17 Observing Constructs of Drawing Process of the Rey-Osterrieth Complex Figure Test as an Indicator of Persisting Post-Concussive Symptoms

• Published in: Journal of the International Neuropsychological Society 2023-11, Vol.29 (s1), p.894-895
• Main Authors: Newman, Michelle, Loveday, Catherine, Edginton, Trudi
• Format: Article
• Language: English
• Subjects: Cognitive ability; Concussion; Concussion/Mild TBI (Adult); Fatigue; Poster Session 10: Late Breaking Science; Regression analysis; Traumatic brain injury
• ISSN: 1355-6177; 1469-7661
• DOI: 10.1017/S1355617723010998

Objective:Evidence regarding cognitive impairment following concussion/mild traumatic brain injury (mTBI) has been conflicting. Criticism has focused on what is being measured, how it is being measured, and who is being measured (Pertab et al, 2009; Iverson, 2010). However, literature suggests that clinicians and researchers should examine how individuals complete a task rather than what they achieve (Geary et al, 2011). Studies examining the drawing process used to complete the Rey-Osterrieth Complex Figure Task (RCF) have been inconclusive and methodologically weak. The current study addressed several criticisms and limitations by examining whether observing RCF drawing process, including a novel strategy construct, could support a diagnosis of persisting post-concussive symptoms.Participants and Methods:Sixteen individuals with a history of concussion/mTBI and sixteen matched controls (age, sex, IQ) were included in multiple regression analyses to examine whether RCF drawing constructs predict post-concussive symptoms (mean age 43.59 years; 22 female). At least 3 months had passed since the concussive/mTBI event. Post-concussive symptoms were assessed with the Rivermead Post-Concussive Symptoms Questionnaire (RPCSQ) and the Mental Fatigue Scale (MFS). Separate regression analyses were conducted for each scale. Predictor variables were statistically selected from a catalogue of 4 RCF drawing process constructs - Wholeness, Order, Continuation and Strategy; 15 traditional measures of cognitive function; and 3 psychological state measures. 17 variables were included in the model for the RPCSQ, including Order and Strategy. 18 variables were included for the MFS, including Order, Continuation and Strategy.Results:Order scores were found to be one of the strongest predictors of RPCSQ scores (B = -2.06; ß= 0.20), and MFS scores (B = -1.54, ß = 0.26). Individuals drawing fewer core elements at the start of the drawing process were found to report more post-concussive symptoms. Participants who observed a stronger temporal-spatial strategy heuristic, as measured by the Strategy construct, reported more symptoms, particularly mental fatigue (RPCSQ: B = 0.49, ß = 0.09; MFS: B = 0.58, ß = 0.19). Continuation was also found to be predictive of MFS scores (B = -0.24, ß = -0.14), such that the fewer continuation points that were observed, the greater the MFS score.Conclusions:Two constructs of RCF drawing process - Order and Strategy - were found to predict persistin