Reduced dual-task gait speed is associated with visual Go/No-Go brain network activation in children and adolescents with concussion

ABSTRACT

Objective: To investigate the association between dual-task gait performance and brain network activation (BNA) using an electroencephalography (EEG)-based Go/No-Go paradigm among children and adolescents with concussion. Methods: Participants with a concussion completed a visual Go/No-Go task with collection of electroencephalogram brain activity. Data were treated with BNA analysis, which involves an algorithmic approach to EEG-ERP activation quantification. Participants also completed a dual-task gait assessment. The relationship between dual-task gait speed and BNA was assessed using multiple linear regression models. Results: Participants (n = 20, 13.9 ± 2.3 years of age, 50% female) were tested at a mean of 7.0 ± 2.5 days post-concussion and were symptomatic at the time of testing (post-concussion symptom scale = 40.4 ± 21.9). Slower dual-task average gait speed (mean = 82.2 ± 21.0 cm/s) was significantly associated with lower relative time BNA scores (mean = 39.6 ± 25.8) during the No-Go task (β = 0.599, 95% CI = 0.214, 0.985, p = 0.005, R² = 0.405), while controlling for the effect of age and gender. Conclusion: Among children and adolescents with a concussion, slower dual-task gait speed was independently associated with lower BNA relative time scores during a visual Go/No-Go task. The relationship between abnormal gait behaviour and brain activation deficits may be reflective of disruption to multiple functional abilities after concussion.

KEYWORDS:

• Locomotion
• mild traumatic brain injury
• electroencephalography
• attention

Acknowledgments

The authors acknowledge the support of ElMindA, Ltd. for providing the EEG equipment and supportive analyses, and also thank Anna Brilliant for her assistance with the collection of data.

Declaration of interest

This research was funded, in part, by ElMindA Ltd. Author Howell received research support through a research contract between Boston Children’s Hospital, Cincinnati Children’s Hospital Medical Center, and ElMindA Ltd [4U01AI778109].Meehan receives royalties from (1) ABC-Clio publishing for the sale of his books, Kids, Sports, and Concussion: A guide for coaches and parents, and Concussions, (2) Springer International for the book Head and Neck Injuries in the Young Athlete and (3) Wolters Kluwer for working as an author for UpToDate. His research is funded, in part, by philanthropic support from the National Hockey League Alumni Association through the Corey C. Griffin Pro-Am Tournament. Reches and Weiss are employed by ElMindA, Ltd.

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