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Cognitive workload as the physiologic basis for symptom provocation with task performance in concussion: an fNIRS study of prefrontal brain activity
Abstract   Open access

Cognitive workload as the physiologic basis for symptom provocation with task performance in concussion: an fNIRS study of prefrontal brain activity

Christina Master, Lei Wang, Eileen Storey, Olivia Podolak, Matthew Grady, Andrew Mayer, Catherine McDonald, Kristy Arbogast and Hasan Ayaz
Frontiers in human neuroscience, v 12
2018
url
https://doi.org/10.3389/conf.fnhum.2018.227.00085View
Published, Version of Record (VoR) Open CC BY V4.0

Abstract

Introduction: The diagnosis of concussion relies primarily on subjective self-report of symptoms, with multiple available standardized symptom scales used for that purpose. Using only symptoms to diagnose and manage concussion has proven problematic as studies haves shown that, while higher acute symptom burden may be related to longer recovery and presumably more severe injury, symptoms can be non-specific to concussion and may be made worse by either cognitive or physical activity or inactivity. In an attempt to make concussion assessment more specific and objective, attention has been turned towards symptom provocation with task performance, which is clinically presumed to be related to concussion injury, with the working hypothesis relating to the inability to handle a particular cognitive or physical workload while injured. Recent studies utilizing fMRI have identified cerebral blood flow (CBF) differences associated with greater physical symptom burden in concussed subjects with symptoms compared to concussed subjects without physical symptoms (Stephens 2018), as well as increased brain activation with higher reported levels of concussion symptomatology (Krivitzky 2011). These studies have associated neuroimaging findings with general symptom status of concussed subjects, without being able to temporally link symptoms with the pathophysiology of the injury state.

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