Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science




Christie, Anita D.


The objective of this thesis was to examine the impact of race on post-concussion symptoms and neurocognitive performance. This was achieved through a systematic review and meta-analysis (Chapter 2), and a retrospective study (Chapter 3). From 15 published studies, it was found that Whites (70.11%) reported a higher prevalence of concussion then Black/African American (13.65%). A small effect (g = 0.3) of race was found on neurocognitive measures, indicating that Whites performed better. Using a database of concussion outcomes, it was found that Black/African American reported significantly higher symptom severities (p <0.05), but this was dependent on the scale used. Significant differences were found on some, but not all, neurocognitive outcomes (p <0.05). This highlights the complex relationship between race and concussion presentation and outcomes and suggests racial differences should be considered when selecting assessment methods.

Summary for Lay Audience

Concussions have the potential to cause a wide variety of symptoms. One of the numerous possible symptoms post-concussion is a decline in neurocognitive performance. Previously, studies have shown that Black/African Americans, when compared to their White counterparts, are more likely to present with high symptom scores and greater cognitive decline post-concussion. Both White and Black/African Americans use the same cognitive assessment tools and currently it is unknown if performance on these assessments is similar. Therefore, the purpose of this thesis was to determine race-based differences in concussion prevalence, symptom presentation, and neurocognitive performance. The results indicated that race played a significant role in symptom presentation, though it was dependent on the scale that was used. In general, Black/African Americans tended to report a higher severity of symptoms and had lower performance on neurocognitive measures post-concussion. In summary, this thesis suggests that post-concussion symptom presentation and neurocognitive performance is different between races. This thesis highlights the complex relationship between race and concussion presentation and outcomes and provides several suggestions for future research.