Reaction Time as a Predictor of Cognitive Function in Collegiate Athletes with Concussion History

Abstract

Background Cognitive-motor impairments are a persistent concern in athletes with a history of concussion. While reaction time (RT) is often used as a performance metric, its role in predicting broader cognitive function remains unclear. This study examines the relationship between RT and key cognitive domains, including executive function, psychomotor speed, and memory, in previously concussed collegiate athletes. Methods 112 college-aged athletes from a NCAA division I institution with a self-reported history of concussion were included in this cross-sectional study. Reaction Time Composite (RT-Comp), executive function, and psychomotor speed were assessed using Concussion Vital Signs (CNS Vital Signs LLC), a computerized neurocognitive assessment. Immediate memory and delayed recall were evaluated using the Sport Concussion Office Assessment Tool – 6th edition (SCOAT-6). Correlations were analyzed using Pearson’s correlation to assess the strength of associations. A priori p-value was set at p \u3c .05. Results RT-Comp demonstrated significant negative correlations with executive function (r = -0.430, 95% CI [-0.572, -0.265], p \u3c 0.001), indicating that slower reaction times were associated with reduced cognitive flexibility and decision-making abilities. A similar negative correlation was observed with psychomotor speed (r = -0.355, 95% CI [-0.508, -0.184], p \u3c 0.001), suggesting impairments in motor response efficiency. Additionally, slower RT was associated with lower scores in immediate memory (r = -0.307, 95% CI [-0.469, -0.127], p = 0.001) and delayed recall (r = -0.233, 95% CI [-0.403, -0.043], p = 0.013), highlighting potential long-term cognitive consequences of concussion. Conclusion Reaction time appears to be a strong indicator of cognitive function in post-concussion athletes, correlating with executive function, psychomotor performance, and memory recall. These findings suggest that RT assessments should be integrated into concussion evaluation protocols to enhance return-to-play decisions. Further research is needed to explore whether reaction time improvements correspond with cognitive recovery over time