Psycho-affective health, cognition and neurophysiological function following sports-related concussion in symptomatic and asymptomatic athletes

Abstract

The proposed normal recovery window for a concussive-injury is 10–14 days. However, a significant portion of athletes who sustain a sports-related concussion (SRC) exhibit symptoms beyond this recovery window. Little is known about the neuropsychiatric and neurophysiologic differences within these slow-to-recover athletes, that may explain these prolonged recovery periods. The present study aimed to investigate the psycho-affective and neuropsychological profiles of symptomatic and asymptomatic athletes who recently experienced an SRC. Additionally, we compared these concussed athletes with healthy controls, without a history of concussion. Accordingly, 78 participants with a history of concussion (26 Symptomatic, 26 Asymptomatic) and 26 healthy controls completed a neuropsychiatric and neuropsychological test battery; including the Beck's Depression Index (BDI II), Profile of Mood States (POMS), and 2-Back task. Additionally, event-related brain potentials (ERPs) were recorded during an experimental oddball paradigm. The results suggest that symptomatic athletes report significantly worse levels of depressive symptoms and negatively altered mood, compared to both asymptomatic and control athletes. Additionally, symptomatic athletes demonstrated poorer performance on the 2-back test, characterized by increased commission errors and slower reaction times. Finally, ERP analyses revealed that both symptomatic and asymptomatic athletes demonstrated reduced allocation of attentional resources during the oddball task, indexed by reduced P3b amplitude. However, only asymptomatic athletes exhibited prolonged P3 latency indicative of delayed information processing. Taken together these results suggest that compared to asymptomatic and healthy athletes, athletes with persistent concussive-like symptoms not only report greater disruptions in affect and mood, but also demonstrate impaired cognitive and neurophysiologic function.