Examining the Subacute Effects of Mild Traumatic Brain Injury Using a Traditional and Computerized Neuropsychological Test Battery

Rune Hatlestad Karlsen, Simen Berg Saksvik, Jonas Stenberg, Astri Johansen Lundervold, Alexander Olsen, Ida Rautio, Line Folvik, Asta Kristine Håberg, Anne Vik, Justin E. Karr, Grant L. Iverson, Toril Skandsen

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


This study investigates subacute cognitive effects of mild traumatic brain injury (MTBI) in the Trondheim Mild TBI Study, as measured, in part, by the neuropsychological test battery of the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) program, including computerized tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and traditional paper-and-pencil tests. We investigated whether cognitive function was associated with injury severity: Intracranial traumatic lesions on neuroimaging, witnessed loss of consciousness (LOC), or post-traumatic amnesia (PTA) >1 h. Further, we explored which of the tests in the CENTER-TBI battery might be associated with the largest subacute effects of MTBI (i.e., at 2 weeks post-injury). We recruited 177 patients with MTBI (16-59 years of age) from a regional trauma center and an outpatient clinic,79 trauma control participants, and 81 community control participants. The MTBI group differed from community controls only on one traditional test of processing speed (coding; p = 0.009, Cliff's delta [Δ] = 0.20). Patients with intracranial abnormalities performed worse than those without on a traditional test (phonemic verbal fluency; p = 0.043, Δ= 0.27), and patients with LOC performed differently on the Attention Switching Task from the CANTAB (p = 0.020, Δ=-0.20). Patients with PTA >1 h performed worse than those with <1 h on 10 measures, from traditional tests and the CANTAB (Δ= 0.33-0.20), likely attributable, at least in part, to pre-existing differences in intellectual functioning between groups. In general, those with MTBI had good neuropsychological outcome 2 weeks after injury and no particular CENTER-TBI computerized or traditional tests seemed to be more sensitive to subtle cognitive deficits.

Original languageEnglish
Pages (from-to)74-85
Number of pages12
JournalJournal of Neurotrauma
Issue number1
StatePublished - Jan 1 2021

Bibliographical note

Funding Information:
This work was supported by the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology.

Funding Information:
Dr. Grant Iverson has received research support from test publishing companies in the past, including ImPACT® Applications Systems, Psychological Assessment Resources, Inc. (PAR, Inc.), and CNS Vital Signs. He receives royalties from PAR, Inc. for the WCST-64. He has a clinical practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained MTBIs. He has received grant funding from the National Football League and salary support from the Harvard Integrated Program to Protect and Improve the Health of NFLPA Members. He serves as a scientific advisor for BioDirection, Inc., SWAY Operations, LLC, and Highmark, Inc. He acknowledges unrestricted philanthropic support from the Mooney-Reed Charitable Foundation, ImPACT® Applications, Inc., the Heinz Family Foundation, and the Spaulding Research Institute. The remaining authors have no competing financial interests to disclose.

Publisher Copyright:
© 2021 Mary Ann Liebert, Inc., publishers.


  • brain concussion
  • cognition
  • neuropsychology

ASJC Scopus subject areas

  • Clinical Neurology


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