Longitudinal Clinical and Neuroimaging Evaluation of Symptomatic Concussion in 10- to 14-Year-Old Youth Athletes
| Autor: | Nina de Lacy, Nancy R. Temkin, David B. Coppel, Kody Zalewski, Steve Ottinger, Jason N. Wright, Jason Barber, Chris Panks, Samantha Sun, Suzanne Peck, Christine L. Mac Donald |
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| Rok vydání: | 2019 |
| Předmět: |
Male
030506 rehabilitation medicine.medical_specialty Adolescent Neuroimaging 03 medical and health sciences 0302 clinical medicine Concussion medicine Humans Cognitive Dysfunction Longitudinal Studies Child Brain Concussion biology business.industry Athletes medicine.disease biology.organism_classification Diffusion Tensor Imaging Athletic Injuries Physical therapy Female Neurology (clinical) 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurotrauma. 36:264-274 |
| ISSN: | 1557-9042 0897-7151 |
| DOI: | 10.1089/neu.2018.5629 |
| Popis: | This study longitudinally assessed 10- to 14-year-old patients with sports and recreational concussion (n = 22) who remained symptomatic 3 to 4weeks post-injury compared with typically developing controls (n = 24). Examination by multi-modal magnetic resonance imaging (MRI) and multi-domain clinical outcome measures was completed at 1-month and 6-months post-injury. Concussion patients showed evidence of improvement by 6-month follow-up in domains of cognitive function, whereas measures of psychological health were less resolved with patients exhibiting sustained symptoms of depression, behavior impairment, and concussion symptoms. Quantitative neuroimaging measures identified measures indicative of chronic injury with regional reductions observed by both volumetric segmentation and white matter fractional anisotropy (FA) from diffusion tensor imaging (DTI). Volumetric reductions (p 0.01) were observed in the middle anterior and posterior portions of the corpus callosum, and right caudal anterior cingulate cortex of patients, although none held after strict correction. Examination of the FA data identified significant reductions in the left middle frontal gyrus white matter (p = 0.0003). Linear regression analysis on the 6-month depression outcome variable using the initial clinical, demographic, and imaging measures identified the top predictive models to include concussion diagnosis, and initial symptoms of depression, concussion symptoms, and sleep impairment with additional contribution from other measures of mental health, behavior impairment, and quality of life depending on the model (adjusted r-squared = 0.69 indicating strong predictive ability). This study supports further inclusion of mental health rehabilitation and imaging supplementing traditional cognitive rehabilitation strategies employed in these young athletes. |
| Databáze: | OpenAIRE |
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