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Time Course of Clinical and Electrophysiological Recovery After Sport-Related Concussion

Prichep, Leslie S. PhD; McCrea, Michael PhD; Barr, William PhD; Powell, Matthew PhD; Chabot, Robert J. PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

The Journal of Head Trauma Rehabilitation: July/August 2013 - Volume 28 - Issue 4 - p 266–273
doi: 10.1097/HTR.0b013e318247b54e
Concussion in Sports: 2013

Background and Purpose: Recent neuroimaging studies suggest that abnormalities in brain function after concussion exist beyond the point of observed clinical recovery. This study investigated the relationship between an index of brain dysfunction (traumatic brain injury [TBI] Index), concussion severity, and outcome.

Methods: EEG was collected from forehead locations in 65 male athletes with concussion within 24 hours of concussion, with follow-up at 8 and 45 days postinjury. Neurocognitive and symptom assessments were also performed and used to classify subjects in mild or moderate concussion categories. Time to return to play was recorded.

Results: The TBI Index was higher in the moderate than mild concussion group at injury, day 8, and day 45. The moderate group had increased symptoms and decreased cognitive performance only at the time of injury. At the time of injury, only the TBI Index was significantly associated with the length of time to return to play.

Conclusions: Recovery of brain function after sport-related concussion may extend well beyond the time course of clinical recovery and be related to clinical severity. An index of brain dysfunction may be an objective indicator of injury, recovery, and readiness to return to play. The relatively small sample indicates the need for further study on the time course of physiological recovery.

Department of Psychiatry, NYU School of Medicine, Brain Research Laboratories, New York, New York (Drs Prichep and Chabot); Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee (Dr McCrea); Departments of Neurology and Psychiatry, NYU Langone Medical Center, New York, New York (Dr Barr); and Department of Neuropsychology, Marshfield Clinic, Minocqua, Wisconsin (Dr Powell).

Corresponding Author: Leslie S. Prichep, PhD, Department of Psychiatry, NYU School of Medicine, Brain Research Laboratories, 550 First Ave, New York, NY 10016 (

This research was supported by a clinical research grant from BrainScope, Inc, as an investigator-initiated study. Drs Prichep, Barr, and Chabot serve as consultants to BrainScope, Inc, and Dr Prichep and NYU School of Medicine hold financial interest in BrainScope, Inc, through patented technology. Aside from the author investigators, representatives from BrainScope, Inc, had no role in the conduct of the studies, analysis of the data, or preparation of manuscripts.

The authors acknowledge the contributions of those who made this research possible, including Julie Filipenko, Michael Powers, Bryant Howard, Susan Mahoney, and the athletic trainers and student athletes who participated in the studies.

The authors declare no conflicts of interest.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins