Acute effects and recovery after sport-related concussion: A neurocognitive and quantitative brain electrical activity study

Neuroscience Center, Waukesha Memorial Hospital, Waukesha, Wisconsin 53118, USA.
The Journal of head trauma rehabilitation (Impact Factor: 2.92). 01/2010; 25(4):283-92. DOI: 10.1097/HTR.0b013e3181e67923
Source: PubMed


To investigate the clinical utility and sensitivity of a portable, automatic, frontal quantitative electroencephalographic (QEEG) acquisition device currently in development in detecting abnormal brain electrical activity after sport-related concussion.
This was a prospective, non-randomized study of 396 high school and college football players, including cohorts of 28 athletes with concussion and 28 matched controls. All subjects underwent preseason baseline testing on measures of postconcussive symptoms, postural stability, and cognitive functioning, as well as QEEG. Clinical testing and QEEG were repeated on day of injury and days 8 and 45 postinjury for the concussion and control groups.
The injured group reported more significant postconcussive symptoms during the first 3 days postinjury, which resolved by days 5 and 8. Injured subjects also performed poorer than controls on neurocognitive testing on the day of injury, but no differences were evident on day 8 or day 45. QEEG studies revealed significant abnormalities in electrical brain activity in the injured group on day of injury and day 8 postinjury, but not on day 45.
Results from the current study on clinical recovery after sport-related concussion are consistent with early reports indicating a typical course of full recovery in symptoms and cognitive dysfunction within the first week of injury. QEEG results, however, suggest that the duration of physiological recovery after concussion may extend longer than observed clinical recovery. Further study is required to replicate and extend these findings in a larger clinical sample, and further demonstrate the utility of QEEG as a marker of recovery after sport-related concussion.

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    • "Reports in the acute time frame (0 – 3 months) following a concussion have reported alterations in amplitude in all frequency bands across the EEG spectrum [65] [66]. "
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    ABSTRACT: Traumatic brain injury (TBI) is a complex pathophysiological process resulting from external forces applied to the skull and affecting the brain. TBI is a significant global contributor to disability and death, particularly in children and young adults. The severity of a TBI may range from " mild " (a brief change in mental status or consciousness) to " severe " (an extended period of unconsciousness or amnesia after the injury), with mild TBI (mTBI) the most common form, diagnosed in 80-90% of cases. Sports-related concussion contributes significantly to mTBI accounting for nearly 20% of all mTBI cases. In the past decade there has been increasing growing public concern regarding the association of sports concussion; in particular further chance of recurrent injury following a concussion due to transient cognitive impairments, and long-term detrimental mental health issues and deterioration in brain function as a consequence of multiple concussions. Attention is also turning to methods to assess concussion with questions surrounding the reliability in traditional methods of concussion assessment that include symptom observation and cognitive assessment. This chapter will discuss the neuroscience of sports-related concussion, reviewing the evidence from new and rigorous methods of concussion assessment, such as neuroimaging and electrophysiology, with a focus on transcranial magnetic stimulation, following acute concussive events through to long-term manifestations of multiple concussions.
    Horizons in Neuroscience Vol 20, Edited by Andres Costa and Eugenio Villalba, 03/2015; Nova.
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    • "There is growing evidence that quantitative electroencephalogram (QEEG) can be used to evaluate minor head trauma, as it can gauge subtle abnormalities in brain electrical activity associated with mild TBI [3] [15] [16]. Recent data have suggested its usefulness in evaluating players with sports-related concussions and assessments of postconcussive syndrome (PCS) [17] [18] [19] [20]. With the advent of waveform recognition algorithm and automated EEG analysis, the viability of using QEEG in the acute setting is possible [3] [21]. "
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    American Journal of Emergency Medicine 11/2014; 33(4). DOI:10.1016/j.ajem.2014.11.015 · 1.27 Impact Factor
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    • "When assessed in the Emergency Room, the traditional physical neurologic exam will be negative and non-focal for pathology, as will the Head CT. The traditional Emergency Room concussion evaluation protocol may not elucidate underlying neuropathology, which is being seen in controlled research studies of athletes with sophisticated neuroimaging including magnetic resonance spectroscopy, fMRI, or diffusion tensor imaging (DTI; Bluml and Brooks, 2006; Pardini et al., 2011) or neuroelectrical assessment including EEG and ERP (Broglio et al., 2009; McCrea et al., 2010; Barr et al., 2012). If someone with a presumed Mild TBI does present with greater neuropathology, such as a basilar skull fracture, intracerebral bleed, or cerebral hematoma, then they are generally referred to as a “complicated” Mild TBI and the severity of injury is noted, with implications for a more complicated recovery. "
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