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Prefrontal Cortex Activity During Gait in People With Persistent Symptoms After Concussion
Douglas N Martini1,2, Martina Mancini2, Prokopios Antonellis2
1Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA.
Neurorehabilitation and Neural Repair
|March 20, 2024
Summary
Persistent concussion symptoms are linked to increased prefrontal cortex (PFC) activity during gait. This heightened PFC activity correlates with worse symptom severity and specific gait issues in individuals with concussions.
Area of Science:
- Neuroscience
- Sports Medicine
- Rehabilitation
Background:
- Concussions cause a temporary metabolic crisis in the brain, but symptoms can persist for years.
- Persistent concussion symptoms are often associated with gait dysfunction, the neurological basis of which is not well understood.
- Investigating prefrontal cortex (PFC) activity during gait may illuminate post-concussion gait problems.
Purpose of the Study:
- To examine how persistent concussion symptoms affect PFC activity during gait.
- To test if individuals with ongoing concussion symptoms exhibit greater PFC activity while walking compared to controls.
- To explore the relationship between symptom severity, PFC activity, and gait characteristics within the concussed group.
Main Methods:
- Concussion symptoms were assessed using the Neurobehavior Symptom Inventory (NSI).
- Functional near-infrared spectroscopy (fNIRS) measured PFC activity (oxygenated hemoglobin [HbO2] changes) in 14 concussed individuals and 25 controls.
- Gait parameters were evaluated in the concussed group using six inertial sensors.
Main Results:
- The concussed group showed significantly higher PFC activity (HbO2) during gait compared to controls (P = .007).
- Within the concussed group, higher PFC activity correlated with greater overall symptom severity (NSI score, ρ = .62; P = .02).
- Increased PFC activity was also associated with poorer sagittal range of motion (r = .79; P = .001) and greater stride time variability (r = -.54; P = .046).
Conclusions:
- Prefrontal cortex activity during gait is associated with symptom severity and specific gait impairments in individuals with persistent concussion symptoms.
- These findings contribute to understanding the neurophysiological mechanisms underlying gait deficits following concussion.
- Identifying these neurophysiological underpinnings can inform interventions for motor behavior deficits in post-concussion syndrome.
