title: Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study.
abstract: BACKGROUND
  Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP).
  
  
  OBJECTIVE
  We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities.
  
  
  METHODS
  We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks.
  
  
  RESULTS
  Our results revealed significantly lower γ-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of γ-NTP were associated with worse scores on neurocognitive tasks.
  
  
  CONCLUSIONS
  Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients.
authors.affiliation: *Center for Comparative NeuroImaging Departments of †Psychiatry §Neurology ‖Sports Medicine ¶Radiology, University of Massachusetts Medical School, Worcester, Massachusetts ‡Office Médico-Pédagogique, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.
authors.forename: Elif M
authors.initials: EM
authors.lastname: Sikoglu
authors.forename: Ana A
authors.initials: AA
authors.lastname: Liso Navarro
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Czerniak
authors.forename: Joseph
authors.initials: J
authors.lastname: McCafferty
authors.forename: Jordan
authors.initials: J
authors.lastname: Eisenstock
authors.forename: J Herbert
authors.initials: JH
authors.lastname: Stevenson
authors.forename: Jean A
authors.initials: JA
authors.lastname: King
authors.forename: Constance M
authors.initials: CM
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000378:metabolism; D001924:Brain Concussion / Q000378:metabolism* / Q000503:physiopathology; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D009705:Nucleosides / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism*; D010759:Phosphorus Isotopes; D017397:Prefrontal Cortex / Q000378:metabolism*; D014495:Universities; D055815:Young Adult
chemical_list: D009705:Nucleosides; D010710:Phosphates; D010759:Phosphorus Isotopes