Diagnosing and monitoring recovery of patients with mild traumatic brain injury (mTBI) is challenging because of the lack of objective, quantitative measures. Diagnosis is based on description of injuries often not witnessed, subtle neurocognitive symptoms, and neuropsychological testing. Since working memory (WM) is at the center of cognitive functions impaired in mTBI, this study was designed to define objective quantitative electroencephalographic (qEEG) measures of WM processing that may correlate with cognitive changes associated with acute mTBI. First-time mTBI patients and mild peripheral (limb) trauma controls without head injury were recruited from the emergency department. WM was assessed by a continuous performance task (N-back). EEG recordings were obtained during N-back testing on three occasions: within five days, two weeks, and one month after injury. Compared with controls, mTBI patients showed abnormal induced and evoked alpha activity including event-related desynchronization (ERD) and synchronization (ERS). For induced alpha power, TBI patients had excessive frontal ERD on their first and third visit. For evoked alpha, mTBI patients had lower parietal ERD/ERS at the second and third visits. These exploratory qEEG findings offer new and non-invasive candidate measures to characterize the evolution of injury over the first month, with potential to provide much-needed objective measures of brain dysfunction to diagnose and monitor the consequences of mTBI.
ObjectivesTo explore neuroplasticity in a longitudinal study of acute mild traumatic brain injury (mTBI).MethodsWe are using quantitative electroencephalography (qEEG) and magnetoencephalography (MEG) during the resting state and during cognitive brain stress to explore neuroplasticity in an ongoing acute mild traumatic brain injury research. Acute mTBI patients are recruited from the emergency department of Huntington Memorial Hospital in Pasadena, CA, and controls are non‐head‐trauma patients. Brain stress includes the N‐back (0‐back and 2‐back) working memory test and Color‐Word Interference Test (CWIT), administered using E‐prime software. Data were collected at three time points: within 1 week of injury, 14 days, and 30 days after injury. Behavioral as well as MEG and qEEG analysis are performed to compare the two groups.ResultsResting MEG detected low frequency activity in the mTBI group, consistent with previous publications. N‐back, in particular during 2‐back trials, and CWIT, in particular during incongruent trials, both show initial executive function impairment that improved on later visits. Time frequency analysis suggested corresponding compromised brain activity.ConclusionsThe EEG/MEG recordings during rest and brain stress are objective and sensitive to neuroplasticity in acute mTBI, and could be potential objective mTBI markers.Support or Funding InformationResearch supported by D.O.D. W81XWH‐13‐1‐0005
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