Award Date

5-1-2022

Degree Type

Thesis

Degree Name

Master of Arts (MA)

Department

Psychology

First Committee Member

Daniel Allen

Second Committee Member

Samantha John

Third Committee Member

Bradley Donohue

Fourth Committee Member

Jennifer Keene

Number of Pages

73

Abstract

Given the high prevalence of concussion in sports, assessment of cognition has become a standard part of athletics, and results are used to inform return to play decisions. Neurocognitive measures (e.g., ImPACT) generate cognitive composite scores from individual subtests, and these scores are compared at baseline and post-concussion. Declines in scores provide evidence for concussive injury, and athletes undergo repeated assessments until their scores and symptoms improve. Recent research suggests that changes in the associations between test scores may provide important information about cognitive recovery. A network framework may help identify post-concussive cognitive changes that may not be apparent when composite scores are compared. The present study examined composite-level comparisons and network-level comparisons to see whether network models could better characterize SRC recovery. Athletes were administered ImPACT at preseason and post-SRC (acute assessment = 72 hours of injury, recovery assessment = within two weeks post-injury). Repeated measures ANOVA was conducted to examine differences in composite scores over time. Cognitive networks were estimated for the baseline, acute, and recovery assessment time points. Centrality indices were calculated to determine relative importance of each cognitive variable in each network. Network comparison tests were conducted to examine differences in network structure, connectedness, and centrality over time. Repeated measures ANOVA results revealed an initial decline in composite scores acutely post-SRC followed by improvement in scores at recovery. Network analysis results indicated significantly increased network connectivity in both the acute and recovery networks compared to the baseline network. Additionally, network structure changed significantly from baseline to recovery. Visual memory and processing speed nodes were highly central and influential within each network. Network comparisons also revealed changes in centrality over time. Specifically, visual memory nodes became more central and influential over time, and impulsivity nodes became more central from acute to recovery. While composite scores suggested cognitive recovery, cognitive network comparisons revealed lingering network disruption at the recovery time point. Increased connectivity may reflect increased effort to complete cognitive tasks, while changes in network structure suggest that compensatory strategies may be used to achieve task demands. Given that visual memory and impulsivity played an increasingly central role in networks over time, it may be helpful to target these processes during treatment. Future research should examine whether certain pre-injury characteristics (e.g., neurodevelopmental history) moderate longitudinal changes in cognitive networks.

Keywords

concussion; ImPACT; network analysis; neurocognitive; neuropsychology; TBI

Disciplines

Clinical Psychology

File Format

pdf

File Size

4200 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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