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Acute Effects and Recovery After Sport-Related Concussion: A Neurocognitive and Quantitative Brain Electrical Activity Study

McCrea, Michael PhD, ABPP-CN; Prichep, Leslie PhD; Powell, Matthew R. PhD, ABPP; Chabot, Robert PhD; Barr, William B. PhD, ABPP

Section Editor(s): Bazarian, Jeffrey J. MD, MPH

The Journal of Head Trauma Rehabilitation: July-August 2010 - Volume 25 - Issue 4 - p 283–292
doi: 10.1097/HTR.0b013e3181e67923
Article

Objective To investigate the clinical utility and sensitivity of a portable, automatic, frontal quantitative electroencephalographic (QEEG) acquisition device currently in development in detecting abnormal brain electrical activity after sport-related concussion.

Design This was a prospective, non-randomized study of 396 high school and college football players, including cohorts of 28 athletes with concussion and 28 matched controls. All subjects underwent preseason baseline testing on measures of postconcussive symptoms, postural stability, and cognitive functioning, as well as QEEG. Clinical testing and QEEG were repeated on day of injury and days 8 and 45 postinjury for the concussion and control groups.

Main Outcomes and Results The injured group reported more significant postconcussive symptoms during the first 3 days postinjury, which resolved by days 5 and 8. Injured subjects also performed poorer than controls on neurocognitive testing on the day of injury, but no differences were evident on day 8 or day 45. QEEG studies revealed significant abnormalities in electrical brain activity in the injured group on day of injury and day 8 postinjury, but not on day 45.

Conclusions Results from the current study on clinical recovery after sport-related concussion are consistent with early reports indicating a typical course of full recovery in symptoms and cognitive dysfunction within the first week of injury. QEEG results, however, suggest that the duration of physiological recovery after concussion may extend longer than observed clinical recovery. Further study is required to replicate and extend these findings in a larger clinical sample, and further demonstrate the utility of QEEG as a marker of recovery after sport-related concussion.

Neuroscience Center, Waukesha Memorial Hospital, Waukesha, Wisconsin (Drs McCrea and Powell); Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin (Dr McCrea); Brain Research Laboratories, Department of Psychiatry, New York University School of Medicine, New York, and Nathan S. Kline Institute for Psychiatric Research, New York State Department of Mental Health, Orangeburg, New York (Dr Prichep); Nathan S. Kline Institute for Psychiatric Research, New York State Department of Mental Health, Orangeburg, New York (Dr Chabot); and Departments of Neurology and Psychiatry, New York University School of Medicine, New York (Dr Barr).

Corresponding Author: Michael McCrea, PhD, ABPP-CN, Neuroscience Center, Waukesha Memorial Hospital, 721 American Ave, Ste 406, Waukesha, WI 53188 (michael.mccrea@phci.org).

This research was supported by a clinical research grant from BrainScope, Inc, as an investigator-initiated study, with Drs McCrea and Barr as principal investigators. The investigators thank the certified athletic trainers and student athletes from those high schools and colleges that participated. We also acknowledge the insights of E. Roy John, PhD, in the concept and design of this study. Drs McCrea and Barr had full access to all of the clinical data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis; Dr Prichep holds the same responsibility for the integrity and accuracy of the electrophysiological data. Drs Barr, Prichep, and Chabot serve as consultants to BrainScope, Inc, and Dr Prichep holds financial interest in BrainScope, Inc, through patented technology. None of the other authors has any conflict of interest to declare with respect to this study or article. The authors have no other personal financial or institutional interest in any of the drugs, materials, or devices described in the article. Aside from the author-investigators, representatives from BrainScope, Inc, did not play a role in the design or execution of the study beyond funding, and had no involvement in the preparation of this article.

© 2010 Lippincott Williams & Wilkins, Inc.