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Neurophysiological abnormalities in individuals with persistent post-concussion symptoms.

Alan J Pearce1, Mark Tommerdahl2, Doug A King3

  • 1School of Allied Health, La Trobe University, Bundoora, Melbourne, Australia.

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Persistent post-concussion symptoms (PCS) are linked to increased cortical inhibition and impaired central processing. This study reveals neurophysiological changes contributing to fatigue in PCS patients, suggesting new rehabilitation avenues.

Keywords:
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Area of Science:

  • Neuroscience
  • Neurology
  • Rehabilitation Medicine

Background:

  • Concussion injuries typically resolve within 7-10 days, but approximately 10% of individuals experience persistent post-concussion symptoms (PCS).
  • Fatigue is a common and lingering effect of PCS, impacting a significant minority of those affected.
  • Understanding the underlying neurophysiological mechanisms of persistent PCS is crucial for developing effective treatments.

Purpose of the Study:

  • To investigate the neurophysiological differences between individuals with persistent PCS, those who have recovered, and healthy controls.
  • To identify specific neural correlates of fatigue and cognitive processing deficits in PCS.
  • To explore the potential of non-invasive brain stimulation techniques in understanding PCS.

Main Methods:

  • Utilized a combination of self-report fatigue scales, transcranial magnetic stimulation (TMS), and somatosensory stimulation.
  • Compared three groups: individuals with diagnosed PCS (n=20), recovered individuals (n=20), and healthy controls (n=20).
  • Assessed reaction time, somatosensory discrimination (amplitude, temporal order, duration), and cortical excitability via TMS protocols (single pulse and paired pulse).

Main Results:

  • PCS participants reported significantly higher fatigue levels compared to recovered and control groups.
  • Individuals with PCS exhibited slower reaction times and increased reaction time variability.
  • Significant differences were observed in somatosensory processing, including amplitude discrimination, temporal order judgment, and duration discrimination.
  • TMS revealed increased intracortical inhibition in PCS participants during both single pulse and paired pulse protocols (SICI and LICI).

Conclusions:

  • This study demonstrates increased cortical inhibition and compromised central information processing in individuals with persistent PCS.
  • These neurophysiological alterations provide a basis for understanding the persistent fatigue experienced by PCS patients.
  • The findings suggest potential targets for clinical rehabilitation strategies aimed at mitigating PCS-related deficits.