title: A validation of the post concussion symptom scale in the assessment of complex concussion using cognitive testing and functional MRI.
abstract: BACKGROUND
  Clinical assessment of cerebral concussion relies on the presence and duration of post concussive symptoms (PCS). Given that these PCS are subjective reports and not always specific to concussion, their usefulness remains to be validated.
  
  
  OBJECTIVE
  To evaluate the usefulness of self-reported PCS by means of cognitive tests and functional MRI (fMRI).
  
  
  METHODS
  28 male athletes with and without concussion were grouped according to their PCS score. They were then administered a computerised cognitive test battery and submitted to an fMRI session where cerebral activations associated with verbal and non-verbal working memory tasks were analysed.
  
  
  RESULTS
  Behaviourally, response accuracy and speed on the cognitive test battery were comparable for the control and low PCS group. The moderate PCS group showed significantly slower response times than the control group on the matching (p<0.05) and one-back tasks (p<0.05). The functional MRI study showed reduced task related activation patterns in the dorsolateral prefrontal cortex for both low and moderate PCS groups. Activation peaks outside the regions of interest, not seen in the control group, were also noted for both PCS groups. Regression analyses indicated an inverse relationship between PCS scores and performances on several CogSport subtests. Severity of PCS also predicted fMRI blood oxygen level dependent signal changes in cerebral prefrontal regions.
  
  
  CONCLUSIONS
  Self-reported PCS is associated with an ongoing cerebral haemodynamic abnormality as well as with mild cognitive impairment. These results support the use of the PCS scale in the assessment of cerebral concussion and in monitoring recovery.
authors: Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
authors: Jen-Kai
authors: JK
authors: Chen
authors: Karen M
authors: KM
authors: Johnston
authors: Alex
authors: A
authors: Collie
authors: Paul
authors: P
authors: McCrory
authors: Alain
authors: A
authors: Ptito
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D004193:Discrimination Learning / Q000502:physiology; D004292:Dominance, Cerebral / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D010364:Pattern Recognition, Visual / Q000502:physiology; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D017397:Prefrontal Cortex / Q000503:physiopathology; D011930:Reaction Time / Q000502:physiology; D014706:Verbal Learning / Q000502:physiology
chemical_list: D010100:Oxygen