Self-reported concussion history is not related to cortical volume in college athletes

Abstract

The long-term consequences of concussion are still being uncovered but have been linked to disruptions in cognition and psychological well-being. Previous studies focusing on the association between concussion history and structural changes in the brain have reported inconsistent results. We sought to examine the effect of concussion history on cortical volume with a focus on functional networks. These networks are associated with many of the functions that can be disrupted in those with an extensive concussion history. We collected baseline behavioral data including the Immediate Post-Concussion Assessment and Cognitive Testing, a self-report measure of the number of diagnosed concussions, and structural MRI in college athletes (n=296; 263 men and 33 women, age range 17-24). Behavioral measures were collected by members of the Department of Athletics concussion management team using a standardized protocol as part of their on-boarding process. Collegiate athletes in the present study who self-reported concussion history did not report different baseline symptoms and did not exhibit consistent differences in cognitive performance relative to those who reported no concussion history. We found that concussion history was not related to cortical volume at the network or region level, even when we compared participants with two or more concussions to those with no concussion history. We did identify relationships between cortical volume in the visual network and dorsal attention network with cognitive performance. In addition to comparing cortical volume between individuals with and without reported concussion history, we also examined whether cortical volume changes could be observed within individuals from baseline to acutely following concussion. We found that network level cortical volume did not change within subjects from baseline measurement to acutely post-concussion. Together, these results suggest that both self-reported concussion history and acute concussion effects are not associated with changes in cortical volume in young adult athletes.

Fig 1. Historgram of self-reported concussion history upon baseline assessment.

Fig 2. The atlases used for cortical volume comparisons.

A. The Destrieux atlas [57] was used for regional comparisons of cortical volume. B. The 7 Network Yeo atlas was used for network-level comparisons of cortical volume [61]. Visualizations were created in R Studio [62] using the ggseg package [63].

Fig 3. Participants who report concussion history do not endorse more symptoms or show differences in cognitive performance (with the possible exception of reaction time) from those who report no concussion history.

Raincloud plots for five measures related to symptoms (total symptoms, cognitive, somatic, affective, and sleep symptoms) in the right panels, and five composite scores for the ImPACT (verbal memory, visual memory, visual motor speed, reaction time, and impulse control) in the left panels. For each raincloud plot the data for each participant is displayed on the left with a jitter. The middle portion is the boxplot for the data. The shape of the distribution of the data is plotted on the right. The FDR-corrected null hypothesis significance testing statistics are reported in each panel.

Fig 4. Cortical volume is related to cognitive performance in the visual and dorsal attention networks.

Visual memory, verbal memory, verbal memory and reaction time composite scores for the ImPACT are correlated with cortical volume in the visual network (purple square). Visual memory performance is correlated with cortical volume in the dorsal attention network (green square).