Identifying Qeeg Evoked Potential Voltage Patterns in Pediatric Cases With Persistent Post-Concussion Symptoms (Ppcs): A Retrospective Study

Abstract

Background: Persistent post-concussion symptoms (PPCS) encompasses a broad spectrum of mood and cognitive impairments related to traumatic brain injury from sport activities. There has been limited studies conducted on determining the significance of quantitative EEG (qEEG) testing in the pediatric population. Hence, investigations on P300 evoked potential patterns may provide insight on PPCS course, prognosis, and management. Purpose: The purpose of this study is to identify possible P300 evoked potential voltage trends in PPCS pediatric patients. Methods: A retrospective study of pediatric patients with PPCS (defined as symptoms greater than one month) from 7/2018 to 12/2019 at a private concussion clinic in Tucson, AZ. Patients were excluded if they had a history of learning disorders, seizure disorder, or complex concussions with a skull fracture or intracranial hemorrhage, or no qEEG data. Patients were tested between 6-12 weeks post injury using the standard oddball audio P300 EEG protocol and measures extracted included P300 voltage. Patients were further classified into substages of PPCS (1: 1-3 months; 2: 3-6 months; 3: 6-12 months; 4: 12-36 months) to compare mean P300 voltage score among stages. Results: We identified 33 pediatric patients (age 8-21) with available qEEG data. 10 patients were in stage 1; 12 in stage 2; 8 in stage 3; and 3 in stage 4. Stage 1 group had an average P300 voltage of 17.4μV. Stage 2 group had an average of 10.9μV. Stage 3 group had an average of 13μV. Stage 4 group had an average of 10.3μV. There was a significant difference in the average P300 voltage seen in PPCS symptoms duration less than 3 months compared to 3 months or longer (p=0.018). Conclusion: There is a potential trend in declining P300 voltage with progressive PPCS stage. Our data suggests that chronic cognitive dysfunction represented by reduced P300 voltage may be most common in PPCS durations that are beyond 3 months. Future studies are needed to further validate this initial finding and to identify the significance of voltage patterns in concussion prognosis and management.