A resting state functional magnetic resonance imaging study of concussion in collegiate athletes

Abstract

Sports-related concussions are currently diagnosed through multi-domain assessment by a medical professional and may utilize neurocognitive testing as an aide. However, these tests have only been able to detect differences in the days to week post-concussion. Here, we investigate a measure of brain function, namely resting state functional connectivity, which may detect residual brain differences in the weeks to months after concussion. Twenty-one student athletes (9 concussed within 6 months of enrollment; 12 non-concussed; between ages 18 to 22 years) were recruited for this study. All participants completed the Wisconsin Card Sort Task and the Color-Word Interference Test. Neuroimaging data, specifically resting state functional Magnetic Resonance Imaging data, were acquired to examine resting state functional connectivity. Two sample t-tests were used to compare the neurocognitive scores and resting state functional connectivity patterns among concussed and non-concussed participants. Correlations between neurocognitive scores and resting state functional connectivity measures were also determined across all subjects. There were no significant differences in neurocognitive performance between concussed and non-concussed groups. Concussed subjects had significantly increased connections between areas of the brain that underlie executive function. Across all subjects, better neurocognitive performance corresponded to stronger brain connectivity. Even at rest, brains of concussed athletes may have to ‘work harder’ than their healthy peers to achieve similar neurocognitive results. Resting state brain connectivity may be able to detect prolonged brain differences in concussed athletes in a more quantitative manner than neurocognitive test scores.

Multiparametric MRI changes persist beyond recovery in concussed adolescent hockey players

“…Previous studies have variably found this pattern, and hyperconnectivity has been proposed to be involved in recovery and compensation for underlying white matter disruption. 4 , 30 – 33 …”

Resting‐state functional connectivity after concussion is associated with clinical recovery

“…In fact, our observation of similar time course of recovery for physiological effects and clinical symptoms following SRC runs contrary to recent work suggesting physiological effects extend beyond clinical recovery. For example, group differences in rs-FC have been reported in clinically recovered athletes after clearance for complete RTP (Churchill, Hutchison, Richards, et al, 2017), at approximately 10 days postinjury (Johnson et al, 2012), after 3 months postconcussion (Manning et al, 2017), and even within 6 months postconcussion (Czerniak et al, 2015). As highlighted in a recent systematic review, much of the prior work has included single postinjury visits and/or has included relatively small numbers of injured athletes.…”

White Matter Damage and Brain Network Alterations in Concussed Patients: A Review of Recent Diffusion Tensor Imaging and Resting-State Functional Connectivity Data

“…Whereas some recent studies have indicated a correlation between cognitive measures and functional [39,42,[48][49][50] or structural neuroimaging data [16,17,24,26,28], other studies have failed to do so [15,19,30].…”