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Adolescent concussion – preliminary brain and behavioral findings

Melissa Pangelinan, Ph.D. 28 July 2015

Overview

•  Studying Cortical Thickness •  Age-Related Changes in Cortical Thickness •  Saguenay Youth Study •  Preliminary Results

–  Cortical Thickness –  Behavioral Analysis

•  Future Directions

Measuring Cortical Thickness

Fischl  &  Dale  (2000)  PNAS  

Age-Related Differences in Cortical Thickness

Tamnes  et  al.  (2013)  NeuroImage  

Impact of Concussion on Brain Aging

•  NHL Study –  Dr. Carrie Esopenko & Dr. Brian Levine

•  Signs of Accelerated Aging

Westlye  et  al.  (2010)  NeuroImage  

Saguenay Youth Study (SYS)

•  Genetic founder population

•  Family structure

•  Prenatal maternal cigarette exposure

Main Measures of Interest

MRI  

Questionnaires  

o Brain  –  Cor>cal  Thickness  

o Concussion  Inventory  o  Lifestyle  –  Sport/Ac>vity  Par>cipa>on  

Neuropsych   o MANY  measures!  

Cortical Thickness - FreeSurfer

Concussion Inventory •  Self-report inventory (11 items)

–  Concussion (y/n) –  Memory Loss/Confusion –  Embarrassment –  Date of Most Recent (within last 2 years) –  How (sport, car accident, other) –  Loss of Consciousness –  Diagnosis (coach, EMT, doctor, other) –  Hospitalization –  How Many Total –  How many during sports –  How many during “other”

Cognitive Testing

•  Manual Dexterity/Speed – Pegboard, Tapping •  Stroop (Interference) •  Memory Scales, Digit Span •  Fluency •  Academic Skills (Math, Reading, Spelling) •  IQ

–  Performance –  Verbal –  Full Scale

Subjects

Neuropsych  

Concussion  

MRI  

All Tested   o N  =  1020  (492  male/528  female)  

o N  =  112  (69  male/43  female)  

o N  =  108  (66  male/42  female)  

o N  =  98  (60  male/38  female)  

Demographics/Matching

Males   Females  

DOF   T-­‐Value   P-­‐Value   DOF   T-­‐Value   P-­‐Value  

Age   T(130)   0.98   0.75  T(82)   0.32   0.75  

Exposure  Status   T(130)   0.00   1.00  T(82)   0.22   0.83  

Income   T(130)   0.14   0.89  T(82)   -­‐0.16   0.87  

Maternal  Educa>on   T(126)   0.27   0.79  T(82)   -­‐1.38   0.17  

Paternal  Educa>on   T(124)   -­‐0.45   0.65  T(81)   -­‐0.25   0.80  

Thickness Results – Overall Group Differences

Thickness Results - Males

Thickness Results – Overall Group Differences

Thickness Results - Females

Thickness Results – Take-Home

•  Concussed > Controls: Executive function and decision making –  Superior frontal –  Rostral middle frontal –  Orbitofrontal

•  Concussed > Controls: Visuospatial function –  Superior parietal

•  Controls > Concussed: memory functions –  Entorhinal and parahippocampal

Cognitive Differences – Movement Impairments in Concussed Females

Cognitive Differences – Movement Impairments in Concussed Females

Cognitive Differences – Interference Susceptibility in Concussed Females

Cognitive Differences – Poor Long-Term Memory in Control Females

Cognitive Differences – Higher IQ in Concussed Females

Cognitive Differences – Higher IQ in Concussed Females

Behavioral Results – Take-Home

•  Some evidence for degraded motor and executive function for concussed females despite high IQ

•  Poor memory performance in control females

•  Brain-behavior connections –  BUT, data are noisy!

Future Directions

•  Additional variables of interest

•  Dose effects? –  Number –  Hospitalization –  Recency

•  Age at concussion

Future Directions – Neck Muscle Segmentation

Thanks for your attention!