Neurophysiological correlates of persistent psycho-affective alterations in athletes with a history of concussion

Understanding the neuropathological underpinnings of sport-related concussion are critical for diagnosis, prognosis, and remediation. Although electro-encephalographic (EEG) methods have proven invaluable for understanding psycho-affective pathologies in various clinical conditions, they have not been used to understand the psycho-affective outcomes of concussive injuries. Accordingly, we evaluated the relation of electroencephalographic (EEG) power in collegiate athletes to psycho-affective measures. We predicted that athletes with a history of concussion would exhibit alterations in frontal EEG asymmetries indicative of increased depression, anxiety and more general mood disturbance. During this cross-sectional study, resting EEG and measures of mood and affect, including the Beck Depression Inventory-II (BDI-II) and Profile of Mood States (POMS) were collected in 81 young-adult male athletes (52 concussion history; 29 controls). All athletes with a history of concussion (9+ months from injury) reported to be symptom free, and all participants were actively taking part in their sport at the time of testing. Compared to control athletes, the athletes with a history of concussion exhibited alterations in frontal-alpha and frontal-beta asymmetry (p's < .05). Correlational analyses revealed that alterations in frontal-alpha asymmetry were related to self-reported depression and anxiety, and alterations in beta-asymmetry were related to self-reported anger/aggression, but these relations were only significant for athletes with a history of concussion. The current study suggests that athletes with a history of concussion who made a complete return to play and reported to be asymptomatic on a commonly used symptom checklist may still exhibit neural activity associated with increased levels of depression, anxiety and anger/hostility. The current results reinforce the clinical necessity for long-term evaluations of athletes irrespective of apparent symptom resolution, and suggest that EEG may serve as a sensitive tool to identify and track concussion-related alterations in psycho-affective health before they manifest as clinical disorders.