Amygdala Perfusion Is Associated with Persistent Affective Symptoms after Sports-Related Concussion (P8-1.003)

Abstract

<h3>Objective:</h3> We evaluated PASL-based amygdala perfusion and symptom recovery after sports-related concussion (SRC). <h3>Background:</h3> Perfusion changes are well-documented in the pathophysiology of SRC. We have previously shown that rsfMRI-BOLD amygdala hyperconnectivity was associated with decreased acute symptoms, but increased chronic symptoms. We hypothesized that amygdala perfusion changes might correlate with symptoms after SRC and partly explain BOLD-connectivity findings. <h3>Design/Methods:</h3> We calculated PASL-based perfusion (mL/100g/min) at 3 timepoints after SRC (T1=1–4days, T2=10–14days, T3=2–3months) in collegiate athletes (N=31, female=14), as well as in-sport (ISC; N=29, female=15), and non-contact (NCC; N=35, female=14) controls. We assessed between- and within-group differences in four amygdala ROIs from the Brainnetome Atlas using ANOVA and Tukey’s HSD. Subject-level PASL values were correlated with SCAT-3 Graded Symptom Checklist (GSC) and Brief Symptom Inventory 18 (BSI-18) scores at each timepoint. <h3>Results:</h3> L medial and lateral amygdala (mAmy/lAmy) perfusion was elevated in SRC subjects compared to controls at T1, returning to control-level by T2 and T3. Among SRC subjects at T1, R lAmy perfusion positively correlated with BSI-18 depression subdomain; perfusion in all 4 amygdala ROIs positively correlated with BSI-18 anxiety subdomain and BSI-18 symptom total. Among ISC subjects at T1, R mAmy perfusion negatively correlated with GSC symptom total, GSC physical subdomain, and GSC cognitive subdomain; among NCC subjects, L mAmy perfusion negatively correlated with BSI-18 depression subdomain. Among SRC subjects at T2, L lAmy, L mAmy, and R lAmy perfusion positively correlated with BSI-18 depression subdomain, BSI-18 anxiety subdomain, and BSI-18 severity score. Among SRC subjects at T3, L lAmy perfusion positively correlated with all three BSI-18 subdomains and BSI-18 severity score. <h3>Conclusions:</h3> Increased amygdala perfusion after SRC positively correlated with affective symptoms; persistently elevated L lAmy perfusion was associated with increased chronic symptoms. Accounting for perfusion in analysis of BOLD-connectivity of the amygdala after SRC may improve prediction of affective symptom persistence. <b>Disclosure:</b> Mr. Sridharan has nothing to disclose. Mr. Sheridan has nothing to disclose. Mr. Hudson has nothing to disclose. Dr. Lipford has nothing to disclose. Dr. Bickart has nothing to disclose. Dr. Thibeault has received personal compensation for serving as an employee of NovaSignal Corp.. Dr. Thibeault has received stock or an ownership interest from NovaSignal Inc.. Dr. Giza has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Highmark Interactive. Dr. Giza has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis Pharmaceutical. Dr. Giza has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Lewitt, Hackman, Shapiro, Marshall &amp; Harlan. Dr. Giza has received stock or an ownership interest from Highmark Interactive. The institution of Dr. Giza has received research support from NCAA. The institution of Dr. Giza has received research support from US Department of Defense. The institution of Dr. Giza has received research support from UCLA: Brain Injury Research Center, Steve Tisch BrainSPORT Program, Easton Clinic for Brain Health. Dr. Giza has received publishing royalties from a publication relating to health care. Dr. Hamilton has received personal compensation for serving as an employee of NovaSignal Corp . Dr. Hamilton has received stock or an ownership interest from NovaSignal Corp. Dr. Hamilton has received intellectual property interests from a discovery or technology relating to health care. Dr. Choe has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Cases. The institution of Dr. Choe has received research support from NIH. The institution of Dr. Choe has received research support from AIR-P. Dr. Choe has a non-compensated relationship as a Board of Directors with NABIS that is relevant to AAN interests or activities. Dr. Choe has a non-compensated relationship as a Consultant with USA Swimming Concussion Task Force that is relevant to AAN interests or activities. Dr. Whitlow has nothing to disclose.