Determining Neuro-cognitive Mechanisms Underpinning Sports Related Concussion and its Recovery
Overview
Each year, millions of adolescents and young adults experience frequent subconcussive impacts (SCI) to the
head as a consequence of engaging in sport. Tens of thousands of these younger athletes also experience
sports related concussion (SRC), a form of mild traumatic brain injury (mTBI).1 The complex pathophysiological
responses to these types of injuries have been shown to include diffuse axonal injury (DAI), increased neurite
deposition in the cortex, cortical tissue death, as well as functional disruption of cortico-cortical/subcortical
networks. The pathophysiological response to repeated injuries is suspected to be linked to pronounced and
permanent cognitive and psychiatric impairment and possibly early death. There is critical need to identify
reliable and treatment-responsive biomarkers that signal when an athlete has recovered from SRC, or may be
at risk of developing a progressive decline. We propose to combine a number of magnetic resonance imaging
(MRI) methodologies to characterize brain changes associated with acute SRC to predict functional outcome.
The Center for Brain, Biology and Behavior (CB3), housed in Memorial Stadium and developed from a
collaboration between Nebraska Athletics and UNL academics, is uniquely positioned to tackle this critical
scientific question. The long-term goal of this collaboration is to determine the neuro-cognitive mechanisms
underpinning SRC and its recovery. Doing so will provide insights for clinical approaches to decisions such as
return to play. Although many different cognitive domains may be impacted following a SRC,
neuropsychological studies of SRC indicate that disruptions of speed of information processing and
learning/memory are most common. The goal of this project is to: 1) determine the relationship between
structural and functional brain connectivity and cognitive function known to be impacted by SRC (speed and
memory), 2) characterize the impact of SRC on brain connectivity, with the prediction that location outweighs
size in determining the functional outcome post-injury, and 3) establish reliable biomarkers that predict SRC
recovery. The rationale is that by identifying the effect of SRC on brain connectivity and cognitive processing,
we can identify biomarkers of their functional integrity crucial for understanding SRC recovery.
References
1. Graham, R., Rivara, F. P., Ford, M. A., Spicer, C. M., Committee on Sports-Related Concussions in Youth, Board on Children, Youth, and Families, Institute of Medicine, & National Research Council (Eds.). (2014). Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. National Academies Press (US).
2. Palacios, E. M., Yuh, E. L., Chang, Y. S., Yue, J. K., Schnyer, D. M., Okonkwo, D. O., Valadka, A. B., Gordon, W. A., Maas, A., Vassar, M., Manley, G. T., & Mukherjee, P. (2017). Resting-State Functional Connectivity Alterations Associated with Six-Month Outcomes in Mild Traumatic Brain Injury. Journal of neurotrauma, 34(8), 1546–1557. https://doi.org/10.1089/neu.2016.4752