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CNS Vital Signs
Availability
For Additional information please see this website: CNS Vital Signs
Classification
Core: Sport-Related Concussion (SRC)
 
Core: One of the Core Cognitive Assesment measures should be collected: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports Computerized Cognitive Assessment Tool (CCAT), CNS Vital Signs, or Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Please note that these could be replaced by a pen or paper battery under the direction of a neuropsychologist.
Core: One of Core Symptoms Checklists should be collected: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports Computerized Cognitive Assessment Tool (CCAT), Child Sport Concussion Assessment Tool (Child-SCAT), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post Concussion Symptom Inventory (PCSI), Post Concussion Symptoms Scale (PCS-S), Sport Concussion Assessment Tool (SCAT-3) or (SCAT-5), Standardized Assessment of Concussion (SAC), or Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
 
Supplemental: Traumatic Brain Injury (TBI)
Short Description of Instrument
CNS Vital Signs is a web-based platform. The CNS Vital Signs battery consists of 7 tests: Verbal Memory (VBM), Visual Memory (VIM), Finger Tapping (FTT), Symbol Digit Coding (SDC), Stroop Test (ST), Shifting Attention Test (SAT) and the Continuous Performance Test (CPT). These tests capture a patient’s composite memory, verbal memory, visual memory, executive function, processing speed, psychomotor speed, reaction time, complex attention and cognitive flexibility. In total, 10 normed neurocognitive tests and 26 unnormed tests and over 50 rating scales are available for the researcher’s use.
 
CNS Vital Signs is normed for ages 8–90 and can be given without the supervision of non-clinical staff.
 
Sport-Related Concussion-Specific:
Advantages: Wide range of modules implemented across a range of conditions and diseases.  It is available in multiple languages.  Internet connection is not required. Computerized neurocognitive assessment battery that includes seven tests including: 1) verbal memory, 2) visual memory, 3) finger tapping, 4) symbol digit coding, 5) stroop, 6) attention, 7) continuous performance test. Comprises composite scores for memory, executive function, processing speed, psychomotor speed, reaction time, complex attention and cognitive flexibility. Take ~30 min to administer. Wide age range from 8–90 years. Administration does not require professional.
 
It is a computerized assessment of cognitive domains (verbal and visual memory, reaction time, cognitive flexibility and complex attention). It utilized well-established tests such as finger tapping, stroop, symbol digit coding etc. It is highly sensitive for the detection of mild cognitive deficits.  It is utilized worldwide. Administration time is approximately 30 minutes.
 
Limitations: Test reliability, sensitivity and specificity have been questioned; should be interpreted by a neuropsychologist. Use of non-professional administrator may limit reliability of test outcomes. It is a lengthy test.  It should only be used during sub-acute and beyond time periods. Limitations include those intrinsic to computerized testing. Some of the tests are modified from standard format. Normative data has not been generated for each language and access to this is test is not free.
Scoring
Raw scores, standard scores (M=100, SD=15) and percentile ranks are provided for each domain.
References
Brooks BL, Daya H, Khan S, Carlson HL, Mikrogianakis A, Barlow KM. Cognition in the Emergency Department as a Predictor of Recovery after Pediatric Mild Traumatic Brain Injury. J Int Neuropsychol Soc. 2016;22(4):379–387.
 
Gualtieri CT, Johnson LG. Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Arch Clin Neuropsychol. 2006;21(7):623–643.
 
Gualtieri CT, Johnson LG. A computerized test battery sensitive to mild and severe brain injury. Medscape J Med. 2008;10(4):90.
Harpham JA, Mihalik JP, Littleton AC, Frank BS, Guskiewicz KM. The effect of visual and sensory performance on head impact biomechanics in college football players. Ann Biomed Eng. 2014;42(1):1–10.
 
Hume PA, Theadom A, Lewis GN, Quarrie KL, Brown SR, Hill R, Marshall SW. A Comparison of cognitive function in former rugby union players compared with former non-contact-sport players and the impact of concussion history. Sports Med. 2017;47(6):1209–1220.
 
Littleton AC, Register-Mihalik JK, Guskiewicz KM. Test-Retest Reliability of a Computerized Concussion Test: CNS Vital Signs. Sports Health. 2015;7(5):443–447.
 
Triplett RL, Asato MR. Brief cognitive and behavioral screening in children with new-onset epilepsy: a pilot feasibility trial. Pediatr Neurol. 2015;52(1):49–55.
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