Journal of the International Neuropsychological Society

Research Articles

Computerized Neurocognitive Testing within 1 Week of Sport-Related Concussion: Meta-analytic Review and Analysis of Moderating Factors

Anthony P. Kontosa1 c1, Rock Braithwaitea2, Scott Dakana1 and R.J. Elbina3

a1 Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania

a2 Department of Kinesiology and Recreation Administration, Humboldt State University, Arcata, California

a3 Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas


The purpose of this study is to perform a meta-analysis assessing the effects of sport-related concussion as measured by computerized neurocognitive tests (NCT) 1-week post injury. Thirty-seven studies involving 3960 participants between 2000 and 2011 were included. Hedge's g provides an adjusted effect size for smaller sample sizes and was calculated for overall and cognitive task effects, and subgroup analyses were conducted for age, type of NCT, and sport. Concussions had a low negative effect (g = −0.16; p < .001) across all groups, outcomes, and time points. Code substitution (g = −0.27; p < .05), visual memory (g = −0.25; p < .05), processing speed (g = −0.18; p < .05), and memory (g = −0.21; p < .05) tasks demonstrated negative effects for concussion. Younger adolescents had lower (g = −0.29; p < .05) NCT performance than older adolescents (g = −0.01) and college aged athletes (g = −0.11). ImPACT studies (g = −0.19; p < .05) demonstrated a negative effect for concussion as did those involving contact sports (g = −0.20; p < .05). A low to moderate overall effect size of concussion on neurocognitive performance was supported. Subgroup analyses revealed different effect sizes for specific cognitive tasks, types of NCTs, age, and type of sport. (JINS, 2014, 20, 1–9)

(Received June 13 2013)

(Revised December 19 2013)

(Accepted December 19 2013)

(Online publication February 13 2014)


  • ANAM;
  • CogSport;
  • Headminder;
  • ImPACT;
  • Neuropsychology;
  • Mild traumatic brain injury


c1 Correspondence and reprint requests to: Anthony P. Kontos, UPMC Sports Medicine Concussion Program, Department of Orthopedic Surgery, University of Pittsburgh, UPMC Center for Sports Medicine, 3200 South Water Street, Pittsburgh, Pennsylvania 15203. E-mail: