Imaging “Brain Strain” in Youth Athletes with Mild Traumatic Brain Injury during Dual-Task Performance

Abstract

Mild traumatic brain injury (mTBI) is a common cause of injury in youth athletes. Much of what is known about the sequelae of mTBI is yielded from the adult literature, and it appears that it is mainly those with persistent post-injury symptoms who have ongoing cognitive and neural abnormalities. However, most studies have employed single-task paradigms, which may not be challenging enough to uncover subtle deficits. We sought to examine the neural correlates of dual-task performance in male athletes aged 9-15 years using a functional neuroimaging protocol. Participants included 13 youths with a history of mTBI three to six months prior to testing and 14 typically-developing controls. All participants completed a working memory task in isolation (single-task) and while completing a concurrent motor task (dual-task); neural activity during performance was then compared between groups. Although working memory performance was similar during the single-task condition, increased working memory load resulted in an altered pattern of neural activation in key working memory areas (i.e., dorsolateral prefrontal and parietal cortices) in youth with mTBI relative to controls. During the dual-task condition, accuracy was similar between groups but injured youth performed slower than typically-developing controls, suggesting a speed-accuracy tradeoff in the mTBI group only. The injured youths also exhibited abnormal recruitment of brain structures involved in both working memory and dual-tasking. These data show that the dual-task paradigm can uncover functional impairments in youth with mTBI who are not highly symptomatic and who do not exhibit neuropsychological dysfunction. Moreover, neural recruitment abnormalities were noted in both task conditions, which we argue suggests mTBI-related disruptions in achieving efficient cognitive control and allocation of processing resources.

Imaging in Pediatric Concussion: A Systematic Review

“…The mTBI group had significantly higher activation in the left hippocampal and right-middle temporal areas. Sinopoli et al 56 135 Participants with mTBI had both higher and lower activity during various conditions of a working memory task, primarily in the dorsolateral prefrontal cortex, compared with the control group at 3-6 mo postinjury. Westfall et al 60 226 During a working memory task, the mTBI group had significantly greater activation in 3 clusters, including BA 13,19, and 39; BA 6 and 13; and BA 4 and 6, which was observed on only the most difficult component of the task.…”

Age at First Exposure to Football Is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players

“…24,25 Moreover, neuroimaging studies show persistent structural and functional changes in the brain following mild TBI in children. [26][27][28] Windows of vulnerability to brain trauma may be associated with critical periods of brain development occurring throughout childhood and adolescence. [29][30][31] One such critical period occurs between ages 10-12 in males.…”

Task-related functional magnetic resonance imaging activations in patients with acute and subacute mild traumatic brain injury: A coordinate-based meta-analysis

“…It is used to assess an individual's ability to hold information in mind for further processing while subject to increasing cognitive demand (Owen et al., 2005). Working memory is an area of cognition that has been found to be adversely affected by mTBI (Dean and Sterr, 2013; Kumar et al., 2013; Sinopoli et al., 2014). Further, problems with working memory also emerge during the early recovery phase rather than forming part of the initial symptomology (Meares et al., 2011).…”