Assessment of acute concussion in the combat environment

Arch Clin Neuropsychol. 2012 Jun;27(4):375-88. doi: 10.1093/arclin/acs036. Epub 2012 Apr 3.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Validation Study

MeSH terms

  • Adult
  • Brain Concussion / diagnosis*
  • Case-Control Studies
  • Decision Support Techniques
  • Humans
  • Iraq War, 2003-2011
  • Male
  • Military Personnel / statistics & numerical data*
  • Neuropsychological Tests / statistics & numerical data*
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires