Preliminary use of the PANESS for detecting subtle motor signs in adolescents with sport-related concussion: a brief report

Sensitive examination tools are needed to optimize evaluation after sport-related concussion (SRC). We preliminarily examined the Physical and Neurological Examination of Subtle Signs (PANESS) for sensitivity to motor changes in a pilot cohort of adolescents aged 13-17 with SRC. 15 Adolescents (5 females) with SRC were evaluated up to 3 times: within 2 weeks of injury, approximately 1 month later (mean 35 days between visits), and for those not recovered at the second visit, again following clinical recovery (mean 70 days between first and last visits for all participants). Comparison data were acquired from 20 age and sex-matched never-concussed healthy control athletes with no history of concussion who were evaluated twice (mean 32 days apart). Main effects of group, time, and interaction effects were evaluated with an analysis of covariance which controlled for socioeconomic status, times tested, and days between testing sessions. Adolescents with concussion had poorer PANESS performance than controls at all time points. Performance improved between visits within the concussion group with no change within the control group. These findings suggest that the PANESS merits additional study in larger cohorts and in combination with other markers of injury to facilitate an enhanced understanding of sports-related concussion and recovery. *Work was conducted while Dr. Stephens was at Kennedy Krieger Institute and Johns Hopkins; she has since moved to Colorado State University. Corresponding Author: Stacy Suskauer, Kennedy Krieger Institute, 7007 N. Broadway, Baltimore, MD, 21205. Email: suskauer@kennedykrieger.org Disclosures: There are no competing interests or financial benefit to the authors to report. Study Funding This research was supported by the National Institutes of Health (J.S. 5T32HD007414); (T.M. & S.S., R21HD080378). Prior Presentation of the Research Prior presentations of this work have been limited to talks given by the senior author (S.S.). Acknowledgements: We thank Dr. Jennifer Reesman for assistance with study design and management. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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