Cognitive function and brain structure after recurrent mild traumatic brain injuries in young-to-middle-aged adults

List, Jonathan; Ott, Sascha; Bukowski, Martin; Lindenberg, Robert; Flöel, Agnes

doi:10.3389/fnhum.2015.00228

Cited by 48 publications

(33 citation statements)

References 50 publications

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“…Others have made the comparison between multiple vs. no concussions [e.g., Ref. ( 20 , 21 )], and we decided to use this approach in the present study. Athletes who were subsequently diagnosed with a concussion ( n = 18) by an independent physician during their competitive season, based on criteria outlined in the Fourth Consensus Statement on Concussion in Sport ( 2 ), underwent additional laboratory testing at 72 h, 2 weeks, and 1 month after the injury.…”

Section: Methodsmentioning

confidence: 99%

Sport-Related Concussion Alters Indices of Dynamic Cerebral Autoregulation

et al. 2018

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Sport-related concussion is known to affect a variety of brain functions. However, the impact of this brain injury on cerebral autoregulation (CA) is poorly understood. Thus, the goal of the current study was to determine the acute and cumulative effects of sport-related concussion on indices of dynamic CA. Toward this end, 179 elite, junior-level (age 19.6 ± 1.5 years) contact sport (ice hockey, American football) athletes were recruited for preseason testing, 42 with zero prior concussions and 31 with three or more previous concussions. Eighteen athletes sustained a concussion during that competitive season and completed follow-up testing at 72 h, 2 weeks, and 1 month post injury. Beat-by-beat arterial blood pressure (BP) and middle cerebral artery blood velocity (MCAv) were recorded using finger photoplethysmography and transcranial Doppler ultrasound, respectively. Five minutes of repetitive squat–stand maneuvers induced BP oscillations at 0.05 and 0.10 Hz (20- and 10-s cycles, respectively). The BP–MCAv relationship was quantified using transfer function analysis to estimate Coherence (correlation), Gain (amplitude ratio), and Phase (timing offset). At a group level, repeated-measures ANOVA indicated that 0.10 Hz Phase was significantly reduced following an acute concussion, compared to preseason, by 23% (−0.136 ± 0.033 rads) at 72 h and by 18% (−0.105 ± 0.029 rads) at 2 weeks post injury, indicating impaired autoregulatory functioning; recovery to preseason values occurred by 1 month. Athletes were cleared to return to competition after a median of 14 days (range 7–35), implying that physiologic dysfunction persisted beyond clinical recovery in many cases. When comparing dynamic pressure buffering between athletes with zero prior concussions and those with three or more, no differences were observed. Sustaining an acute sport-related concussion induces transient impairments in the capabilities of the cerebrovascular pressure-buffering system that may persist beyond 2 weeks and may be due to a period of autonomic dysregulation. Athletes with a history of three or more concussions did not exhibit impairments relative to those with zero prior concussions, suggesting recovery of function over time. Findings from this study support the potential need to consider physiological recovery in deciding when patients should return to play following a concussion.

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Section: Methodsmentioning

confidence: 99%

Sport-Related Concussion Alters Indices of Dynamic Cerebral Autoregulation

et al. 2018

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“…However, the validity of similar mechanisms resulting in cortical thickening within these regions following an mTBI still needs to be confirmed. In a separate study, higher numbers of mTBIs were also associated with reduced CT within the bilateral insula and right middle temporal gyrus (List, Ott, Bukowski, Lindenberg, & Floel, 2015). In that study, it was hypothesized that recurrent mTBIs may induce distinct alterations, especially thinning of the cortex.…”

Section: Time-dependent Cortical Differences Following Mtbimentioning

confidence: 95%

Time‐dependent differences in cortical measures and their associations with behavioral measures following mild traumatic brain injury

Bajaj

Dailey

Rosso

et al. 2018

Human Brain Mapping

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There is currently a critical need to establish an improved understanding of time-dependent differences in brain structure following mild traumatic brain injury (mTBI). We compared differences in brain structure, specifically cortical thickness (CT), cortical volume (CV), and cortical surface area (CSA) in 54 individuals who sustained a recent mTBI and 33 healthy controls (HCs). Individuals with mTBI were split into three groups, depending on their time since injury. By comparing structural measures between mTBI and HC groups, differences in CT reflected cortical thickening within several areas following 0-3 (time-point, TP1) and 3-6 months (TP2) post-mTBI. Compared with the HC group, the mTBI group at TP2 showed lower CSA within several areas. Compared with the mTBI group at TP2, the mTBI group during the most chronic stage (TP3: 6-18 months post-mTBI) showed significantly higher CSA in several areas. All the above reported differences in CT and CSA were significant at a cluster-forming p < .01 (corrected for multiple comparisons). We also found that in the mTBI group at TP2, CT within two clusters (i.e., the left rostral middle frontal gyrus (L. RMFG) and the right postcentral gyrus (R. PostCG)) was negatively correlated with basic attention abilities (L. RMFG: r = -.41, p = .05 and R. PostCG: r = -.44, p = .03). Our findings suggest that alterations in CT and associated neuropsychological assessments may be more prominent during the early stages of mTBI. However, alterations in CSA may reflect compensatory structural recovery during the chronic stages of mTBI.

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“…Behaviorally, changes have been demonstrated in reaching movements requiring complex visuomotor transformations [5], measurements of executive function and processing speed [9], tests of attention and concentration [38], and tasks probing verbal fluency function [34]. The functional alterations associated with a history of concussion may be related to corresponding changes occurring in brain structure and physiology [7,11,12,34,41,51]. It is important to note there is also an array of measurements across several functional domains that are not affected by a history of concussion.…”

Section: Introductionmentioning

confidence: 99%

A History of Concussion Does Not Lead to an Increase in Ocular Near Point of Convergence

et al. 2018

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Ocular near point of convergence (NPC) has been shown to be sensitive to the effects of concussion and subconcussive impacts. To determine if NPC is also sensitive to a previous history of concussion, male contact-sport athletes either with (n=26) or without (n=16) a history of at least one previous concussion had their NPC assessed. The results showed that participants with a history of concussion displayed NPC values (9.4±1.6 cm) indistinguishable from those with no history of concussion (8.4±2.1 cm, t-test, p=0.09). This was the case regardless of whether 1, 2, or 3 or more concussions had occurred and despite the fact participants with concussion (mean time since last concussion: 1136 days) suffered from an increased number and severity of symptoms as assessed with the SCAT 3 (3.6±2.2 vs. 2.13±1.89 symptoms, 6.1±4.1 vs. 3.19±2.99 severity, t-test, p<0.05). Taken together, these results imply that NPC may not be a suitable tool to assess the potential long-term effects of one or more concussions over a longer time frame.: Future research using larger sample sizes is warranted to evaluate the potential dose-response relationship between number of prior concussions and NPC.

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Cognitive function and brain structure after recurrent mild traumatic brain injuries in young-to-middle-aged adults

Cited by 48 publications

References 50 publications

Sport-Related Concussion Alters Indices of Dynamic Cerebral Autoregulation

Sport-Related Concussion Alters Indices of Dynamic Cerebral Autoregulation

Time‐dependent differences in cortical measures and their associations with behavioral measures following mild traumatic brain injury

A History of Concussion Does Not Lead to an Increase in Ocular Near Point of Convergence

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