Alterations in the Cognitive Control of Action Monitoring with a History of Concussion

Abstract

Retired athletes reporting multiple sport-related concussions evidence increased rates and severity of neurodegenerative diseases. Yet, younger athletes with multiple sport-related concussions perform normally on standard clinical assessments of cognitive functioning. More sensitive measures of cognitive functioning may clarify the foundation for performance differences between these two groups. PURPOSE: This investigation sought to evaluate the effect of multiple concussions on neuroelectric and task performance indices of the cognitive control of action monitoring. METHODS: Sixty-three athletes (19 female; 19.6 ± 1.2 yrs) with variable concussion histories completed a clinical neurocognitive assessment and a modified flanker task. The Error-related Negativity (ERN) of the response-locked event-related brain potential was recorded during performance of the flanker task. Participants were divided into groups according to the self-report number of physician-diagnosed concussions (0, 1+). RESULTS: Analyses revealed no significant differences between groups on the clinical neurocognitive assessment. However, increased ERN amplitude and a more diffuse topography were observed in individuals reporting one or more concussions, relative to those without a history of concussion. CONCLUSION: These findings demonstrate that those individuals with a history of concussion have an inefficient action monitoring system as indexed by ERN amplitude, which reflects the evaluation of conflict and signals for alterations in topdown cognitive control. Further, increased diffusion of the ERN signal may indicate the recruitment of compensatory processes due to decrements in areas of the brain that mediate the evaluation of conflict. Given that the neuroelectric differences exist in the absence of disparities in standard clinical assessment, the findings indicate that measures of the neuroelectric system may be more sensitive to signs of chronic cognitive dysfunction due to concussion. Supported by the Mary Jane Neer Research Fund: