Post-concussion Neurophysiology Is Associated With Symptoms And Neurocognitive Performance

The 2022 International Consensus Statement on Concussion in Sport recognized functional neuroimaging methods as a promising tool to assess acute neurobiological changes associated with concussion recovery. Despite evidence of neurobiological changes after concussion, there is a limited understanding of how such changes are associated with clinical recovery. PURPOSE: To examine event-related brain potential (ERP) correlates of concussion outcomes within one month of injury. It was hypothesized that the N200 and P300 ERPs would correlate with individual differences in post-concussion symptoms and cognitive recovery. METHODS: Participants included 15 young adults within one month of their concussion (18.2 +/- 9.1 days) and 15 age- and sex- matched controls. A 256-electrode array recorded EEG during the Go/No-Go test of cognitive inhibition/impulsivity. ERP outcomes included N200 and P300 mean amplitudes, the P300 50% fractional area latency, and within-task changes in the N200/P300 (Block 1 v. Block 2). Clinical outcomes included total symptoms and cognitive symptoms on the Post Concussion Symptom Scale, and the memory, executive function, and attention domains from the Cognitive-Linguistic Quick Test. RESULTS: N200 amplitudes and P300 amplitudes/latencies did not significantly vary between groups. Concussion status did, however, moderate associations between ERPs and concussion outcomes. Smaller P300 amplitudes were associated with greater cognitive symptoms for the concussion group only (p = 0.002). When considering changes in the P300 throughout the Go/No-Go task, increases in P300 amplitudes were associated with greater cognitive symptoms (p = 0.003). Similarly, change in the N200 throughout the task was positively correlated with memory scores for the concussion group only (p < 0.001). P300 latencies were longer and N200 amplitudes larger with fewer days post-concussion (p < 0.05). CONCLUSIONS: These findings suggest that a comparison of group differences on the N200/P300 alone may obscure clinically relevant brain-behavior relationships after concussion. Individual differences in cognitive neurophysiology may partially underlie differences in post-concussion cognitive symptoms and cognitive recovery.