Premorbid clues? Preinjury scholastic performance and present neuropsychological functioning in late postconcussion syndrome

Neuropsychologists rely on demographic variables to form assumptions about premorbid status, and most use years of education as the main variable. School records are a more objective basis for such estimation, particularly in litigated cases. In the present study, final cumulative grade point average (GPA) was regressed on to Halstead-Reitan Battery (HRB), IQ and other neuropsychological test scores in 60 nonmalingering postconcussive litigants and 17 litigants with moderate-severe closed head injury. Results indicated significant correlations between GPA, HRB core tests, commonly used neuropsychological measures, and intelligence. A regression formula indicated litigants with poor grade point average were likely to perform in the impaired range. The present findings suggest the quality of premorbid academic performance also provides an important context in which to view present neuropsychological performance. Marginal premorbid achievement may be a risk factor for late developing postconcussion syndrome and litigation.