title: Acute and subacute changes in neural activation during the recovery from sport-related concussion.
abstract: To study the natural recovery from sports concussion, 12 concussed high school football athletes and 12 matched uninjured teammates were evaluated with symptom rating scales, tests of postural balance and cognition, and an event-related fMRI study during performance of a load-dependent working memory task at 13 h and 7 weeks following injury. Injured athletes showed the expected postconcussive symptoms and cognitive decline with decreased reaction time (RT) and increased RT variability on a working memory task during the acute period and an apparent full recovery 7 weeks later. Brain activation patterns showed decreased activation of right hemisphere attentional networks in injured athletes relative to controls during the acute period with a reversed pattern of activation (injured > controls) in the same networks at 7 weeks following injury. These changes coincided with a decrease in self-reported postconcussive symptoms and improved cognitive test performance in the injured athletes. Results from this exploratory study suggest that decreased activation of right hemisphere attentional networks mediate the cognitive changes and postconcussion symptoms observed during the acute period following concussion. Conversely, improvement in cognitive functioning and postconcussive symptoms during the subacute period may be mediated by compensatory increases in activation of this same attentional network.
authors.affiliation: Clement J. Zablocki VA Medical Center & Department of Psychiatry & Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. thammeke@mcw.edu
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Hammeke
authors.forename: Michael
authors.initials: M
authors.lastname: McCrea
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Coats
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Verber
authors.forename: Sally
authors.initials: S
authors.lastname: Durgerian
authors.forename: Kristin
authors.initials: K
authors.lastname: Flora
authors.forename: Gary S
authors.initials: GS
authors.lastname: Olsen
authors.forename: Peter D
authors.initials: PD
authors.lastname: Leo
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Gennarelli
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications*; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D038223:Post-Concussion Syndrome / Q000209:etiology* / Q000473:pathology*; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D010100:Oxygen