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New investigation or diagnostic strategies
Neuroimaging dual task performance in youth after sports-related concussion: an fMRI study
  1. Michelle L Keightley1,2,3,4,5,*,
  2. Katia Sinopoli2,6,
  3. Greg Wells6,7,
  4. Jen-Kai Chen2,8,9,
  5. Tim Taha7,
  6. Alain Ptito8,9
  1. 1Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital
  2. 2Department of Occupational Science and Occupational Therapy (University of Toronto)
  3. 3Graduate Department of Rehabilitation Science (University of Toronto)
  4. 4Toronto Rehabilitation Institute
  5. 5Department of Psychology (University of Toronto)
  6. 6The Hospital for Sick Children
  7. 7Faculty of Kinesiology and Physical Education (University of Toronto)
  8. 8Montreal Neurological Institute
  9. 9McGill University


    Objective To identify the neural substrates of a dual-task paradigm and evaluate performance in concussed versus non-concussed youth 3–6 months post-injury.

    Design Standard structural (T1, T2, FLAIR, DTI) and functional (single-shot T2*-weighted pulse sequence with in-out spiral readout images) were collected using a 3 Tesla imaging system. fMRIstat was used to analyse the data.

    Setting Male participants 9–15 years of age were recruited from The Greater Toronto Hockey League and The Hospital for Sick Children via poster advertising.

    Subjects 13 concussed youth (mean age=12.61+1.55 years) and 14 control subjects (mean age 12.59±1.55 years).

    Intervention None.

    Outcome Measures Accuracy (ACC) and reaction time (RT) during (1) a 0–3 back visuospatial working memory task; (2) a two finger button pressing motor task and (3) dual-task cost associated with simultaneously performing the working memory and motor tasks.

    Results There were no significant group differences across single and dual-task conditions. Although both groups activated similar brain regions across tasks, concussed youth demonstrated significantly less percent BOLD change in the prefrontal cortex across all working memory task comparisons. Similar results were found during the 1 vs 0 back and 2 vs 0 back dual task conditions, but not for the 3 vs 0 back dual task condition.

    Conclusions Differences in brain function can be observed in youth who have sustained a single injury 3–6 months earlier. Further research is needed to identify the clinical correlates of these atypical activation patterns.

    Acknowledgements Canadian Institute of Health Research (CIHR) and Ontario Neurotrauma Foundation (ONF).

    Competing interests None.

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