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Functional brain abnormalities are related to clinical recovery and time to return-to-play in athletes

Neurosurgery. 2007 Aug;

61(2):352-359; discussion 359-360.

Lovell, M. R., J. E. Pardini, J. Welling, M. W. Collins, J. Bakal, N. Lazar, R. Roush, W. F. Eddy and J. T. Becker.

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Abstract:

OBJECTIVE: The relationship between athlete reports of symptoms, neurophysiological activation, and neuropsychological functioning is investigated in a sample of high school athletes. METHODS: All athletes were evaluated using functional magnetic resonance imaging (fMRI), a computer-based battery of neurocognitive tests, and a subjective symptom scale. Athletes were evaluated within approximately 1 week of injury and again after clinical recovery using all assessment modalities. RESULTS: This study found that abnormal fMRI results during the first week of recovery predicted clinical recovery. As a group, athletes who demonstrated hyperactivation on fMRI scans at the time of their first fMRI scan demonstrated a more prolonged clinical recovery than athletes who did not demonstrate hyperactivation at the time of their first fMRI scan. CONCLUSION: These results demonstrate the relationship between neurophysiological, neuropsychological, and subjective symptom data in a relatively large sample composed primarily of concussed high school athletes. fMRI represents an important evolving technology for the understanding of brain recovery after concussion and may help shape return-to-play guidelines in the future.

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