Comparison and utility of King-Devick and ImPACT® composite scores in adolescent concussion patients

B. Joel Tjarks, Jason C. Dorman, Verle D. Valentine, Thayne A. Munce, Paul A. Thompson, Shanna L. Kindt, Michael F. Bergeron

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


The King-Devick (KD) oculomotor test has recently been advocated for sideline diagnosis of concussion. Although visual processing and performance are often impaired in concussion patients, the utility of KD as a concussion diagnostic tool is not validated. Purpose To examine the diagnostic value of KD, by comparing KD with post-concussion symptom scale (PCSS) and ImPACT® composite scores. We hypothesized that KD would be correlated with visual motor speed/memory (VMS, VIS) and reaction time (RT), because all require cognitive visual processing. We also expected parallel changes in KD and PCSS across recovery. Methods Thirty-five concussed individuals (12-19 y; 18 females, 17 males) were evaluated with PCSS, ImPACT® composite and KD scores over four clinical visits (V). Results KD times improved with each visit (ΔV1-V2: 7.86 ± 11.82; ΔV2-V3: 9.17 ± 11.07; ΔV3-V4: 5.30 ± 7.87 s) and paralleled improvements in PCSS (ΔV1-V2: 8.97 ± 20.27; ΔV2-V3: 8.69 ± 14.70; ΔV3-V4: 6.31 ± 7.71), RT (ΔV1-V2: 0.05 ± 0.21; ΔV2-V3: 0.09 ± 0.19; ΔV3-V4 0.03 ± 0.07) and VMS (ΔV1-V2: - 5.27 ± 6.98; ΔV2-V3: - 2.61 ± 6.48; ΔV3-V4: - 2.35 ± 5.22). Longer KD times were associated with slower RT (r = 0.67; P < 0.0001) and lower VMS (r = - 0.70; P < 0.0001), respectively. Conclusion Cognitive visual performance testing using KD has utility in concussion evaluation. Validation would further establish KD as an effective ancillary tool in longitudinal concussion management and research.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalJournal of the neurological sciences
Issue number1-2
StatePublished - Nov 15 2013
Externally publishedYes


  • Diffuse axonal injury
  • Neuropsychological tests
  • Oculomotor dysfunction
  • Post-concussion syndrome
  • Return to play
  • Traumatic brain injury
  • Visual-motor deficits

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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