@article{ref1,
title="Working memory recovery in adolescents with concussion: longitudinal fMRI study",
journal="Journal of clinical medicine",
year="2024",
author="Manelis, Anna and Lima Santos, João P. and Suss, Stephen J. and Holland, Cynthia L. and Perry, Courtney A. and Hickey, Robert W. and Collins, Michael W. and Kontos, Anthony P. and Versace, Amelia",
volume="13",
number="12",
pages="e3585-e3585",
abstract="BACKGROUND: Understanding the behavioral and neural underpinnings of the post-concussion recovery of working memory function is critically important for improving clinical outcomes and adequately planning return-to-activity decisions. Previous studies provided inconsistent results due to small sample sizes and the use of a mixed population of participants who were at different post-injury time points. We aimed to examine working memory recovery during the first 6 months post-concussion in adolescents. <br><br>METHODS: We used functional magnetic resonance imaging (fMRI) to scan 45 concussed adolescents [CONCs] at baseline (<10 days post-concussion) and at 6 months post-concussion. Healthy control adolescents [HCs; n = 32] without a history of concussion were scanned once. During the scans, participants performed one-back and two-back working memory tasks with letters as the stimuli and angry, happy, neutral, and sad faces as distractors. <br><br>RESULTS: All affected adolescents were asymptomatic and cleared to return to activity 6 months after concussion. Working memory recovery was associated with faster and more accurate responses at 6 months vs. baseline (p-values < 0.05). It was also characterized by significant difficulty-related activation increases in the left inferior frontal gyrus (LIFG) and the left orbitofrontal cortex (LOFC) at 6 months vs. baseline. Although the activation differences between one-back and two-back were comparable between HCs and CONCs at 6 months, HCs had more pronounced activation in the LIFG than concussed adolescents. <br><br>CONCLUSIONS: Post-concussion recovery is associated with significant performance improvements in speed and accuracy, as well as the normalization of brain responses in the LIFG and LOFC during the n-back task. The observed patterns of LOFC activation might reflect compensatory strategies to distribute neural processing and reduce neural fatigue post-concussion.<p /> <p>Language: en</p>",
language="en",
issn="2077-0383",
doi="10.3390/jcm13123585",
url="http://dx.doi.org/10.3390/jcm13123585"
}