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Acute sports concussion
Persistent differences in patterns of brain activation after sports- related concussion: a longitudinal fMRI study
  1. Annegret Dettwiler1,*,
  2. Murali Murugavel1,
  3. Margot Putukian2,
  4. Ruben Echemendia3,
  5. Valerie Cubon4,
  6. John Furtado2,
  7. Daniel Osherson5
  1. 1Princeton Neuroscience Institute, Princeton University, Princeton New Jersey, USA
  2. 2University Health Services, Princeton University, Princeton, New Jersey, USA
  3. 3Psychological and Neurobehavioral Associates Inc, State College, Pennsylvania, USA
  4. 4Kent State University, Kent, Ohio, USA
  5. 5Department of Psychology, Princeton University, Princeton, New Jersey, USA


    Objective To define neural correlates of SRC during the 2 month post-injury period using a working memory (WM) task and fMRI and correlate these to clinical measures.

    Design Longitudinal fMRI study assessing subject's brain activation as they perform a N-back task (N=1 to 3) consisting of 30 randomised blocks.

    Setting Varsity collegiate athletes were recruited from high-risk sports teams. Images were acquired on a 3T Siemens Skyra scanner.

    Subjects All athletes were evaluated prospectively within 48 h, 2, 8 weeks postinjury on SCAT2 and hybrid NP battery (ImPACT, paper and pencil tests). 15 right-handed, varsity contact sport athletes who sustained a SRC were scanned at 72 h, 2 and 8 weeks post injury. 15 uninjured control athletes were scanned at baseline and 2 weeks.

    Outcome Measures Post-hoc, whole brain t tests of the 2–1 contrast were performed using FSL-FEAT (mixed effects modelling, z>2.3, corrected p=0.05).

    Results Across all 3 sessions, concussed athletes demonstrated significantly increased activation in the right dorsolateral prefrontal cortex (DLPFC). In session 1, concussed subjects demonstrated increased activation in additional areas: left DLPFC and bilateral inferior parietal. In all 3 sessions, no significant between group differences were observed in subjects performance for all 3 N-back task conditions.

    Conclusions Functional brain activation differences persist at 8 weeks post injury in concussed athletes, despite the fact that their performance on a WM task is comparable to normal controls and normalisation of clinical/hybrid NP tests. These results might indicate a delay between neural and behaviorally-assessed recovery.

    Acknowledgements This research was supported by NJBIR Grant 10-3217-BIR-E-0 AMSSM Grant 005548 Goldstein Family Fund.

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