title: Acute motor, neurocognitive and neurophysiological change following concussion injury in Australian amateur football. A prospective multimodal investigation.
abstract: OBJECTIVE
  This multimodal study investigated the motor, neurocognitive and neurophysiological responses following a sports related concussion injury in the acute-phase (up to 10 days) in sub-elite Australian football players.
  
  
  METHODS
  Between-group, repeated measures.
  
  
  METHODS
  Over the course of one season (six months), 43 male players from one football club (25.1 ± 4.5 years) were assessed for fine motor dexterity, visuomotor reaction time, implicit learning and attention. Motor cortex excitability and inhibition were assessed using transcranial magnetic stimulation.
  
  
  RESULTS
  Of the 43 players, eight suffered concussion injuries, and were compared to 15 non-concussed players (active control) who returned for follow up testing. Post-concussion assessments using the aforementioned tests were carried out at 48 and 96 h, and 10 days. Compared to the non-concussed players, those who suffered concussion showed slowed fine dexterity (P = 0.02), response (P = 0.02) and movement times (P = 0.01) 48 h post-concussion. Similarly, attentional performance was reduced in the concussed group at all time points (48 h: P < 0.01; 96 h: P < 0.01; and 10 days: P = 0.02) post-concussion. TMS revealed significantly increased corticospinal inhibition at 48 (P = 0.04) and 96 h post concussion (P = 0.02) with significant correlations between increased corticospinal inhibition and response (r = 0.48; P < 0.01), movement time (r = 0.42; P = 0.02), and attention performance (r = 0.44; P = 0.01).
  
  
  CONCLUSIONS
  This study has demonstrated that acutely concussed Australian football players show abnormalities in motor, cognitive and neurophysiological measures with variable rates of recovery. These findings suggest that measuring the recovery of concussed athletes should incorporate a range of testing modalities rather than relying on one area of measurement in determining return to play.
authors.affiliation: Cognitive Neuroscience Laboratory, School of Psychology, Deakin University, Melbourne, Australia. Electronic address: alan.pearce@deakin.edu.au.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Pearce
authors.affiliation: Monash Alfred Psychiatric Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Hoy
authors.affiliation: Cognitive Neuroscience Laboratory, School of Psychology, Deakin University, Melbourne, Australia.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rogers
authors.affiliation: Cognitive Neuroscience Laboratory, School of Psychology, Deakin University, Melbourne, Australia.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Corp
authors.affiliation: Cognitive Neuroscience Laboratory, School of Psychology, Deakin University, Melbourne, Australia.
authors.forename: Charlotte B
authors.initials: CB
authors.lastname: Davies
authors.affiliation: Monash Alfred Psychiatric Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Jerome J
authors.initials: JJ
authors.lastname: Maller
authors.affiliation: Monash Alfred Psychiatric Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D001288:Attention; D001315:Australia; D001924:Brain Concussion / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D005538:Football / Q000293:injuries* / Q000502:physiology / Q000523:psychology; D006801:Humans; D007858:Learning; D008297:Male; D011446:Prospective Studies; D011597:Psychomotor Performance; D011930:Reaction Time; D000068958:Return to Sport / Q000502:physiology / Q000523:psychology; D050781:Transcranial Magnetic Stimulation
keywords: Australian football; Motor cortex inhibition; Sports concussion; Transcranial magnetic stimulation