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

Abstract

Mild traumatic brain injury (mTBI) in contact sport is a problem of such magnitude that improved approaches to diagnosis, investigation and management are urgent. Concussion has traditionally been described as a transient, fully reversible, cerebral dysfunction. However, this seemingly 'mild' injury sometimes results in long-lasting and disabling post-concussion symptoms (PCS) and abnormal neuropsychological profiles characteristic of frontal and/or temporal lobe dysfunction. At present, the pathological changes following concussion remain unclear, but it is now widely accepted that concussion results mainly in functional disturbance rather than structural damage. Therefore, functional imaging techniques can help in demonstrating brain abnormalities undetectable by structural imaging methods. This paper will review the use of functional magnetic resonance imaging (fMRI) in studies of concussion. Our existing and ongoing fMRI studies will be described as examples to highlight the potential and contribution of this non-invasive functional neuroimaging technique in the assessment of sports-related concussion and its management.

Consensus Statement on Concussion in Sport: The 4th International Conference on Concussion in Sport, Zurich, November 2012

“…Other imaging modalities, such as functional MRI (fMRI) demonstrate activation patterns that correlate with symptom severity and recovery in concussion. [10][11][12][13][14] While not part of routine assessment at the present time, they nevertheless provide additional insight to pathophysiologic 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.…”

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.…”

A unified science of concussion

“…74 The cognitive symptoms of both types of injuries include deficits associated with concentration, memory, and high-level executive functions, such as planning and decision making. 54,57,74,75 It has been suggested that preparatory neural activity, i.e., attention, enables the efficient integration of sensory information and goal-based repre- sentations. 76 This theoretical framework allows PCS to be grouped into primary and secondary symptoms ( Table 2).…”