Relating brain function to cognitive-visuomotor integration performance in working-aged adults with persisting concussion symptoms

Introduction In everyday life we interact with our environment in an indirect way, where there is a mapping between the viewed goal of our action and the required movement (e.g., using a computer mouse). Such tasks require cognitive- motor integration (CMI), where rules dictate the relationship between perception and action. Previous research with primarily young adult male athletes has demonstrated that the underlying movement and cognitive control networks that rely on intact frontal, parietal, and subcortical brain region connectivity may be compromised following concussion, resulting in an impaired ability to engage in complex movements. Here we investigate whether such relationships also exist in working-aged adults with persistent post-concussion symptoms (PPCS). Methods Twenty-two individuals (17 females) performed two visuomotor tasks: one requiring direct (standard) interaction with visual targets, and one comprising a plane-change and feedback reversal (non-standard interaction) between viewed target and required hand motion (CMI). PPCS and dizziness were related to brain network function via resting state functional connectivity (RSFC) in six networks, structural integrity via cortical thickness in CMI-related brain regions, and white matter tract integrity via diffusion tensor imaging. Results We observed that lower cortical thickness in the inferior and superior parietal cortices were associated with dizziness and impaired non-standard visuomotor performance, respectively. Furthermore, increased PPCS severity was associated with hyperconnectivity within the visual, sensorimotor control, frontoparietal control, and dorsal attention networks, while hyperconnectivity within the salience ventral attention network was associated with better non-standard visuomotor performance. Lastly, we found that lower white matter tract integrity in several long associative, projection, and commissural tracts were associated with poor cognitive-motor integration performance, PPCS severity, and dizziness. Discussion These preliminary findings characterize the impact of PPCS on structure and function underlying impaired visuomotor performance.