Persistent Choice reaction-time slowing in collegiate athletes with a history of concussion.

OBJECTIVE

To determine whether collegiate athletes with a history of concussion exhibit persistent reaction-time deficits after accounting for SCAT6-based memory/concentration measures and computerized neurocognitive domain scores.

METHODS

547 NCAA Division I athletes completed computerized neurocognitive testing, SCAT6-based symptom and cognitive assessments, and balance evaluations. Propensity-score matching produced 138 athletes with concussion history matched to 138 controls. Four RT outcomes were analyzed: Choice RT, Simple RT, Stroop RT, and Shifting-Attention RT. Multivariate analyses of covariance (MANCOVA) examined group differences controlling for SCAT6-based memory and concentration measures and CNS Vital Signs cognitive domain scores.

RESULTS

Athletes with a prior concussion demonstrated significantly slower Choice RT both before adjustment (p = 0.019) and after controlling for all covariates (p = 0.006). No significant group differences emerged for Simple RT, Stroop RT, or Shifting-Attention RT (all p 0 > .53). Executive function, cognitive flexibility, and visual memory showed consistent associations with RT performance across outcomes.

CONCLUSION

History of concussion is selectively associated with persistent slowing in Choice RT, independent of SCAT6-based memory and concentration measures and CNS Vital Signs cognitive domain scores. Choice RT may be a sensitive marker of subtle neurocognitive slowing and may help inform both post-concussion assessment and rehabilitation planning.