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Baseline Symptoms and Neurocognitive Performance across Collision, Contact, and Noncontact Female High School Athletes

Oldham JR, Howell DR, Lanois CJ, Berkner PD, Iverson GL, Mannix RC, Meehan WP

Medicine and science in sports and exercise, 2025

Abstract

PURPOSE: Our purpose was to represent a rare cohort of female collision sport athletes and investigate the association between sport type (collision, contact, and noncontact), symptoms, and performance on baseline neurocognitive assessments.

METHODS: We conducted a cross-sectional study using baseline computerized neurocognitive scores (Immediate Postconcussion Assessment and Cognitive Testing [ImPACT]) of 75,128 female high school student-athletes (age, 15.27 ± 1.05 yr) playing multiple sports. The dependent variables were verbal memory, visual memory, visual motor speed, reaction time, and total symptom score. The independent variable was sport type, categorized as collision, contact, noncontact, adjusted for the effect of the following covariables: age, concussion history, and comorbidities (learning disability, ADHD, psychiatric condition, headaches, migraines, speech therapy, special education, and repeating one of more years of school) using multivariable regression models.

RESULTS: Female collision sport athletes reported significantly higher symptoms (9.81 ± 12.63) at baseline compared with contact (5.78 ± 9.25) or noncontact (6.39 ± 9.74) sport athletes ( P < 0.001). Using noncontact sports as a reference, there was no significant association between collision sport participation and cognitive composite scores (verbal memory: β = -0.57, 95% confidence interval = -1.80 to 0.66, P = 0.38; visual memory: β = -0.83, 95% confidence interval = -2.46 to 0.79, P = 0.31;…

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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

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