The return-to-play incentive and the effect of motivation on neuropsychological test-performance: implications for baseline concussion testing.

Athletes may be less engaged in baseline cognitive testing in the absence of a powerful return-to-play incentive. The present study sought to evaluate whether athletes' level of motivation (1) influences baseline test performance and (2) changes across pre- and post-injury assessments. We found a significant relationship between examiners' ratings of athletes motivation toward testing and baseline cognitive test performance. Athletes, but not controls, demonstrated increased motivation between tests. These findings suggest that baseline test performance may underestimate true premorbid abilities for a subset of athletes.