Objective Cognitive-motor integration (CMI) is required in sport when performing movements where a rule is used to align the required motor output and the guiding visual information. Previous research has shown CMI declines in young athletes with a concussion history, deemed recovered at the time of evaluation. The purpose of this study was to characterise differences in symptoms, CMI, and white matter integrity (fractional anisotropy, FA) in those with post-concussion syndrome (PCS) and healthy controls. We hypothesised that those with PCS would have decreased FA and CMI performance, with increased symptom scores.

Participants Twelve females were included; 6 with PCS for 6 months or more, and 6 age-matched healthy controls with no concussion history.

Methods Participants were administered the SCAT3, four visuomotor CMI tasks, and diffusion weighted images were acquired. Participants displaced a cursor from a central target to peripheral targets by sliding their finger on a horizontally placed tablet either directly to the viewed target or with decoupled eye-hand coordination (targets viewed on a vertical monitor, 180° feedback rotation, or both).

Results We observed worse symptom scores and impaired performance in CMI tasks, as well as decreased mean FA in bilateral corticospinal tracts beneath the premotor and primary motor cortices and in the white matter underlying the right superior parietal lobule, in those with PCS compared to healthy controls.

Conclusions CMI decline may be related to decreased FA within the frontal-parietal-subcortical network. Measuring CMI, a skill crucial to athletes, provides an effective behavioural means for detection of brain alterations associated with concussion.

Competing interests None.