TY - JOUR
T1 - King-Devick Test identifies real-Time concussion and asymptomatic concussion in youth athletes
AU - Dhawan, Priya S.
AU - Leong, Danielle
AU - Tapsell, Lisa
AU - Starling, Amaal J.
AU - Galetta, Steven L.
AU - Balcer, Laura J.
AU - Overall, Trenton L.
AU - Adler, Jennifer S.
AU - Halker-Singh, Rashmi B.
AU - Vargas, Bert B.
AU - Dodick, David
N1 - Funding Information:
P.S. Dhawan reports no disclosures. D. Leong serves as Director of Research for King-Devick Test, Inc. She did not directly collect the data, which was made available to all authors during the creation and revision of the manuscript. L. Tapsell reports no disclosures. A. Starling serves on scientific advisory boards for Amgen, eNeura, and Eli Lilly & Company and has received funding for travel or speaker honoraria from eNeura. S. Galetta has received funding for travel or speaker honoraria from Biogen and Genzyme, serves on the editorial boards of Neurology® and Journal of Neuro-ophthalmology, and serves as a consultant for Biogen and Vaccinex. L.J. Balcer serves on a scientific advisory board for and has received funding for travel or speaker honoraria from Biogen; has served as a consultant for Biogen Idec, Questcor, and Novartis; and receives research support from Biogen, NIH (NINDS, NEI), State of New York, and National MS Society. T. Overall and J. Adler report no disclosures. R. Halker serves as Headache Section Editor for Current Neurology and Neuroscience Reports. B.B. Vargas serves on scientific advisory boards for Allergan, Zogenix, Pernix, Alder, Avanir, and Lilly; has received funding for travel or speaker honoraria from American Headache Society; serves on the speakers’ bureau for Avanir; and receives research support from Mayo Clinic. D. Dodick serves on a scientific advisory board and/or as a consultant for Acorda, Allergan, Amgen, Alder, Dr Reddy’s, Merck, Promius, eNeura, Eli Lilly & Company, Insys therapeutics, Autonomic Technologies, Teva, Xenon, Tonix, Trigemina, Boston Scientific, GBS, Colucid, Zosano, Laydenburg Thalmann, Biocentric, Biohaven, Magellan, and Pfizer (Japan); receives publishing royalties from Oxford University Press, Cambridge University Press, UpTo-Date, Chameleon Communications, Medscape, WebMD, Academy for Continued Healthcare Learning, Haymarket Medical Education, Global Scientific Communications, HealthLogix, Academy for
PY - 2017
Y1 - 2017
N2 - Background: Sports concussion has an annual incidence of approximately 3.8 million. Over half go unreported and a substantial number may be asymptomatic. A rapid, cost-effective, and reliable tool that facilitates diagnosis of concussion is needed. The King-Devick (K-D) test is a visionbased tool of rapid number naming for assessment of concussion. In this study, we evaluated the utility of the K-D test in real time for identification of symptomatic concussion in youth athletes and to determine if similar impairment (subclinical concussion) exists in youth athletes without an obvious head injury or symptoms. Methods: Youth hockey players underwent K-D testing preseason, postseason, and immediately after suspected concussion. Additional testing was performed in a subgroup of nonconcussed athletes immediately before and after a game to determine effects of fatigue on K-D scores. Results: Among 141 players tested, 20 had clinically diagnosed concussion. All 20 had immediate postconcussion K-D times .5 seconds from baseline (average 7.3 seconds) and all but 2 had worse postseason scores (46.4 seconds vs 52.4 seconds, p < 0.05, Wilcoxon signed rank test). Nonconcussed athletes saw minimal improvement postseason (43.9 seconds vs 42.1 seconds, p < 0.05) and 51 nonconcussed players assessed before and after a game revealed no significant time change as a result of fatigue. Conclusions: Rapid number naming using the K-D test accurately identifies realtime, symptomatic concussion in youth athletes. Scores in concussed players may remain abnormal over time. Athletes should undergo preseason and postseason K-D testing, with additional evaluation real time to inform the assessment of suspected concussion. Classification of Evidence: This study provides Class III evidence that the K-D test accurately identifies real-Time concussions in youth athletes.
AB - Background: Sports concussion has an annual incidence of approximately 3.8 million. Over half go unreported and a substantial number may be asymptomatic. A rapid, cost-effective, and reliable tool that facilitates diagnosis of concussion is needed. The King-Devick (K-D) test is a visionbased tool of rapid number naming for assessment of concussion. In this study, we evaluated the utility of the K-D test in real time for identification of symptomatic concussion in youth athletes and to determine if similar impairment (subclinical concussion) exists in youth athletes without an obvious head injury or symptoms. Methods: Youth hockey players underwent K-D testing preseason, postseason, and immediately after suspected concussion. Additional testing was performed in a subgroup of nonconcussed athletes immediately before and after a game to determine effects of fatigue on K-D scores. Results: Among 141 players tested, 20 had clinically diagnosed concussion. All 20 had immediate postconcussion K-D times .5 seconds from baseline (average 7.3 seconds) and all but 2 had worse postseason scores (46.4 seconds vs 52.4 seconds, p < 0.05, Wilcoxon signed rank test). Nonconcussed athletes saw minimal improvement postseason (43.9 seconds vs 42.1 seconds, p < 0.05) and 51 nonconcussed players assessed before and after a game revealed no significant time change as a result of fatigue. Conclusions: Rapid number naming using the K-D test accurately identifies realtime, symptomatic concussion in youth athletes. Scores in concussed players may remain abnormal over time. Athletes should undergo preseason and postseason K-D testing, with additional evaluation real time to inform the assessment of suspected concussion. Classification of Evidence: This study provides Class III evidence that the K-D test accurately identifies real-Time concussions in youth athletes.
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U2 - 10.1212/CPJ.0000000000000381
DO - 10.1212/CPJ.0000000000000381
M3 - Article
C2 - 29431168
AN - SCOPUS:85044335574
VL - 7
SP - 464
EP - 473
JO - Neurology: Clinical Practice
JF - Neurology: Clinical Practice
SN - 2163-0402
IS - 6
ER -