Persistent Differences in Patterns of Brain Activation after Sports-Related Concussion: A Longitudinal Functional Magnetic Resonance Imaging Study

被引:100
作者
Dettwiler, Annegret [1 ]
Murugavel, Murali [1 ]
Putukian, Margot
Cubon, Valerie [3 ]
Furtado, John [2 ]
Osherson, Daniel [4 ]
机构
[1] Princeton Univ, Princeton Neurosci Inst, Princeton, NJ 08540 USA
[2] Princeton Univ, Univ Hlth Serv, Princeton, NJ 08540 USA
[3] Kent State Univ, Dept Chem, Warren, OH USA
[4] Princeton Univ, Dept Psychol, Princeton, NJ 08540 USA
关键词
concussion; DLPFC; fMRI; n-back task; working memory; COMPENSATORY CORTICAL ACTIVATION; WORKING-MEMORY; MULTIPLE-SCLEROSIS; PREFRONTAL CORTEX; INJURY; FMRI; REORGANIZATION; PERFORMANCE; RECOVERY; ABNORMALITIES;
D O I
10.1089/neu.2013.2983
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
Avoiding recurrent injury in sports-related concussion (SRC) requires understanding the neural mechanisms involved during the time of recovery after injury. The decision for return-to-play is one of the most difficult responsibilities facing the physician, and so far this decision has been based primarily on neurological examination, symptom checklists, and neuropsychological (NP) testing. Functional magnetic resonance imaging (fMRI) may be an additional, more objective tool to assess the severity and recovery of function after concussion. The purpose of this study was to define neural correlates of SRC during the 2 months after injury in varsity contact sport athletes who suffered a SRC. All athletes were scanned as they performed an n-back task, for n=1, 2, 3. Subjects were scanned within 72 hours (session one), at 2 weeks (session two), and 2 months (session three) post-injury. Compared with age and sex matched normal controls, concussed subjects demonstrated persistent, significantly increased activation for the 2 minus 1 n-back contrast in bilateral dorsolateral prefrontal cortex (DLPFC) in all three sessions and in the inferior parietal lobe in session one and two (0.01 corrected). Measures of task performance revealed no significant differences between concussed versus control groups at any of the three time points with respect to any of the three n-back tasks. These findings suggest that functional brain activation differences persist at 2 months after injury in concussed athletes, despite the fact that their performance on a standard working memory task is comparable to normal controls and normalization of clinical and NP test results. These results might indicate a delay between neural and behaviorally assessed recovery after SRC.
引用
收藏
页码:180 / 188
页数:9
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