Assessment of acute concussion in the combat environment

Mark P. Kelly*, Rodney L. Coldren, Robert V. Parish, Michael N. Dretsch, Michael L. Russell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

Despite the prevalence of concussion in soldiers deployed to Iraq and Afghanistan, neuropsychological tests used to assist in concussion management have not been validated on the battlefield. This study evaluated the validity of the Automated Neuropsychological Assessment Metrics (ANAM) in the combat environment. Cases meeting criteria for concussion, healthy controls, and injured controls were assessed. Soldiers were administered the ANAM, traditional neuropsychological tests, and a background questionnaire. Cases were enrolled within 72 h of concussion. Cases exhibited poorer performance than controls on all ANAM subtests, with significant differences on simple reaction time (SRT), procedural reaction time (PRT), code substitution, and matching to sample (p < .001). Discriminant ability of scores on SRT and PRT subtests was 71%, which improved to 76% when pre-deployment baseline scores were available. An exploratory clinical decision tool incorporating ANAM scores and symptoms improved discriminant ability to 81%. Results provide initial validation of the ANAM for detecting acute effects of battlefield concussion.

Original languageEnglish
Pages (from-to)375-388
Number of pages14
JournalArchives of Clinical Neuropsychology
Volume27
Issue number4
DOIs
StatePublished - Jun 2012
Externally publishedYes

Keywords

  • Automated Neuropsychological Assessment Metrics
  • Combat
  • Concussion
  • Military
  • Neuropsychological testing

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