Brain Creatine Concentration Associations With Tandem Gait And Reaction Time Among Adolescents With Concussion

PURPOSE: After concussion, an energy deficit may occur within the brain. Creatine, an energy marker, may relate to functional performance during concussion recovery. Creatine can be quantified using magnetic resonance spectroscopy (MRS). Our purpose was to assess associations between total creatine concentrations in the posterior cingulate gyrus (PCG) with tandem gait (TG) and reaction time (RT) performance among adolescents with concussion. METHODS: We conducted a cross-sectional study of adolescents <21 days post-concussion. Total creatine concentration was obtained using 3 T magnetic resonance spectroscopy (MRS) (Skrya, Siemens, Erlangen, Germany) with PRESS localization: TR = 2000, TE = 30 ms, voxel size = 20x20x20mm3 to quantify the concentration of creatine in the PCG. Participants completed single-task and dual-task TG, and the average time (seconds) for task completion was averaged across three trials. RT was calculated using a simple RT test on a smartphone. Pearson correlation coefficient (r) was used to assess the association of creatine concentration in the PCG and functional performance measures. RESULTS: We enrolled 27 adolescents following concussion (age = 15.8 ± 1.3 years of age, 56% female; 11.7 ± 4.2 days post-concussion). Higher total creatine concentrations in the PCG were moderately and significantly correlated with both faster dual-task TG (Figure 1B) and faster RTs (Figure 1C). Single-task TG and creatine concentration were weakly and non-significantly correlated (Figure 1A). CONCLUSION: We observed that adolescents with higher total creatine concentration in the PCG following concussion had both faster dual-task TG and RTs, suggesting that higher total creatine concentrations during concussion recovery are associated with better functional capabilities. These findings provide the basis for understanding one potential mechanism underlying post-concussion functional performance. Supported by: Tai Foundation