Cited by 2,395Traumatic Brain Injury ResearchCognitive Functions and MemoryTraumatic Brain Injury and Neurovascular Disturbances

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Paced Auditory Serial-Addition Task: A Measure of Recovery from Concussion

Gronwall, D. M. A.·1977·Perceptual and Motor Skills

DOI 10.2466/pms.1977.44.2.367

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Abstract

The need for a measure of severity of concussion apart from duration of post-traumatic amnesia is examined. The paced auditory serial-addition test, a measure of rate of information processing, is presented as a convenient test for estimating individual performance during recovery. Procedures for administration and control data are given, and the programme used for managing the rehabilitation of concussion patients described.

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Crossref · 10.2466/pms.1977.44.2.367

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DELAYED RECOVERY OF INTELLECTUAL FUNCTION AFTER MINOR HEAD INJURY
Gronwall, D., & Wrightson, P. (1974) · The Lancet · doi:10.1016/s0140-6736(74)91939-4 · Cited by 539
Self-citation
CUMULATIVE EFFECT OF CONCUSSION
Gronwall, D., & Wrightson, P. (1975) · The Lancet · doi:10.1016/s0140-6736(75)90288-3 · Cited by 394
Self-citation
The psychological effects of concussion
Gronwall, D., & Sampson, H. (1974) · Cited by 289
Self-citation
The Psychological Effects of Concussion
Walsh, K. W. (1975) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1975.tb106128.x · Cited by 287
Causes of the post-concussional syndrome.
Hf, L., Linderoth, B., & Norlin, B. (1974) · PubMed · Cited by 109
Mental Sequelæ of Head Injury
Miller, H. (1966) · Proceedings of the Royal Society of Medicine · doi:10.1177/003591576605900327 · Cited by 40
Mental Sequelæ of Head Injury
Russell, W. R. (1966) · Proceedings of the Royal Society of Medicine · doi:10.1177/003591576605900329 · Cited by 17
Effcts of practice on paced performance
Sampson, H. (1961) · Australian Journal of Psychology · doi:10.1080/00049536108256002 · Cited by 7
The post-traumatic syndrome in closed head injuries accident neurosis.
Landy, P. J. B. (1968) · PubMed · Cited by 5

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Cairns H., 1942, Proc. Roy. Soc. Med., 35, 299
Gronwall D. M. A. Concussion; does intelligence help? N.Z. Psychol., 1976, in press. (a).
Gronwall D. M. A. Performance changes during recovery from closed head injury. Proc. Austral. Assn Neurol., 1976, in press. (b).
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Lidvall H. F., 1974, Acta Neurol. Scand., 50

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Identifying risk factors for cognitive issues in multiple sclerosis
Amato, M. P., Prestipino, E., & Bellinvia, A. (2019) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2019.1590199 · Cited by 41
“Other tests, such as the Wisconsin Card Sorting Test [42] exploring executive functions or the Stroop Test [43] exploring complex attention are less frequently used.”
Method
The correlation between dyslipidemia and cognitive impairment in multiple sclerosis patients
Noori, H., Gheini, M. R., Rezaeimanesh, N., Saeedi, R., Aliabadi, H. R., Sahraian, M. A., & Moghadasi, A. N. (2019) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2019.101415 · Cited by 42
Longitudinal prevalence and determinants of pain in multiple sclerosis: results from the German National Multiple Sclerosis Cohort study
Heitmann, H., Haller, B., Tiemann, L., Mühlau, M., Berthele, A., Tölle, T. R., Salmen, A., Ambrosius, B., Bayas, A., Asseyer, S., et al. (2020) · Pain · doi:10.1097/j.pain.0000000000001767 · Cited by 47
Magnetic resonance spectroscopy of normal appearing white matter in early relapsing-remitting multiple sclerosis: correlations between disability and spectroscopy
Ruíz-Peña, J. L., Piñero, P., Sellers, G., Argente, J., Casado, A., Foronda, J., Sánchez, A. J. U., & Izquierdo, G. (2004) · BMC Neurology · doi:10.1186/1471-2377-4-8 · Cited by 41
Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity
Oken, B., Flegal, K. E., Zajdel, D. P., Kishiyama, S. S., Lovera, J. F., Bagert, B. A., & BOURDETTE, D. N. (2006) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2004.11.0148 · Cited by 41
“Abbreviations: AED = antiepileptic drug, ANCOVA = analysis of covariance, CESD-10 = Center for Epidemiologic Studies Depression Scale 10-item short form, CNS = central nervous system , EDSS = Expanded Disability Status Scale, MANCOVA = multivariate analysis of covariance, MS = multiple sclerosis, OHSU = Oregon Health…”
MethodInfluential
Frontal parenchymal atrophy measures in multiple sclerosis
Locatelli, L., Zivadinov, R., Grop, A., & Zorzon, M. (2004) · Multiple Sclerosis Journal · doi:10.1191/1352458504ms1093oa · Cited by 41
Psychological States and Neuropsychological Performances in Chronic Lyme Disease
Elkins, L. E., Pollina, D. A., Scheffer, S. R., & Krupp, L. (1999) · Applied Neuropsychology · doi:10.1207/s15324826an0601_3 · Cited by 41
Distress tolerance moderates the relationship between negative affect intensity with borderline personality disorder levels
Bornovalova, M. A., Matusiewicz, A., & Rojas, E. (2011) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2010.11.005 · Cited by 39
“As our first behavioral measure of willingness to tolerate emotional distress, we used a modified computerized version of the Paced Auditory Serial Addition Task (PASAT [51]), which has been shown to produce elevated levels of emotional distress [42, 43].”
Side-effects of mdma-assisted psychotherapy: a systematic review and meta-analysis
Colcott, J., Guerin, A. A., Carter, O. L., Meikle, S. E., & Bedi, G. (2024) · Neuropsychopharmacology · doi:10.1038/s41386-024-01865-8 · Cited by 42
Neurocognitive Impairment is Associated with Lower Health Literacy Among Persons Living with HIV Infection
Morgan, E. E., Iudicello, J. E., Cattie, J. E., Blackstone, K., Grant, I., & Woods, S. P. (2014) · AIDS and Behavior · doi:10.1007/s10461-014-0851-7 · Cited by 41
“Attention/Working Memory: Paced Auditory Serial Addition Test (PASAT; [40, 41]), Wechsler Adult Intelligence Scale-III (WAIS-III) Letter-Number Sequencing [37, 39]; 4.”
Method
Cognitive performance in relapsing remitting multiple sclerosis: A longitudinal study in daily practice using a brief computerized cognitive battery
Edgar, C. J., Jongen, P. J., Sanders, E. A. C. M., Sindic, C. J. M., Goffette, S., Dupuis, M., Jacquerye, P., Guillaume, D., Reznik, R., & Wesnes, K. A. (2011) · BMC Neurology · doi:10.1186/1471-2377-11-68 · Cited by 40
“The PASAT 3” measures processing speed and working memory in the auditory/verbal sphere [22].”
Background
Effect of Oral Amino Acids on Counterregulatory Responses and Cognitive Function During Insulin-Induced Hypoglycemia in Nondiabetic and Type 1 Diabetic People
Rossetti, P., Porcellati, F., Ricci, N. B., Candeloro, P., Cioli, P., Nair, K. S., Santeusanio, F., Bolli, G. B., & Fanelli, C. G. (2008) · Diabetes · doi:10.2337/db08-0276 · Cited by 39
The effect of natalizumab on cognitive function in patients with relapsing-remitting multiple sclerosis: preliminary results of a 1-year follow-up study
Mattioli, F., Stampatori, C., & Capra, R. (2010) · Neurological Sciences · doi:10.1007/s10072-010-0412-4 · Cited by 40
“Table 3 Change from baseline in median (range) scores of clinical and neuropsychological assessments following 1 year of treatment Natalizumab group (n = 17) Control group (n = 7) P value* Number of relapses in previous year -2 (-3 to 1) 0 (0–1) 0.001 EDSS 0 (-1 to 1) 0.0 (-1.5 to 3.0) 0.248 PASAT 30 0 -0.5 (-13.0 to…”
MethodInfluential
A Randomized Clinical Trial of Atomoxetine for Mild Cognitive Impairment in Parkinson's Disease
Hinson, V. K., Delambo, A., Elm, J. J., & Turner, T. H. (2016) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.12455 · Cited by 40
Applying causal models to explore the mechanism of action of simvastatin in progressive multiple sclerosis
Eshaghi, A., Kievit, R., Prados, F., Sudre, C. H., Nicholas, J. M., Cardoso, M. J., Chan, D., Nicholas, R. S., Sebastien Ourselin, A., Greenwood, J., et al. (2019) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1818978116 · Cited by 36
Sedentary behaviour is associated with heightened cardiovascular, inflammatory and cortisol reactivity to acute psychological stress
Chauntry, A. J., BISHOP, N. C., Hamer, M., Kingsnorth, A. P., Chen, Y., & Paine, N. J. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105756 · Cited by 41
Amnesia and driving
Anderson, S. W., Rizzo, M., Skaar, N. R., Stierman, L., Cavaco, S., Dawson, J. D., & Damasio, H. (2006) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390590954182 · Cited by 40
“During an uneventful segment of highway, the Paced Auditory Serial-Addition Test (PASAT; Gronwall, 1977 ) was presented (audio tape recorded by an U.”
Method
Additional road markings as an indication of speed limits: Results of a field experiment and a driving simulator study
Daniëls, S., Vanrie, J., Dreesen, A., & Brijs, T. (2010) · Accident Analysis & Prevention · doi:10.1016/j.aap.2009.06.020 · Cited by 40
“The secondary task consisted of a series of simple arithmetic tasks, the Paced Serial Addition Task (PASAT) (Gronwall, 1977).”
Method
Natural History of Attention Deficits and Their Influence on Functional Recovery from Acute Stages to 6 Months after Stroke
Barker-Collo, S. L., Feigin, V. L., Lawes, C. M. M., Senior, H., & Parag, V. (2010) · Neuroepidemiology · doi:10.1159/000319894 · Cited by 40
“a test of visual conceptualisation and visuomotor tracking involving motor speed and attention requiring participants to connect numbered circles in order (part A), after which they connect circles with both numbers and letters in alternating order (i.e. 1-A-2-B etc.; part B), and (iv) the 2 slowest Paced Auditory Ser…”
Negative affect predicts subsequent cognitive change in multiple sclerosis
Christodoulou, C., Melville, P., SCHERL, W. F., MacAllister, W. S., Abensur, R., Troxell, R. M., & Krupp, L. (2009) · Journal of the International Neuropsychological Society · doi:10.1017/s135561770809005x · Cited by 40
“…Group of the National Multiple Sclerosis Society, 1990 ; Smith, 1973 ); the Paced Auditory Serial Addition Test (PASAT) (Benedict et al., 2002 ; Gronwall, 1977 ; Rao & the Cognitive Function Study Group of the National Multiple Sclerosis Society, 1990 ), a task assessing working memory,…”
Method
Attention and Information Processing Efficiency in Patients with Chronic Fatigue Syndrome
Michiels, V., Gucht, V. D., Cluydts, R., & Fischler, B. (1999) · Journal of Clinical and Experimental Neuropsychology · doi:10.1076/jcen.21.5.709.875 · Cited by 40
Effects of gabapentin on cognition and quality of life in patients with epilepsy
Mortimore, C., Trimble, M., & Emmers, E. (1998) · Seizure · doi:10.1016/s1059-1311(05)80003-2 · Cited by 40
A Brief Mindfulness Exercise Reduces Cardiovascular Reactivity During a Laboratory Stressor Paradigm
Steffen, P. R., & Larson, M. J. (2015) · Mindfulness · doi:10.1007/s12671-014-0320-4 · Cited by 39
A Rapid Screen of the Severity of Mild Traumatic Brain Injury
Comerford, V. E., Geffen, G. M., May, C., Medland, S. E., & Geffen, L. B. (2002) · Journal of Clinical and Experimental Neuropsychology · doi:10.1076/jcen.24.4.409.1044 · Cited by 39
“A follow-up study showed that the Paced Auditory Serial Addition Task was effective in measuring the severity of injury since patients with poorest performance took longest to achieve normal scores (Gronwall, 1977).”
Background
Cognitive and Typing Outcomes Measured Simultaneously with Slow Treadmill Walking or Sitting: Implications for Treadmill Desks
Larson, M. J., LeCheminant, J. D., Hill, K. R., Carbine, K. A., Masterson, T. D., & Christenson, E. (2015) · PLoS ONE · doi:10.1371/journal.pone.0121309 · Cited by 43
“Fifty-one numbers (50 responses per block for a total of 200 possible responses) were presented for four separate trial blocks [36].”
Background
Clinical Utility of Diffusion Tensor Imaging for Evaluating Patients with Diffuse Axonal Injury and Cognitive Disorders in the Chronic Stage
Sugiyama, K., Kondo, T., Oouchida, Y., Suzukamo, Y., Higano, S., Endo, M., Watanabe, H., Shindo, K., & Izumi, S. (2009) · Journal of Neurotrauma · doi:10.1089/neu.2008.0839 · Cited by 39
“There were no correlations between brain areas with decreased FA and MMSE, PASAT, GM, ViM, and A = C of WMS-R and RBMT or CA and DMS of KWCST and BADS.”
Immune function and brain abnormalities in patients with systemic lupus erythematosus without overt neuropsychiatric manifestations
Kozora, E., Filley, C. M., Zhang, L., Brown, M., Miller, D., Arciniegas, D. B., Pelzman, J., & West, S. (2011) · Lupus · doi:10.1177/0961203311429116 · Cited by 39
Measurement and maintenance of reserve in multiple sclerosis
Sandroff, B. M., Schwartz, C. E., & DeLuca, J. (2016) · Journal of Neurology · doi:10.1007/s00415-016-8104-5 · Cited by 39
Predicting Nonsuicidal Self-Injury in Borderline Personality Disorder Using Ecological Momentary Assessment
Ammerman, B. A., Olino, T. M., Coccaro, E. F., & McCloskey, M. S. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2017_31_278 · Cited by 39
A Single Bout of High-Intensity Interval Training Reduces Awareness of Subsequent Hypoglycemia in Patients With Type 1 Diabetes
Rooijackers, H. M. M., Wiegers, E. C., van der Graaf, M., Thijssen, D. H. J., Kessels, R. P. C., Tack, C. J., & de Galan, B. E. (2017) · Diabetes · doi:10.2337/db16-1535 · Cited by 40
“Paced Auditory Serial Addition Test The Paced Auditory Serial Addition Test evaluates the speed of information processing and divided and sustained attention (21).”
Method
Alemtuzumab Improves Cognitive Processing Speed in Active Multiple Sclerosis—A Longitudinal Observational Study
Riepl, E., Pfeuffer, S., Ruck, T., Lohmann, H., Wiendl, H., Meuth, S. G., & Johnen, A. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2017.00730 · Cited by 39
“Processing speed, as commonly measured by the SDMT or Paced Auditory Serial Addition Task (37) (PASAT-3), also primarily improved under treatment with other DMDs (12, 14–16, 38).”
Background
Preventing Recurrence of Depression: Long-Term Effects of a Randomized Controlled Trial on Cognitive Control Training for Remitted Depressed Patients
Hoorelbeke, K., den Bergh, N. V., Raedt, R. D., Wichers, M., & Koster, E. H. W. (2021) · Clinical Psychological Science · doi:10.1177/2167702620979775 · Cited by 43
“For this purpose, we reassessed a nonadaptive version of the PASAT task (i.e., the standardized PASAT task in which task difficulty is not tailored to the performance of the individual; Gronwall, 1977) as an indicator of task-specific transfer.”
Method
Attentional task aptitude and performance anxiety.
Hopko, D. R., Hunt, M. K., & Armento, M. E. A. (2005) · International Journal of Stress Management · doi:10.1037/1072-5245.12.4.389 · Cited by 44
Neuropsychological patterns in systemic lupus erythematosus patients with depression
Kozora, E., Arciniegas, D. B., Zhang, L., & West, S. G. (2007) · Arthritis Research & Therapy · doi:10.1186/ar2203 · Cited by 39
“The neuropsychological tests evaluate eight cognitive domains: intelligence [31], attention [38, 39 ], reasoning [32], learning [34,40], recall [40], fluency [37,41], language [42,43], and perceptual motor skills [31].”
Method
Attentional processing in cervical spine syndromes
Radanov, B. P., Hirlinger, I., Stefano, G. D., & Valach, L. (2009) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.1992.tb04060.x · Cited by 39
Physical activity and cognitive function in adults with multiple sclerosis: an integrative review
Morrison, J. D., & Mayer, L. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2016.1213900 · Cited by 38
“The Paced Auditory Serial Addition Test (PASAT),[47] a test of auditory processing speed, cognitive flexibility, and numeracy, was used alone in four of the studies; [26,29,36,37] in six studies, [20,22–25,27] it was given along with the Symbol Digit Modality Test (SDMT).”
Method
Functional MR Imaging Correlates of Neuropsychological Impairment in Primary-Progressive Multiple Sclerosis
Rocca, M. A., Riccitelli, G. C., Rodegher, M., Ceccarelli, A., Falini, A., Falautano, M., Meani, A., Comi, G., & Filippi, M. (2010) · American Journal of Neuroradiology · doi:10.3174/ajnr.a2071 · Cited by 38
Gated auditory speech perception: effects of listening conditions and cognitive capacity
Moradi, S., Lidestam, B., Saremi, A., & Rönnberg, J. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00531 · Cited by 38
“The PASAT was initially designed to estimate information processing speed (Gronwall, 1977), but it is widely considered a test of attention (for a review, see Tombaugh, 2006).”
Method

Authors: Gronwall, D. M. A.
Affiliations: Auckland City Hospital (NZ)
Corresponding author: Gronwall, D. M. A.
Venue: Perceptual and Motor Skills
Publisher: SAGE Publications
Published: 1977-04
Volume: 44
Issue: 2
Pages: 367-373
ISSN: 0031-5125 (ISSN-L)
1558-688X
DOI: 10.2466/pms.1977.44.2.367
OpenAlex: W2000399989
Cited by: 2,395
References: 10
Citations by year: 2026: 50 · 2025: 75 · 2024: 65 · 2023: 57 · 2022: 64 · 2021: 103 · 2020: 94 · 2019: 96 · 2018: 95 · 2017: 89 · 2016: 95 · 2015: 97 · 2014: 111 · 2013: 96 · 2012: 103
FWCI: 0.56
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Perceptual and Motor Skills (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Keywords: concussion, Paced Auditory Serial Addition Test, concussion recovery, processing speed, post-traumatic amnesia, concussion severity, concussion rehabilitation, neuropsychological assessment
MeSH terms: Adolescent, Adult, Age Factors, Auditory Perception, Brain Concussion, Cognition, Convalescence, Humans, Mathematics, Middle Aged, Occupational Therapy, Psychological Tests, Time Factors

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Paced Auditory Serial-Addition Task: A Measure of Recovery from Concussion

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