Time-course responses following sports-related concussion: a multi-modality study
Alan J Pearce1, Kane Middleton2, Anthea Clarke2
1Swinburne Neuroimaging (SNI) Facility, School of Health Science, Swinburne University of Technology, Melbourne, Victoria, Australia.
The Physician and Sportsmedicine
|July 31, 2025
Summary
Sports-related concussion (SRC) in athletes leads to prolonged neurophysiological changes, specifically in cortical inhibition, lasting longer than symptom recovery. These findings highlight the need for physiological testing alongside clinical assessments for return-to-play decisions.
Area of Science:
- Sports Medicine
- Neuroscience
- Concussion Research
Background:
- Sports-related concussion (SRC) is a common injury in athletes.
- Assessing recovery from SRC typically relies on symptom reporting and cognitive tests.
- The neurophysiological changes following SRC and their recovery timeline require further elucidation.
Purpose of the Study:
- To investigate the time-course of reported symptoms, oculomotor function, and neurophysiological responses following SRC.
- To compare the recovery trajectories of clinical and physiological measures post-concussion.
Main Methods:
- A repeated-measures design was employed with 115 athletes from football and ice hockey teams.
- Data collected included self-reported symptoms, cognitive tests (10-word recall, digit backwards), oculomotor performance (eye-pursuits), and neurophysiology (transcranial magnetic stimulation).
- Measurements were taken at baseline and at 2, 12, 19, and 26 days post-concussion for injured athletes.
Main Results:
- Twenty-two athletes sustained concussions.
- Significant symptom increases were observed at 2 and 12 days post-injury.
- Cognitive and oculomotor performance showed decrements at 48 hours post-injury.
- Transcranial magnetic stimulation revealed increased cortical inhibition at 48 hours, 12 days, and 19 days post-injury.
Conclusions:
- Cortical inhibition changes following SRC resolve by 26 days, indicating a longer recovery period than symptoms or cognitive/oculomotor measures.
- These findings suggest that physiological testing, such as transcranial magnetic stimulation, should complement clinical assessments for determining return-to-play readiness after SRC.
