Navigational memory fMRI: A test for concussion in children.

J Neurotrauma. 2014 Oct 1;

Authors: Saluja RS, Chen JK, Gagnon I, Keightley M, Ptito A

Abstract
Concussions are high incidence injuries with potentially devastating consequences. Youths are at risk because of a higher threat of repeat injury and cumulative effects of concussions exist, making accurate diagnosis and follow-up essential. This study examines a navigational memory fMRI task to determine whether activation differences exist between concussed children and uninjured controls. Fifty adolescents were recruited, 35 controls and 15 concussed. All subjects underwent structural and functional MRI testing using our navigational memory task, and a battery of neuropsychological testing. The activation patterns of the 15 concussed subjects were compared to those of 15 age and sex-matched controls. Subtraction and regression analyses were performed using the matched controls along with scatter-plots using means and 95% quantiles of the 35 controls. While no differences were seen with neuropsychological testing or task performance, concussed subjects had significantly diminished activation in the retrosplenial, thalamic, and parahippocampal areas bilaterally, along with the right dorsolateral prefrontal cortex and left precuneus. Interestingly, they had increased activation in the left hippocampus and right middle temporal gyrus. Regression analysis demonstrated negative correlations between activation and post concussive symptoms in the left premotor cortex, superior and inferior parietal lobules, and parahippocampal gyrus. Concussed subjects show both diminished and increased activation in specific cerebral regions, differentiating them from controls. This is one of the first studies to look at such a task using fMRI and its applicability in testing for concussion in children. These findings support navigational memory fMRI as a potential objective test for concussions.

PMID: 25270364 [PubMed - as supplied by publisher]