Follow-up evaluation of oculomotor performance with fMRI in the subacute phase of concussion.

Abstract

OBJECTIVE: To expand on our previous study by performing a follow-up testing session in the subacute phase of injury for participants recently diagnosed with a concussion. METHODS: A battery of oculomotor tests were administered to participants 30 days postconcussion while simultaneous fMRI was performed. RESULTS: Three of the 7 oculomotor tasks (antisaccade, self-paced saccade, and memory-guided saccade) administered showed significant differences between the recently concussed group compared with normal volunteers. However, performance in these 3 tasks did show improvement from the acute phase of injury. The fMRI analysis revealed significant differences in brain activation patterns compared with normal volunteers, with the concussed group still demonstrating increased and larger areas of activation. Similar to the oculomotor performance, the fMRI analysis showed that at 30 days postinjury, the concussed group more closely mirrored that of the normal volunteer group compared with at 7 days following insult. CONCLUSIONS: Even at 30 days postinjury, and despite being clinically asymptomatic, advanced techniques are able to detect subtle lingering alterations in the concussed brain. Therefore, progressive neuroimaging techniques such as fMRI in conjunction with assessment of oculomotor performance may be beneficial in clinical management of concussion.