The Persistent Influence of Concussive Injuries on Cognitive Control and Neuroelectric Function

Abstract

Context: Increasing attention is being paid to the deleterious effects of sport-related concussion on cognitive and brain health.Objective: To evaluate the influence of concussion incurred during early life on the cognitive control and neuroelectric function of young adults.Design: Cross-sectional study. Setting: Research laboratory.Patients or Other Participants: Forty young adults were separated into groups according to concussive history (0 or 1þ). Participants incurred all injuries during sport and recreation before the age of 18 years and were an average of 7.1 6 4.0 years from injury at the time of the study.Intervention(s): All participants completed a 3-stimulus oddball task, a numeric switch task, and a modified flanker task during which event-related potentials and behavioral measures were collected.Main Outcome Measure(s): Reaction time, response accuracy, and electroencephalographic activity.Results: Compared with control participants, the concussion group exhibited decreased P3 amplitude during target detection within the oddball task and during the heterogeneous condition of the switch task. The concussion group also displayed increased N2 amplitude during the heterogeneous version of the switch task. Concussion history was associated with response accuracy during the flanker task.Conclusions: People with a history of concussion may demonstrate persistent decrements in neurocognitive function, as evidenced by decreased response accuracy, deficits in the allocation of attentional resources, and increased stimulusresponse conflict during tasks requiring variable amounts of cognitive control. Neuroelectric measures of cognitive control may be uniquely sensitive to the persistent and selective decrements of concussion.Key Words: concussions, inhibition, mental flexibility, attention, P3, N2 Key PointsSeven years after concussion, participants displayed disrupted higher-order neurocognition in the form of chronically impaired attention, working memory, inhibition, and interference control. The observed deficits in attention and conflict monitoring were only evident when cognitive demands were increased. Subtle deficits may remain unrecognized with other types of testing.

Concussion May Increase the Risk of Subsequent Lower Extremity Musculoskeletal Injury in Collegiate Athletes

“…Studies have indicated that there may be neurocognitive deficits from concussion that persist past the point of return to play [31, 32] that current clinical neurocognitive assessments may not be able to detect under current standard testing protocols [33, 34]. Similarly, there is a growing body of evidence that persistent neuromuscular performance impairments are present in concussed athletes during relatively simple gait tasks; furthermore, these impairments are more prominent when a concomitant dual-attention cognitive task is employed [3–9].…”

Investigating a Novel Measure of Brain Networking Following Sports Concussion

“…Similar findings related to persistent changes in the P3a component have been reported in previously concussed participants 22 to 60 months [60], 3.4 years [8], and 26 years [15] post-injury. To a lesser extent, suppressed Ne has been shown at 2.9 years [47], suppressed P1 amplitude at 6.7 years [45], and an altered N2 component at 7.1 years post-injury [46]. While these findings were generated in response to the target stimuli during a visual task, compared to the auditory task implemented here, it is possible that ongoing deficits may need to be accounted for by clinicians when interpreting post-concussion results.…”

The persistent influence of pediatric concussion on attention and cognitive control during flanker performance

“…Flanker tasks require individuals to ignore task-irrelevant information in order to correctly respond to a centrally presented target stimulus amid either congruent or incongruent flanking stimuli. While conceptually simplistic, this task has demonstrated high sensitivity for detecting deficits from years (Moore, Hillman, & Broglio, 2014;) to decades (de Beaumont, Brisson, Lassonde, & Jolicoeur, 2007) following injury in adults. This sensitivity is due to the rich variety of cognitive processes/effects, which can be evaluated during flanker performance.…”