Document Type
Article
Publication Date
7-6-2021
Publication Title
Frontiers in Neurology
Volume
12
First page number:
1
Last page number:
6
Abstract
Background: There is a current lack of any composite measure for the effective tracking and monitoring of clinical change in individuals exposed to repetitive head impacts (RHI). The aim of this study is to create a composite instrument for the purposes of detecting change over time in cognitive and behavioral function in individuals exposed to RHI. Methods: The data to derive the composite instrument came from the Professional Fighters Brain Health Study (PFBHS), a longitudinal study of active and retired professional fighters [boxers and mixed martial arts (MMA) fighters] and healthy controls. Participants in the PFBHS underwent assessment on an annual basis that included computerized cognitive testing and behavioral questionnaires. Multivariate logistic regression models were employed to compare active fighters (n = 117) with controls (n = 22), and retired fighters (n = 26) with controls to identify the predictors that could be used to differentiate the groups over time. In a second step, linear discriminant analysis was performed to derive the linear discriminant coefficients for the three groups by using the predictors from the two separate logistic regression models. Results: The composite scale is a weighted linear value of 12 standardized scores consisting of both current and yearly change scores in domains including: processing speed, choice reaction time, semantic fluency, letter fluency, and Barrett Impulsiveness Scale. Because the weighting of values differed between active and retired fighters, two versions emerged. The mean and standard deviation ratio (MSDR) showed that the new index had better sensitivity compared to the individual measures, with the ratio of MSDR of the new index to that of the existing measures of at least 1.84. Conclusion: With the increasing need for tools to follow individuals exposed to RHI and the potential of clinical trials on the horizon for CTE, the RHICI is poised to serve as an initial approach to a composite clinical measure.
Keywords
Chronic traumatic encephalopathy; Cognition; Composite index; Composite index; Traumatic brain injury
Disciplines
Medical Specialties | Medicine and Health Sciences | Neurology
File Format
File Size
180 KB
Language
English
Rights
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Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Repository Citation
Bernick, C.,
Shan, G.,
Bennett, L.,
Alberts, J.,
Cummings, J.
(2021).
Assessing Clinical Change in Individuals Exposed to Repetitive Head Impacts: The Repetitive Head Impact Composite Index.
Frontiers in Neurology, 12
1-6.
http://dx.doi.org/10.3389/fneur.2021.605318