TY - JOUR
T1 - Assessment of acute concussion in the combat environment
AU - Kelly, Mark P.
AU - Coldren, Rodney L.
AU - Parish, Robert V.
AU - Dretsch, Michael N.
AU - Russell, Michael L.
N1 - Funding Information:
This work was supported in part by the U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, Maryland 21702-5014, Project W81XWIH-09-2-0057.
PY - 2012/6
Y1 - 2012/6
N2 - 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.
AB - 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.
KW - Automated Neuropsychological Assessment Metrics
KW - Combat
KW - Concussion
KW - Military
KW - Neuropsychological testing
UR - http://www.scopus.com/inward/record.url?scp=84863216017&partnerID=8YFLogxK
U2 - 10.1093/arclin/acs036
DO - 10.1093/arclin/acs036
M3 - Article
AN - SCOPUS:84863216017
SN - 0887-6177
VL - 27
SP - 375
EP - 388
JO - Archives of Clinical Neuropsychology
JF - Archives of Clinical Neuropsychology
IS - 4
ER -