Psycho-affective health, cognition, and neurophysiological functioning following sports-related concussion in symptomatic and asymptomatic athletes, and control athletes

Abstract

Little is known about the neuropsychiatric and neurophysiological differences that characterize abnormal recovery following a concussion. The present study aimed to investigate the psycho-affective, cognitive, and neurophysiological profiles of symptomatic, slow-to-recover, concussed athletes, asymptomatic concussed athletes, and control athletes. Seventy-eight athletes (26 symptomatic, 26 asymptomatic, 26 control) completed the Beck Depression Inventory-II, Profile of Mood States, and 2-Back task. Additionally, event-related brain potentials were recorded during an experimental three-stimulus visual Oddball paradigm. Compared to asymptomatic and control groups, the symptomatic group reported greater depression symptoms and negatively altered mood states. Symptomatic athletes also exhibited poorer cognitive performance on the 2-Back task, indicated by more errors and slower reaction time. ERP analyses indicated prolonged P3b latency for both symptomatic and asymptomatic groups, but symptomatic athletes also exhibited reduced P3b amplitude compared to both asymptomatic and control groups. For the asymptomatic group, correlations were observed between time since last concussion and functioning, but no relations were observed within the symptomatic group for any measure. The current findings provide valuable information regarding the psycho-affective, cognitive, and neurophysiological profiles of athletes with and without persistent symptoms following a concussion and highlight the need to assess and treat symptomatic, slow-to-recover athletes from a multidimensional and integrative perspective.

WITHDRAWN: Remotely Supervised At-home tDCS for Veterans with Persistent Post-Traumatic Headache: A Double-Blind, Sham-Controlled Randomized Pilot Clinical Trial

“…for migraine, with reference electrode at supraorbital region (SO) [33]. Because emotional reactivity and mood disturbance are common in mTBI and PPTH patients [34][35][36][37], we wanted to avoid inadvertently modulate cortical regions involved in behavioral and mood regulation (e.g., right PFC, inferior frontal gyrus) located near SO, a common tDCS cathodal/reference electrode location. Finally, migraine patients often demonstrate greater neuronal excitability within the occipital lobe [38], and cathodal stimulation over the lower occipital pole has shown to be effective in pain reduction in migraine [39].…”

Role of biomarkers and emerging technologies in defining and assessing neurobiological recovery after sport-related concussion: a systematic review

“…Studies consistently found lower resting EEG power in one or more frequency bands (ranging from delta to gamma) post-SRC,73–75 with SRC-related effects potentiated in standing (vs seated) positions 73 74. Similarly, seven studies found altered amplitudes of numerous ERPs to auditory and visual stimuli after SRC,76–82 with all but one80 finding lower amplitude in SRC (vs non-SRC) groups and concussed athletes with more severe symptoms. P3/P300 was the most commonly studied ERP76–78 80–82; others were N1, P2, N4 and a brainstem potential to speech sounds (frequency following response (FFR)) 77 79 80.…”

“…Similarly, seven studies found altered amplitudes of numerous ERPs to auditory and visual stimuli after SRC,76–82 with all but one80 finding lower amplitude in SRC (vs non-SRC) groups and concussed athletes with more severe symptoms. P3/P300 was the most commonly studied ERP76–78 80–82; others were N1, P2, N4 and a brainstem potential to speech sounds (frequency following response (FFR)) 77 79 80. Studies have been mixed in whether80 82 or not76 81 ERP latency was associated with SRC.…”

The Role of Reported Affective Symptoms and Anxiety in Recovery Trajectories After Sport-Related Concussion

“…These results align with previous literature suggesting that athletes who are slow to recover from their concussion demonstrate higher affective symptom burden, measured with the Beck Depression Inventory–II, relative to asymptomatic concussed athletes and non-concussed control athletes. 41 In addition, in a study by Turner et al, 46 upward of 70% of concussed athletes exceeded the threshold of clinical state anxiety—defined as a score ≥38 on the State-Trait Anxiety Inventory for Adults 42 —acutely after their injury. However, over half of athletes still displayed state anxiety above clinical thresholds at RTP, suggesting that affective symptoms may last longer than other symptom subtypes.…”

“…For example, adolescents with affective symptoms—including anxiety and depression at baseline and after SRC—presented with higher symptom burden and poorer cognitive performance. 1 In a small sample of collegiate athletes, Sicard et al 41 reported a greater affective symptom burden in athletes with slower symptomatic recovery compared with asymptomatic athletes with a concussion and with non-injured controls. Still, the relationship between anxiety and postconcussive symptoms remains unclear; and limited empirical evidence in the collegiate athletic setting demonstrates the potential effects of experiencing affective symptoms on the entire RTP trajectory.…”