Recovery from mild head injury in sports: Evidence from serial functional magnetic resonance imaging studies in male athletes

被引:82
作者
Chen, Jen-Kai [1 ]
Johnston, Karen M. [2 ]
Petrides, Michael [1 ]
Ptito, Alain [1 ]
机构
[1] McGill Univ, Montreal Neurol Inst, Neuropsychol Dept, Cognit Neurosci Unit, Montreal, PQ H3A 2B4, Canada
[2] Univ Toronto, Concuss Clin Rehabil Program, Toronto Rehabil Div Neurosurg, Toronto, ON, Canada
来源
CLINICAL JOURNAL OF SPORT MEDICINE | 2008年 / 18卷 / 03期
关键词
concussion; mild head injury; post-concussive symptoms; fMRI; recovery;
D O I
10.1097/JSM.0b013e318170b59d
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective: To examine functional brain activation patterns before and after postconcussive symptoms (PCS) resolution. Design: Prospective serial study with male athletes using functional magnetic resonance imaging (fMRI). Setting: Hospital laboratory and imaging facility. Participants: 9 symptomatic concussed athletes who experienced persisting PCS at least I month postinjury and 6 healthy athletes. Interventions: All athletes filled out a PCS checklist and underwent an fMRI session during which they performed a working-memory task. Main outcome measurements: Behavioral outcomes were response speed and accuracy on the working memory tasks performed during the fMRI session. Functional imaging outcomes were blood oxygen level-dependent fMRI activation patterns associated with a working memory task. Results: There was no difference in behavioral performance between the groups. Despite normal structural MRI findings, all symptomatic concussed athletes initially showed atypical brain activation patterns in the dorsolateral prefrontal cortex (DLPC). Compared to the initial postinjury evaluation, those athletes at follow-up with PCS resolved showed significant increases in activation in the left DLPC. Concussed athletes whose PCS status remained unchanged at follow-up continued to show atypical activation in DLPC. Healthy athletes showed remarkably clear and consistent brain activations in DLPC initially as well as in follow-up, highlighting the test-retest reliability of fMRI. Conclusions: The results demonstrate the feasibility of using fMRI to detect an underlying pathology in symptomatic concussed athletes with normal structural imaging results and its potential to document recovery. Such information may be of considerable value for clinical judgment and patient management.
引用
收藏
页码:241 / 247
页数:7
相关论文
共 40 条
[1]   Summary and agreement statement of the 1st International Symposium on Concussion in Sport, Vienna 2001 [J].
Aubry, M ;
Cantu, R ;
Dvorak, J ;
Graf-Baumann, T ;
Johnston, KM ;
Kelly, J ;
Lovell, M ;
McCrory, P ;
Meeuwisse, WH ;
Schamasch, P .
CLINICAL JOURNAL OF SPORT MEDICINE, 2002, 12 (01) :6-11
[2]   NEUROPSYCHOLOGICAL DEFICITS IN PATIENTS WITH PERSISTENT SYMPTOMS 6 MONTHS AFTER MILD HEAD-INJURY [J].
BOHNEN, N ;
JOLLES, J ;
TWIJNSTRA, A .
NEUROSURGERY, 1992, 30 (05) :692-696
[3]   Second-impact syndrome [J].
Cantu, RC .
CLINICS IN SPORTS MEDICINE, 1998, 17 (01) :37-+
[4]   Neural substrates of symptoms of depression following concussion in male athletes with persisting postconcussion symptoms [J].
Chen, Jen-Kai ;
Johnston, Karen M. ;
Petrides, Michael ;
Ptito, Alain .
ARCHIVES OF GENERAL PSYCHIATRY, 2008, 65 (01) :81-89
[5]   A validation of the post concussion symptom scale in the assessment of complex concussion using cognitive testing and functional MRI [J].
Chen, Jen-Kai ;
Johnston, Karen M. ;
Collie, Alex ;
McCrory, Paul ;
Ptito, Alain .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2007, 78 (11) :1231-1238
[6]   Functional abnormalities in symptomatic concussed athletes: an MRI study [J].
Chen, JK ;
Johnston, KM ;
Frey, S ;
Petrides, M ;
Worsley, K ;
Ptito, A .
NEUROIMAGE, 2004, 22 (01) :68-82
[7]   Relationship between concussion and neuropsychological performance in college football players [J].
Collins, MW ;
Grindel, SH ;
Lovell, MR ;
Dede, DE ;
Moser, DJ ;
Phalin, BR ;
Nogle, S ;
Wasik, M ;
Cordry, D ;
Daugherty, MK ;
Sears, SF ;
Nicolette, G ;
Indelicato, P ;
McKeag, DB .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (10) :964-970
[8]   Cumulative effects of concussion in high school athletes [J].
Collins, MW ;
Lovell, MR ;
Iverson, GL ;
Cantu, RC ;
Maroon, JC ;
Field, M .
NEUROSURGERY, 2002, 51 (05) :1175-1179
[9]  
DELANEY IS, 1997, CLIN J SPORT MED, V10, P9
[10]   Descriptive epidemiology of concussion [J].
Gordon, Kevin E. ;
Dooley, Joseph M. ;
Wood, Ellen P. .
PEDIATRIC NEUROLOGY, 2006, 34 (05) :376-378