Abstract:
Objective: Contact sports provides an excellent opportunity to study the physiological recovery process that occur following mild traumatic brain injury (concussion). To date, we have studied over 200 athletes through a five-year NIH-funded grant titled “functional MRI and sport-related concussion”. This presentation will review the scientific literature that formed the foundation for this study and will explore fMRI as a research tool. The relationship between fMRI, neuropsychological and self-report data will be discussed as this information relates to making return to sport decisions. Participants and Methods: Concussed athletes underwent evaluation within one week of injury. All athletes in the concussed group were symptomatic and demonstrated impairment on neurocognitive testing at the time of their first fMRI study. Data collected included structural and functional MRI (fMRI), neuropsychological test data and self-report symptom data. fMRI data were acquired while participants completed two tasks “in scanner”: 1) an n-back test, designed to detect changes in neurometabolic activity during a task of increasing working memory load, and 2) a task designed to assess response inhibition. Concussed athletes received fMRI scans while concussed and when determined to be recovered based on current international concussion management guidelines. An age-matched non-injured athlete control group also received functional fMRI scans and ImPACT testing at two time points, corresponding to the assessment periods of concussed group. Results: Although currently a research tool, fMRI is likely to be increasingly utilized as a clinical tool in the management of sports-related MTBI. Conclusions: Our current 5 year study of recovery from concussion in high school and college age athletes suggests that this technology can provide useful information regarding the recovery process. Furthermore, fMRI technology is likely to prove useful in developing establishing future guidelines for return to sport following concussion.