October 2001 • Volume 7 • Number 10
Neuropsychological testing a boon to team physicians
Family Physician Cindy Chang, M.D., head team physician at the University of California, Berkeley, understands the angst of college athletes awaiting medical clearance before returning to play after an injury. She oversees 27 Division I varsity sports and 900 college-level athletes. And Chang is pleased with a tool now available to her -- neuropsychological testing -- that helps assess athletes who have suffered head injuries. "It gives us objective data to say 'Yes, you're OK to play' or 'No, you're not OK to play,'" says Chang.
Here's how it works at Berkeley.
During the preseason, all intercollegiate football, rugby, and men's and women's basketball and soccer players are asked to participate in a research study that involves testing of the effects of multiple sports-related traumas on the brain. All athletes with a past history of head injury are also asked to take the brief battery of standard neuropsychological tests to establish a baseline.
The 30-minute computerized test measures memory and speed of mental processing. For example, to test short-term memory, several common words are displayed on the computer screen. They are displayed a second time, in the same order. The words appear a third time assimilated into a larger list, and the athlete's task is to choose the original words.
During the season, if the athlete receives a head injury, a post-concussion test is given. Then the results are compared to the athlete's baseline. "We can actually show the results to the student athlete," says Chang. "'This is how you tested when you came in preseason, and this is how you're testing now. Your memory is off. You were slow at processing these symbols during the second test. Your brain has not fully recovered from your head injury.'"
Sometimes, the test allows Chang to clear athletes for play earlier than current concussion guidelines recommend.
Chang says she wants to protect her athletes from a condition called second impact syndrome. If an athlete returns to play before a head injury is resolved and receives another head injury, brain function can rapidly deteriorate. "It's life-threatening," says Chang, "and it's something we warn our students about."
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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