Citation

Slobounov S, Sebastianelli WJ, Hallett M. Clin. Neurophysiol. 2012; 123(9): 1755-1761.

Affiliation

Department of Kinesiology, The Pennsylvania State University, 276 Recreation Building, University Park, PA 16802, USA; Department of Orthopedics and Medical Rehabilitation, The Pennsylvania State University, HMC, USA; National Institutes of Health, National Institute of Neurological Disorders and Stroke, 10 Center Drive, Bethesda, MD 20892, USA.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.clinph.2011.12.022

PMID

22361265

Abstract

OBJECTIVES: There is still considerable debate and controversy about whether EEG can be used as a robust clinical tool for assessment of mild traumatic brain injury (MTBI). Nonhomogeneous subject populations, inaccurate assessment of severity of brain injury, time since injury when EEG testing was performed, the lack of EEG research conducted serially and in conjunction with other behavioral measures as injury evolves over time may contribute to the existing controversies. In this study, we implemented a concussion assessment protocol combining a series of EEG and balance measures throughout one year post-injury to document the efficacy of EEG and balance measures as relate to differential recovery of patients suffering from MTBI. METHODS: Three hundred and eighty subjects at risk for MTBI were initially recruited for baseline testing. Forty nine from this initial subjects pool subsequently suffered a single episode of concussive blow and were tested on day 7, 15, 30days, 6months and 12months post-injury. EEGs were recorded while sitting, standing on the force plate and then on a foam base of support with eyes open/closed conditions. EEG alpha power (8-12Hz) and its percent suppression from sitting to standing postures were computed. The center of pressure (COP) measures were obtained from the force platform and analyzed for eyes open and eyes closed conditions. RESULTS: Percent alpha power suppression from sitting to standing postural conditions significantly increased in MTBI subjects shortly after the injury (p<0.01). Percent alpha power suppression significantly correlated with increased area of COP during standing posture with eye closed (r(2)=0.53, p<0.01). The magnitude of alpha power suppression predicted the rate of recovery of this measure in sub-acute and chronic phases of injury (r(2)=0.609, p<0.01). Finally, 85% of MTBI subjects who showed more than 20% of alpha power suppression in the acute phase of injury did not return to pre-injury status up to 12months post-injury. CONCLUSIONS: The efficacy of serially implemented EEG measures in conjunction with balance assessment over the course of MTBI evolution to document residual cerebral dysfunction was demonstrated. Specifically, alteration of EEG alpha power dynamics in conjunction with balance data in the acute phase of injury with respect to baseline measures may predict the rate of recovery from a single concussive blow. SIGNIFICANCE: Neurophysiological measures are excellent tools to assess the status and prognosis of patients with MTBI.

Language: en