Background Concussions are a leading cause of sustained physical, cognitive and emotional impairment in both athletes and military personnel. A pathological feature is disinhibited brain frontal and temporal lobe function, with impaired attention, memory, judgment, emotional regulation and decision-making.
Objective Conventional neuroimaging has limited ability to detect structural abnormalities in mTBI. Alternatively, a neuroimaging biomarker using MRI magneto-encephalograpy (MEG) is capable of mapping brain wave activity in mTBI. The objective was to use MEG technology to study brain function during a computerized “Go-No Go” vigilance and reaction test in military personnel.
Design Prospective, case series clinical study.
Setting Active duty infantrymen from the US Marine Corps explosive ordnance disposal program (high concussion risk).
Participants 37 male subjects, tested (summer of 2013) during pre-deployment training at Camp Pendleton, CA.
Assessment of risk factors The subjects completed neuroimaging, neurocognitive assessment and clinical interviews. Each provided data on mTBI, post-traumatic stress disorder (PTSD) symptoms, and had a MEG scan while performing the neurocognitive Go-NoGo test.
Main outcome measurements 1) Motor cortex, frontal and temporal lobe activation, 2) commission errors (reacting when not supposed to), 3) PTSD and mTBI scoring.
Results The Go stimulus activated the motor cortex exclusively, while the NoGo stimulus activated the dorsolateral prefrontal cortex (DLPFC) and left mediolateral temporal lobe (MLTL) exclusively. There were statistically significant negative correlations between: DLPFC and commission errors, and MLTL and Clinican-Administered PTSD scale.
Conclusions MEG imaging showed regional brain activation patterns during functional tests requiring the individual to act, or to repress action. Lower activation of the frontal and temporal lobes was associated with more errors of inhibition, and greater fear symptoms. These structure-function relationships of the brain may be useful to predict concussion risk or monitor recovery. The subjects were deployed overseas (Fall 2013), and will be retested post-deployment (expected Spring 2015).
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