(14) Association Between Symptom Severity, Cogsport Tests Results, and Functional Mri Activation in Symptomatic Concussed Athletes

Consensus Statement on Concussion in Sport—the 4th International Conference on Concussion in Sport Held in Zurich, November 2012

“…Other imaging modalities such as fMRI demonstrate activation patterns that correlate with symptom severity and recovery in concussion. [10][11][12][13][14] Although not part of routine assessment at the present time, they nevertheless provide additional insight to pathophysiological mechanisms. Alternative imaging technologies (eg, positron emission tomography, diffusion tensor imaging, magnetic resonance spectroscopy, functional connectivity), while demonstrating some compelling findings, are still at early stages of development and cannot be recommended other than in a research setting.…”

Contributions of functional Magnetic Resonance Imaging (fMRI) to sport concussion evaluation

“…Interestingly, the authors have noted similar 'atypical' activation foci in a different group of athletes, and they attributed them to the use of compensatory mechanisms through recruitment of extra neuronal resources [12]. Taken together, these results support the ability of the self-rated PCS score to suggest different degrees of behavioral and functional deficits [8,9,11].…”

“…It also showed that the presence of self-reported symptoms is a scientifically valid measure of injury severity and strengthened the clinical validity of the PCS scale as a diagnostic tool. Further, it highlighted the potential of fMRI, in conjunction with the working memory task, to detect abnormalities among symptomatic concussed athletes who had normal structural imaging results [8,9,11].…”

Discovery of Therapy-targeting Biomarkers for Post-Concussion Syndrome using Functional Neurocognitive Imaging

“…An initial 69 PCS patients underwent the fNCI protocol and z-scores were calculated for each FR in each fNCI exam. In previous task-related fMRI studies of PCS, distinct patterns of either hyperactivation [25][26][27][28][29][30][31][32] or hypoactivation [26,[33][34][35][36][37][38][39][40] have been reliably observed, depending on the cognitive task employed and the cortical…”

“…However, these directional patterns are typically observed across multiple regions, involving coordination between neural systems that are putatively engaged during the execution of the given task at hand. For example, when comparing patients with PCS to healthy controls, working memory tasks (e.g., n-back) have typically shown hyperactivation in dorsolateral prefrontal and parietal cortex [26,30,41,42] and verbal memory tasks have shown hypoactivation in several regions of frontal and temporal cortex in the language dominant hemisphere [33][34][35][36][37]. Accordingly, for biomarker candidate discovery, we grouped functional regions into functional-cognitive systems that would most likely show cohesive levels of either hyper-or hypoactivation in PCS within and across the 6 fNCI tests.…”