ANAM4 TBI reaction time-based tests have prognostic utility for acute concussion

Jacob N. Norris, Walter Carr, Thomas Herzig, D. Walter Labrie, Richard Sams

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


The Concussion Restoration Care Center has used the Automated Neuropsychological Assessment Metrics version 4 Traumatic Brain Injury (ANAM4 TBI) battery in clinical assessment of concussion. The study's aim is to evaluate the prognostic utility of the ANAM4 TBI. In 165 concussed active duty personnel (all ultimately returned to duty) seen and tested on the ANAM4 TBI on days 3 and 5 (median times) from their injury, Spearman's ρ statistics showed that all performance subtests (at day 5) were associated with fewer days return-to-duty (RTD) time, whereas concussion history or age did not. Kruskal-Wallis statistics showed that ANAM4 TBI, loss of consciousness, and posttraumatic amnesia were associated with increased RTD time; ANAM4 TBI reaction time-based subtests, collectively, showed the largest effect sizes. A survival analysis using a Kaplan-Meier plot showed that the lowest 25% on the reaction time-based subtests had a median RTD time of 19 days, whereas those in the upper 25% had a median RTD time of approximately 7 days. Results indicate that until validated neurocognitive testing is introduced, the ANAM4 TBI battery, especially reaction time-based tests, has prognostic utility.

Original languageEnglish (US)
Pages (from-to)767-774
Number of pages8
JournalMilitary medicine
Issue number7
StatePublished - Jul 2013
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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