Pre-frontal Cortex Oxygenation Changes During Aerobic Exercise in Elite Athletes Experiencing Sport-Related Concussion

Abstract

Aims: Recent research suggests that aerobic exercise can be performed safely within the first week following a concussion injury and that early initiation of exercise may speed recovery. To better understand the physiological changes during a concussion, we tested the hypothesis that mild-to-intense exercise testing can be performed within days immediately following injury, and can be used to discern differences between the concussed and normal healthy state. Thus, the purpose was to observe the cerebral hemodynamic responses to incremental exercise testing performed acutely post-concussion in high-performance athletes.Methods: This study was a within-and between-experimental design, with seven male university ice hockey teams participating. A subgroup of five players acted as control subjects (CON) and was tested at the same time as the 14 concussed (mTBI) players on Day 2, 4, and 7 post-concussion. A 5-min resting baseline and 5-min exercise bouts of mild (EX1), moderate (EX2), and high (EX3) intensity exercise were performed on a cycle ergometer. Near-infrared spectroscopy was used to monitor pre-frontal cortex oxy-haemoglobin (HbO 2 ), deoxy-haemoglobin (HHb), and total blood volume (tHb) changes.Results: ANOVA compared differences between testing days and groups, and although large percentage changes in HbO 2 (20-30%), HHb (30-40%), and tHb (30-40%) were recorded, no significant (p ≤ 0.05) differences in cerebral hemodynamics occurred between mTBI vs. CON during aerobic exercise testing on any day post-injury. Furthermore, there was a linear relationship between exercise intensity vs. cerebral hemodynamics during testing for each day (r 2 = 0.83-0.99). Conclusion:These results demonstrate two novel findings: (1) mild-to-intense aerobic exercise testing can be performed safely as early as Day 2 post-concussion injury in a controlled laboratory environment; and (2) evidence-based objective measures such as Frontiers in Human Neuroscience | www.frontiersin.org 1 February 2020 | Volume 14 | Article 35 Neary et al. Exercise Testing During Acute Concussion cerebral hemodynamics can easily be collected using near-infrared spectroscopy (NIRS) to monitor physiological changes during the first-week post-injury. This research has important implications for monitoring physiological recovery post-injury and establishing new rehabilitation guidelines.

Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review

“…Neuroimaging was the focus of 46 papers 43 44 47 50 51 174 185–222. Conventional MRI revealed limited utility in the diagnosis of concussion 206.…”

Cerebral Hemodynamics and Microvasculature Changes in Relation to White Matter Microstructure After Pediatric Mild Traumatic Brain Injury: An A-CAP Pilot Study

“…The region selected for functional connectivity assessment may impact the ability to detect injury. Most studies to date on mTBI in children have focused solely on pre-frontal activity, 5–7 , 24 , 25 but changes have also been noted in the motor cortex, 27 whereas one study evaluated the frontal lobe in conjunction with the occipital lobe. 30 Although differences are often observed in the DLPFC after mTBI, it remains to be determined whether measuring other regions will add to the differentiation of mTBI.…”

Potensi Pemanfaatan Functional Near-Infrared Spectroscopy Pada Penelitian Psikologi

“…Fenomena yang cukup sering terjadi di dunia kerja khususnya pada saat wawancara kerja (Bourdage, Roulin, & Levashina, 2017), nyatanya bisa terjadi pula di ranah klinis seperti kesehatan dan psikologi. Oleh karenanya, peran pemeriksaan penunjang berbasis teknologi pencitraan otak untuk mengetahui fungsi otak manusia (Brammer, 2009) Kapabilitas fNIRS sebagai instrumen yang memungkinkan partisipan untuk bergerak ditunjukkan salah satunya melalui peletakan optode fNIRS yang diletakkan pada kepala partispan yang ditugaskan untuk beraktivitas fisik guna menganalisis kaitan antara peningkatan frekuensi nafas dan jantung terhadap perubahan kadar HbO2 di regio otak (Neary, Dudé, Singh, Len, & Bhambhani, 2020). Selain itu, dengan dimungkinkannya partispan untuk bergerak, maka pemeriksaan fungsi otak balita pun dimungkinkan (Cristia et al, 2013), sekalipun balita sebagai partisipan sulit untuk bertenang dan bergerak selama pemeriksaan berlangsung.…”