ABSTRACT
OBJECTIVES: To investigate neurophysiological alterations within the typical symptomatic period after concussion (1-month) and throughout recovery (6-months) in adolescents; and (2) to examine relationships between neurophysiological and upper limb kinematic outcomes.
METHODS: 18 adolescents with concussion were compared to 17 healthy controls. Transcranial magnetic stimulation (TMS) was used to assess neurophysiological differences between groups including: short- and long-interval intracortical inhibition, intracortical facilitation, short- and long-latency afferent inhibition, afferent facilitation, and transcallosal inhibition (TCI). Behavioral measures of upper limb kinematics were assessed with a robotic device.
RESULTS: Mixed model analysis of neurophysiological data identified two key findings. First, participants with concussion demonstrated delayed onset of interhemispheric inhibition, as indexed by TCI, compared to healthy controls. Second, our exploratory analysis indicated that the magnitude of TCI onset delay in adolescents with concussion was related to upper limb kinematics.
CONCLUSIONS: Our findings indicate that concussion in adolescence alters interhemispheric communication. We note relationships between neurophysiological and kinematic data, suggesting an affinity for individuals with less concussion-related physiological change to improve their motor behavior over time. These data serve as an important step in future development of assessments (neurobiological and clinical) and interventions for concussion.
Highlights
After concussion, adolescents show altered interhemispheric communication
Changed neurophysiological patterns after concussion appear to be compensatory and enable movement patterns more typical to those seen in healthy controls
These data serve as an important step in futures development of assessments (neurobiological and clinical) and interventions for concussion
Abbreviations
Akaike Information Criterion (AIC)
Afferent facilitation (AF)
Abductor pollicis brevis (APB)
Cortical silent period (CSP)
Dorsolateral prefrontal cortex (DLPFC)
Electromyography (EMG)
Health and Behavior Inventory (HBI)
Intracortical facilitation (ICF)
Ipsilateral silent period (iSP)
Long-interval intracortical inhibition (LICI)
Long-latency interval afferent inhibition (LAI)
Motor evoked potential (MEP)
Resting motor threshold (RMT)
Short-interval intracortical inhibition (SICI)
Short-latency interval afferent inhibition (SAI)
Sport Concussion Assessment Tool (SCAT)
Transcallosal conduction time (TCT)
Test stimulus (TS)
Transcallosal inhibition (TCI)
Transcranial magnetic stimulation (TMS)
Visual Ocular Motor Scale (VOMS)