Detection of Persisting Concussion Effects on Neuromechanical Responsiveness

Abstract

Performance on dual-task VMRT tests and the WBRA test identified neuromechanical responsiveness deficiencies among elite athletes who reported a history of concussion.

Concussion History and Neuromechanical Responsiveness Asymmetry

“…Given that the WBRA lateral test data and Sport Fitness Index responses were available from a previous study, 18 the 1. A comparison of ROC curves derived from applying the same logistic regression model for calculating SRC Hx probability for individual athletes in both cohorts is provided in Figure 2.…”

“…11 Given that the volume and spatial distribution of white matter is not symmetric between brain hemispheres, diffuse axonal injury could logically be expected to slow neural processing to a greater extent in 1 hemisphere than the other. We identified the same 15-millisecond cut point for the dual-task VMRT right-left difference reported previously, 18 but the strength of association did not meet the criterion of OR 3 used to identify the set of strongest predictors. The combination of WBRA values for reaction time asymmetry, speed asymmetry, acceleration asymmetry, and deceleration asymmetry to create the continuous composite lateral asymmetry variable appears to have provided 10% and 15% binary classifications with good generalizability for different cohorts.…”

“…Both upper extremity visual-motor reaction time (VMRT) and whole-body reactive agility (WBRA) test metrics have been shown to discriminate between elite athletes who self-reported versus those who denied SRC Hx. 18 Wilkerson et al 18 found that a 3-factor prediction model involving metrics relating to the peripheral-tocentral VMRT ratio, left-to-right VMRT difference, and WBRA lateral-movement speed asymmetry provided 100% positive and 90% negative predictive values. Slow responsiveness to peripheral visual stimuli has been associated with disruption of white matter tracts in the corpus callosum, which may represent an indirect measure of the time required to transfer information between brain hemispheres.…”

“…20 Disruption of attention network connectivity can produce neglect of stimuli in the left visual hemifield, 21,22 which provides a plausible explanation for an observed reversal of responsiveness asymmetry that favored the right visual hemifield among athletes with SRC Hx. 18 Researchers 14,18,23 have demonstrated strong associations of dichotomized VMRT and WBRA metrics with both selfreported SRC Hx and subsequent MSK injury. Dichotomous categorization of continuous variables is a common predictive modeling procedure that provides an easily interpretable estimation of relative risk for a positive diagnostic or prognostic outcome.…”

A Novel Approach to Assessment of Perceptual-Motor Efficiency and Training-Induced Improvement in the Performance Capabilities of Elite Athletes

“…Impaired information processing efficiency following SRC may be a clinically measurable factor that is highly relevant to future injury risk (Fino et al, 2017), as well as long-term brain health. The term neuromechanics has been defined as "the interaction between the nervous system and the mechanical properties of the body" (Enoka, 2002), and the term neuromechanical responsiveness has been used to refer to the ability to optimally integrate neurocognitive and neuromuscular processes to generate forces that will meet the demands of rapidly changing environmental challenges (Wilkerson et al, 2017(Wilkerson et al, , 2018(Wilkerson et al, , 2020. Separate brain networks have been identified that process information specific to visual attention, cognition, and motor functions in a somewhat independent manner, but the respective processes are integrated within specific areas of the thalamus and basal ganglia (Greene et al, 2020).…”