Department of Health Science, University of Alabama, Tuscaloosa, Alabama, USA.
Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
Am J Sports Med. 2020 Sep;48(11):2774-2782. doi: 10.1177/0363546520946753. Epub 2020 Aug 17.
Given the high participation of Black/African American individuals in high school sports, especially high-risk sports for concussion, it is important to note if racial and socioeconomic status (SES) differences exist in baseline performance on clinical measures of concussion.
To explore the association between race and SES on baseline concussion assessments of neurocognitive performance and oculomotor function in adolescent athletes.
Cohort study (Diagnosis); Level of evidence, 3.
A total of 564 high school athletes (mean ± SD age, 15.33 ± 1.1 years) completed the baseline Immediate Post-Concussion Assessment and Cognitive Test and King-Devick (KD) battery before the start of their competitive season. Race was defined as either White/non-Hispanic or Black/African American. SES status was determined by whether the individual's participating high school was a Title I or non-Title I school. A series of multivariable linear regression analyses were conducted to evaluate the association of computerized neurocognitive test scores (verbal memory, visual memory, motor processing speed, and reaction time), symptom severity scores, and KD scores by race and SES.
White/non-Hispanic individuals performed significantly better than Black/African American individuals on verbal memory ( < .01), visual memory ( < .01), visual motor processing speed ( < .01), and reaction time ( < .01) and had a lower symptom score ( < .01). Regarding SES, individuals from non-Title I schools performed better on visual memory ( = .05) and reaction time ( = .02) than individuals from Title I schools. Examination of cumulative KD test reading time revealed that there was no association between race on baseline reading times ( = .12). There was a significant association between cumulative reading time and SES ( = .02). Individuals from non-Title I schools performed significantly faster than individuals from Title I schools on KD test time.
Overall, race and SES influence neurocognitive and oculomotor concussion baseline performance in high school athletes. These findings add to the growing literature on the influence of race and SES on neurocognitive and oculomotor function baseline concussion assessments; they highlight the necessity for individualized concussion baseline measurements or race-specific normative reference values.
鉴于黑人和非裔美国人在高中体育项目中的高参与率，尤其是在易发生脑震荡的高风险运动项目中，了解种族和社会经济地位（SES）对青少年运动员的脑震荡临床评估中基本表现是否存在差异非常重要。
探讨种族和 SES 与青少年运动员神经认知功能和眼动功能的基线脑震荡评估之间的关联。
队列研究（诊断）；证据水平，3 级。
共有 564 名高中运动员（平均年龄±标准差，15.33±1.1 岁）在竞争赛季开始前完成了即时脑震荡后评估和认知测试（Immediate Post-Concussion Assessment and Cognitive Test，ImPACT）和 King-Devick（KD）测试的基线测试。种族定义为白人/非西班牙裔或黑人/非裔美国人。SES 状况通过参与者所在高中是否为“Title I”学校来确定。进行了一系列多变量线性回归分析，以评估计算机化神经认知测试评分（言语记忆、视觉记忆、运动处理速度和反应时间）、症状严重程度评分和 KD 评分与种族和 SES 的关联。
白人/非西班牙裔个体在言语记忆（<0.01）、视觉记忆（<0.01）、视觉运动处理速度（<0.01）和反应时间（<0.01）方面的表现明显优于黑人/非裔美国人，且症状评分较低（<0.01）。关于 SES，来自非“Title I”学校的个体在视觉记忆（=0.05）和反应时间（=0.02）方面的表现优于来自“Title I”学校的个体。对累积 KD 测试阅读时间的检查表明，种族对基线阅读时间（=0.12）没有关联。累积阅读时间与 SES 之间存在显著关联（=0.02）。来自非“Title I”学校的个体在 KD 测试时间方面的表现明显快于来自“Title I”学校的个体。
总体而言，种族和 SES 影响高中运动员的神经认知和眼动功能的脑震荡基线表现。这些发现增加了关于种族和 SES 对神经认知和眼动功能基线脑震荡评估影响的文献，强调了对个体脑震荡基线测量或种族特异性正常参考值的必要性。
