Tomographic Task-Related Functional Near-Infrared Spectroscopy in Acute Sport-Related Concussion: An Observational Case Study.

Mario Forcione,Arcangelo Merla,David Hacker,Antonio Belli,David Perpetuini,Antonio Maria Chiarelli,Patrick O'Halloran,David James Davies

doi:10.3390/ijms21176273

Abstract

Making decisions regarding return-to-play after sport-related concussion (SRC) based on resolution of symptoms alone can expose contact-sport athletes to further injury before their recovery is complete. Task-related functional near-infrared spectroscopy (fNIRS) could be used to scan for abnormalities in the brain activation patterns of SRC athletes and help clinicians to manage their return-to-play. This study aims to show a proof of concept of mapping brain activation, using tomographic task-related fNIRS, as part of the clinical assessment of acute SRC patients. A high-density frequency-domain optical device was used to scan 2 SRC patients, within 72 h from injury, during the execution of 3 neurocognitive tests used in clinical practice. The optical data were resolved into a tomographic reconstruction of the brain functional activation pattern, using diffuse optical tomography. Moreover, brain activity was inferred using single-subject statistical analyses. The advantages and limitations of the introduction of this optical technique into the clinical assessment of acute SRC patients are discussed.

Highlights

Sport-related concussion (SRC) is a traumatic brain injury (TBI) characterized by a functional brain impairment in the absence of abnormalities on conventional neuroimaging (i.e., computerized tomography and magnetic resonance imaging (MRI)) [1,2].In the United States, sport-related concussion (SRC) is estimated to affect a range of between 1.6 and 3.8 million participants every year, with a continuous increase of athletes participating in contact sports [3,4]
This study aims to show a proof of concept of mapping brain activation, using tomographic task-related functional near-infrared spectroscopy (fNIRS), as part of the clinical assessment of acute SRC patients
This study aims to illustrate a proof of concept of recording the brain activation pattern during 3 neurocognitive tests (i.e., Silent Word Generation (SWG), Digit Span (DS) backward, Symbol Search (SS)) in SRC players, within 72 h from injury, using optical tomographic reconstruction

Summary

Introduction

In the United States, SRC is estimated to affect a range of between 1.6 and 3.8 million participants every year, with a continuous increase of athletes participating in contact sports [3,4]. These numbers could hide a more widespread burden as concussion can be underreported, underestimated, or denied by contact-sport players [5,6]. Following SRC, there is a timeframe, called the window of vulnerability, when a second impact could result in disproportional damage to the brain [7,8,9]. The clinical decision regarding return-to-play is a pivotal moment in the management of contact-sport patients

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