Working Memory Recovery in Adolescents with Concussion: Longitudinal fMRI Study
Anna Manelis1, João P Lima Santos1, Stephen J Suss1
1Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Journal of Clinical Medicine
|June 27, 2024
Summary
Adolescent recovery from concussion shows improved working memory speed and accuracy within six months. Brain scans reveal normalized activity in key regions like the left inferior frontal gyrus, suggesting effective neural compensation strategies.
Area of Science:
- Neuroscience
- Cognitive Psychology
- Pediatric Medicine
Background:
- Concussion recovery of working memory is crucial for clinical outcomes and return-to-activity decisions.
- Previous research yielded inconsistent findings due to small sample sizes and mixed participant groups.
- This study focuses on working memory recovery in adolescents within the first six months post-concussion.
Purpose of the Study:
- To investigate the behavioral and neural changes in working memory function during the first six months after concussion in adolescents.
- To identify specific brain regions and activation patterns associated with working memory recovery.
- To inform clinical management and return-to-activity protocols for adolescent concussion.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was used to scan 45 concussed adolescents (CONCs) at baseline and 6 months post-injury.
- A control group of 32 healthy adolescents (HCs) without concussion history was scanned once.
- Participants completed one-back and two-back working memory tasks using letter stimuli and emotional face distractors.
Main Results:
- Concussed adolescents demonstrated significant improvements in working memory speed and accuracy at 6 months compared to baseline (p<0.05).
- fMRI revealed increased activation in the left inferior frontal gyrus (LIFG) and left orbitofrontal cortex (LOFC) at 6 months post-concussion.
- While overall task performance normalized, HCs showed more pronounced LIFG activation than CONCs at 6 months, suggesting potential differences in neural engagement.
Conclusions:
- Working memory recovery post-concussion in adolescents is linked to enhanced performance and normalized brain activity in the LIFG and LOFC.
- The observed activation patterns in the LOFC may indicate compensatory mechanisms for neural processing and fatigue management.
- These findings contribute to understanding the neurobiological basis of concussion recovery and support evidence-based return-to-activity guidelines.
