Sports Medicine

, Volume 47, Issue 9, pp 1893–1899 | Cite as

A Retrospective Cross-Sectional and Longitudinal Study of the Effects of Age on CNS Vital Signs Scores in High-School Athletes

  • Sharon D. RogersEmail author
  • Patrick J. Smith
  • Alexandra J. Stephenson
  • D. Erik Everhart
Original Research Article



Current recommendations for concussion management acknowledge the importance of objective assessments of neuropsychological (NP) ability, and computerized NP assessments have been widely integrated into the concussion management protocols of high schools. The optimal intervals for baseline test administration in high-school athletes are currently uncertain. The ability to accurately detect subtle NP deficits is particularly important for high-school athletes, in which concussions are increasingly recognized for adverse effects to the developing brain.


The aim of this study was to assess the pattern of change in neurocognitive test performance, as well as changes in different domains of NP functioning over time.


Baseline computerized NP assessments were conducted at six high schools over 4 academic years using CNS Vital Signs, a battery consisting of seven well-established NP tests. Data were retrospectively examined for age differences in both cross-sectional (n = 3015) and longitudinal (n = 1221) analyses.


Moderate changes were observed across several NP domains over time (Cohen’s d = 0.39–0.61), with the largest improvements observed in executive functioning (mean improvement 5.78, 95% confidence interval [CI] 5.41–6.14, p < 0.001), psychomotor speed (mean improvement 4.59, 95% CI 3.97–5.22, p < 0.001), cognitive flexibility (mean improvement 5.11, 95% CI 4.76–5.45, p < 0.001), and reaction time (mean improvement −12.44 ms, 95% CI −10.10 to −14.78, p < 0.001). Improvements in NP performance were most pronounced between the freshman and senior years.


There is an appreciable change that occurs each year of high school in one or more domains of an NP battery, with executive functioning indicating the greatest magnitude of change. Females performed better relative to males across all time points though males exhibited more substantial improvement over time.


Executive Functioning Cognitive Flexibility Psychomotor Speed Continuous Performance Test Test Administration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards


The project described in this paper and the preparation of this material were completed without funding.

Conflicts of interest

Sharon Rogers is contracted by the six schools that participated in this study to provide advisement relating to sports medicine policies and procedures. Patrick Smith, Alexandra Stephenson, and Erik Everhart declare they have no conflicts of interest relevant to this work.

Author contributions

SR was responsible for study conception and design, data acquisition, drafting and revising the article, approval of the drafts and final version, and serves as the corresponding author. PS was responsible for contributions to the intellectual content, design of the work, data analysis and interpretation, drafting and revising the article, and approval of the drafts and final version. AS was responsible for contributions to the intellectual content and final approval. EE was responsible for interpretation of data, significant contributions to the intellectual content, drafting and revising the article, and approval of the drafts and final version.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Sharon D. Rogers
    • 1
    Email author
  • Patrick J. Smith
    • 2
  • Alexandra J. Stephenson
    • 3
  • D. Erik Everhart
    • 3
  1. 1.East Carolina UniversityGreenvilleUSA
  2. 2.Duke University Medical CenterDurhamUSA
  3. 3.East Carolina UniversityGreenvilleUSA

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