Objective: Although the vast majority of athletes who sustain a concussion recover within approximately 30 days, some may have neuropsychological sequelae that continue for months post-injury. More specifically, some individuals with mild traumatic brain injury or concussion have difficulties in sustained visual attention and slower choice decision making. The objective of the current study was to investigate the association between concussion history and performance on a computerized test of attention and executive functioning (i.e., the attention network test; ANT-I). 
Method: Collegiate female varsity athletes completed a health history questionnaire, the Sport Concussion Assessment Tool-5 (SCAT-5), and the ANT-I during pre-season testing.  Only participants with a 90% accuracy rate on the 288 trials of the ANT-I were included in the study. The final sample included 31 female varsity athletes divided into two categories; 16 females with a history of concussion (range of 1-6 previous concussions) and 15 females without a history of concussion. Participants ranged from 18 – 25 years of age (M= 19.90, SD= 1.72) and engaged in a variety of sports (e.g. field and ice hockey, volleyball, basketball, soccer). Mean reaction times were calculated for separate attention networks (i.e. alerting, orienting, and executive) and intra-individual variability was measured by calculating the individual standard deviations (ISD) to examine the stability of performance across the trials. Mann-Whitney U-Tests were conducted to compare between groups with concussion history (with and without a concussion history) as the dependent variable and ISD, mean reaction time, alerting score, orienting score, executive score, and SCAT-5 scores entered as the independent variables. 
Results:  Female athletes who had a history of one or more concussions had lower orienting network scores than female athletes with no history of concussion (p=.05; Cohen’s d=0.68). When examining performance in athletes with a history of two or more concussions, female athletes had lower orienting network scores (p=.04; Cohen’s d=0.66) and more errors on balance testing (i.e., the Modified Balance Error Scoring System; M-BESS from SCAT-5, p=.04; Cohen’s d=0.15). 
Discussion: The ability to select and attend to specific spatial information using visual cues (orienting) may be negatively impacted by a history of one or multiple concussions in female varsity athletes. Future research needs to be conducted in larger samples to better understand the influence of the level of contact, gender differences, and concussion severity on this relationship.

Influence of Concussion History on the Performance of the Attention Network Task (ANT-I) in Female Varsity Athletes