Miao Iris Yi, Gifford Katherine, Kerr Zachary Yukio, Cole Wesley R, Guskiewicz Kevin M, McCrea Michael A, Brett Benjamin L
Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
Clin Neuropsychol. 2025 Mar 24:1-21. doi: 10.1080/13854046.2025.2479213.
The association between head injury history and subjective cognitive symptoms among contact sport athletes has been frequently reported, but links between head injury history and performance-based measures have been more variable. Dispersion-based intraindividual variability (IIV) may better align with subjective cognitive concerns and be a more sensitive measure of subtle head injury-related changes. This study investigated the associations among IIV, subjective cognitive symptoms, and head injury history. Former collegiate football players ( = 57 included in analyses; age = 38 ± 1.5 years) completed evaluations consisting of neuropsychological assessment, subjective rating of cognition (Neuro-QoL Cognitive Functioning-Short Form and Behavior Rating Inventory of Executive Function-Adult; BRIEF-A), and structured interviews of head impact history (i.e. HIEE). Three IIV indices were calculated reflecting degree of dispersion across cognitive domains: Memory-IIV, reaction time/processing speed-IIV (RT/PS-IIV), and attention/executive function-IIV. General linear models were fit to test associations among IIV, subjective measures, concussion history, and Head Impact Exposure Estimate (HIEE). Greater history of concussion and RHI exposure were not significantly associated with levels of cognitive dispersion (IIV indices, 's >.05). Worse general subjective cognition was associated with greater RT/PS-IIV, and worse BRIEF-A metacognition was associated with greater memory-IIV, even when controlling for psychological distress and sleep quality. Results support the assessment of dispersion in cognitive performance as a useful objective measure that complements subjective cognitive symptoms. While IIV is clinically relevant for detecting subtle cognitive difficulties not captured by central tendency methods, it may only indirectly, if at all, relate to changes associated specifically with head injury history.
接触性运动运动员的头部损伤史与主观认知症状之间的关联已被频繁报道，但头部损伤史与基于表现的测量指标之间的联系则更具变化性。基于离散度的个体内变异性（IIV）可能与主观认知问题更相符，并且是对轻微头部损伤相关变化更敏感的测量指标。本研究调查了IIV、主观认知症状和头部损伤史之间的关联。前大学橄榄球运动员（分析中纳入n = 57；年龄 = 38 ± 1.5岁）完成了评估，包括神经心理学评估、认知的主观评分（神经生活质量认知功能简表和执行功能行为评定量表-成人版；BRIEF-A）以及头部撞击史的结构化访谈（即HIEE）。计算了三个反映认知领域离散程度的IIV指标：记忆-IIV、反应时间/处理速度-IIV（RT/PS-IIV）和注意力/执行功能-IIV。采用一般线性模型来检验IIV、主观测量指标、脑震荡史和头部撞击暴露估计值（HIEE）之间的关联。脑震荡和重复性头部撞击暴露的病史较长与认知离散程度（IIV指标，p值 >.05）无显著关联。即使在控制了心理困扰和睡眠质量的情况下，较差的总体主观认知与较高的RT/PS-IIV相关，较差的BRIEF-A元认知与较高的记忆-IIV相关。结果支持将认知表现的离散度评估作为一种有用的客观测量指标，以补充主观认知症状。虽然IIV在临床上对于检测集中趋势方法未捕捉到的细微认知困难具有相关性，但它可能仅间接（如果有的话）与特定于头部损伤史的变化相关。
