, Processing Speed, and Impulse Control composite scores PCSS, which correctly classified 85.5% of the cases. Approximately 82% of participants in the concussion group and 89% of participants in the control group were correctly classified. Using these data, the sensitivity of ImPACT was 81.9%, and the specificity was 89.4%. As part of a formal concussion management program, ImPACT is a useful tool for the assessment of the neurocognitive and neurobehavioral sequelae of concussion, and can also provide post-injury cognitive and symptom data that can assist a practitioner in making safer return to play decisions.