Concussion disrupts brain synchrony: Evidence from interactive metronome on young children with persisting symptoms and prolonged recovery post-concussion

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Objective Concussions cause microstructural damage, which we hypothesize leads to a lack of synchrony in the brain. Interactive Metronome (IM) behaviorally assesses how well an individual can maintain a steady rhythm under both unsupervised (absence of feedback) and supervised (presence of visual feedback) conditions. If concussion causes dyssynchrony, then we predict that children with concussion do worse on IM than healthy children and that the difficulty should be greatest during the unsupervised condition, when the children must self-regulate their rhythm performance. Setting and Participants Seventy-four children and adolescents (age range 8–17 years) were assessed on IM across two different tasks (unsupervised – “no feedback” and supervised – “visual feedback”) during a clinic visit after their concussion injury and diagnosis. Design and Main Measures We compared the participants with concussion to a healthy control group (N = 73, age range 15–19 years) with respect to their ability to clap on time with a steady beat using IM, calculated as ms off the beat, separately for the unsupervised and supervised conditions. Results Results reveal participants with concussion struggled to maintain a steady rhythm compared to the control group, particularly during the unsupervised condition. Conclusion These results support the hypothesis that concussion can give rise to brain dyssynchrony. IM captures this dysfunction and, we suggest rhythmic training has the potential to re-establish synchronization among neural networks that may be compromised after a concussion. Interventional studies are a necessary next step for testing the efficacy of IM training to accelerate concussion recovery.