Diminished Motor Performance in Athletes Cleared to Return to Play after Sports-Related Concussion

运动相关脑震荡后恢复比赛的运动员运动表现下降

• 批准号: 10022143
• 负责人: Jaclyn Stephens
• 金额: $ 13.08万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10022143
• 关键词: Area; Athletic; Attention; Behavior; Behavior assessment; Behavioral; Biological Markers; Brain Concussion; Characteristics; Cognitive; Computers; Data; Effectiveness of Interventions; Electroencephalography; Evaluation; Event-Related Potentials; Financial compensation; Foundations; Future; Goals; Health; Hemoglobin; Injury; Link; Measures; Methods; Motor; Movement; Near-Infrared Spectroscopy; Outcome; P300 Event-Related Potentials; Performance; Play; Prefrontal Cortex; Protocols documentation; Proxy; Public Health; Readiness; Recording of previous events; Recovery; Reporting; Research; Research Design; Resources; Rest; Risk; Sports; Symptoms; System; TBI treatment; Task Performances; Techniques; Testing; Work; Youth; base; behavior measurement; behavior test; brain behavior; cognitive testing; cost; design; distraction; effectiveness evaluation; high risk; improved; indexing; innovation; mild traumatic brain injury; motor behavior; negative affect; neural recruitment; neuroimaging; neuromechanism; neurophysiology; novel; peer; recruit; relating to nervous system; research clinical testing; tool

PROJECT SUMMARY/ABSTRACT Sports-related concussion, a type of mild traumatic brain injury (TBI), is a significant public health concern, especially given recent discoveries that athletes with a history of concussion are more likely to sustain new injuries when they return to high-risk activity, which is linked to adverse long-term health outcomes. Importantly, this heightened risk of new injury has been found in young athletes who were “cleared” to return to play using current clinical evaluation protocols, suggesting that these protocols are suboptimal. An option for improved evaluation is dual task assessment – appraisal of motor performance with a secondary task added, typically a cognitive distractor task. Notably, dual task assessments have elicited diminished motor abilities in young athletes who were “cleared” to return to play after concussion. These diminished motor abilities may underlie the increased likelihood for new injury, however, it is currently unclear why clinical evaluation protocols fail to detect them. Therefore, as a logical first step, the objective of the current proposal is to better understand why diminished motor abilities are missed with clinical evaluation protocols. Preliminary neuroimaging data and dual task performance data suggest that “cleared” youth with a history of concussion compensate for diminished motor ability by recruiting additional neural attention resources to support single task performance, or motor performance without a cognitive distractor task. Conceivably, this compensatory recruitment is insufficient for dual task performance, which is why dual task assessments elicit diminished motor abilities. Current clinical evaluation protocols include subjective symptom reporting and behavioral assessments administered in a single task design (i.e. without secondary task distraction). However, nearly all sports require motor performance in the presence of distraction. This proposal includes behavioral measures with improved ecological validity (i.e. dual task assessments) and seeks to elucidate neural underpinnings of diminished motor abilities in “cleared” young athletes with recent concussion. Neuroimaging methods include a well- established electroencephalography (EEG) paradigm and an innovative technique – a functional near-infrared spectroscopy (fNIRS) system that can accommodate gross motor movement. “Cleared” young athletes with recent concussion will be compared to never-concussed young athletes and evaluated on single and dual task performance with simultaneous neural recording. It is anticipated that these “cleared” young athletes will show comparable single task performance but – importantly – have poorer dual task performance and demonstrate aberrant recruitment of neural attention regions compared to never-concussed peers. These findings would suggest that some “cleared” athletes have not completely recovered from their concussion. By identifying neural characteristics associated with diminished motor abilities and increased risk for new injury, this work will have a significant impact by: 1) better describing the neurophysiology of concussion and 2) laying the foundation for future studies designed to identify and reduce short- and long-term risk of concussion.

项目摘要/摘要 与体育有关的咨询是一种轻度的脑损伤（TBI），是一个重大的公共卫生问题， 特别是考虑到最近的发现，有咨询史的运动员更有可能维持新的 伤害重返高风险活动时，这与不利的长期健康结果有关。 重要的是，在“被清理”回到的年轻运动员中发现了这种新伤害的风险增加 使用当前的临床评估方案进行播放，表明这些方案是次优的。一个选择 改进的评估是双重任务评估 - 对运动性能的评估，并添加了次要任务， 通常是认知干扰器任务。值得注意的是，双重任务评估引起了运动能力的降低 咨询后“被清理”的年轻运动员返回比赛。这些运动能力降低可能 但是，新伤害的可能性增加的基础，目前尚不清楚为什么临床评估方案为何 无法检测到它们。因此，作为逻辑上的第一步，当前建议的目的是更好地理解 为什么通过临床评估方案错过运动能力的降低。初步的神经影像学数据和 双重任务绩效数据表明，具有咨询史的“清除”年轻人补偿 通过招募其他神经注意力资源来支持单个任务绩效来降低运动能力， 或运动性能，而无需认知干扰器任务。可以想象，这种补偿性招募是 双重任务性能不足，这就是为什么双重任务评估会导致运动能力降低的原因。 当前的临床评估方案包括主观符号报告和行为评估 在单个任务设计中管理（即没有次要任务分散注意力）。但是，几乎所有运动都需要 在分心的情况下，运动性能。该建议包括改进的行为措施 生态有效性（即双重任务评估），并试图阐明降低的神经基础 最近咨询的“清除”年轻运动员的运动能力。神经影像学方法包括 建立的脑电图（EEG）范式和一种创新技术 - 一种功能性的近红外 光谱（FNIRS）系统可以容纳总体运动。 “清除”的年轻运动员 将最近的咨询与从未引起的年轻运动员进行比较，并在单一和双重任务上进行评估 通过简单的神经记录进行性能。预计这些“清除”的年轻运动员将显示 可比的单个任务绩效，但重要的是 - 双重任务绩效较差并证明 与从未引起的同龄人相比，神经注意区域的异常招募。这些发现会 暗示一些“清除”的运动员尚未完全从咨询中恢复过来。通过识别 与运动能力降低和新伤害风险增加有关的神经特征，这项工作将 具有以下影响：1）更好地描述咨询的神经生理学； 2） 未来研究的基础旨在识别和减少咨询的短期和长期风险。