Persistent Choice reaction-time slowing in collegiate athletes with a history of concussion

OBJECTIVE: To determine whether collegiate athletes with a history of concussion exhibit persistent reaction-time deficits after accounting for SCAT6-based memory/concentration measures and computerized neurocognitive domain scores. METHODS: 547 NCAA Division I athletes completed computerized neurocognitive testing, SCAT6-based symptom and cognitive assessments, and balance evaluations. Propensity-score matching produced 138 athletes with concussion history matched to 138 controls. Four RT outcomes were analyzed: Choice RT, Simple RT, Stroop RT, and Shifting-Attention RT. Multivariate analyses of covariance (MANCOVA) examined group differences controlling for SCAT6-based memory and concentration measures and CNS Vital Signs cognitive domain scores. No significant group differences emerged for Simple RT, Stroop RT, or Shifting-Attention RT (all p 0 > .53). Executive function, cognitive flexibility, and visual memory showed consistent associations with RT performance across outcomes. CONCLUSION: History of concussion is selectively associated with persistent slowing in Choice RT, independent of SCAT6-based memory and concentration measures and CNS Vital Signs cognitive domain scores. Choice RT may be a sensitive marker of subtle neurocognitive slowing and may help inform both post-concussion assessment and rehabilitation planning.