High School GPA But Not Neurocognitive Test Performance Differs By Concussion History

Individuals who sustain concussions often report school-related difficulties following injury. There is limited evidence concerning the impact of concussion history on objective measures of academic and cognitive performance. PURPOSE: To examine differences in grade point average (GPA) and computerized neurocognitive test scores between high school students with and without a history of concussion. METHODS: Participants in this cross-sectional design included individuals from eight high schools who completed pre-season baseline testing as part of a larger concussion clinical trial (n = 832; 15.9 ± 1.2 years old; 285 females). Two-hundred sixty individuals (260/832; 31.2%) reported having had at least one prior concussion (1.5 ± 0.7 prior concussions; range = 1-4). Wilcoxon rank sum tests were used to examine differences between those with and without a history of concussion across high school GPA and ImPACT composite scores (domains: verbal memory; visual memory; visual motor speed; reaction time; impulse control). Five-hundred sixty-seven students (567/832; 68%) provided information about GPA, and students at six of the eight high schools (781/832 students [94%]) were administered the ImPACT test. All analyses were conducted using an a priori alpha level of p = .05. RESULTS: Individuals with a history of concussion (median = 3.5; IQR = 0.5; range = 2.1-4.3) had a significantly lower (W = 42297, p < .001) average GPA than did those without a history of concussion (median = 3.7; IQR = 0.5; range = 2.2-4.7). Group differences were also examined within each school to account for variations in GPA scale, yielding the same general pattern of findings. There were no significant differences between those with and without a history of concussion for any ImPACT composite score domain (p’s ≥ .07). CONCLUSIONS: On average, those with a history of concussion evidenced slightly lower GPA than did those without. There were no differences between concussion history groups in computerized neurocognitive test performance across any domains. Future research should explore the clinical implications of such findings and contextual factors that may be driving differences in this academic performance related metric for those with a history of concussion. FUNDING: Supported by a grant from the National Football League.