Objective To investigate neurovascular coupling (NVC) in acutely concussed pediatric patients.

Design Prospective cohort.

Setting Sports medicine clinic.

Participants 21 patients reporting within 28 days of concussion (female=8(38.1%); age=14.4±1.9 years) and 17 controls reporting with a musculoskeletal injury (female=7(41.2%); age=14.0±1.7 years).

Interventions (or Assessment of Risk Factors) Concussion vs. controls.

Outcome Measures Transcranial doppler ultrasound was used to measure changes in patients’ posterior cerebral artery velocity (PCAv) in response to two progressively challenging visual tasks: 1) reading and 2) visual search. Resting PCAv was averaged across a 2-minute baseline period that preceded the visual tasks. NVC response curves were time-aligned to stimulus onset to generate a single ensemble-averaged curve representing NVC response for each participant for each task.

Main Results Average resting PCAv did not significantly differ between concussion (36.6±8.0cm/s) and controls (40.6±8.2cm/s) (p=0.14). On average, concussion patients presented with greater NVC response relative to controls during the reading task (1.9% greater) and the visual search task (4.9% greater). The differential response to task was significantly greater in concussion patients relative to controls (p<0.001). NVC response to the visual search task was 7.1% higher than reading in concussion patients relative to 4.4% higher in controls.

Conclusions Our data indicate that concussed patients present with elevated NVC response to visual tasks and a significantly greater differential response to task. This may suggest that concussed patients require increase neural resource allocation to complete a visual task relative to controls. The study provides insight into the neurophysiological consequences of concussion in pediatric patients.